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Objective: To investigate injury risk associated with occupation and occupational physical demand levels among U.S. Army Soldiers. Study design: Retrospective cohort study. Methods: Personal characteristics, physical fitness, military occupational specialty (MOS), and injury data were obtained by survey from Soldiers in an Army light infantry brigade (n = 2101). Odds ratios (OR) and 95% confidence intervals (95% CI) from a multivariate analysis assessing injury risk were calculated. Results: Injury incidence for the prior 12 months was 43%. Physical fitness and behavioral factors associated with injury risk included age 21-29 (OR [age 21-29/age ≤ 20] = 1.37, 95% CI 1.00-1.90), BMI 27.5-29.9 (high-overweight) (OR high-overweight/normal = 1.62, 95% CI 1.20-2.18); BMI >29.9 (obese) (OR obese/normal = 1.73, 95% CI 1.23-2.44), cigarette smoking (OR Smoker/Nonsmoker = 1.34, 95% CI 1.11-1.63), and poor APFT two mile run performance (OR (Q4/Q1) = 1.61, 95% CI 1.19-2.19). Higher risk of injury was associated with some MOSs (OR (Chemical, Explosives & Ammunition/Infantry) = 2.82, 95% CI 1.19-6.68; OR (Armor/Infantry) = 1.53, 95% CI 1.13-2.07). Conclusion: This study identified a number of potentially modifiable risk factors for injuries including: maintenance of healthy weight, improved aerobic endurance, and reduction in smoking. Results also indicate certain Army occupations may be at higher risk of injury. Further investigation into reasons for their higher risk is warranted. [ABSTRACT FROM AUTHOR]

Objective: This study examined risk factors for self-reported injury incurred before arrival at Ordnance School for advanced individual training (AIT). Study design: During AIT in-processing, soldiers (n = 27,289 men and 3856 women) completed a questionnaire that collected demographic and lifestyle information, and asked if the soldier currently had an injury that would affect their AIT performance. Methods: Potential risk factors for self-reported injury were explored using logistic regression. Results: For men, self-reported injury was associated with older age [odds ratio (OR) ≥ 30 years/17-19 years = 1.9], race (OR Black/Caucasian = 1.2), basic combat training (BCT) site (OR Fort Benning/Fort Jackson = 1.7; OR Fort Leonard Wood/Fort Jackson = 1.6, OR Fort Knox/Fort Jackson = 1.3), smoking on 20 or more days in the 30 days prior to BCT (OR smoker/non-smoker = 1.2) and current illness (OR ill/not ill = 6.2). For women, increased self-reported injury was associated with older age (OR ≥ 30 years/17-19 years = 2.0), BCT site (OR Fort Leonard Wood/Fort Jackson = 1.5) and current illness (OR ill/not ill = 5.8). Conclusions: Certain demographic characteristics and lifestyle behaviours may be identified as injury risk factors on arrival at Ordnance AIT. [ABSTRACT FROM AUTHOR]

Abstract: Grier, T, Benedict, T, Mahlmann, O, and Canham-Chervak, M. Relative Strength and Physical Performance in U.S. Army Male and Female Soldiers. J Strength Cond Res 38(8): 1479-1485, 2024-In occupations with high physical demands, strength relative to bodymass is an important measure as it signifies an individual's ability to control and move their body mass through space. The purpose of this investigation was to examine physical characteristics, training, and performance based on different magnitudes of relative strength. Subjects were 1,806 male and 319 female US Army soldiers. Sex, age, height, body mass, and physical training data were obtained by an electronic survey. Physical performance was measured by the Army Combat Fitness Test (ACFT), which includes a three-repetition maximum deadlift, standing power throw, hand release push-up, sprint-drag-carry, leg tuck, and two-mile run. The relative body mass deadlifted was calculated and categorized into 4 groups for men and 3 groups for women. An analysis of variance and post hoc least significant difference test were used to evaluate the differences in relative strength and physical performance. Overall, 33% of men deadlifted ≥1.5 times their body mass, while 30% of women deadlifted ≥1.25 times their body mass. Men and women deadlifting the highest percentage of their body mass (≥1.5 times for men and ≥1.25 times for women) outperformed those with lower relative strength within their own sex in all 6 ACFT events. In 4 of the 6 ACFT events, women who deadlifted ≥1.25 times their body mass had similar performance compared with men deadlifting 1 to 1.24 times their body mass and outperformed men deadlifting <1 times their body mass. Greater strength relative to body mass was associated with higher physical performance., (Copyright © 2024 National Strength and Conditioning Association.)

