The Etiology of Injuries in US Army Initial Entry Training

Area of Science:

• Sports Medicine
• Military Health
• Injury Epidemiology

Background:

• US Army Initial Entry Training (IET) involves prolonged, intense physical activity.
• Trainees frequently sustain injuries, with lower extremities and back historically being most affected.
• Existing surveillance focuses on these common injury sites.

Purpose of the Study:

• To identify the most significant training-related injuries in US Army IET.
• To update clinical diagnostic codes (ICD-10-CM) for injury surveillance.
• To estimate the financial impact of these training injuries.

Main Methods:

• Utilized a comprehensive injury taxonomy to categorize 65,026 injuries from 106,367 trainees in 2016.
• Classified injuries by causal energy source, distinguishing acute trauma from cumulative microtrauma (overuse).
• Analyzed electronic healthcare records for injury ICD-10-CM codes, frequencies by demographics, and calculated costs.

Main Results:

• Mechanical energy transfers caused 75% of all injuries, with 65% being cumulative microtrauma.
• Lower extremities were the most frequently injured region, with the knee accounting for 20% of all injuries.
• The knee alone incurred an estimated cost exceeding $39 million.

Conclusions:

• Lower extremity and low back injuries remain the primary training-related injuries.
• Recommendations include careful management of weight-bearing activity progression and assessment of pre-training fitness.
• Future monitoring should incorporate medical costs and lost training time.