{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T06:12:55Z","timestamp":1793081575000,"version":"4.5.0"},"reference-count":97,"publisher":"Oxford University Press (OUP)","issue":"9-10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Noncombat injuries (\u201cinjuries\u201d) greatly impact soldier health and United States (U.S.) Army readiness; they are the leading cause of outpatient medical encounters (more than two million annually) among active component (AC) soldiers. Noncombat musculoskeletal injuries (\u201cMSKIs\u201d) may account for nearly 60% of soldiers\u2019 limited duty days and 65% of soldiers who cannot deploy for medical reasons. Injuries primarily affect readiness through increased limited duty days, decreased deployability rates, and increased medical separation rates. MSKIs are also responsible for exorbitant medical costs to the U.S. government, including service-connected disability compensation. A significant subset of soldiers develops chronic pain or long-term disability after injury; this may increase their risk for chronic disease or secondary health deficits potentially associated with MSKIs. The authors will review trends in U.S. Army MSKI rates, summarize MSKI readiness-related impacts, and highlight the importance of standardizing surveillance approaches, including injury definitions used in injury surveillance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials\/Methods<\/jats:title>\n                    <jats:p>This review summarizes current reports and U.S. Department of Defense internal policy documents. MSKIs are defined as musculoskeletal disorders resulting from mechanical energy transfer, including traumatic and overuse injuries, which may cause pain and\/or limit function. This review focuses on various U.S. Army populations, based on setting, sex, and age; the review excludes combat or battle injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>More than half of all AC soldiers sustained at least one injury (MSKI or non-MSKI) in 2017. Overuse injuries comprise at least 70% of all injuries among AC soldiers. Female soldiers are at greater risk for MSKI than men. Female soldiers\u2019 aerobic and muscular fitness performances are typically lower than men\u2019s performances, which could account for their higher injury rates. Older soldiers are at greater injury risk than younger soldiers. Soldiers in noncombat arms units tend to have higher incidences of reported MSKIs, more limited duty days, and higher rates of limited duty days for chronic MSKIs than soldiers in combat arms units. MSKIs account for 65% of medically nondeployable AC soldiers. At any time, 4% of AC soldiers cannot deploy because of MSKIs. Once deployed, nonbattle injuries accounted for approximately 30% of all medical evacuations, and were the largest category of soldier evacuations from both recent major combat theaters (Iraq and Afghanistan). More than 85% of service members medically evacuated for MSKIs failed to return to the theater. MSKIs factored into (1) nearly 70% of medical disability discharges across the Army from 2011 through 2016 and (2) more than 90% of disability discharges within enlisted soldiers\u2019 first year of service from 2010 to 2015. MSKI-related, service-connected (SC) disabilities account for 44% of all SC disabilities (more than any other body system) among compensated U.S. Global War on Terrorism veterans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MSKIs significantly impact soldier health and U.S. Army readiness. MSKIs also figure prominently in medical disability discharges and long-term, service-connected disability costs. MSKI patterns and trends vary between trainees and soldiers in operational units and among military occupations and types of operational units. Coordinated injury surveillance efforts are needed to provide standardized metrics and accurately measure temporal changes in injury rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usaa027","type":"journal-article","created":{"date-parts":[[2020,3,16]],"date-time":"2020-03-16T05:57:34Z","timestamp":1584338254000},"page":"e1461-e1471","source":"Crossref","is-referenced-by-count":244,"title":["Musculoskeletal Injuries and United States Army Readiness Part I: Overview of Injuries and their Strategic Impact"],"prefix":"10.1093","volume":"185","author":[{"given":"Joseph M","family":"Molloy","sequence":"first","affiliation":[{"name":"Oak Ridge Institute for Science and Education, Oak Ridge, TN 37830"},{"name":"U.S. Army Office of the Surgeon General, Physical Performance Service Line, G 3\/5\/7, Falls Church, VA 22042"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy L","family":"Pendergrass","sequence":"additional","affiliation":[{"name":"U.S. Army Office of the Surgeon General, Physical Performance Service Line, G 3\/5\/7, Falls Church, VA 22042"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian E","family":"Lee","sequence":"additional","affiliation":[{"name":"Solution Delivery Division, U.S. Defense Health Agency, Falls Church, VA 22042"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle C","family":"Chervak","sequence":"additional","affiliation":[{"name":"U.S. Army Public Health Center, Injury Prevention Program, Aberdeen Proving Ground, Aberdeen, MD 21005"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith G","family":"Hauret","sequence":"additional","affiliation":[{"name":"U.S. Army Public Health Center, Injury Prevention Program, Aberdeen Proving Ground, Aberdeen, MD 21005"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel I","family":"Rhon","sequence":"additional","affiliation":[{"name":"Oak Ridge Institute for Science and Education, Oak Ridge, TN 37830"},{"name":"U.S. Army Office of the Surgeon General, Physical Performance Service Line, G 3\/5\/7, Falls Church, VA 22042"},{"name":"Center for the Intrepid, Brooke Army Medical Center, Joint Base San Antonio Fort Sam Houston, TX 78234"},{"name":"Duke Clinical Research Institute, Duke University, Durham, NC 27701"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,3,16]]},"reference":[{"key":"2020092112042556800_ref1","volume-title":"Profile of the Military Community: 2017 Demographics Report","author":"United States Department of Defense"},{"key":"2020092112042556800_ref2","volume-title":"Defense Medical Surveillance System database, completed","author":"U.S. Army Public Health Center internal analysis","year":"2018"},{"key":"2020092112042556800_ref3","volume-title":"Soldier Outcomes Trajectory 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