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Filed under: Injuries

Exercise for the wounded warrior—mind and body

The physical benefits of exercise abound, but there are also psychological benefits associated with physical activity.

Not only is exercise good for the body, it’s good for the mind. The expert consensus from the International Society of Sport Psychology is that exercise can increase your sense of well-being and help reduce anxiety, tension, and depression.

For veterans coping with depression, PTSD, or other mental-health issues, sports and exercise may be a great way to relieve stress. Scientists have shown the positive benefits of physical activity on symptoms of depression in veterans. What’s more, Veterans’ Administration studies have found that physical activity—especially vigorous activity—can decrease the risk of PTSD among Warfighters. The opposite is also true: Veterans who do not engage in physical activity are more likely to experience PTSD. Several organizations specialize in physical activity and exercise for warriors and their families, but you can always try a yoga class, a family bike ride, or other fitness opportunities in your community.

Getting motivated to exercise and stay active can be especially difficult for those suffering from PTSD and depression. Here are some tips to help you get up and get out the door.

  • Make a date with yourself. Put it on your calendar or set a daily alarm—whatever you need to do to remind yourself that you’ve set aside some time for you to exercise. And don’t stand yourself up!
  • Set a SMART goal and write it down. Post it on your bathroom mirror, your fridge, your car dashboard—wherever you’ll see it daily to remind yourself of what you want to accomplish.
  • Recruit friends or family members to help. Telling people what your goals are is a great way to stay accountable. An exercise partner is especially helpful when you need that extra nudge to get off the couch and start moving.
  • Keep a journal. Record your exercise activities and how you felt afterwards. While you may not feel better after every workout, you probably will most of the time. Being able to go back and read/remember how good exercise made you feel may motivate you for the next workout.

What’s the big IDEO?

The Intrepid Dynamic Exoskeletal Orthosis (IDEO), a new orthotic technology designed for limb-salvage patients, helps Warfighters return to running, sports, and combat.

The U.S. Army has developed a device that will not only reduce the number of amputations but will help severely injured Warfighters return to duty. In the past, Warfighters with crushed and battered legs faced amputation or, at best, dysfunction due to pain and weakness. Now, with the introduction of the U.S. Army’s newest orthotic technology, amputations and decreased mobility may be a thing of the past for some.

The Intrepid Dynamic Exoskeletal Orthosis (IDEO) is the latest orthotic technology designed for Warfighters whose legs were crushed in combat. It uses technology similar to that of prosthetics worn by amputees and is higher in user satisfaction and performance compared with other braces available. Unlike other braces, IDEO does not depend on ankle movement, so Warfighters with fused ankle bones, where function is limited, can use them with little pain. With each step, IDEO stores energy and transfers it to the back of the brace, which springs the leg forward (similar to running-blade prosthetics). This allows the wearer to continue rebuilding the muscles in his or her leg while also working on functional movement.

In a study conducted by the Center for the Intrepid, eight of ten patients fitted with IDEO were able to run at least two miles without stopping. All ten Warfighters returned to weightlifting, many returned to playing sports or participating in mini-triathlons, and three returned to combat—two with Special Forces and one Army Ranger. The published report emphasized that the success of these patients was due not only to the innovative IDEO but also to the intense rehabilitation program and—most important—the motivation and drive of the individuals.

In combination with rehabilitation programs, IDEO looks like the newest in a wave of innovations that will help Warfighters return to normal function. If you are interested in learning more about IDEO and other innovative rehabilitation programs, please visit the U.S. Army Institute for Surgical Research and the Brooke Army Medical Center’s Center for the Intrepid.

Center for Rehabilitation Sciences Research

The Center for Rehabilitation Sciences Research (CRSR) is working to improve the lives and rehabilitation experience for injured servicemen and women.

Are you or is a service member you know going through rehab for an injury? Well it should be a comfort to know that there are people out there working hard to make sure you/they receive the best and most advanced forms of therapy and technology during rehab. The Center for Rehabilitation Sciences Research (CRSR) is headquartered at the Uniformed Services University, in Bethesda, MD, and their goals are to find solutions for improving rehabilitative care for injured service members and promote successful return to duty and reintegration. Most of their research is focused in the areas of orthopedic trauma, limb loss, and neurological complications, but they’re not working alone. Their expert team of researchers is partnered with other military medical facilities across the country, and they are committed to educating and training future healthcare providers within the military healthcare system. Visit the CRSR website to learn more about their current research, publications, and events.

