Physical activity is associated with a low prevalence of musculoskeletal disorders in the Royal Norwegian Navy: a cross sectional study Risk factors of acute and overuse musculoskeletal injuries among young conscripts: a population-based cohort study What Risk Factors Are Associated With Musculoskeletal Injury in US Army Rangers? A Prospective Prognostic Study Epidemiological patterns of musculoskeletal injuries and physical training. Outcomes associated with cardiac rehabilitation participation in patients with musculoskeletal comorbidities. Neuromuscular training with injury prevention counselling to decrease the risk of acute musculoskeletal injury in young men during military service: a population-based, randomised study Effect of a general fitness program on musculoskeletal symptoms, clinical status, physiological capacity, and perceived work environment among home care service personnel The association between psychological distress and musculoskeletal symptoms experienced by Chinese high school students. A step towards understanding the mechanisms of running-related injuries. Endurance training in MS: short-term immune responses and their relation to cardiorespiratory fitness, health-related quality of life, and fatigue Musculoskeletal injuries in British Army recruits: a prospective study of diagnosis-specific incidence and rehabilitation times Injuries in sedentary individuals enrolled in a 12-month, randomized, controlled, exercise trial. Association of Injury History and Incident Injury in Cadet Basic Military Training. Gender differences in musculoskeletal injury rates: a function of symptom reporting? The influence of exercise and BMI on injuries and illnesses in overweight and obese individuals: a randomized control trial Musculoskeletal dysfunction in physical education teachers Musculoskeletal disorders and occupational exposures: How should we judge the evidence concerning the causal association?
Background Despite considerable knowledge about musculoskeletal disorders ( MSD ) and physical , psychosocial and individual risk factors there is limited knowledge about physical activity as a factor in preventing MSD . In addition , studies of physical activity are often limited to either leisure activity or physical activity at work . Studies among military personnel on the association between physical activity at work and at leisure and MSD are lacking . This study was conducted to find the prevalence of MSD among personnel in the Royal Norwegian Navy and to assess the association between physical activity at work and at leisure and MSD . Methods A question naire about musculoskeletal disorders , physical activity and background data ( employment status , age , gender , body mass index , smoking , education and physical stressors ) was completed by 2265 workers ( 58 % ) 18 to 70 years old in the Royal Norwegian Navy .  Multiple logistic regression with 95 % confidence intervals was used to assess the relationship between physical activity and musculoskeletal disorders . Results A total of 32 % of the workers reported musculoskeletal disorders often or very often in one or more parts of the body in the past year . The most common musculoskeletal disorders were in the lower back ( 15 % often or very often ) , shoulders ( 12 % often or very often ) and neck ( 11 % often or very often ) . After adjustment for confounders , physical activity was inversely associated with musculoskeletal disorders for all body sites except elbows , knees and feet . Conclusion The one-year prevalence of musculoskeletal disorders among workers in the Royal Norwegian Navy was rather low . A physically active lifestyle both at work and at leisure was associated with fewer musculoskeletal disorders  among personnel in the Royal Norwegian Navy . Prospect i ve studies are necessary to confirm the cause and effect in this association Background Military service in Finl and is compulsory for all male citizens and annually about 80 % of 19-year-old men enter into the service . The elevated risk for many chronic diseases and loss of function among those who are inactive and unfit can be often detected already in youth . On the other h and , activity-induced injuries among young are true public health issue . The purpose of the present prospect i ve cohort follow-up study was to evaluate predictive associations between acute or overuse injuries and their various intrinsic risk factors . Methods Four successive cohorts of conscripts who formed a representative sample of Finnish young men were followed for 6 months . At the beginning of the service , the risk factors of injuries were measured and recorded and then the acute and overuse injuries treated at the garrison clinic were identified . Predictive associations between injuries and their risk factors were examined by multivariate Cox ’s proportional hazard models . Results Of the 1411 participants , 27 % sustained an acute injury and 51 % suffered from overuse injury . Concerning acute injuries , highest risk for severe injuries were detected among conscripts with low fitness level in both the st and ing long-jump and push-up tests ( hazard rate , HR=5.9 ; 95 % CI : 1.6‒21.3 ) . A history of good degree in school sports was not a protective factor against acute injuries . High waist circumference and , on the other h and , being underweight according to BMI increased the HR for overuse injuries . Brisk leisure time physical activity before military entry was a protective factor against overuse injuries . Poor result in Cooper ’s test was a warning signal of elevated risk of overuse injuries . Conclusion We confirmed previous findings that low level of physical fitness is predictor for musculoskeletal injuries during intensive physical training . The U-shaped relationship between body composition and overuse injuries was noticed indicating that both obesity and underweight are risk factors for overuse injuries . Persons with excellent sports skills according to their earlier degrees in school sports had similar HR for acute injuries than those with poorer degrees . This indicates that school-age sports skills and fitness do not carry far and therefore preventive programmes are needed to prevent activity-induced injuries Background Musculoskeletal injury is the most common reason that soldiers are medically not ready to deploy . Underst and ing intrinsic risk factors that may place an elite soldier at risk of musculoskeletal injury may be beneficial in preventing musculoskeletal injury and maintaining operational military readiness . Findings from this population may also be useful as hypothesis-generating work for particular civilian setting s such as law enforcement officers ( SWAT teams ) , firefighters ( smoke jumpers ) , or others in physically dem and ing professions . Questions / purpose sThe purpose s of this study were ( 1 ) to examine whether using baseline measures of self-report and physical performance can identify musculoskeletal injury risk ; and ( 2 ) to determine whether a combination of predictors would enhance the accuracy for determining future musculoskeletal injury risk in US Army Rangers . Methods Our study was a planned secondary analysis from a prospect i ve cohort examining how baseline factors predict musculoskeletal injury . Baseline predictors associated with musculoskeletal injury were collected using surveys and physical performance measures . Survey data included demographic variables , injury history , and biopsychosocial questions . Physical performance measures included  ankle dorsiflexion , Functional Movement Screen , lower and upper quarter Y-balance test , hop testing , pain provocation , and the Army Physical Fitness Test ( consisting of a 2-mile run and 2 minutes of sit-ups and push-ups ) . A total of 320 Rangers were invited to enroll and 211 participated ( 66 % ) . Occurrence of musculoskeletal injury was tracked for 1 year using monthly injury surveillance surveys , medical record review s , and a query of the Department of Defense healthcare utilization data base . Injury surveillance data were available on 100 % of the subjects . Receiver operator characteristic curves and accuracy statistics were calculated to identify predictors of interest . A logistic regression equation was then calculated to find the most pertinent set of predictors . Of the 188 Rangers ( age , 23.3 ± 3.7 years ; body mass index , 26.0 ± 2.4 kg/m2 ) remaining in the cohort , 85 ( 45.2 % ) sustained a musculoskeletal injury of interest .  Results Smoking , prior surgery , recurrent prior musculoskeletal injury , limited-duty days in the prior year for musculoskeletal injury , asymmetrical ankle dorsiflexion , pain with Functional Movement Screen clearing tests , and decreased performance on the 2-mile run and 2-minute sit-up test were associated with increased injury risk . Presenting with one or fewer predictors result ed in a sensitivity of 0.90 ( 95 % confidence interval [ CI ] , 0.83–0.95 ) , and having three or more predictors result ed in a specificity of 0.98 ( 95 % CI , 0.93–0.99 ) . The combined factors that contribute to the final multivariable logistic regression equation yielded an odds ratio of 4.3 ( 95 % CI , 2.0–9.2 ) , relative risk of 1.9 ( 95 % CI , 1.4–2.6 ) , and an area under the curve of 0.64 . Conclusions Multiple factors ( musculoskeletal injury history , smoking , pain provocation , movement tests , and lower scores on physical performance measures ) were associated with individuals at risk for musculoskeletal injury . The summation of the number of risk factors produced a highly sensitive ( one or less factor ) and specific ( three or more factors ) model that could potentially be used to effectively identify and intervene in those persons with elevated risk for musculoskeletal injury . Future research