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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 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.

Abstract Background A retrospective examination was conducted of injuries, physical fitness, and their association among Federal Bureau of Investigation (FBI) new agent trainees. Methods Injuries and activities associated with injuries were obtained from a review of medical records in the medical clinic that served the new agents. A physical fitness test (PFT) was administered at Weeks 1, 7 and 14 of the 17-week new agent training course. The PFT consisted of push-ups, sit-ups, pull-ups, a 300-meter sprint, and a 1.5-mile run. Injury data were available from 2000 to 2008 and fitness data were available from 2004 to early 2009. Results During the survey period, 37% of men and 44% of women experienced one or more injuries during the new agent training course (risk ratio (women/men) = 1.18, 95% confidence interval = 1.07-1.31). The most common injury diagnoses were musculoskeletal pain (not otherwise specified) (27%), strains (11%), sprains (10%), contusions (9%), and abrasions/lacerations (9%). Activities associated with injury included defensive tactics training (48%), physical fitness training (26%), physical fitness testing (6%), and firearms training (6%). Over a 6-year period, there was little difference in performance of push-ups, sit-ups, pull-ups, or the 300-meter sprint; 1.5-mile run performance was higher in recent years. Among both men and women, higher injury incidence was associated with lower performance on any of the physical fitness measures. Conclusion This investigation documented injury diagnoses, activities associated with injury, and changes in physical fitness, and demonstrated that higher levels of physical fitness were associated with lower injury risk.

Abstract Background This paper reports on a systematic review of the literature on the post-conflict injury-related mortality of service members who deployed to conflict zones. Methods Literature databases, reference lists of articles, agencies, investigators, and other sources were examined to find studies comparing injury-related mortality of military veterans who had served in conflict zones with that of contemporary veterans who had not served in conflict zones. Injury-related mortality was defined as a cause of death indicated by International Classification of Diseases E-codes E800 to E999 (external causes) or subgroupings within this range of codes. Results Twenty studies met the review criteria; all involved veterans serving during either the Vietnam or Persian Gulf conflict. Meta-analysis indicated that, compared with non-conflict-zone veterans, injury-related mortality was elevated for veterans serving in Vietnam (summary mortality rate ratio (SMRR) = 1.26, 95% confidence interval (95%CI) = 1.08–1.46) during 9 to 18 years of follow-up. Similarly, injury-related mortality was elevated for veterans serving in the Persian Gulf War (SMRR = 1.26, 95%CI = 1.16–1.37) during 3 to 8 years of follow-up. Much of the excess mortality among conflict-zone veterans was associated with motor vehicle events. The excess mortality decreased over time. Hypotheses to account for the excess mortality in conflict-zone veterans included post-traumatic stress, coping behaviors such as substance abuse, ill-defined diseases and symptoms, lower survivability in injury events due to conflict-zone comorbidities, altered perceptions of risk, and/or selection processes leading to the deployment of individuals who were risk-takers. Conclusion Further research on the etiology of the excess mortality in conflict-zone veterans is warranted to develop appropriate interventions.

Abstract Background Avoidance of allergens is still recommended as the first and best way to prevent allergic illnesses and their comorbid diseases. Despite a variety of attempts there has been very limited success in the area of environmental control of allergic disease. Our objective was to identify a non-invasive, non-pharmacological method to reduce indoor allergen loads in atopic persons' homes and public environments. We employed a novel in vivo approach to examine the possibility of using aluminum sulfate to control environmental allergens. Methods Fifty skin test reactive patients were simultaneously skin tested with conventional test materials and the actions of the protein/glycoprotein modifier, aluminum sulfate. Common allergens, dog, cat, dust mite, Alternaria, and cockroach were used in the study. Results Skin test reactivity was significantly reduced by the modifier aluminum sulfate. Our studies demonstrate that the effects of histamine were not affected by the presence of aluminum sulfate. In fact, skin test reactivity was reduced independent of whether aluminum sulfate was present in the allergen test material or removed prior to testing, indicating that the allergens had in some way been inactivated. Conclusion Aluminum sulfate was found to reduce the in vivo allergic reaction cascade induced by skin testing with common allergens. The exact mechanism is not clear but appears to involve the alteration of IgE-binding epitopes on the allergen. Our results indicate that it may be possible to diminish the allergenicity of an environment by application of the active agent aluminum sulfate, thus producing environmental control without complete removal of the allergen.

