Profiling "Noncombat" Musculoskeletal Injuries in Special Operations Forces: A Systematic Review

Special Operations Forces (SOF) personnel are at a high risk of musculoskeletal (MSK) injury. The aims of this systematic review were to a) profile MSK injuries sustained by SOF personnel and b) identify evidence-based injury prevention strategies.

Registered with the Open Science Framework, the protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Of the 3,773 studies identified, 14 met the eligibility criteria, with 6 additional studies identified following screening of the reference lists of the included studies. Extracted data were summated in five naturally occurring MSK injury themes: 1) incidence in SOF populations; 2) anatomical location; 3) nature; 4) mechanism; and 5) risk factors.

Injury incidence ranged from 8 to 846 injuries per 1,000 personnel per year with the lower extremities as the most reported site of injury. The leading nature of MSK injuries were strains and sprains, while the most common mechanism of injury was physical training. Smoking, physical performance, movement limitations, muscular asymmetries, and imbalances were reported as factors that can increase MSK injury risk.

This review informs injury prevention strategies within SOF populations, notably, reducing run mileage and alternating running with weight load walking, educating Operators on proper lifting technique, and analyzing force plate testing data to guide program design and implementation.