The Musculoskeletal Injury Rehabilitation Research for Operational Readiness (MIRROR) will deliver high value research, education, and training, and provide the infrastructure to immediately execute clinically relevant musculoskeletal injury (MSI) studies within the military health system (MHS).

Leading Musculoskeletal Injury Care


MIRROR will support a broad scope of projects, including epidemiological investigation, investigator initiated pilot trials, and prospective randomized multisite clinical trials. Areas of clinical evaluation will comprise general MSI care process models and highly prevalent anatomically-specific (e.g. back, knee, shoulder pain, etc.) targeted interventions with protocols examining effective return to running and return-to-duty activities. Results of these studies will generate evidence-based approaches for future clinical practice guidelines as well as educational opportunities for future military and civilian providers.

Areas of Focus

Research Focus 1: Identification, Prevention, and Treatment of MSI Risk Factors and Comorbid Disorders

Research Focus 2: Optimization of Standard of Care Practices for the Treatment and Rehabilitation of MSI Injuries

Research Focus 3: Establishment of Strategies to Mitigate Injury Occurrence

Research Focus 4: Application of New Technologies in Preventative and Rehabilitative Care


Musculoskeletal injuries (MSI) affect approximately 800,000 service members annually and result in 25 million days of limited duty. These conditions are the primary reasons for medical discharge and downgrade, and result in 34% of medical evacuations from theatre. Most concerning though is that the disability discharge rate for MSI has increased 13x between 1981 and 2005 (70 vs. 950 per 100,000 persons), which negatively impacts cost, care, and utilization within the military health system (MHS).

Given the strict requirements for physical fitness in the military, and impact of MSI on combat readiness, the Defense Health Agency has supported the creation of MIRROR, which will provide critical infrastructure, operational and research support to advance the treatment and preventive care for service members with non-combat related MSI. Headquartered at the Uniformed Services University (USU), MIRROR will coordinate inter-service partnerships with the primary military treatment facilities (MTFs), as well as other sites that experience a high volume of MSI, but lack a robust infrastructure to conduct rigorous clinical studies.

MIRROR additionally provides risk assessment and preventative action in order to decrease the incidence and burden of MSI among service members to include special recognition of the MSI demands unique to the female wounded warrior. This occurs through a coordinated process which includes: (1) determining the existence and magnitude of the problem, (2) identifying causes of the problem, (3) determining what prevents the problem, (4) implementing prevention strategies and programs, and (5) continuing surveillance and monitoring/evaluating the effectiveness of prevention efforts. In order to determine the most effective and efficient methods of treatment and prevention of MSI in the military, MIRROR researchers closely align with DoD leadership and have advisory members who serve as MTF administrators, senior investigators, Joint Program Committee (JPC) chairs, etc.

Learn more about MIRROR on their website or view this press release


Our Partners

MIRROR collaborates with a number of military treatment facilities and civilian sites across the United States to promote innovative research and effective care.

Musculoskeletal Injury Hub

Learn More

Learn more about MIRROR, its capabilities, and ways to get involved.

Air Force woman with amputated leg