Is a Postpartum British Army Population more likely to sustain a musculoskeletal injury when compared with their non-postpartum counterparts?

Purpose

Pregnancy is associated with significant changes to the musculoskeletal (MSK) system. One in three women report MSK pain on their return to running postpartum with the majority of this pain located in the lumbopelvic region. Musculoskeletal injury (MSKi) is considered a major problem for athletes as well as for many British Army populations. It can result in a loss of training time, impaired professional performance and in the case of BA personnel, permanent discharge. Despite the large number of serving females in the BA, there is currently no official guidance given to BA personnel on how to safely return to high-level exercise, postnatally. With that said, this appears to be a universal issue rather than one contained within the BA. Indeed in 2017, an IOC Consensus Statement concluded that there were huge gaps in the literature pertaining to the safe return to strenuous exercise postnatally for recreational and elite athletes. To our knowledge, this is the first study to analyse MKSi data in a postpartum BA population. The purpose of this study was to ascertain whether there was a higher proportion of MSKis sustained by a postpartum, BA population during the immediate postpartum period and the 12 months following their return to work, when compared with a control group. The study also compared the types of injuries sustained by both groups.

54.9% of post partum injuries
lumbopelvic, abdominal, hip and groin regions

Approach

This retrospective study compared the percentage of postpartum, BA females that sustained an MSKi during the early postpartum period and the 12 months following their return to work to the percentage sustained by a non-postpartum, BA, female control group. This data was accessed from the Defence Medical Information Capability Programme (DMICP) database. The type of MSKis sustained by the groups were recorded and analysed.

Outcomes

Results: The proportion of participants that sustained MSKis in the postpartum and non-postpartum groups were 71% and 28% respectively. 54.9% of injuries sustained by the postpartum group were in the lumbopelvic, abdominal, hip and groin regions compared to 32.6% in the non-postpartum group. Stress Urinary Incontinence was reported in 17.6% of women in the postpartum group.

Conclusion(s): A postpartum, British Army (BA) population is significantly more likely to sustain an MSKi during the initial postpartum period and the year following their return to work, when compared with a control group. The Lumbopelvic, Abdominal and Hip and Groin were the most common areas of MSKi for the postpartum group. Evidence-based guidelines on physical activity during the postpartum period are needed universally. Consequently, performing an RCT or longitudinal study on a Military postpartum population looking at the effects of exercise in the postpartum period could be ground-breaking.

Cost and savings

No further information. 

Implications

With the IOC stating that studies performed on soldiers potentially helping to inform return to exercise guidance for elite or recreational athletes internationally, this research could benefit female athletes globally. These findings could also help create new Military policy, giving evidence-based guidance on the physical management of postpartum personnel, returning to work.

Top three learning points

No further information. 

Funding acknowledgements

Part of this work was funded by the CSP Charitable Trust Education Awards Panel