Purpose: In physically demanding occupations or athletic populations, sleep has been shown to be an important factor for both performance and recovery. However, evidence is limited on sleep duration and its association with musculoskeletal injury risk in physically active populations. Therefore, the purpose of this analysis was to evaluate the relationship between sleep duration and musculoskeletal injury incidence in a population of physically active men and women., Methods: Data were collected via electronic survey and analyzed for 7,576 soldiers from the United States Army Special Operations Command., Results: This population was mostly men (95%) ≤ 35 years old (70%). The incidence of musculoskeletal injury was 53% over the twelve months before survey administration. After adjusting for other covariates, soldiers who slept ≤ 4 hours were 2.35 (95% CI: 1.89-2.93, p <0.01) times more likely to experience a musculoskeletal injury compared with those who slept eight ≥ 8 hours. When stratified by age (≤ 35 years, > 35 years), older men were found to have significantly higher risk of a musculoskeletal injury than their younger counterparts across all sleep duration groups., Conclusions: These findings suggest that sleep duration may be inversely related to risk of musculoskeletal injury. It is possible that interventions targeted at sleep may have a positive impact on prevention of musculoskeletal injuries within physically active populations., (Copyright © 2020 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.)

There is limited literature concerning the types of injuries that military working dogs (MWDs) face while in a deployed theater of operations and associated risk factors. To summarize injuries and identify injury risk factors in MWDs during their first deployments to Iraq, demographic and medical data were collected for 794 MWDs from the U.S. Army, Air Force, Navy, and Marine Corps that deployed to Iraq between March 20, 2003 and December 31, 2007. Sixty-two percent (n = 490) had a medical encounter during deployment. Injuries were categorized as traumatic or musculoskeletal. MWD demographics, characteristics, and injury types were summarized. Injury risk factors were assessed using multivariable logistic regression. A majority of the population were German Shepherds (56 %), intact males (49 %), and dogs certified in both patrol and explosives detection (73 %). During their first deployment to Iraq, 20 % (n = 156) experienced an injury. Risk factors included breed, age, and occupational certification. Belgian Malinois and Labrador Retriever dogs had greater odds of injury compared to German Shepherds (p = 0.04 and p = 0.02) and the oldest MWDs had about a 50 % higher risk of injury compared to the youngest (p = 0.01), especially for musculoskeletal injuries. MWDs with Specialized Search certification were at increased injury risk (p = 0.02). Training, equipment, and supplies for veterinary service personnel, MWD handlers, and MWDs should be tailored with consideration of the injury risks of the MWD population. Further study is needed to investigate chronic injuries in military working dogs to better understand causation and prevention., (Published by Elsevier B.V.)

Background: Prior studies have identified cigarette smoking and low fitness as independent risk factors for injury; however, no studies have evaluated the combined effect of cigarette smoking and fitness on injury risk., Objective: To evaluate the combined effect of cigarette smoking and fitness on injury risk in men and women., Design: This is a secondary analysis of data collected from US Army recruits (n = 2000) during basic combat training within the United States in 2007. Physical training and fitness, cigarette smoking, and prior injury data were obtained from questionnaires, whereas demographic and injury data were obtained from medical and basic combat training unit records. Chi-squared tests were used to assess differences in injury risk by fitness level and cigarette smoking. Relative risk values were calculated with 95% confidence intervals., Results: The primary findings showed that smokers experienced 20%-30% higher risk of injury than nonsmokers. In addition, higher aerobic and muscular fitness was generally not protective against injury between least fit and more fit smokers. However, higher fitness was protective against injury between least and more fit nonsmokers, with least fit nonsmokers being 30%-50% more likely to experience an injury than fit nonsmokers., Conclusion: This study revealed that higher aerobic and muscular fitness was not protective against injury among smokers; however, it was protective against injury among nonsmokers. Further implementation of smoking cessation programs may be beneficial for military and civilian personnel who are required to be physically fit in order to carry out their job responsibilities., Implications: Male and female smokers experienced significantly higher risk of injury than nonsmokers. Although higher fitness is protective against injury in nonsmokers, the protective effect of fitness is lost among smokers. In an attempt to reduce injury risk among military and emergency personnel, smoking cessation programs should be further implemented among both more fit and less fit smokers., (© The Author(s) 2018. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objectives: The objectives of the study are to quantify the proportion of cumulative microtraumatic overuse injuries in a physically active population, evaluate their impact in terms of lost work time, and link them to precipitating activities to inform prevention initiatives., Study Design: The study design is retrospective cohort study., Methods: For a population of U.S. Army Soldiers, diagnoses from medical records (International Classification of Diseases [ICD]-9 800-999 and selected ICD-9 710-739) were matched with self-reported injury information. Common diagnoses, limited duty days, and activities and mechanisms associated with the injuries were summarized., Results: Most self-reported injuries (65%) were classified by providers with diagnoses that described cumulative microtraumatic tissue damage, and these injuries led to a higher incidence of limited duty (85%) than acute traumatic injury diagnoses. Reported mechanisms and activities often indicated repetitive physical training-related onset., Conclusions: Because many diagnoses for cumulative microtraumatic musculoskeletal tissue damage are categorized as diseases to the musculoskeletal system in the International Classification of Diseases, they are often not included in definitions of injury. However, reported injury activities and mechanisms in this population provide evidence that cumulative microtraumatic injuries often arise from identifiable and preventable events. This finding confirms that these diagnoses should be classified as injuries in epidemiologic evaluations and surveillance to accurately represent injury burden., (Published by Elsevier Ltd.)

