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Neck injuries in fighter pilots

The neck is the most vulnerable part of our bodies by design. The neck sacrifices stability for its extra mobility in order to protect our brain and special sensory organs. Under normal circumstances, this would be beneficial but for pilots, it's a different story. High-G force injuries are incredibly common and among them, the most common posture that causes injury includes the ‘checking six’ position, followed closely by the ‘forward bend’.

A survey of 129 F-15 pilots in JASDF concluded that 115 (89.1%) reported musculoskeletal pain from flying, averaging approximately 7.6 events of pain, of which 95% occurred in the F-15. Within these statistics, 44 of the 115 pilots reported that their flight duty performance was impacted by their condition, and 50 reported that their daily life was hindered by the symptoms. In this particular study, muscle training and manual therapy were found to be significant in preventing injury (Kikukawa et al. 1995).

Another study conducted by the RAAF found that pilots that flew either the F/A-18 Hornet or the MB326H Macchi reported having neck injuries under high-G force. The majority of injuries reported were simple muscle sprains, however, 20 of 52 fighter pilots reported that their injury interfered with their ability to complete their mission. A higher rate of injury was reported by the pilots of the F/A-18. Again, air combat maneuvering sorties and the ‘checking six’ positions were identified as the cause (Newman, 1997).

How can Osteopathy help?

Osteopathy focuses on the realignment and balance of the body. Neck injuries happen when a force is placed upon it that exceeds what the muscular contraction can maintain. When there is dysfunction in the neck you typically will have shorter muscles on one side and stretched muscles on the opposite. This results in poor nerve stimulation to the muscle and incomplete contraction. Additionally, it can create nerve impingement and eventually migrate into the shoulders and down the arms.

Can I stretch it out to restore balance?

Technically you can, but in my clinical experience, I have found that most people have a tendency to stretch what is actively hurting them. A vast majority of the time when it comes to the neck, the side that is already on stretch is the side that produces pain and because of that, the individual tends to stretch that side more. This is counterproductive and can aggravate the injury. It’s always best to have someone check it through a hands-on assessment to know exactly what the musculature and the deeper articular structures are doing in order to correct it.


Kikukawa A, Tachibana S, Yagura S. G-related musculoskeletal spine symptoms in Japan Air Self Defense Force F-15 pilots. Aviat Space Environ Med. 1995 Mar;66(3):269-72. PMID: 7661840.

Newman DG. +GZ-induced neck injuries in Royal Australian Air Force fighter pilots. Aviat Space Environ Med. 1997 Jun;68(6):520-4. PMID: 9184740.


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