U.S. Coast Guard Academy Injury and Risk Factor Study

Purpose: Injury rates and injury risk factors were examined for the first time among cadets undergoing Summer Warfare Annual Basic (SWAB) training at the U.S. Coast Guard Academy (USCGA).
Methods: Participants were 778 men and 286 women from four years of SWAB training. Before SWAB training, the subjects were administered a Physical Fitness Assessment (PFA) (2-minute maximal effort sit-ups and 1.5 mile run) and functional movement screening (FMS) test. Height and weight were measured and, gender, age and ethnicity were obtained from administrative records. Training-related injuries were compiled from student medical records. The diagnosis, body part location, disposition, and limited duty days were recorded for each clinic visit.
Results: During the 8 weeks of SWAB training, 23.8% of the women and 18.4% of the men were injured at least once. Compared to the men, the odds of an overall injury among women was 1.39 (95% confidence interval= 1.00-1.92). The odds of an overuse injury among women was 1.72 (95%confidence interval= 1.21-2.43) times higher than the men and the number of limited duty days for overuse injuries was also higher among the women (p <0.01). Independent risk factors for injuries among both men and women included lower aerobic fitness and lower functional movement screening scores.
Conclusions: Female USCGA cadets were at higher risk of injuries, especially overuse-type injuries. Specific factors that put cadets at higher injury risk included lower aerobic capacity and inefficient movement strategies. Future injury studies should focus on females, aerobic fitness, and movement strategies. Prevention strategies should be tested to reduce injuries to limit lost training time.