This investigation aimed to identify risk factors for lower extremity sprain/strain injuries in physically active men. Lower extremity (LE) sprain/strain injuries are a significant source of morbidity among physically active populations. Data on and risk factors for injuries, including personal characteristics, and physical training and fitness were obtained from male Soldiers in an operational US Army division (N=6,865) by survey. Injury risks, risk ratios (RR), odds ratios (OR), and 95% confidence intervals (95% CI) were calculated. Multivariate analysis utilized logistic regression. Self-reported injury incidence for the prior 12 months was 43% (n=2,939), with 30% (n=878) of injuries attributed to LE sprains/strains. Lower extremity sprain/strain injuries were most commonly caused by falls, jumps, trips, or slips (49.4%), occurred while running (30.6%), and often resulted in limited duty profiles (64%). Higher risk of LE sprain/strain injury was independently associated with higher body mass index (ORoverweight/normal=1.2, 95% CI: 1.0-1.5), (ORobese/normal=1.4, 95% CI: 1.1-1.9), lower aerobic endurance (from 2-mile run time) (ORQuartile 2 (Q2)/Quartile 4 (Q4)=1.4, 95% CI: 1.0-1.8), (ORQuartile 1 (Q1)/Q4=1.6, 95% CI: 1.3-2.1), and lower core strength (sit-up repetitions) (ORQ1/Q4=1.4, 95% CI: 1.1-1.8). Lower risk of LE sprain/strain injury was associated with performing unit resistance training 3 or more times per week (OR3 times/none=0.5, 95% CI: 0.3-0.8). LE sprain/strain injuries contribute a significant portion of injuries among US Army Soldiers. Emphasis on aerobic fitness, core strength, and resistance training may help reduce the risk of LE sprain/strain injury among physically active men.

Introduction: In basic combat training, women experience twice as many injuries as men; however, evidence at the operational Army level is limited. This study aims to investigate the association between gender and injury likelihood while controlling for certain confounding factors in the operational Army., Methods: Data were analyzed in 2015 from a cross-sectional study utilizing data from a 2010-2011 survey of light infantry Army Soldiers. Gender, age, body fat, tobacco use, Army Physical Fitness Test (2-mile run, push-ups, and sit-ups), occupational physical demand, and injury data were obtained via paper survey. ORs and 95% CIs from a multivariable analysis were calculated., Results: Surveys were completed by 4,384 male and 363 female Soldiers. Injury incidence was 42% for men and 53% for women. After adjusting for the aforementioned variables, injury likelihood was higher in Soldiers aged ≥27 years (OR [age 27-29/22-26 years]=1.26, 95% CI=1.07, 1.48; OR [age ≥30/22-26 years]=1.28, 95% CI=1.08, 1.51), Soldiers with body fat ≥23.38% (OR [body fat ≥23.38%/≤19.28%]=1.30, 95% CI=1.08, 1.57), and Soldiers with the slowest 2-mile run times (OR [≥15.68/≤14.13 minutes]=1.53, 95% CI=1.26, 1.85). Women were no more likely than men to sustain an injury., Conclusions: When accounting for age, body fat, physical performance, and occupational physical demand, there was no gender difference in the likelihood of injury among Soldiers. Although women, on average, have lower aerobic and muscular performance than men, results suggest men and women of similar physical performance experience similar injury likelihood., (Copyright © 2016. Published by Elsevier Inc.)

