An innovative research project involving academics from the University of Bath with the Royal Navy and Royal Marines has launched, aiming to reduce the number of painful and debilitating musculoskeletal injuries (MSKI) and the long-term burden of those injuries for individual Service personnel.

The programme – in collaboration with researchers from the universities of Exeter and Southampton – comes at a time when roughly 20% of Royal Navy or Royal Marines personnel are 'medically downgraded', and around half of these medical downgrades are due to musculoskeletal injuries.

These injuries can significantly reduce their participation in active service over the short or long-term, subsequently affecting the operational capability of the Royal Navy. Crucially, MSKIs have not necessarily arisen through active service, but rather through routine occupational duties and regular training exercises.

The Royal Navy Musculoskeletal Injury Mitigation Programme (RN MMP) will develop evidence-based applied solutions to mitigate risk, support optimum musculoskeletal health and promote the wellbeing of Service personnel.

The joint programme will build on work conducted at the three academic institutions, including a major project to enhance the health and fitness of UK Fire and Rescue Services led by the University of Bath.

Through this collaboration and evidence from previous studies developed by the Institute of Naval Medicine and the Consortium and the universities of Bath, Exeter and Southampton, a new state-of-the-art screening model will be developed, alongside new education materials and training interventions.

The RN MMP will contribute to the development of a multi-causality risk factor model for different categories of MSKI. The work – in collaboration with Defence Primary Healthcare teams – will also inform enhanced care to support recovery and rehabilitation from MSKI. It will collect data about Service personnel’s physical fitness, movement control and movement patterns, health behaviours (i.e. diet, physical activity, sleep, alcohol consumption and tobacco use), as well as information to better understand the impact of the military environment and work routines.

Lt. Col Erik Nielsen MBE RM from the Institute of Naval Medicine, who jointly leads the programme with Dr Jo Fallowfield, explained: “Royal Navy and Royal Marines personnel need to maintain optimal physical and cognitive performance, to endure extended periods of activity with unpredictable rest, as well as exposure to climatic and occupational stressors.

“Despite this, we know that MSKI remains a common and persistent problem, which negatively impacts individuals and the Force’s overall operational effectiveness. Through this work, collaborating with some of the UK’s leading universities, we want to develop a whole systems approach to reduce the prevalence of these injuries and improve the health outcomes and lived experiences of our people.”

Professor of Applied Human Physiology James Bilzon from the University of Bath's Department for Health added: “MSKI injury among Service personnel is a clear challenge for the Royal Navy and Royal Marines and, of course, for the individuals directly affected.

“Based on our previous research, we know there are evidence-based ways to design and evaluate new interventions that can mitigate these risks and improve individuals’ long-term musculoskeletal health outcomes. We’re delighted to be using our insights and experience, including working with other uniformed services to explore this in a military context.”

Prior to working at the University of Bath, Professor Bilzon was an Exercise Physiologist in various Ministry of Defence (MOD) departments, including the Institute of Naval Medicine and the Headquarters Army Recruiting & Training Division (ARTD).

Through the collaboration, the Royal Navy Musculoskeletal Injury Mitigation Programme Doctoral College will bring together existing PhD students working in related fields, as well as six new PhD programmes that are due to start from Sept 2023.

The Research Team

The research team

Back row: Dr Kate Harrison (Defence Statistics), Dr Steve Powell (INM), Dr Martin Warner (University of Southampton), Prof James Bilzon (University of Bath), Dr Max Western (University of Bath); Front row: Dr Sharon Dixon (University of Exeter), Lt Col Erik Nielsen (INM), Dr Jo Fallowfield (INM); Missing from picture: Prof Elaine Dennison (University of Southampton), Dr Leo Westbury (University of Southampton).