Page 141 - Journal of Special Operations Medicine - Winter 2014

An Ongoing Series

Injuries and Injury Prevention During Foot Marching

Joseph J. Knapik, ScD

ABSTRACT
Since the beginning of recorded history, Soldiers have Figure 1 Loads carried by Soldiers on the march throughout
carried arms and equipment on their bodies. More re- history.
cently, loads have substantially increased, driven by
improvements in weapons technology and personal pro-
tection. As Soldier loads increase, there are increases in
energy cost, altered gait mechanics, increased stress on
the musculoskeletal system, and more rapid fatigue, fac-
tors that may increase the risk of injury. Common injuries
and symptoms experienced by Soldiers on load-carriage
missions include foot blisters, metatarsalgia, knee prob-
lems, and back problems. This article discusses these
problems, providing diagnoses, injury mechanisms, and
preventive measures. In general, lighter loads, improving
load distribution, using appropriate physical training,
selecting proper equipment, and using specific preven-
tion techniques will facilitate load carriage and provide
Special Operations Forces with a higher probability of
mission success.

Keywords: load-carriage, foot blisters, knee injuries Soldiers can now carry weapon systems that can dis-
able and/or destroy aircraft and armored vehicles, while
developments in body armor have provided enhanced
individual protection from hostile fire.
Introduction
In military operations dating back to the beginning of Loads carried on the body have been shown to in-
recorded history, Soldiers have been required to carry crease energy cost, alter the mechanics of walking, place
arms and equipment on their bodies. Before the 18th stresses on the musculoskeletal system, and lead to more
century, Soldier loads seldom exceeded 30 lb while on rapid fatigue. These and other factors may be associ-
unopposed marches, but in more recent history, loads ated with high risk for injury. This article will point out
that Soldiers carry on foot marches have progressively the most common injuries associated with load carriage
increased, as shown in Figure 1. During US military op- during foot marches and provide suggestions for reduc-
1
erations in Afghanistan, infantry Soldiers carried an av- ing the likelihood of these injuries.
erage load of 101 lb, although different positions within
the unit carried loads ranging between 87 and 127 lb.
2
The increase in Soldier loads over time are likely due Types of Load-Carriage Injuries
to new technologies that have increased the lethality of Table 1 shows injuries and symptoms experienced by
the individual Soldier, while at the same time increas- Soldiers during military load-carriage missions. Study
ing the Soldier’s survivability. Compared to their histori- 1 followed 335 male US infantry Soldiers who car-
cal counterparts in wars over 100 years ago, infantry ried about 101 lb during a maximal effort 20-km road

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