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Background: Musculoskeletal Injuries (MSKI) and the subsequent attrition incurred during basic military training represent a significant socioeconomic burden across global defence forces. The collection of accurate injury surveillance data is fundamental to meaningful analysis, identification of trends and subsequent introduction of targeted prevention strategies. Aim: The purpose of this study was to evaluate the regimental specific musculoskeletal injury patterns and training outcomes. Methods: This was a descriptive retrospective observational study of 4101 MSKI reported from a total of 10498 British infantry recruits over four consecutive training years (1st April 2012-31st March 2016 at ITC). The cohort comprised of recruits from the parachute regiment (n = 1592), Line infantry (n = 6569), Guards (n = 1614) and the Gurkha regiment (n = 723). Injury data was collected and reviewed for recruit trainees, undertaking the Combat Infantryman Course (CIC). Results: The four year accumulative incidence varied between the individual training regiments; 66.21% (95% CI: 64.19-68.23), 38.48% (95% CI: 35.04-41.92) 34.22% (95% CI: 33.23-35.21), and 24.62% (95% CI: 22.76-26.48) for Parachute, Guards, Line, and Gurkha respectively. Overuse MSKI were the most common across all regiments whilst specifically injuries to the knee were most frequently reported with the exception of the Parachute Regiment in which injuries to the calf and shin had the highest reported occurrence. The results show a significant difference (p < 0.02) in the incidence of all MSKI between phase 1 and phase 2 training for all training regiments. 45.5% of the total MSKI reported by all infantry recruits presented within the first 8 weeks of Phase 1 training. Irrespective of injury rate, training outcomes were found to be significantly difference (p < 0.01) between regiments. In ascending order, the percentage of regimental recruits successfully completing training at the first attempt was 38.63%, 53.78%, 64.47% and 98.76% for the Parachute, Guards, Line and Gurkha Regiment respectively. Conclusions: The disparity between MSKI incidence and training outcomes across the Infantry Regiments, suggests that there is a requirement to thoroughly investigate the specific content and delivery of training between the individual regiments.

Musculoskeletal Injuries in British Army Recruits: A Retrospective Study of Incidence and Training Outcome in Different Infantry Regiments