title: Shoulder impingement in the United States military.
abstract: BACKGROUND
  Little is known about the incidence and characteristics of primary, or external, shoulder impingement in an occupationally and physically active population. A longitudinal, prospective epidemiologic database was used to determine the incidence and risk factors for shoulder subacromial impingement in the United States (U.S.) military. Our hypothesis was that shoulder impingement is influenced by age, sex, race, military rank, and branch of service.
  
  
  METHODS
  The Defense Medical Epidemiology Database was queried for all shoulder impingement injuries using International Classification of Disease, Ninth Addition, Clinical Modification code 726.10 within a 10-year period from 1999 through 2008. An overall injury incidence was calculated, and a multivariate analysis performed among demographic groups.
  
  
  RESULTS
  In an at-risk population of 13,768,534 person-years, we identified 106,940 cases of shoulder impingement resulting in an incidence of 7.77/1000 person-years in the U.S. military. The incidence of shoulder impingement increased with age and was highest in the group aged ≥40 years (incidence rate ratio [IRR], 4.90; 95% confidence interval [CI], 4.61-5.21), was 9.5% higher among men (IRR, 1.10, 95% CI, 1.06-1.13), and compared with service members in the Navy, those in the Air Force, Army, and Marine Corps were associated with higher rates of shoulder impingement (IRR, 1.46 [95% CI, 1.42-1.50], 1.42 [95% CI, 1.39-1.46], and 1.31 [95% CI, 1.26-1.36], respectively).
  
  
  CONCLUSIONS
  The incidence of shoulder impingement among U.S. military personnel is 7.77/1000 person-years. An age of ≥40 years was a significant independent risk factor for injury.
authors: Department of Orthopaedic Surgery & Rehabilitation, William Beaumont Army Medical Center/Texas Tech University Health Science Center, El Paso, TX, USA.
authors: Mark S
authors: MS
authors: Hsiao
authors: Department of Orthopaedic Surgery, John A. Feagin Jr. Sports Medicine Fellowship, Keller Army Hospital, West Point, NY, USA.
authors: Kenneth L
authors: KL
authors: Cameron
authors: Department of Orthopaedics and Rehabilitation, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA.
authors: Christopher J
authors: CJ
authors: Tucker
authors: US Special Operations Command, MacDill Air Force Base, Tampa, FL, USA.
authors: Matthew
authors: M
authors: Benigni
authors: Department of Orthopaedics and Rehabilitation, Yale Medical School/Yale New Haven Hospital, New Haven, CT, USA.
authors: Theodore A
authors: TA
authors: Blaine
authors: Department of Orthopaedic Surgery, John A. Feagin Jr. Sports Medicine Fellowship, Keller Army Hospital, West Point, NY, USA. Electronic address: b.owens@us.army.mil.
authors: Brett D
authors: BD
authors: Owens
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D019534:Shoulder Impingement Syndrome / Q000453:epidemiology*; D020069:Shoulder Pain / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: DMED; Shoulder; U.S. military; epidemiology; impingement; incidence