New Year, new first aid kit for the Army

Filed under: First aid, Gear, Injuries
The Army has been working to improve front-line first-aid treatment for soldiers. Read on to learn about the “Individual First Aid Kit II” (IFAK II), which includes new life-saving equipment.

The Army has been working to make sure that the small first-aid kits that soldiers carry are equipped with the proper equipment they might need in an emergency. Here’s the lowdown on the additions to the IFAK II.

The new design is compatible with the Improved Outer Tactical Vest, where it can be mounted on the back, out of the way but still easy to reach. The creators of the IFAK II made individual tabs that “feel” different for each of the kit’s contents—so that when a soldier is trying to reach for something quickly, he/she can easily distinguish between products without actually looking at each pouch. This design is critical for rapid access to first-aid materials.

Other upgrades to the kit include the addition of a second tourniquet, a strap cutter, and a rubber-seal device to treat a sucking chest wound (when a bullet penetrates the lung and interferes with proper air flow). The addition of an eye patch to the kit also can help reduce damage to injured eyes.

Some soldiers in Afghanistan are already carrying the kits to test their functionality and provide feedback that can help lead to even more improvements.

One small step for man, one giant leap for lower-limb amputees

Thought-controlled bionic technology previously only available for arms now exists for legs. The once-farfetched idea of a bionic man is becoming a reality.

In 2013, the Research Institute of Chicago (RIC) presented the first mind-controlled bionic leg, thanks to support from the U.S. Army Medical Research and Material Command's (USAMRMC) Telemedicine and Advanced Technology Research Center (TATRC). Until now, this technology was only available for prosthetic arms. These brainy bionic legs are still being studied and perfected, but it’s hoped that they will be available in the next few years. This life-changing technology will be able to help the more than 1,600 service members who have returned from Iraq and Afghanistan with amputations. Bionic limbs will make the transition to active duty or civilian life smoother for wounded warriors.

In one case study, a civilian who lost his lower leg in a motorcycle accident underwent a procedure called “Targeted Muscle Re-innervation”. This procedure redirects nerves that originally went to muscles in the amputated limb to still-healthy muscles in the limb above the amputation. As these healthy muscles contract, they generate signals that are detected by sensors within the prosthetic and analyzed by a specially-designed computer chip and program The program rapidly decodes the type of movement the individual is preparing to do, such as bending the knee, and then sends those commands to the leg. This allows the person to walk up and down ramps and stairs and transition between activities without stopping. The user also can move (reposition) the bionic leg just by thinking about it, which is not possible with current motorized prosthetics.

The bionic leg is also showing a decreased rate of falling and quicker response time. Stay tuned for availability of this groundbreaking technology.

[Image Source: RIC/NWU]

Bomb blasts and eye damage

Blast shockwaves can cause serious damage to a Warfighter’s eyes, but early and proper care can help prevent serious permanent injury.

Many Warfighters exposed to bomb blasts in the field walk away unscathed—or so it would seem. However, there could be some damage they’re not “seeing.”

Many Warfighters survive bomb blasts without obvious injuries, but the high-pressure shockwaves from explosive blasts can cause serious physical damage to a Warfighter’s eyes. In fact, up to 10% of all blast survivors experience significant eye injuries, either from projectiles thrown into their eyes, eye perforations caused by the high-pressure blast waves, or effects on the eyes associated with traumatic brain injury (TBI). If you were exposed to a blast while in the field but were not otherwise injured, don’t wait to set up an appointment with your eye doctor. Your vision is extremely important! Don’t let potential eye injury go untreated. For more information on how blast waves can affect your vision, visit the Vision Center of Excellence.

Tips on tendonitis

Tendonitis results from damage to connective structures in your body. Learn more about it and get your body back in action.

You’ve been training, and now you’re in pain. It could be you’re having a painful introduction to one of your tendons. Strong tendons connect your muscles to the bones in your body and help you move by pulling on the bones when your muscles contract. Damage to tendons can occur from repetitive activities (including running and firing your weapon repeatedly over an extended period of time) or from sudden movements that put too much stress on a tendon. If you can’t avoid these activities, then pay attention to the warning signs that a tendon could be reaching its breaking point: pain, especially when moving the affected area; swelling over the area of pain; and, possibly, loss of motion in the joint.

