Load Carriage-Related Injury Mechanisms, Risk Factors, and Prevention

Since the beginning of recorded history, soldiers have been required to carry arms and equipment on their bodies. Recently, the weight of these loads has substantially increased due to improvements in weapons and personal protection. As soldier loads increase there are increases in energy cost, altered gait mechanics, increased stress on the musculoskeletal system, and more rapid fatigue, factors that may increase the risk of injury. Passive surveillance of injuries experienced by soldiers on load carriage missions and surveys of hikers and backpackers indicate that foot blisters, stress fractures, compression-related paresthesias (brachial plexus palsy, meralgia paresthetica, digitalgia paresthetica), metatarsalgia, knee problems, and back problems are among the most common load carriage-related maladies. This article discussed these injuries providing incidences, rates, symptoms, mechanisms, and risk factors, and provides evidence-based preventative measures to reduce injury risk. In general, lighter loads, improving load distribution, using appropriate physical training, selecting proper equipment, and using specific techniques directed at injury prevention will facilitate load carriage. An understanding of injury mechanisms and implementation of appropriate prevention strategies will provide service members a higher probability of mission success.