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Musculoskeletal injuries in UK service personnel and the impact of in-theatre rehabilitation during cold weather warfare training: Exercise CETUS 2020
  1. David Ferraby,
  2. D Hayhurst and
  3. J Fallowfield
  1. RAMC, British Army, London, UK
  1. Correspondence to Capt David Ferraby, HQ DPHC, Coltman House, DMS Whittington, Lichfield WS14 9PY, Staffordshire, UK; david.ferraby100{at}mod.gov.uk

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Background

The UK is increasing its presence in the Arctic region, and there is an aspiration to deploy increasing numbers to Norway under Project HEIMDALL. The Royal Marines are the lead service for the UK Defence’s mountain and cold weather warfare capability. To that end, Royal Marine Forces regularly deploy to Norway.

The Royal Marine cold weather warfare course is the mandatory training undertaken by Royal Navy, Royal Marine, Army and Royal Air Force personnel who are likely to deploy to the cold weather environment. It comprises three phases–Survival, Mobility and Warfare–and culminates in a final exercise that tests newly taught knowledge and skills. Ski touring and skijoring are fundamental skills that are essential to all phases and are developed under the challenging conditions of darkness (due to time of year and northern latitude), icy surfaces (due to environmental temperatures) and while personnel carry load and in a fatigued state. These are all important risk factors for skiing-related musculoskeletal injury1 (MSKI).

Identification of the nature, causation and injury location is essential to characterise the nature of MSKI during winter deployments.2 In-theatre rehabilitation and the ability to treat patients when deployed have also been demonstrated.2 However, to truly understand and mitigate MSKI, one must understand the occupational demands of training in the Arctic. This editorial will provide insight to the challenges facing Commandos undertaking cold weather warfare training in Norway; specifically, the occupational demands of the courses, skiing, and the factors and deductions of the most common patterns of injury, in order to mitigate MSKI on future deployments.

The demand

Cold weather training and ski touring involve uphill and downhill transit, over Arctic landscapes, without removing skis, while carrying a weapon, a loaded bergan (up to 55 kg; including mission-specific equipment, personal survival equipment, water and food), potentially pulling pulks (sledge), in …

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Footnotes

  • Twitter @itsDHF

  • Collaborators The authors wish to acknowledge the support of Surg Lt Cdr T Haigh who were instumental in the creation of this editorial.

  • Contributors DF, DH and JF contributed to the authorship of this editorial.

  • 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.

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