Neck pain and neck injuries are a systematic problem within the CH-146 Griffon pilot and flight engineer communities, with 70-80% of crew members reporting persistent neck pain directly attributed to flying [1,2]. In addition to persistent neck pain after flying, approximately 10% of pilots have reported experiencing neck pain that was either severe or incapacitating during flight [1]. Incapacitating neck pain during flight has the potential to reduce aircrew task performance in addition to being a long term health concern. The objective of this paper was to assimilate the knowledge gained in a series of studies investigating neck pain and injury in Griffon aircrew in order to establish a mechanism of injury so that potential means of mitigating injury can be evaluated. A series of four studies were critically reviewed [1–4]. The studies ranged from comprehensive survey and questionnaire studies of current aircrew to a mission function task analysis and physical demands analysis. Cumulative load for a range of typical CH-146 Griffon missions was also determined. Knowledge and insight gained from each study was then compiled, interpreted and recommendations to mitigate neck injury were made. The mechanism of injury for both Griffon pilots and flight engineers was determined to be an accumulation of tissue damage resulting from cumulative loading during long duration missions (particularly night missions while wearing Night Vision Goggles). Sufficient rest and recovery time between missions results in the repair of tissue damage and the cessation of pain. Insufficient rest and recovery time between missions results in the accumulation of tissue damage between missions. An accumulation of tissue damage beyond the tissue tolerance threshold results in injury and potentially chronic disabling pain.