Background: Loaded ruck marching is a common workout and selection tool for military schools.
Source of data: Analysis of the current literature and expert opinion.
Areas of agreement: Soldiers performing loaded marches are prone to overuse injuries such as stress fractures, foot blisters, foot infections, brachial plexus lesions, digitalgia paresthetica, and meralgia paresthetica, knee pain, back pain, metatarsalgia.
Areas of controversy: At present, risk factors needed to be addressed to reduce the rate of injuries.
Growing points: Speed of march, terrain grade, and task type and duration, together with safety risk checks, such as administrative checks and physical conditioning, may all impact injury risks and have to be evaluated in military training programs.
Areas timely for developing research: Although noncombat injuries in the military have historically been a hidden epidemic, they are now being recognized as a major health problem for the military services. Risks for soldier health, tactical performance, and mission success related to military load carriage have been analyzed. Risk modifiers have been also addressed.Speed and load combinations of military marches have to be analysed to optimize marching pace and reduce energy expenditure. Load and speed should be managed to maintain an exercise intensity of ~45% VO2 max to delay the time to fatigue during prolonged marches.
Keywords: loaded ruck marching; military training; overuse injuries.
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