should establish if screening and intervening can improve musculoskeletal health and if our findings among US Army Rangers translate to other occupations or athletes . Level of Evidence Level II , prognostic study PURPOSE The purpose of this study was to identify rates of diagnosis-specific musculoskeletal injuries in U.S. Marine Corps recruits and to examine the association between patterns of physical training and these injuries . METHODS Subjects were 1,296 r and omly selected male Marine recruits , ages 17 to 28 yr , who reported to Marine Corps Recruit Depot San Diego for boot camp training between January 12 and September 14 , 1993 . Recruits were followed prospect ively through 12 wk of training for injury outcomes . Injury patterns were examined in relation to weekly volumes and types of vigorous physical training . RESULTS The overall injury rate was 39.6 % ( number of recruits injured/ population at risk ) , with 82 % of injuries occurring in the lower extremities . Overuse injuries accounted for 78 % of the diagnoses . The most frequent site of injury was the ankle/foot region ( 34.3 % of injuries ) , followed by the knee ( 28.1 % ) . Ankle sprains ( 6.2 % , N = 1,143 ) , iliotibial b and syndrome ( 5.3 % , N = 1,143 ) , and stress fractures ( 4.0 % , N = 1,296 ) were the most common diagnoses . Injury rates were highest during the weeks with high total volumes of vigorous physical training and the most hours of running and marching . Weekly injury rates were significantly correlated with hours of vigorous physical training ( overuse injuries r = 0.667 , P = 0.018 ; acute injuries r = 0.633 , P = 0.027 ) . CONCLUSIONS The results of this controlled epidemiological investigation indicate that volume of vigorous physical training may be an etiologic factor for exercise-related injuries . The findings also suggest that type of training , particularly running , and abrupt increases in training volume may further contribute to injury risk BACKGROUND Individuals with coronary artery disease ( CAD ) and musculoskeletal comorbidities ( MSKCs ) have much to gain from physical activity , yet are less likely to be referred to cardiac rehabilitation ( CR ) than those without MSKCs . Whether patients with MSKCs achieve demonstrated benefits of CR participation such as improved quantity and quality -of-life remains unknown . AIM To compare all-cause mortality , major acute cardiovascular events ( MACEs ) , quality -of-life and psychosocial well-being in patients with CAD and coexisting MSKCs by CR participation . DESIGN Prospect i ve and observational study in which patients were administered a question naire in the hospital and 1 year later . The cohort was linked to provincial data bases . SETTING Eleven hospitals in Ontario , Canada . POPULATION CAD patients ( N.=1680 ) . METHODS CAD in patients were administered a question naire assessing sociodemographic and clinical characteristics . Clinical data were extracted from charts .  CR participation , quality -of-life , depressive symptoms , functional status , and physical activity behavior were measured 1 year later by question naire . The cohort was linked to provincial administrative data bases to ascertain mortality and MACEs for a median of 2.7 years post-index cardiac hospitalization . Associations of CR participation with outcomes were tested after adjustment for differences in participation propensity . RESULTS Of study participants , 50.7 % ( 851/1680 ) had MSKCs and of those with MSKCs , 49.8 % ( 424/851 ) participated in CR . Patients with MSKCs who participated in CR had greater physical quality -of-life ( P<0.03 ) and lower mortality than those with MSKCs who did not attend CR , after adjusting for propensity for CR participation ( 1.4 % vs. 4 % ; participant vs. non- participants , P=0.03 ) - non- participants ' hazard ratio 3.91 [ 95%CI,1.23 - 12.36 ] ) . There were no differences for MACEs . CONCLUSION Among those with MSKCs , participation in CR is associated with survival benefit and better physical quality -of-life compared to non- participants . CLINICAL REHABILITATION IMPACT Our findings showing the high prevalence of MSKCs in those with CAD and the benefits of CR , add to the literature that will provide the basis for exploration of initiatives to improve care for those with CAD and MSKC , and to overcome barriers to improved outcomes and reduced death . These results will help to guide focused research to optimize complex outpatient care in this group , including increasing the utilization of CR Background The rapidly increasing number of activity-induced musculoskeletal injuries among adolescents and young adults is currently a true public health burden . The objective of this study was to investigate whether a neuromuscular training programme with injury prevention counselling is effective in preventing acute musculoskeletal injuries in young men during military service . Methods The trial design was a population -based , r and omised study . Two successive cohorts of male conscripts in four companies of one brigade in the Finnish Defence Forces were first followed prospect ively for one 6-month term to determine the baseline incidence of injury . After this period , two new successive cohorts in the same four companies were r and omised into two groups and followed prospect ively for 6 months . Military service is compulsory for about 90 % of 19-year-old Finnish men annually , who comprised the cohort in this study . This r and omised , controlled trial included 968 conscripts comprising 501 conscripts in the intervention group and 467 conscripts in the control group .  