Introduction

Musculoskeletal injuries affect the muscular and skeletal systems and are typically characterized by pain, discomfort, and limited mobility [1]. Military personnel face high‑intensity training in daily routines and combat environments, which increases their risk of musculoskeletal injuries [2]. Injuries from military training are a leading cause of reduced readiness and impose a substantial economic burden. They can also cause functional disability, reduced performance, and disruptions in the active military population [3]. A study of U.S. military personnel reported that approximately 55% of service members were diagnosed with one or more musculoskeletal disorders or related pain between 2001 and 2011 [4]. Musculoskeletal injuries are a major health concern among active military personnel, accounting for an estimated 1.6 million injury‑related medical visits per year and representing the second leading cause of medical visits [5].
Given their frequency and severity in training and combat settings, musculoskeletal injuries are a major challenge for military forces, affecting health, performance, and physical fitness. A systematic review is needed to examine these injuries comprehensively. They not only decrease soldiers’ physical capacity but also impose heavy economic costs on military organizations. Evidence indicates that factors such as training techniques, improper body positions, and repetitive tasks contribute to injury risk. Because there is no single standard effective prevention approach and previous study results vary, a systematic review can identify epidemiologic patterns, risk factors, and effective prevention strategie. Such a review could improve ergonomic conditions, reduce physical and psychological strain in military workplaces, and generally enhance the health and efficiency of armed forces. Therefore, this study aimed to comprehensively investigate musculoskeletal injuries in military populations and identify factors influencing their occurrence to guide ergonomic improvements and cost reduction.

Methods

This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta‑Analyses (PRISMA) guidelines to ensure quality and transparency.
Primary sources were retrieved from four major databases: PubMed, SCOPUS, CENTRAL (Cochrane Register of Controlled Trials), and Web of Science. The search covered all articles from database inception through October 9, 2025. MeSH terms were used to develop keyword strategies, which were then adapted to capture all relevant studies.
Google Scholar was also searched to broaden coverage and identify articles indexed elsewhere. References of included studies were screened to find additional relevant publications. Electronic searches used multiple keyword combinations to ensure comprehensive retrieval.
Search terms included: "Musculoskeletal Injuries" OR "Military Injuries" OR "Combat‑Related Injuries" OR "Physical Trauma" OR "Injury Prevention" OR "Sprains and Strains" OR "Fractures" OR "Tendon Injuries" OR "Ligament Injuries" OR "Overuse Injuries" OR "Joint Disorders" OR "Physical Training" OR "Load Carriage" OR "Repetitive Motion" OR "Environmental Factors" OR "Pre‑existing Conditions" OR "Active Duty Personnel" OR "Veterans" OR "Reserve Forces" OR "Special Operations Forces" OR "Rehabilitation" OR "Physical Therapy" OR "Surgical Interventions" OR "Pain Management" OR "Injury Assessment" OR "Epidemiology of Injuries" OR "Biomechanics" OR "Injury Surveillance" OR "Military Health Studies" OR "Performance Optimization" OR "Occupational Health" OR "Fitness and Conditioning" OR "Sports Medicine" OR "Ergonomics" OR "Recovery Strategies".
In addition to international databases, Persian databases (MAGIRAN, IRANDOC, IranMedex, MedLib, and SID) were searched using equivalent keywords to include relevant Persian‑language studies and enrich the review.

Results

The electronic search yielded 1,523 titles; manual searching and reference checks identified an additional 36 titles. After removing duplicates, 623 abstracts were screened. Title and abstract screening excluded 574 articles, leaving 49 articles for full‑text review. Of these, 32 studies that specifically examined musculoskeletal injuries in military personnel met inclusion criteria and were included in the final analysis.

Discussion and Conclusion

This review examined musculoskeletal injuries in military populations, focusing on classification, temporal trends, geographic distribution, epidemiology, and clinical patterns. The goals were to identify trends, risk factors, and preventive measures from the literature, particularly epidemiological studies. Over half of the included research was published after 2015, indicating growing attention to military injuries, likely driven by scientific advances and the need for prevention strategies.
Findings show higher incidence of musculoskeletal injuries among women and newly enlisted personnel, and evidence suggests targeted exercise programs can reduce these risks. International collaboration and diverse expertise are strengths of the current literature, but the predominance of Western‑centric studies limits generalizability to non‑Western populations. The review underscores the need for longitudinal studies and incorporation of psychological factors in future research to improve prevention and management strategies.

Ethical Considerations

No ethical issues were applicable to this research.

Funding

There is no funding support.

Authors’ Contribution

All authors contributed equally to preparing the article.

Conflict of Interest

The authors declare no conflicts of interest.