Many epidemiological studies rely on valid physical fitness data. The purpose of this investigation was to assess the validity of self-reported Army Physical Fitness Test (APFT) data and determine whether men and women recall APFT performance differently. U.S. Army soldiers (N = 1,047) completed a survey, including questions on height, weight, and most recent APFT performance. Height, weight, and APFT performance were also obtained from unit records. The mean ± SDs for unit and self-reported push-up repetitions were 63.5 ± 13.1 and 66.3 ± 14.0 for men and 37.7 ± 12.8 and 40.2 ± 12.8 for women, respectively. The mean ± SD for unit- and self-reported sit-up repetitions were 66.3 ± 11.4 and 68.1 ± 12.1 for men and 64.2 ± 13.6 and 66.5 ± 12.9 for women, respectively. The mean ± SD unit- and self-reported 2-mile run times were 15.2 ± 1.8 and 14.9 ± 1.6 minutes for men, and 18.0 ± 2.9 and 17.4 ± 1.9 minutes for women, respectively. Unit- and self-reported body mass indices (BMIs) (calculated by height and weight) were 26.4 ± 3.4 and 26.3 ± 3.6 for men and 24.6 ± 2.8 and 24.2 ± 3.3 for women. Correlations between unit- and self-reported scores for push-ups, sit-ups, 2-mile run, height, weight, and BMI were 0.82, 0.78, 0.85, 0.87, 0.97, and 0.88 for men and 0.86, 0.84, 0.87, 0.78, 0.98, and 0.78 for women, respectively. On average, men and women slightly overreported performance on the APFT and overestimated height, resulting in underestimated BMI. There was no difference in recall ability between men and women (p > 0.05). The very good to excellent correlations (r = 0.78-0.98) between unit- and self-reported scores indicate that self-reported data are valid for capturing physical fitness performance in this population.

This article traces the history of the athletic shoe, examines whether selecting running shoes based on foot arch height influences injuries, and examines historical data on injury rates when physical training (PT) is performed in boots versus running shoes. In the 1980s and into the 2000s, running shoe companies were advertising specialized shoes with "motion control," "stability," and "cushioning," designed for individuals with low, normal, and high arches, respectively. Despite marketing claims that these shoes would reduce injury rates, coordinated studies in Army, Air Force, and Marine Corps basic training showed that assigning or selecting shoes on this basis had no effect on injury rates. Consistent with this finding, biomechanical studies have shown that the relationships between arch height, foot joint mobility, and rear-foot motion are complex, variable, and frequently not as strong as often assumed. In 1982, the US Army switched from PT in boots to PT in running shoes because of the belief that boots were causing injuries and that running shoes would reduce injury rates. However, a historical comparison of injury rates before and after the switch to running shoes showed virtually no difference in injury risk between the two periods. It is not clear at this point if the type of footwear effects injury incidence., (2015.)

Purpose: To investigate changes in physical training (PT), fitness, and injury during deployment and identify differences between men and women., Methods: Data were collected on male and female US Army Soldiers through self-reported surveys completed before and after deployment to Afghanistan. Changes in physical training activities, physical fitness, injury incidence, BMI, and smoking status were analyzed. Descriptive statistics were used to compare before deployment and deployment results and differences between men and women., Results: Surveys were completed by 727 men and 43 women. The percentage of Soldiers engaging in unit PT running of 5 miles or more per week decreased by almost half for men and women. The percentage of Soldiers doing personal PT running of 5 miles or more per week and engaged in resistance training 3 or more days per week more than doubled for men and women during deployment. Cardiorespiratory endurance for women improved by 50 seconds (P=.06) and for men declined by 29 seconds (P<.01), while muscular endurance increased by 0.6 repetitions (P<.01) during deployment. Injury rates for men decreased, on average, 36.2 to 19.0 injuries per 1,000 Soldiers per month (P=.01). Injury rates for women decreased on average from 42.6 to 14.0 injuries per 1,000 Soldiers per month (P=.02). During deployment, BMI did not change for men or women and smoking increased 19% for men (P<.01), but did not increase for women., Conclusion: Comparisons of physical training activities and health behavior among men and women before and during deployment suggests that increased resistance training could be recommended for women and smoking cessation for men. Given the potentially important role of personal PT in maintaining physical fitness in the deployment environment, future work should support provision of the necessary environment and equipment for Soldiers to perform personal PT effectively and safely on their own. Further, the physical training gaps between men and women should be addressed, with suggestions regarding where improvements can be made, especially for women interested in seeking combat positions with high physical demands.