A neuromuscular training programme was used to enhance conscripts ' motor skills and body control , and an educational injury prevention programme was used to increase knowledge and awareness of acute musculoskeletal injuries . The main outcome measures were acute injuries of the lower and upper limbs . Results In the intervention groups , the risk for acute ankle injury decreased significantly compared to control groups ( adjusted hazards ratio ( HR ) = 0.34 , 95 % confidence interval ( 95 % CI ) = 0.15 to 0.78 , P = 0.011 ) . This risk decline was observed in conscripts with low as well as moderate to high baseline fitness levels . In the latter group of conscripts , the risk of upper-extremity injuries also decreased significantly ( adjusted HR = 0.37 , 95 % CI 0.14 to 0.99 , P = 0.047 ) . In addition , the intervention groups tended to have less time loss due to injuries ( adjusted HR = 0.55 , 95 % CI 0.29 to 1.04 ) . Conclusions A neuromuscular training and injury prevention counselling programme was effective in preventing acute ankle and upper-extremity injuries in young male army conscripts . A similar programme could be useful for all young individuals by initiating a regular exercise routine . Trial registration Clinical Trials.gov identifier number NCT00595816 The aim of the present controlled study was to evaluate the effect of a general fitness program , performed by an occupational health service , using pre-post assessment for a number of different outcome measures . A total of 160 employees working in the central home care service district of Umeå , Sweden were asked to participate in a program of a 1-year long exercise program . Of the 160 selected , 54 subjects declined to participate and nine subjects were rejected after a medical check up . The remaining 97 subjects participated in a schedule consisting of pre-post medical and physiotherapy examinations , question naires concerning sociodemography , musculoskeletal and general health complaints and work environment , physiological tests of cardiovascular fitness , and of strength and endurance of shoulder flexors and knee extensors , and registration of sick leave . The subjects were r and omly assigned to an exercise ( treatment ) or control group . The exercise group trained twice a week for 1 year using a mixed program including exercises for coordination , strength/endurance , and fitness . The test schedule was repeated for both groups after 1 year . The exercise intervention was associated with positive changes in prevalence and intensity of musculoskeletal and psychosomatic complaints , better physiotherapy status ( less muscle tightness , better neck mobility , and less tender points ) , increased shoulder strength and increased coordination in thigh muscles . However , the exercise group reported worse situations post-exercise concerning aspects of their physical and psychosocial work-environment ( i.e. , concerning ergonomy , influence , appreciation and communication with work manager ) , which might have been due to stress associated with the exercise situation STUDY DESIGN A cross-sectional nonexperimental study . OBJECTIVES To determine the prevalence of musculoskeletal symptoms during a 6-month period and explore the contributing factors associated with these symptoms in Chinese senior class high school students . We also explored the relationship between psychological distress and musculoskeletal symptoms in this population . BACKGROUND Musculoskeletal symptoms with no underlying identifiable pathology are a management puzzle to medical professionals . Finding the prevalence of musculoskeletal symptoms is the first step in the prevention of further chronic pain syndromes in young adults . No study , however , has directly measured the prevalence of musculoskeletal symptoms in this population . Investigations of the contributing factors to these symptoms , though rare , can provide information to assist in the prevention of further injuries . METHODS The Musculoskeletal Symptom Question naire ( MSQ ) and the 12- question version of the Chinese Health Question naire ( CHQ-12 ) were r and omly distributed to students ( n = 550 ) in 4 different high