Purpose of Review: Legacy lead exposures persist as a widespread problem. Blood lead is traditionally used for lead exposure surveillance; however, bone lead proves to be a cheaper, more accessible, and more revealing tool for surveillance that can be measured using portable x-ray fluorescence techniques. We outline how this approach excels for bone lead measurements., Recent Findings: Portable XRF offers quick, non-invasive in vivo quantification of bone lead. Compared to traditional KXRF systems, pXRF is limited to cortical bone but allows for quicker and similar results. Current methodologies of lead exposure need re-evaluation as lead-related disease burden and trends are dependent on both cumulative and acute impacts. We examined the evolution of XRF techniques for measuring bone lead, comparing current methods with previous ones. We assessed their accuracy, identified limitations, and discussed potential advances in future techniques. Legacy lead exposures call for a revitalization of lead surveillance methods, and pXRF measurement of bone lead offers such a solution., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

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.)

Objectives: Only one-third of U.S. Army Soldiers meet the recommended sleep guideline of 7 or more hours per night. Soldiers meeting the recommended sleep guideline are more likely to perform better on cognitive and physical tasks. The purpose of this analysis was to compare the physical and behavioral characteristics of Soldiers who met and did not meet the sleep recommendation guideline and determine associations between physical and behavioral characteristics and the acquisition of recommended amounts of sleep per night., Methods: A survey was administered to U.S. Army Soldiers. Adjusted odds ratios and corresponding 95% confidence intervals were calculated to determine associations between achieving the recommended number of hours of sleep per night and age, physical characteristics, health behaviors, physical training, and physical performance., Results: A survey was completed by 4229 men and 969 women. Male Soldiers who met the recommended sleep requirement had lower estimated body fat [20.3 ± 4.2% vs. 21.1 ± 4.4%], were less likely to use tobacco [11.5% vs. 16.2%] and exercised more [259 ± 226 vs. 244 ± 224 min/wk] compared with those who did not obtain 7 hours of sleep per night. Female Soldiers who met the recommended sleep requirement had lower estimated body fat [31.4 ± 4% vs. 32.1 ± 4.6%] and exercised more [258 ± 206 vs. 241 ± 216 min/wk] compared with those who did not obtain 7 hours of sleep per night., Conclusion: Soldiers who choose to adopt healthy lifestyle characteristics may be more likely to meet the recommended sleep duration guideline., (Published by Elsevier Inc.)