The best way to avoid having to get treatment for tendonitis is to prevent it from happening in the first place! Follow these tips:

  1. Overall health: Maintain a healthy diet and weight, and check out HPRC’s Nutrition domain.
  2. Posture and body mechanics: Pay attention to your posture and make sure that you use correct body mechanics, especially when lifting and moving heavy objects.
  3. Maintain adequate muscle strength so your body can react to stresses you place on it.
  4. Maintain adequate flexibility.
  5. Consider proper workout gear, especially footwear; check out this HPRC article for more information.

How do get yourself back into your training program if you are suffering from tendonitis? The American Orthopaedic Society for Sports Medicine and the Cleveland Clinic recommend the following:

  1. Activity modification: Rest the affected area. This could mean taking some time off from activities that cause pain and further damage. For example, if you’re a runner with Achilles tendonitis, try biking instead until the tendon has healed enough.
  2. Ice: Cold can help to decrease pain and swelling.
  3. Physical therapy: Gentle stretching and strengthening exercises, as well as massage, might help but should be done under the supervision of a healthcare provider.
  4. Anti-inflammatory medications: Ask your physician about medications that can help your condition.
  5. Bracing or casting might be needed in severe cases.

You should see your doctor right away if you experience fever, redness, and warmth in the affected area, or multiple sites of pain. For more information on injury prevention, check out HPRC’s “Preventing common injuries,” which covers six specific areas of injury: wrist and hand, knee, ankle, rotator cuff, back, and IT band.

Performance Strategies for injury prevention

An ounce of prevention is worth a pound of cure. Check out our performance strategies for preventing common military injuries.

Injury prevention is critical in maintaining optimal performance and operational readiness. Ankle sprains, knee pain, and back pain are very common injuries in the military. Take the time now to protect yourself from injury, and you’ll be glad you did later. Read our performance  strategies to help fend off common military and athletic injuries, compiled from our recent injury prevention series of posts.

Injury prevention Part 6 – Hands and wrists

Even if you haven’t experienced carpal tunnel syndrome, you’ve probably heard of it. For more about this condition and ways to keep your hands and wrists pain-free, read on.

If you’ve been experiencing pain, burning, numbness, or tingling in one or both of your hands, you might be experiencing symptoms of carpal tunnel syndrome. This “tunnel” in the wrist carries the important tendons and nerves that supply your hands with motor and sensory functions, allowing your hands to move and feel. Swelling inside the carpal tunnel can squeeze the median nerve that passes through it, causing discomfort. According to the Defense Medical Epidemiology Database, in the military, women are more likely than men to develop this condition. It’s also more likely to develop with age and rank. There are surgical and non-surgical treatments for carpal tunnel syndrome, but as the saying goes, “An ounce of prevention is worth a pound of cure.” The University of Maryland Medical Center has advice, which includes:

  1. Do exercises to keep your muscles and tendon flexible. (See the UMMC link above for detailed instructions.)
  2. When performing repetitive activities your the wrists and hands, take frequent breaks, even if it’s just for a minute or two at a time—called “microbreaks.”
  3. Use correct posture and technique, especially wrist position when using a keyboard or hand tools.
  4. Make sure that your work area is ergonomically sound. Military-specific information is available from both the Army Public Health Command and the Naval Safety Center.

HPRC’s Physical Fitness domain also has a section on Injury Prevention.

Injury Prevention Part 4 – The Back

Back pain is common among military personnel. Follow these tips to maintain a healthy back and stay at the top of your game.

A 2011 study of musculoskeletal injuries in an Infantry Brigade Combat Team deployed to Afghanistan found that low back pain due to stress and strain on the back (not actual spinal cord injuries) was the most common complaint. Common causes of back injury include overuse, poor physical conditioning, and incorrect body movements when lifting and moving objects. Fortunately you can decrease your chances of injuring the muscles and ligaments of your back. The key is prevention: Stretching is one way to help prevent lower back pain, but it’s essential to use correct posture and body mechanics when you pick up and move objects such as heavy ammo cans! Daily back exercises (from the Mayo Clinic) and stretches can help strengthen your core and improve your posture, and the University of Maryland offers more valuable tips for prevention. If you’re experiencing back pain, however, you need to see a qualified healthcare professional for an accurate diagnosis and exercise program.

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