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High-risk head and neck movements at high G and interventions to reduce associated neck injury.

Coakwell MR; Bloswick DS; Moser R Jr.
Aviat Space Environ Med 2004 Jan; 75(1):68-80
Background: Neck injuries are a significant concern for aviators of high performance aircraft. A recent comprehensive technical report on cervical spinal injury associated with exposure to sustained acceleration, from NATO's Research and Technology Organization, recommended delineating the neck muscles used by aviators in this flying environment and developing improved neck muscle strengthening programs in an attempt to reduce such injuries. Methods: A review of current literature was conducted in the fields of biomechanics, ergonomics, orthopedics, neurology, neurosurgery, rehabilitative medicine, and aerospace medicine. An objective description is provided of the muscles involved in specific head and neck movements, and those movements that are associated with a greater risk of injury during high-G sorties. The intensity and duration of force exposures common to high performance aircraft sorties, the effects of seat-back angle on these exposures, and the types and mechanisms of neck injury reported in this environment are also described. Results: Primary, secondary, and tertiary preventive interventions are introduced with the goal of providing unit-level flight surgeons an approach to reducing neck injury and promoting prompt, safe return to flying of aviators with identified neck injury. A central component of these interventions is a "specific" and "intensive" neck muscle training regimen, as described in the medical literature. Conclusion: Increased axial compressive force and unique biomechanics combine to make neck injury likely in high performance aviators. The application of some proposed intervention strategies may reduce the occurrence of these injuries.
Musculoskeletal-system-disorders; Injuries; Injury-prevention; Traumatic-injuries; Neck-injuries; Aircraft; Aircrews; Aerospace-industry; Pilots; Flight-personnel; Space-physiology; Gravitational-forces; Spinal-shock; Spinal-cord; Muscles; Aerospace-medicine; Aerospace-workers; Biomechanics; Author Keywords: aerospace medicine; biomechanics; neck muscles; occupational exposure; cervical spinal injuries; neck injuries; prevention and control; rehabilitation
Mark R. Coakwell, M.D., MPH, PSC 76, Box 4024, APO AP 96319
Publication Date
Document Type
Journal Article
Email Address
Funding Type
Fiscal Year
Identifying No.
Grant-Number-T42-CCT-810426; Grant-Number-T42-OH-008414
Issue of Publication
Source Name
Aviation, Space, and Environmental Medicine
Performing Organization
Rocky Mountain Center for Occupational and Environmental Health, Department of Family & Preventive Medicine, University of Utah, Salt Lake City, Utah
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division