Current Pathobiology Reports

, Volume 6, Issue 3, pp 149–158 | Cite as

Musculoskeletal Injuries in Astronauts: Review of Pre-flight, In-flight, Post-flight, and Extravehicular Activity Injuries

  • Vignesh Ramachandran
  • Sawan Dalal
  • Richard A. Scheuring
  • Jeffrey A. JonesEmail author
Effects of the Space Environment on Human Pathobiology (R Kerschmann, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Effects of the Space Environment on Human Pathobiology


Purpose of the Review

To provide a comprehensive review of musculoskeletal injuries in astronauts during pre-flight, in-flight (including extravehicular activity), and post-flight periods. The discussion is inclusive of etiology and nature of the injury, preventative measures, and future considerations.

Recent Findings

The most common injuries were to the hand, shoulder, and back/spine. Patterns and location of injury depend on the phase of flight during which they occurred. Current countermeasures are effective for some concerns, but do not ameliorate all musculoskeletal risks, thus new countermeasure and preventative approaches are warranted in some arenas.


During pre-flight preparations, the shoulder is a site with the most concerning injuries, and they occur during extravehicular activity training, usually secondary to interaction with the planar hard upper torso. Suit redesign is under consideration, for both the pre- and in-flight environments. Hand injuries are also common in both pre-flight training and in-flight extravehicular activity. Countermeasures include reducing moisture and protective bandaging of fingertips. Space-adaptation back pain and herniated nucleus pulposus occur in-flight and post-flight, respectively. In-flight exercise countermeasures may mitigate many in-flight and post-flight spinal pathologies. In-flight loss of bone mineral and trabecular architecture can be mediated via both pharmacologic and exercise countermeasures. The advanced resistive exercise device has shown ability to reduce not only bone loss, but also muscular atrophy. Standardized and anonymous injury reporting is essential to track the full range of injuries over time. Participation of physical medicine and orthopedic-trained physicians and therapists, working alongside the ASCR (Astronaut Strength, Conditions, and Rehabilitation) group during astronaut exercise, training, and rehab should be considered value added.


Astronaut Extravehicular Training Injury Musculoskeletal Spaceflight 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Vignesh Ramachandran
    • 1
  • Sawan Dalal
    • 1
    • 2
  • Richard A. Scheuring
    • 3
  • Jeffrey A. Jones
    • 1
    Email author
  1. 1.Center for Space MedicineBaylor College of MedicineCambridge HoustonUSA
  2. 2.University of HoustonHoustonUSA
  3. 3.National Aeronautics and Space AdministrationHoustonUSA

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