Introduction: Military studies have investigated acute injuries associated with parachute jumps, but the literature does not address paratroopers' cumulative microtraumatic (CMT) injury risk, nor does it compare injury risks between paratroopers and the rest of the military population. This study determined whether US active duty Army paratroopers experienced greater injury risks than their non-paratrooper soldier counterparts and whether their injuries cost more to treat suggesting greater injury severity., Methods: This retrospective study evaluated electronic medical records (2016-2018) for 31 621 paratroopers and a randomly selected comparison group of 170 715 non-paratrooper soldiers. Analyses included univariate and multivariate regression to quantify odds of injuries associated with risk variables and additional descriptive statistics., Results: Paratroopers had a 57% increase in the odds of experiencing one or more injuries (OR=1.57, 95% CI: 1.52 to 1.62) after controlling for sex, race and age, with a greater proportion of acute injuries (OR=1.38, 95% CI: 1.34 to 1.42), relative to comparison group soldiers. Injury types proportionally higher among paratroopers included head trauma and shoulder injuries. Average injury cost among paratroopers was 13% lower than for non-paratroopers ($2470 vs $2830 per injury). Among both populations, acute injury costs were notably higher than for CMT injuries (paratroopers, $1710/$630; non-paratroopers, $1860/$880 per injury)., Conclusions: Paratroopers were more likely to incur injury, especially an acute injury, than non-paratroopers. However, paratroopers' average injury costs were less. This may be due to higher return-to-duty motivations, fitness levels, and/or facility-specific cost of care. Future studies should investigate causes of injuries found to be proportionally higher among paratroopers., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Falls/near falls are the second leading cause of hospitalisation and outpatient visits among US Army soldiers. While numerous studies have evaluated fall-related or near fall-related injuries among elderly adults, few have evaluated this association among young adults. The objective of this study is to describe the characteristics and risk factors associated with fall-related or near fall-related injuries among male US Army soldiers., Methods: This is a cross-sectional study of male US Army Airborne Division soldiers (n=5187). Electronic surveys captured demographic, lifestyle, physical training (PT), fitness and injury data during spring/summer of 2016. Multiple logistic regression was used to identify independent risk factors of fall-related or near fall-related injuries, adjusting for potential confounders., Results: Primary findings indicated that activities and risk factors associated with fall-related or near fall-related injuries among soldiers included younger age (≤35 years), holding a job that required minimal lifting activities, slower 2-mile run times and not running during personal PT., Conclusions: The findings from this study suggest that male US Army soldiers and other physically active men may benefit from (1) obtaining and/or maintaining higher aerobic endurance and muscular strength, and (2) training focused on preventing fall-related injuries during PT, road marching and sports/recreational activities. Moreover, prevention strategies and education should further target younger soldiers (≤35 years old), as younger age is not modifiable., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Multiple studies report increasing cases of surgically treated pectoralis major (PM) muscle and tendon ruptures in military populations. Studies associate this with a growing popularity of weight-training and bench press exercises. Mild-to-moderate non-surgical PM traumas and overuse injuries have not been included in these studies despite evidence that these types of outpatient injuries account for the majority of the military's injury medical burden., Methods: To assess rates of all PM injuries (ruptures, tears, strains, overuse), regardless of form of treatment, a PM injury surveillance definition was derived from International Classification of Disease (ICD) diagnostic codes used in routine US Army injury surveillance. A detailed clinical examination of 2016 Active Duty Army medical records was used to identify ICD codes commonly associated with PM injuries. Cost data were calculated and the definition applied to medical data from 2016 through 2018to assess trends., Results: The estimated incidence of PM cases among soldiers was over 95% greater than if only considering severe surgical cases. Over 96% of army annual PM injury costs (direct medical and indirect from lost labour) were for outpatient services. PM injury incidence rates were not statistically different from 2016 to 2018., Conclusions: The PM injury surveillance definition provides a consistent means to monitor trends over time and evaluate the effectiveness of prevention efforts. PM injuries have a larger military impact than previously recognised and prioritised prevention strategies are needed to reduce them. Future interventions could focus on the bench press given its observed association with PM injuries., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Abstract: Grier, T, Brooks, RD, Solomon, Z, and Jones, BH. Injury risk factors associated with weight training. J Strength Cond Res 36(2): e24-e30, 2022-The purpose of this evaluation was to identify injury risk factors associated with weight training (WT). Subjects were 4,785 men and 542 women in a U.S. Army Division. Personal characteristics, unit training, personal training, fitness, and 12-month injury history were obtained by an electronic survey. Risk factors for WT injuries were explored using backward stepping multivariable logistic regression. Risk ratios, odds ratios (ORs), and 95% confidence intervals (95% CIs) were calculated for each risk factor. Over a one-year period, 4.5% of men and 0.6% of women experienced a WT injury. Weight-training injury incidence was 0.31 and 0.05 per 1,000 hours of WT for men and women, respectively. Overall, men were 7.4 times more likely to experience a WT injury compared with women. For men who participated in WT, independent risk factors for a WT injury included older age (OR [23-27/≤ 22 years] = 1.99, 95% CI 1.22-3.27; OR [>28/≤ 22 years] = 2.48, 95% CI 1.52-4.03) and higher amounts of personal WT per week (OR [60-165/≥ 166 minutes] = 0.58, 95% CI 0.39-0.88; and OR [15-59/≥ 166 minutes] = 0.40, 95% CI 0.24-0.66). A linear trend was revealed indicating an increasing risk of a WT injury with greater amounts of time spent WT per week (p < 0.01). Performing moderate amounts of WT may reduce the risk of experiencing a WT injury. However, because muscle strength is an important component of fitness for Soldiers, specialized WT programs that improve strength while minimizing injury risks are needed., (Copyright © 2020 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.)

Injuries are a leading health and readiness concern for the US Army. For effective prevention planning, details concerning circumstances associated with injuries are needed. Over 5,000 Soldiers were surveyed to collect demographic and injury details (type, body part, mechanism, activity, limited duty days); 874 reported an injury within 6 months of survey administration. The greatest proportion of limited duty time was associated with knee (19.2%), ankle (14.8%), and lower back injuries (12.9%). Overexertion was the leading injury mechanism (43.9%), followed by falls, jumps, trips, and slips (35.2%), which accounted for the highest average limited duty days per injury (42±43 days). Running was the leading activity associated overexertion injuries (39.3%) and falls (30.5%). Running also accounted for the greatest total limited duty days (5,844 days, 29.8%). For Army infantry units, results suggested a focus of prevention activities on running-related injuries resulting in overexertion or falls. Healthcare providers can facilitate injury prevention with contributions to initiatives providing details on injury mechanisms and activities associated with injuries.

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.