DOI: 10.1249/tjx.0000000000000392 ISSN: 2379-2868

Perceived Health and Readiness for Duty Following Return to Duty from a Musculoskeletal Injury in U.S. Army Soldiers

Daniel I. Rhon, Tina A. Greenlee, Phillip J. Plisky, Kyle Kiesel, Rebecca A. Milan, Deydre S. Teyhen
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Introduction:

Musculoskeletal injuries (MSKIs) significantly impair military readiness, and roughly half of service members who return to duty (RTD) after musculoskeletal injury are re-injured within 1 yr. Characterizing soldiers’ health at RTD may reveal unresolved deficits warranting further intervention. The purpose of this study was to characterize perceived health and readiness and self-reported health behaviors among soldiers cleared to RTD and compare perceptions between those with spine and lower-extremity injuries.

Methods:

In this cohort study, U.S. Army soldiers cleared for unrestricted duty after a lumbar/thoracic spine or lower-extremity injury were recruited from three military hospitals. Participants completed patient-reported outcomes and questions about perceived health and readiness for duty. Data were summarized descriptively and compared between injury regions.

Results:

Participants ( n = 469) had a mean (standard deviation) age of 27.1 (6.1) yr; 13.9% were female, 88.3% enlisted, and 38.2% served in combat units. Soldiers completed a median (range) of 8 (0–62) physical therapy visits before RTD. After being cleared to RTD, 16.4% felt they still required medical care, 11.9% doubted they could pass their physical fitness test, and 15.1% did not feel capable of wearing full-body armor or handling their weapon if deployed tomorrow. Only 72.7% reported feeling fully 100% mission-capable, and 66.3% experienced pain during movement assessments. Mean kinesiophobia, fear-avoidance, and pain catastrophizing scores were low, suggesting minimal psychological distress. Only 20.7% rated their health as excellent, and 48.2% as very good; one in four reported poor sleep. Findings were largely comparable between spine and lower-extremity subgroups.

Conclusion:

A substantial proportion of soldiers cleared to RTD do not perceive themselves as fully recovered, with 66.3% experiencing pain with movement. One in four did not perceive themselves as fully mission-capable, and one in ten doubted they could meet minimum fitness standards. These findings underscore the need for validated, clinically feasible, and holistic health RTD criteria.

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