Musculoskeletal injuries (MSIs) result in the most medical encounters, lost duty days, and permanent disability. Women are at greater risk of injury than men and physical training is the leading cause of injury. The purpose of this study was to investigate the demographic, body composition, fitness, and physical training risk factors for injuries in female Soldiers serving in garrison Army units over the past 12 months. Self-report survey was collected from 625 women. The ankle was the most frequently injured body region, 13%. Running was the activity most often associated with injury, 34%. In univariate analysis lower rank, older age, history of deployment, no unit runs, weekly frequency of personal resistance training, and history of injury were all associated with injury. In multivariate analysis rank, history of injury, weekly frequency of unit runs, and weekly frequency of personal resistance training were the best combination of predictors of injury. Running once or twice a week with the unit protected against MSIs, whereas participating in personal resistance training sessions once or twice a week increased the risk of MSIs. With more emphasis on running and resistance training, the U.S. Army could reduce injuries and save billions of dollars in training and health care costs., (Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.)

Context: Brigades and battalions throughout the US Army are currently implementing a variety of exercise and conditioning programs with greater focus on preparation for mission-specific tasks. An Army physical therapy clinic working with a light infantry brigade developed the Advanced Tactical Athlete Conditioning (ATAC) program. The ATAC program is a unique physical training program consisting of high-intensity aquatic exercises, tactical agility circuits, combat core conditioning, and interval speed training. Along with ATAC, battalions have also incorporated components of fitness programs such as the Ranger Athlete Warrior program and CrossFit (Crossfit, Inc, Santa Monica, CA) an extreme conditioning program (ECP)., Objective: To determine if these new programs (ATAC, ECP) had an effect on injury rates and physical fitness., Design: Surveys were administered to collect personal characteristics, tobacco use, personal physical fitness training, Army physical fitness test results, and self-reported injuries. Medical record injury data were obtained 6 months before and 6 months after the implementation of the new program. Predictors of injury risk were assessed using multivariate logistic regression. Odds ratios (OR) and 95% confidence intervals (CI) were reported., Results: Injury incidence among Soldiers increased 12% for overall injuries and 16% for overuse injuries after the implementation of the ATAC/ECPs. However, injury incidence among Soldiers not participating in ATAC/ECPs also increased 14% for overall injuries and 10% for overuse injuries. Risk factors associated with higher injury risk for Soldiers participating in ATAC/ECPs included: greater mileage run per week during unit physical training (OR (>16 miles per week÷≤7 miles per week)=2.24, 95% CI, 1.33-3.80); higher body mass index (BMI) (OR (BMI 25-29.9÷BMI<25)=1.77, 95% CI, 1.29-2.44), (OR (BMI =30÷BMI<25)=2.72, 95% CI, 1.67-4.43); cigarette use (OR (smoker÷nonsmoker)=1.80, 95% CI, 1.34-2.42); poor performance on the 2-mile run during the Army Physical Fitness Test (APFT) (OR (=15.51 minutes÷≤13.52 minutes)=1.76, 95% CI, 1.13-2.74); Injury risk was lower for those reporting resistance training, (OR (<1 time per week÷none)=0.53, 95% CI, 0.31-0.92), (OR (1-2 times per week÷none)=0.50, 95% CI, 0.29-0.84), (OR (≥3 times per week÷none)=0.45, 95% CI, 0.24-0.85)., Conclusions: Given that Soldiers participating in ATAC/ECPs showed similar changes in injury rates compared to Soldiers not participating in ATAC/ECPs, no recommendation can be made for or against implementation of ATAC/ECPs.