schools in the Tainan area of Taiwan . Of these , 471 students returned the question naires for analysis . Descriptive statistics were computed for means , st and ard deviations , and frequencies . Chi-square statistics were used for analysis of the association between psychological distress and musculoskeletal symptoms . RESULTS The most frequent complaints of musculoskeletal symptoms among the adolescent Chinese student population were reported as being located in the following anatomical areas : neck ( 56 % ) , shoulder ( 45 % ) , and back ( 37 % ) . Based on the results from the CHQ-12 , all of the participants were divided into 2 groups : a high psychological ( CHQ-12 score > or = 5 ) and a low psychological ( CHQ-12 score < 5 ) distress group . There were significant differences of prevalence of musculoskeletal symptoms between these 2 groups ( P < .05 ) , especially for the neck region ( P = .003 ) . CONCLUSION The results showed that the prevalence of musculoskeletal symptoms was high in this adolescent population and demonstrated a certain association with psychological distress . We suggest that surveys of this type may serve as pre clinical detectors of future musculoskeletal disorders and may permit early interventions . Developing an intervention that addresses both physical and psychological problems may be beneficial for this population OBJECTIVES To investigate the association between training-related characteristics and running-related injury using a new conceptual model for running-related injury generation , focusing on the synergy between training load and previous injuries , short-term running experience or body mass index ( > or < 25 kg m(-2 ) ) . DESIGN Prospect i ve cohort study with a 9-month follow-up . METHODS The data of two previous studies using the same methodology were revisited . Recreational runners ( n = 517 ) reported information about running training characteristics ( weekly distance , frequency , speed ) , other sport participation and injuries on a dedicated internet platform  . Weekly volume ( dichotomized into < 2h and ≥ 2 h ) and session frequency ( dichotomized into < 2 and ≥ 2 ) were the main exposures because they were considered necessary causes for running-related injury . Non-training-related characteristics were included in Cox regression analyses as effect-measure modifiers . Hazard ratio was the measure of association . The size of effect-measure modification was calculated as the relative excess risk due to interaction . RESULTS One hundred sixty-seven runners reported a running-related injury . Crude analyses revealed that weekly volume < 2h ( hazard ratio = 3.29 ; 95 % confidence intervals = 2.27 ; 4.79 ) and weekly session frequency < 2 ( hazard ratio = 2.41 ; 95 % confidence intervals = 1.71 ; 3.42 ) were associated with increased injury rate . Previous injury was identified as an effect-measure modifier on weekly volume ( relative excess risk due to interaction = 4.69 ; 95 % confidence intervals = 1.42 ; 7.95 ; p = 0.005 ) and session frequency ( relative excess risk due to interaction = 2.44 ; 95 % confidence intervals = 0.48 ; 4.39 ; p = 0.015 ) . A negative synergy was found between body mass index and weekly volume ( relative excess risk due to interaction = -2.88 ; 95 % confidence intervals = -5.10 ; -0.66 ; p = 0.018 ) . CONCLUSIONS The effect of a runner 's training load on running-related injury is influenced by body mass index and previous injury . These results show the importance to distinguish between confounding and effect-measure modification in running-related injury research The influences of exercise on cytokine response , health-related quality of life ( HR-QoL ) , and fatigue are important aspects of MS rehabilitation . Physical exercises performed within these programs are often practice d in water , but the effects of immersion have not been investigated . To investigate the influences of short-term immune responses and cardiorespiratory fitness on HR-QoL and fatigue during 3 weeks endurance training conducted on a cycle-ergometer or an aquatic-bike . R and omized controlled clinical trial in 60 MS patients .  HR-QoL , fatigue , cardiorespiratory fitness , and short-term immune changes ( serum concentrations in response to cardiopulmonary exercise test ) of brain-derived neurotrophic factor ( BDNF ) , nerve growth factor ( NGF ) , interleukin-6 , and the soluble receptor of IL-6 ( sIL-6R ) were determined at the beginning and end of 3 weeks of training intervention . Subjects performed daily 30 min training at 60 % of their VO2peak . SF-36 total ( p = 0.031 ) , physical ( p = 0.004 ) , and mental health ( p = 0.057 ) scores show time effects within both groups . Between-group effects were shown for FSMC total ( p = 0.040 ) and motor function score ( p = 0.041 ) . MFIS physical fatigue showed time effects ( p = 0.008 ) for both groups . Linear regression models