Exploring musculoskeletal injury risk in a physically demanding military occupational role: Understanding individual, role and organisational factors to inform mitigation strategies

Abstract

Musculoskeletal injury (MSKI) is one of the biggest health burdens faced by the United Kingdom (UK) military. A reduction in workforce through MSKI directly impacts operational preparedness due to loss of training days or removal of the individual from their role. Military Specialists comprise a relatively small, finite number of UK personnel who are highly trained in their specific area of expertise. This thesis presents a systematic approach to understand MSKI occurrence in Military Specialists with the purpose of informing future mitigation strategies. A mixed methods research design has been used across five studies that have focused on the individual, the role and organisational factors.
This PhD identified that collectively military training was associated with the highest number of MSKI (32%) in Military Specialists. However, personal physical training (strength/power training [15%] and running [11%]) represented individual activities most associated with MSKI (Chapter 3). The physically demanding tasks encountered by the population during their occupational role were established (Chapter 4). Assessment of the physical demands of the role indicated that role-specific tasks were arduous in nature, required high rates of energy expenditure (3345 – 4070 kcal.day-1) and drew upon a range of fitness components for successful task completion (Chapter 6). It was identified that Military Specialists conduct their own physical training for 45 to 60 minutes, three to five days a week. Personal physical training tended to focus on cardiorespiratory and muscle strength/endurance training and did not address all the fitness components required for task which may increase MSKI risk (Chapter 5). Organisational factors that may influence individual behaviour and increase MSKI risk were identified as peer influence, work routine and accountability (Chapter 7).
This thesis concluded that factors associated with the individual, the occupational role, and the organisational culture and context should be considered in developing MSKI mitigation interventions. This would ensure stakeholder and end-user engagement, as well as being appropriately resourced and prioritised against competing military demands. This approach could have utility for understanding injury risk and mitigation in non-military physically demanding occupations including uniformed services and first responders.

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Identifiers

ORCID for Maria Stokes: orcid.org/0000-0002-4204-0890

ORCID for Martin Warner: orcid.org/0000-0002-1483-0561

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