Exercise Regimen for Mitigation of Neck Pain in Military Aircrew and Support Personnel

INTRODUCTION: Operators of rotary wing aircraft and high-performance jet aircraft often face musculoskeletal pain and cervical spine injury risks due to flight-related factors, including heavy vibrational and g-loading, abrupt head maneuvering, and a large number of flight hours. This study explores the use of a portable lightweight resistance band exercise device (PLED) to strengthen and stretch neck musculature, potentially mitigating these risks.

METHODS: A multi-aircraft study building on an initial pilot study of 10 high-performance jet aircraft aviators involved both active-duty aviators and civilians. Over 6 wk, subjects engaged in targeted PLED-based exercises. Baseline and endpoint measurements were obtained. Quantitative measurements assessed range of motion (ROM) and endurance, while Visual Analog Scale reports tracked pain. A total of 47 subjects consented, with 26 completing the protocol. There were 21 subjects who were either lost to follow-up or withdrew due to scheduling conflicts.

RESULTS: Analysis of this interventional study showed significant ROM improvement, increased muscular endurance, and reductions in pain magnitude. Subjects reported improvements in flexibility, strength, stiffness, and pain relief. Active-duty aviators noted improved ROM, quicker postflight recovery, and reduced in-flight pain.

DISCUSSION: This collaborative Department of Defense-academia-Department of Veterans Affairs research highlights the effectiveness of regular PLED-based cervical musculature exercises in enhancing ROM and endurance. While promising, further research with larger datasets is needed to support definitive recommendations. Moreover, the study’s findings may benefit a broad population engaging in activities that stress the cervical spine and surrounding musculature.

Keller RJ, Rosenthal R, Dalal S, O’Conor D, Ramachandran V, Vandeven S, Butler N, Shivers B, Shender B, Jones JA. Exercise regimen for mitigation of neck pain in military aircrew and support personnel. Aerosp Med Hum Perform. 2025; 96(4):314–321.