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Injuries and injury risk factors among British army infantry soldiers during predeployment training
  1. David M Wilkinson1,
  2. Sam D Blacker1,
  3. Victoria L Richmond1,
  4. Fleur E Horner1,
  5. Mark P Rayson1,
  6. Anita Spiess2,
  7. Joseph J Knapik2
  1. 1Optimal Performance Limited, Bristol, UK
  2. 2United States Army Public Health Command, Aberdeen, USA
  1. Correspondence to David M Wilkinson, Optimal Performance Limited, The Coach House, 26B Oakfield Road, Clifton, Bristol BS8 2AT, UK; david{at}


Purpose This prospective cohort study examined injuries and injury risk factors in 660 British Army infantry soldiers during a predeployment training cycle.

Methods Soldiers completed a questionnaire concerning physical characteristics, occupational factors, lifestyle characteristics (including physical training time) and previous injury. Direct measurements included height, body mass, sit-ups, push-ups and run time. Electronic medical records were screened for injuries over a 1-year period before operational deployment. Backward-stepping Cox regression calculated HR and 95% CI to quantify independent injury risk factors.

Results One or more injuries were experienced by 58.5% of soldiers. The new injury diagnosis rate was 88 injuries/100 person-years. Most injuries involved the lower body (71%), especially the lower back (14%), knee (19%) and ankle (15%). Activities associated with injury included sports (22%), physical training (30%) and military training/work (26%). Traumatic injuries accounted for 83% of all injury diagnoses. Independent risk factors for any injury were younger age (17–19 years (HR 1.0), 20–24 years (HR 0.71, 95% CI 0.55 to 0.93), 25–29 years (HR 0.89, 95% CI 0.66 to 1.19) and 30–43 years (HR 0.41, 95% CI 0.27 to 0.63), previous lower limb injury (yes/no HR 1.49, 95% CI 1.19 to 1.87) and previous lower back injury (yes/no HR 1.30, 95% CI 1.03 to 1.63).

Conclusion British infantry injury rates were lower than those reported for US infantry (range 101–223 injuries/100 soldier-years), and younger age and previous injury were identified as independent risk factors. Future efforts should target reducing the incidence of traumatic injuries, especially those related to physical training and/or sports.

  • Injuries
  • military personnel
  • occupational
  • physical fitness
  • risk factors
  • sports, surveillance

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  • Funding This work was funded by the Human Dimension and Medical Science domain of the Ministry of Defence scientific research programme.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the UK Ministry of Defence Research Ethics Committee, reference 0736/121, 20 July 2007.

  • Provenance and peer review Not commissioned; externally peer reviewed.