showed relationships between short-term immune responses and cardiorespiratory fitness with HR-QoL and fatigue after the intervention . This study indicates beneficial effects of endurance training independent of the training setting . Short-term immune adaptations and cardiorespiratory fitness have the potential to influence HR-QoL and fatigue in persons with MS . The specific immune responses of immersion to exercise need further clarification Background Musculoskeletal injuries during initial military training are a significant medical problem facing military organisations globally . In order to develop an injury management programme , this study aims to quantify the incidence and rehabilitation times for injury specific diagnoses . Methods This was a prospect i ve follow-up study of musculoskeletal injuries in 6608 British Army recruits during a 26-week initial military training programme over a 2-year period .  Incidence and rehabilitation times for injury specific diagnoses were recorded and analysed . Results During the study period the overall incidence of musculoskeletal injuries was 48.6 % , and the most common diagnosis was iliotibial b and syndrome ( 6.2 % ) . A significant proportion of the injuries occurred during the first 11 weeks of the programme . The longest rehabilitation times were for stress fractures of the femur , calcaneus and tibia ( 116 ± 17 days , 92 ± 12 days , and 85 ± 11 days , respectively ) . The combination of high incidence and lengthy rehabilitation indicates that medial tibial stress syndrome had the greatest impact on training , accounting for almost 20 % of all days spent in rehabilitation . Conclusion When setting prevention priorities consideration should be given to both the incidence of specific injury diagnoses and their associated time to recovery BACKGROUND The risk of musculoskeletal injury with the introduction of moderate-to-vigorous exercise in sedentary adults is not well established . The purpose of this report is to examine the effect of a 12-month exercise intervention on musculoskeletal injury and bodily pain in predominately overweight , sedentary men ( n = 102 ) and women ( n = 100 ) , ages 40 to 75 years . METHODS Participants were r and omized to a moderate-to-vigorous aerobic exercise intervention ( EX )  ( 6 d/wk , 60 min/d , 60 % to 85 % max . heart rate ) or usual lifestyle control ( CON ) . Participants completed a self-report of musculoskeletal injury and body pain at baseline and 12-months . RESULTS The number of individuals reporting an injury ( CON ; 28 % vs. EX ; 28 % , P = .95 ) did not differ by group . The most commonly injured site was lower leg/ankle/foot . The most common causes of injury were sports/physical activity , home maintenance , or " other . " In the control group , bodily pain increased over the 12 months compared with the exercise group ( CON -7.9 , EX -1.4 , P = .05 ) . Baseline demographics and volume of exercise were not associated with injury risk . CONCLUSIONS Previously sedentary men and women r and omized to a 12-month aerobic exercise intervention with a goal of 360 min/wk reported the same number of injuries as those in the control group and less bodily pain PURPOSE This study aim ed to determine the association between injury history at enrollment and incident lower extremity ( LE ) injury during cadet basic training among first-year military cadets . METHODS Medically treated LE injuries during cadet basic training documented in the Defense Medical Surveillance System were ascertained in a prospect i ve cohort study of three large US military academies from 2005 to 2008 . Both acute injuries ( International Classification of Disease , Ninth Revision , codes in the 800 - 900s , including fracture , dislocations , and sprains/strains ) and injury-related musculoskeletal injuries ( International Classification of Disease , Ninth Revision , codes in the 700s , including inflammation and pain , joint derangement , stress fracture , sprain/strain/rupture , and dislocation ) were included . Risk ratio ( RR ) and 95 % confidence interval ( CI ) were computed using multivariate log-binomial models stratified by gender . RESULTS During basic training , there were 1438 medically treated acute and 1719 musculoskeletal-related LE injuries in the 9811 cadets . The most frequent LE injuries were sprains/strains ( 73.6 % of acute injuries ) and inflammation and pain ( 89.6 % of musculoskeletal-related injuries ) . The overall risk of incident LE injury was 23.2 % ( 95 % CI = 22.3%-24.0 % ) . Cadets with a history of LE injury were at increased risk for incident LE injury . This association was identical in males ( RR = 1.74 , 95 % CI = 1.55 - 1.94 ) and females ( RR = 1.74 , 95 % CI = 1.52 - 1.99 ) . In site-specific analyses , strong associations between injury history and incident injury were observed for hip , knee ligament , stress fracture , and ankle