Hiring athletic trainers and strength and conditioning specialists can save you millions

Financial impact of embedded injury prevention experts in US Army initial entry training

Daniel R. Clifton, D. Alan Nelson, Y. Sammy Choi, Daniel Edgeworth, Donald Shell, Patricia A. Deuster. J Athl train 2022; doi: https://doi.org/10.4085/1062-6050-0353.22

Full text freely available

Take home message

By using athletic trainers and certified strength and conditioning specialists in initial entry-level training for the Army, the Army saved at least three times the cost of contracting these professionals, saving $11 to 20 million annually.

Background

More than 1 in 4 men and women suffer a musculoskeletal injury during initial training for the US military. The U.S. Army began deploying teams of athletic trainers and strength and conditioning specialists in 2010 to address the problem of early-career musculoskeletal discharges. The military could demonstrate the need for these teams if we knew how much money they saved by preventing injuries and treating them quickly.

Study objectives

The author’s purpose was to assess whether built-in injury prevention experts were associated with reduced training costs for soldiers discharged early from service.

Methods

The authors conducted a retrospective analysis of 198,166 active-duty soldiers who began training from January 2014 through May 2017. Soldiers who began training at two locations between April 2015 and November 2015 did not have athletic trainers and strength and conditioning specialists on hand. on site due to a lapse in contracts. The authors categorized these soldiers as not coming into contact with injury prevention experts. All other soldiers were categorized as having been exposed to injury prevention experts. The authors estimate soldier training costs based on average basic and advanced training costs from 2014-2017 for an average of six months of training. To be eligible for discharge from active duty, the discharge had to occur within six months of the start of training and due to a musculoskeletal condition.

Results

A total of 14,094 soldiers had no contact with injury prevention experts. 2.8% of these soldiers were discharged early due to musculoskeletal injuries. Of the 184,072 soldiers exposed to injury prevention experts, 1.0% were discharged early due to musculoskeletal injuries. The authors calculated that the injury prevention experts saved the Army $11 to $20 million per year in lost training costs due to early career discharges (net of contract costs for the experts).

Viewpoints

At a relatively small financial cost (approximately $900,000 per location or $4 million total), the Army reduced the likelihood of early discharge by ~64%. There were also significant savings on lost training costs due to early career medical layoffs. We should also keep in mind that these costs do not include other long-term savings. For example, preventing injuries or treating an injury promptly can reduce the risk of medical discharge later in a person’s life due to chronic pain (e.g., osteoarthritis) or save healthcare costs associated with chronic pain or functional limitations. Furthermore, while the costs help justify hiring these experts, we cannot ignore the other benefits that may accrue, including improved soldier quality of life and function and improved military readiness.

Clinical implications

Clinicians and administrators can use this data to advocate for athletic trainers and strength and conditioning specialists in the military and possibly industrial or performing arts fields to demonstrate a 3 to 5x return on investment.

Written by Mitchell Barnhart
Reviewed by Jeffrey Driban

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