Interdisciplinary Occupational Health System for Recovery From Musculoskeletal Injuries in US Army Personnel

Abstract

Importance Musculoskeletal injuries are a leading cause of pain, disability, and lost workforce productivity in the US. These injuries are more frequent in physically demanding occupations, making strategies to accelerate recovery a critical economic, public health, and workforce sustainability issue. Objective To evaluate whether an embedded interdisciplinary occupational health intervention was associated with faster return-to-work times after a musculoskeletal injury. Design, Setting, and Participants This cohort study analyzed longitudinal data on 43 870 526 person-month observations from active-duty US Army personnel collected between October 1, 2017, and September 30, 2025. Exposure Assignment to an Army unit with an embedded Holistic Health and Fitness (H2F) occupational health system, which includes on-site physical therapists, athletic trainers, occupational therapists, registered dietitians, strength and conditioning coaches, and cognitive performance specialists. Main Outcomes and Measures Number of limited duty workdays after a musculoskeletal injury and time to return to full duty. Linear regression, logistic regression, and Kaplan-Meier models with inverse probability of treatment weighting were used to estimate the association between the intervention and recovery outcomes. Results Among 1 420 195 musculoskeletal injuries in active-duty soldiers (mean [SD] age, 28.6 [7.64] years; 79% male) that resulted in limited duty restrictions, 19% were in soldiers exposed to the H2F embedded occupational health system. Exposure to H2F was associated with a 5.9% (95% CI, 7.2%-4.6%; P < .001) reduction in the duration of limited duty workdays compared with soldiers not exposed to H2F. Reductions in limited duty workdays were greater for lower-body injuries than for upper-body injuries. These reductions corresponded to an estimated 3.3 million to 4.0 million workdays restored during the study period, representing an annual labor productivity value of $93 million to $164 million. Conclusions and Relevance In this cohort study of active-duty US Army soldiers, embedding an interdisciplinary occupational health system directly into the workplace was associated with a significantly accelerated recovery time from musculoskeletal injuries. These findings suggest that employer-sponsored occupational health interventions are a scalable strategy to reduce injury-related absenteeism and enhance workforce productivity, particularly in high-risk industries.

The authors' abstract, as published at the source. JAMA Network Open, 2026 · DOI ↗