Musculoskeletal disorders in physically active conscripts: a one-year follow-up study in the Finnish Defence Forces

Abstract

Background: Musculoskeletal disorders (MSDs) are an important cause for morbidity in military service. They result in disabilities needing long-term rehabilitation and functional impairment leading to premature discharge from military service. The purpose of the study was to investigate the incidence and nature of MSDs in Finnish conscripts.

Methods: Two successive arrivals of 18-28-yr-old male conscripts (N = 955, median age 19) were followed for six months. MSDs, including overuse and acute injuries, treated at the garrison clinic were identified and analysed.

Results: During the 12-month study period there were 437 outpatient clinic visits in 955 persons. The occurrence rate was 33% during 6-month service while the event-based incidence was 3.3 per 1000 person-days. Occurrence peaked in summer months. The most common types of MSDs were low back pain (LBP, 20%), lower limb overuse injuries (16%) and sprains or strains (13%). Disorders mostly occurred in combat training in combat gear (40%) and during marching on foot or bicycle (28%). Overuse-related MSDs were more prevalent (66%) than traumatic ones (34%). One-third (34%) of the MSDs were recurrent and 66% were new ones. Disorders of the back and the knee were most frequently recurrent conditions (44% for both). Fractures, knee ligament ruptures, dislocations and muscle strains accounted for the highest number of service days lost. Twenty-four (2.5%) out of 955 conscripts were prematurely discharged due to MSDs.

Conclusion: Preventive measures during military service should be targeted at decreasing low back pain and lower limb overuse injuries, because these inflict the largest burden of MSDs and tend to have a chronic nature.

Figure 1

Distribution of musculoskeletal disorders by associated activities in 955 male conscripts during 6-month military service. * The term "not during actual military service" includes disorders during vacations, during travel to vacation or back to garrison or during off-duty time in the evenings. Count next to the bar is the absolute number.

Figure 2

Distribution of musculoskeletal disorders by injury type in 955 male conscripts during 6-month military service. Count next to the bar is the absolute number.

Figure 3

Distribution of musculoskeletal disorders by anatomical location in 955 male conscripts during 6-month military service. Count next to the bar is the absolute number.