Female soldiers in combat positions - A literature review

Lital Skoop-Golan, Esti Danus, Prof. Tamar Jacob

Abstract

Background: Since the first half of the 20th century, combat positions began to be made available to Israeli women as part of their military service. Given that serving in combat positions includes lifting of heavy loads, which may cause injury, and given that there are significant physiological discrepancies between the sexes, a dilemma evolved not only about whether to integrate women in combat positions, but also about the potential consequences of this integration.

Goal: To review literature discussing the gains vs. risks of integrating women in combat positions, with an emphasis on frequency of back and lower extremity injury.

Method: We reviewed experiments and studies dealing with gender equality in the military and the integration of female soldiers in combat positions, the physiological differences between men and women, and overuse injuries in male and female combatants. Keywords searched were: stress fractures, overuse injuries, bone-muscle injuries, female combatants, integrating women in the military and Israel Defense Forces (IDF). The inclusion criteria were limited to articles and books in English or in Hebrew, to which full access was available.

Results: The review included 20 articles, one book,
and six official websites. Most studies found a higher frequency of back and lower extremity injury amongst female combatants relative to male combatants. These differences were mostly explained in terms of the physiological differences between the sexes.

Conclusions: Physiological differences are a key element for the exclusion of women from combat positions. Nevertheless, despite the higher frequency of back and lower extremity injury amongst women relative to men, attributing this higher frequency of injuries mainly to gender differences should be done with greater caution, as other factors are likely to contribute as well. The review also presents recommendations in the literature for decreasing overuse injury among females combatants. The implementation of these recommendations may promote the integration of women into combat positions, while minimizing health injuries.

Keywords: Overuse injury, bone-muscle injury, female combatants, woman in combat, IDF.