Risk factors for training-related injuries among men and women in basic combat training

Purpose: Past investigations indicate that training-related injuries are as sociated with certain performance-oriented measures of physical fitness and certain lifestyle characteristics. This study examined associations betwee n injuries, direct (physiological) measures of physical fitness, and lifest yle characteristics. Methods: Subjects were 756 men and 474 women performin g the standardized activities involved in U.S. Army Basic Combat Training ( BCT). Before BCT, a subsample of subjects (182 men and 168 women) were admi nistered a series of rests that included a treadmill running test (peak (V) over dotO(2)), dual-energy x-ray absorptiometry (for body composition), sev eral measures of muscle strength, a hamstring flexibility test, and a verti cal jump. A questionnaire addressed smoking habits and prior physical activ ity. All subjects were administered the Army Physical Fitness test consisti ng of push-ups, sit-ups, and a 3.2-km run. Gender, age, stature, and body m ass were obtained from physical examination records. Injuries incurred duri ng BCT were transcribed from medical records; for each medical visit, the d iagnosis, anatomical location, disposition (final outcome of visit), and da ys of limited duty were recorded. Results: Women had over twice the injury rate of men. For men and women, fewer push-ups, slower 3.2-km run times, lo wer peak (V)over dotO(2) and cigarette smoking were risk factors for time-l oss injury. Among the men only, lower levels of physical activity before BC T and both high and low levels of flexibility were also time-loss injury ri sk factors. Multivariate analysis revealed that lower peak (V)over dotO(2) and cigarette smoking were independent risk factors for time-loss injury. C onclusions: Lower aerobic capacity and cigarette smoking were independently associated with a higher likelihood of injury in both men and women during a standardized program of physical training. Further studies are needed to assess associations between injury and body composition and muscular stren gth.