This study examined demographic and physical risk factors for stress fractures in a large cohort of basic trainees. New recruits participating in US Army BCT from 1997 through 2007 were identified, and birth year, race/ethnicity, physical characteristics, body mass index, and injuries were obtained from electronic databases. Injury cases were recruits medically diagnosed with inpatient or outpatient stress fractures. There were 475 745 men and 107 906 women. Stress fractures incidences were 19.3 and 79.9 cases/1 000 recruits for men and women, respectively. Factors that increased stress fracture risk for both men and women included older age, lower body weight, lower BMI, and race/ethnicity other than black. Compared to Asians, those of white race/ethnicity were at higher stress fractures risk. In addition, men, but not women, who were taller or heavier were at increased stress fracture risk. Stress fracture risk generally increased with age (17-35 year range) at a rate of 2.2 and 3.9 cases/1 000 recruits per year for men and women, respectively. This was the largest sample of military recruits ever examined for stress fractures and found that stress fracture risk was elevated among recruits who were female, older, had lower body weight, had lower BMI, and/or were not of black race/ethnicity., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: A one-year prospective examination of injury rates and injury risk factors was conducted in Federal Bureau of Investigation (FBI) new agent training., Methods: Injury incidents were obtained from medical records and injury compensation forms. Potential injury risk factors were acquired from a lifestyle questionnaire and existing data at the FBI Academy., Results: A total of 426 men and 105 women participated in the project. Thirty-five percent of men and 42% of women experienced one or more injuries during training. The injury incidence rate was 2.5 and 3.2 injuries/1,000 person-days for men and women, respectively (risk ratio (women/men) = 1.3, 95% confidence interval = 0.9-1.7). The activities most commonly associated with injuries (% of total) were defensive tactics training (58%), physical fitness training (20%), physical fitness testing (5%), and firearms training (3%). Among the men, higher injury risk was associated with older age, slower 300-meter sprint time, slower 1.5-mile run time, lower total points on the physical fitness test (PFT), lower self-rated physical activity, lower frequency of aerobic exercise, a prior upper or lower limb injury, and prior foot or knee pain that limited activity. Among the women higher injury risk was associated with slower 300-meter sprint time, slower 1.5-mile run time, lower total points on the PFT, and prior back pain that limited activity., Conclusion: The results of this investigation supported those of a previous retrospective investigation emphasizing that lower fitness and self-reported pain limiting activity were associated with higher injury risk among FBI new agents.

Introduction: This investigation examined risk factors for injuries during military parachute training and solicited attitudes and opinions regarding a parachute ankle brace (PAB) that has been shown to protect against ankle injuries., Methods: Male Army airborne students (N = 1677) completed a questionnaire after they had successfully executed 4 of the 5 jumps necessary for qualification as a military paratrooper. The questionnaire asked about injuries during parachute descents, demographics, lifestyle characteristics, physical characteristics, physical fitness, airborne recycling (i.e., repeating airborne training because of failure to qualify on a previous attempt), PAB wear, problems with aircraft exits, and injuries in the year before airborne school. A final section of the questionnaire solicited open-ended comments about the PAB., Results: Increased risk of a parachute-related injury occurred among students who had longer time in service, were older, taller, heavier, performed fewer push-ups, ran slower, were airborne recycles, did not wear the PAB, had an aircraft exit problem, and/or reported an injury in the year prior to jump school. Among students who wore the brace, most negative comments about the PAB had to do with design, comfort, and difficulties during parachute landing falls., Conclusions: This study supported some previously identified injury risk factors (older age, greater body weight, and not using a PAB) and identified a number of new risk factors. To address PAB design and comfort issues, a strap is being added over the dorsum of the foot to better hold the PAB in place.

Background: This project documented injuries in the professional musical performers of the US Army Band and used a multivariate approach to determine injury risk factors., Methods: Injuries were obtained from a medical surveillance database. Administrative records from the Band provided fitness test scores, physical characteristics, performing unit (Blues, Ceremonial, Chorale, Chorus, Concert, Strings), and functional group (strings, winds, keyboard, vocal, percussion, brass). A questionnaire completed by 95% of the Band (n=205) included queries on practice time, physical activity, tobacco use, and medical care., Results: One or more injuries were diagnosed in 44 and 53% of Band members in the years 2004 and 2005, respectively. In univariate analysis, higher injury risk was associated with higher body mass index (BMI), less physical activity, prior injury, unit, functional group, and practice duration. In multivariate analysis, less self-rated physical activity, a prior injury, and functional group were independent risk factors., Conclusion: In the US Army Band, about half the performers had a medical visit for an injury in a 1-year period and injury risk was associated with identifiable factors.