sprain . Injury risk was greater ( P < 0.01 ) for females ( 39.1 % ) compared with males ( 18.0 % ) . The elevated injury risk in females ( RR = 2.19 , 95 % CI = 2.04 - 2.36 ) was independent of injury history ( adjusted RR = 2.09 , 95 % CI = 1.95 - 2.24 ) . CONCLUSION Injury history upon entry to the military is associated with the incidence of LE injuries sustained during cadet basic training . Prevention programs targeted at modifiable factors in cadets with a history of LE injury should be considered PURPOSE This study determined gender differences in voluntary reporting of lower extremity musculoskeletal injuries among U.S , Marine Corps ( USMC ) recruits , and it examined the association between these differences and the higher injury rates typically found among women trainees . METHODS Subjects were 176 male and 241 female enlisted USMC recruits who were followed prospect ively through 11 wk ( men ) and 12 wk ( women ) of boot camp training . Reported injuries were measured by medical record review s. Unreported injuries were determined by a question naire and a medical examination administered at the completion of training . RESULTS Among female recruits the most commonly reported injuries were patellofemoral syndrome ( 10.0 % of subjects ) , ankle sprain ( 9.1 % ) , and iliotibial b and syndrome ( 5.8 % ) ; the most common unreported injuries were patellofemoral syndrome ( 2.1 % ) , metatarsalgia ( 1.7 % ) , and unspecified knee pain ( 1.7 % ) . Among male recruits iliotibial b and syndrome ( 4.0 % of subjects ) , ankle sprain ( 2.8 % ) , and Achilles tendinitis/bursitis ( 2.8 % ) were the most frequently reported injuries ; shin splints ( 4.6 % ) , iliotibial b and syndrome ( 4.0 % ) , and ankle sprain ( 2.8 % ) were the most common unreported diagnoses . Female recruits were more likely to have a reported injury than male recruits ( 44.0 % vs 25.6 % , relative risk ( RR ) = 1.72 , 95 % confidence interval ( CI ) 1.29 - 2.30 ) , but they were less likely to have an unreported injury ( 11.6 % vs 23.9 % , RR = 0.49 , 95 % CI 0.31 - 0.75 ) . When both reported and unreported injuries were measured , total injury rates were high for both sexes ( 53.5 % women , 45.5 % men , RR = 1.18 , 95 % CI 0.96 - 1.44 ) , but the difference between the rates was not statistically significant . CONCLUSIONS Our results indicate that the higher injury rates often found in female military trainees may be explained by gender differences in symptom reporting Background Medically treated injuries have been shown to increase with increasing body mass index ( BMI ) . Information is lacking on the frequency and type of injuries and illnesses among overweight and obese adults who engage in regular physical activities as part of weight loss or weight gain prevention programs . Methods Sedentary adults with BMI s between 25 and 40 kg/m2 ( n = 397 ) enrolled in one of two r and omized clinical trials that emphasized exercise as part of a weight loss or weight gain prevention program . Interventions differed by duration of the exercise goal ( 150 , 200 , or 300 minutes/week or control group ) . Walking was prescribed as the primary mode of exercise . At six month intervals , participants were asked , " During the past six months , did you have any injury or illness that affected your ability to exercise ? " Longitudinal models were used to assess the effects of exercise and BMI on the pattern of injuries/illnesses attributed to exercise over time ; censored linear regression was used to identify predictors of time to first injury/illness attributed to exercise . Results During the 18-month study , 46 % reported at least one injury/illness , and 32 % reported at least one injury that was attributed to exercise .  Lower-body musculoskeletal injuries ( 21 % ) were the most commonly reported injury followed by cold/flu/respiratory infections ( 18 % ) and back pain/injury ( 10 % ) . Knee injuries comprised one-third of the lower-body musculoskeletal injuries . Only 7 % of the injuries were attributed to exercise alone , and 59 % of the injuries did not involve exercise . BMI ( p ≤ 0.01 ) but not exercise ( p ≥ 0.41 ) was significantly associated with time to first injury and injuries over time . Participants with higher BMI s were injured earlier or had increased odds of injury over time than participants with lower BMI s. Due to the linear dose-response relationship between BMI and injury/illness , any weight loss and reduction in BMI was associated with a decrease risk of injury/illness and delay in time to injury/illness . Conclusions Overweight and obese adults who were prescribed exercise as part of weight loss or weight gain prevention intervention were not at increased risk of injury compared to overweight adults r and omized not to participate in prescribed exercise . Since onset of injury/illness and pattern of injuries over time in overweight and obese