Injuries Following Implementation of a Progressive Load Carriage Program in United States Marine Corps Training

Rob Marc Orr, B Niederberger, A Givens, J Bernards, Karen Kelly

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PURPOSE: The overall physical demands placed on recruits completing United States Marine Corps (USMC) training is high and comes concomitantly with high rates of injuries. Load carriage with heavy loads is of particular concern. However, load carriage conditioning, if optimised, can reduce injury risk.

METHODS: Retrospective injury data of recruits completing training informed this study. Data were drawn from recruits completing an original load carriage (OLC) program (n=2,363) and those completing a modified load carriage (LCMOD) program (n=681). Musculoskeletal injury data were drawn from the USMC San Diego sports medicine injury database. A population estimate of the OLC:LCMOD relative risk ratio (RR) was calculated.

RESULTS: The proportion of injuries sustained by the LCMOD cohort (n=268; 39%) was notably lower than that sustained by the OLC cohort (n=1,372; 58%). The reoccurrence rate *f injury for LCMOD soldiers compared to the OLC was 0.68 (95% CI 0.61 to 0.75). The leading nature of injury (i.e., sprains and strains) was consistent between both cohorts (OLC: n=396; 29% vs. LCMOD: n=66; 25%). Inflammation (n=172; 13%) and fractures (n=144; 11%) were next most common for OLC recruits; while pain (n=58; 22%) and medial tibial stress syndrome (n=18; 8%) were next most common for LCMOD recruits. While stress reactions were proportionally higher in LCMOD (n=17; 6%) when compared to OLC (n=4; 0.3%), stress fractures were proportionality lower (LCMOD: n=9; 3% vs. OLC: n=114; 8%). Pre-existing / chronic injuries were higher in LCMOD (+5%) while new overuse injuries were lower (-7%). Totalling 65% (OLC) and 70% (LCMOD) of reported injuries the knee, lower leg, ankle, and foot were the top 4 bodily sites of injuries, although there were variations in the orders of presentations (See Table 1 for top 10 bodily sites).

RELEVANCE: Careful periodisation and planning of a load carriage program can reduce injuries without reducing training outcomes.
Original languageEnglish
Number of pages2
Publication statusPublished - 26 Feb 2023
Event4th International Physical Employment Standards Conference - Bond University, Robina, Australia
Duration: 23 Feb 202326 Feb 2023


Conference4th International Physical Employment Standards Conference
Abbreviated titleIPES
OtherHosted by the Bond University Tactical Research Unit the conference will address the three T's essential to supporting physical performance in physically demanding occupations; Theory, Testing and Training. Specific topics will include physical employment standards, identifying and mitigating injury risk factors, physical conditioning and assessing occupational readiness.

The conference content will be a blend of research and applied practice in a range of physically demanding occupations including military, law enforcement, fire and rescue and first responders.
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