The aim of this review is twofold first, to review the current literature regarding injury causes in the military and second, to demonstrate the influence footwear can have on injury incidence.
Footwear can have a significant effect on gait and performance of tasks, which in turn can lead to injury. Load carriage and training are commonly cited as causative factors towards musculoskeletal injury within military forces, particularly army however, the effect that footwear can have on injuries has received minimal attention in previous reviews of military injuries despite the research completed in this area. Substantial research has assessed the risk factors for injury in the military however, results are often contradictory and focus on individual factors, when in reality, a large number are inextricably linked. There is, however, a large proportion of injuries that may result from (or be exacerbated by) controllable factors such as training and equipment. While certainly undesirable, some amount of catastrophic injury is unavoidable during deployment and is a direct result of the conditions in which military personnel work. One study found a 13 % increase in the incidence of lower limb injury if the recruit had suffered a previous ankle sprain. Furthermore, once a musculoskeletal injury is incurred, the risk of sustaining another such injury increases causing a greater risk of attrition. Soldiers injured in basic training may be unable to deploy, while soldiers injured during deployment may not be fit to return to active duty. The most prevalent factor that could prevent the achievement of these two criteria is musculoskeletal injury. Military personnel serve in many capacities around the world and there are two factors of paramount importance to all efforts that soldiers are physically capable for duty and that they return safely.
The relative success of these strategies is highly variable however, with advancements in technology, new approaches will become available and existing strategies may become more effective. A number of preventative strategies have been developed within military bodies around the world to address these issues. In particular, the large loads borne by soldiers, the high intensity training programs and the influence of footwear have been identified as significant causative factors of lower limb injury in military populations. Collective evidence suggests that training and equipment contribute to a large proportion of the injuries sustained. In an effort to address this, a considerable amount of research has gone into identifying the most prevalent types of injury and their associated risk factors.
Injuries cause a substantial number of working days lost, a significant cost through compensation claims and an increased risk of attrition. Injuries are common within military populations, with high incidence rates well established in the literature.
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