individuals were attributed to BMI , weight reduction may be an avenue to reduce the risk of injury/illness in sedentary and previously sedentary overweight and obese adults . Trial Registration Clinical trials.gov NCT00177502 and OBJECTIVES To investigate the prevalence of musculoskeletal disorders , especially symptomatic osteoarthrosis ( OA ) of the knee and hip , health and lifestyle factors among  physical education ( PE ) teachers , and whether they differed from the general population in these respects . METHODS The study base was all Swedish men ( n=290 ) and women ( n=281 ) who graduated from the only training college for PE teachers in Sweden , between the years 1957 and 1965 , and age matched referents , 255 men and 257 women , r and omly selected from the Swedish population register . A postal question naire was sent to the subjects with questions on occupational history , participation in sports , musculoskeletal disorders , height , weight , smoking habits , and general health . RESULTS The PE teachers had a higher prevalence ratio ( PR ) of symptomatic OA of the knee ( men : 2.8 95 % confidence interval ( 95 % CI ) 1.6 to 4.8 ; women : 3.2 95 % CI 1.8 to 5.5 ) and knee injury compared with the referents . The PE teachers reported more absence from work , and the women had had to change jobs more often because of knee disorders . The prevalence ratio for symptomatic OA of the hip was 2.7 ( 95 % CI 1.0 to 7.1 ) for the female PE teachers . At the age of 25 the body mass index ( BMI ) of male PE teachers was higher than the male referents , but at an older age both the female and male PE teachers had lower BMI than the referents . The participation in sports activities was considerably higher in the group of PE teachers . They also smoked less , reported less serious diseases , and better health than the referents . CONCLUSIONS The PE teachers had a high risk of developing knee disorders , which entailed difficulties in continuing their work as PE teachers . They differed from the referents in lifestyle factors as they smoked less , were less overweight , and had a higher lifelong sports exposure Musculoskeletal disorders ( MSDs ) affecting the back , upper and lower extremities are widespread in the general population , implying a variety of causal factors . Multiple causes are not mutually exclusive , and a high background rate does not preclude associations with specific factors that are uncommon in the general population . MSDs have well-documented associations with occupational ergonomic stressors such as repetitive motion , heavy lifting , non-neutral postures , and vibration . Organizational features of the work environment , such as time pressure and low decision latitude , may also play a role , at least by potentiating the effects of physical loading . Numerous systematic review s have mostly concurred with these overall findings . Nevertheless , some continue to debate whether MSDs are sometimes work-related , even for those performing jobs with repetitive and routinized tasks , heavy lifting , and /or pronounced postural strain . This article discusses ( 1 ) some epidemiologic features of MSDs that underlie that debate ; and ( 2 ) the question of what should appropriately be considered a gold st and ard for scientific evidence on an etiological question such as the health effects of a non-voluntary exposure , such as an occupational or environmental agent . In particular , r and omized clinical trials have little relevance for determining the health effects of non-therapeutic risk factors
Primary findings indicate that there is ( a ) strong evidence that poor performance on a set distance run for time is a predictor for MSK-I risk in both genders ; ( b ) strong evidence that poor performance on timed shuttle runs is a predictor for MSK-I risk in males ; ( c ) moderate evidence in males and limited evidence in females that poor performance on a timed step test is a predictor of MSK-I risk ; and ( d ) limited or insufficient evidence that poor performance on the Cooper run test , maximal and submaximal aerobic grade d exercise tests , and the Conconi test are predictors of MSK-I risk in males or females or both .
Several measures of CRE are risk factors for training-related MSK-I in military and civilian athletic population s , indicating that CRE may be an important measure for MSK-I risk stratification
A systematic review of the association between physical fitness and musculoskeletal injury risk : part 1—cardiorespiratory endurance .
J Strength Cond Res 31(6 ) : 1744–1757 , 2017—Musculoskeletal injuries ( MSK-Is ) are a significant health problem for both military and athletic population s. Research indicates that MSK-I is associated with physical fitness ; however , the association between specific components of physical fitness and MSK-I in military and athletic population s has not been systematic ally examined .