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Scapular winging on Exercise Cambrian Patrol: three soldiers in three days - an occupational risk?
  1. Samuel Green1,
  2. H Hodgson1 and
  3. J Bobrowski2
  1. 1 3 Medical Regiment, Preston, UK
  2. 2 Physiotherapy, Defence Primary Care Rehabilitation Facility, Preston, UK
  1. Correspondence to Samuel Green, 3 Medical Regiment, Fulwood Barracks, Preston PR2 8AB, UK; sasasgreensam{at}


Exercise CAMBRIAN PATROL is an internationally recognised, arduous patrolling exercise held annually in Mid-South Wales. The 2017 iteration of the exercise generated three uncommon shoulder injuries in three consecutive days, all of which were thought to have a similar aetiology. This article presents a case series of three instances of scapular winging in soldiers carrying heavy weight. We review the relevant anatomy and pathophysiology of long thoracic nerve injury and discuss management strategies of scapular winging. Occupational health considerations are reviewed, with respect to carrying large amounts of weight over distance and difficult terrain within the armed forces, along with discussion of a novel weight distribution system (VIRTUS) which has recently been brought into service by the British Army.

  • Scapula
  • Paralysis
  • Occupational Health
  • Military Medicine
  • physical therapy modalities
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  • Contributors SG is the lead author and is responsible for overall content, planning and conduct of the submission. SG wrote most of the article, collated figures and arranged the consent forms. HH contributed to the initial identification and diagnosis of patients on the patrol and was consulted to ensure accuracy of the article. JB contributed content in the physiotherapy management section and provided a number of useful references.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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