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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.

Injury Prevention Part 3 – The Rotator Cuff

Injuries to the shoulder are common among military personnel—take steps to keep yours injury-free.

Staying in the physical condition you need for demanding duties and missions means that you are at risk for specific types of injuries, and rotator cuff injuries are common among service members. The rotator cuff is actually a group of muscles key to shoulder movement, including the ability to perform overhead activities. For those who are preparing for the CFT, this includes performing the Ammo Lift.

Warning signs of a shoulder injury can include not only pain and abnormal sounds during shoulder movement but also a decrease in strength and mobility/motion. What can you do about it? First, check with your healthcare provider to make sure that your injury does not require medical treatment. Then:

  1. Rest your injured shoulder! It is important to allow adequate time for healing.
  2. Use the RICE and ISE methods.
  3. Strengthen the muscles that control shoulder movement.
  4. Make sure that you have adequate flexibility of the rotator cuff muscles.

Of course, it’s always better to prevent injuries in the first place. To help reduce your risk of rotator cuff injury, it’s important to develop the strength and flexibility of the related muscles. For specific information on rotator-cuff exercises and self-care, check out these suggestions from MedLine Plus (a service of the National Institutes of Health) and this conditioning program from the American Academy of Orthopaedic Surgeons.

Injury Prevention Part 2 – Don’t neglect your ankles!

Injuries to the ligaments of the ankle are very common in the military, but there are some important tips you can use to help prevent them.

Stretching and strengthening the muscles of the foot and ankle can help you prevent (and recover) from ankle sprains. The Foot and Ankle Conditioning Program from the American Academy of Orthopaedic Surgeons focuses on recovering from injury, but it includes well-illustrated exercises that are good for preventive conditioning too. Here are some other exercises useful for strengthening the foot and ankle structure:

  • From a seated position, “pretend” writing the alphabet with each foot, in both upper- and lower-case letters.
  • Stand on one leg on a pillow for 10 seconds and then switch legs. Be sure to have something nearby to grab for balance if necessary.
  • From a seated position, use a resistance band looped to a secure surface, and wrap the other end around your forefoot; then move your foot/ankle forward, backward, and side-to-side, flexing at the ankle.

An ankle sprain involves damage to ligaments—bands of tissue that help hold joints together—in the foot and ankle, usually from the force of landing wrong on your foot. In military populations, ankle sprains are very common, significantly affecting operational readiness. In fact, ankle sprains are more common in the military than in civilian populations and more likely among women than men. By strengthening the muscles in your legs and feet, you can give more support to your ankle in the event of a misstep or an encounter with uneven terrain. The transition from military boots, which offer more ankle support, to traditional athletic shoes may also leave you and your ankles feeling vulnerable to twists and sprains. Start including ankle-strengthening exercises into your daily workout routine to help keep your ankles strong and free from injury.

Introducing the injury prevention series

You’ve worked hard to get to the level of fitness you’re at. If you want to stay there, here’s the best tip we have: Decrease your risk of injury!

The physical demands of military life are challenging, and if you’re not prepared, they can lead to injuries. The injury prevention series we’ll be running over the next several weeks will provide you with information and strategies for preventing some of the most common injuries: those to the knee, ankle, rotator cuff, back, iliotibial band and wrist/hand. Prevention is key: Taking time for the small stuff may have big payoff down the road. Much of what the exercises done for recovery after an injury can actually be done to prevent the injury in the first place. Stay injury-free for optimal performance! Check back soon for the first in this series.

Elastic therapeutic tape

Scientists still disagree about the value of elastic therapeutic tape, but you can give it a try next time you’re injured and see how it compares to what you’ve used in the past.

If you’ve injured a muscle or tendon during your PT training and wondered if that elastic tape that comes in bright colors could help you, read on. Elastic therapeutic tape is significantly different from regular elastic bandages, and it became popular during the 2008 Beijing Olympics when athletes such as professional beach volleyball player Kerri Walsh used it. Both are used to treat athletic injuries such as strains and sprains, but they produce their benefits in different ways. Elastic therapeutic tape is made of a thin material with thickness and elasticity similar to that of human skin. When taped on skin it supports injured muscles. However, it has also been reported that it helps relieve pain by lifting the skin away from the tissue beneath and enhancing blood and lymph flow to the injured area. Regular elastic bandages such as ACE bandages also provide support and reduce pain when wrapped around an injury, but unlike elastic therapeutic tape, they provide localized pressure to reduce swelling. In addition, they don’t stick to skin and usually restrict range of motion. Users report that elastic therapeutic tape works, but scientific evidence is contradictory. There just isn’t enough evidence to support the use of elastic therapeutic taping over other types of tape/bandage, and there is no scientific explanation for why it should work. So just be aware and use this tape at your discretion.

Deploying psychological first aid

HPRC Fitness Arena: Mind Tactics, Total Force Fitness
Experiencing an emergency or a crisis can be disturbing. Learn how you can help by providing psychological first aid following a disaster.

Individuals involved in disasters and terrorist attacks often experience psychological trauma that needs both immediate and ongoing attention. In addition to getting medical first-aid to individuals, responders can also help administer psychological first aid (PFA). A few features from the VA’s Psychological First Aid: Field Operations Guide are:

  • Ensure safety first. Physical needs (medical attention, food, and shelter) take priority. Before you begin PFA, assess whether these other needs have been taken care of. Remember to communicate clearly and be compassionate and polite as you come into contact with survivors.
  • Stay calm and spread calm. Be patient and pay attention to survivors, who are often in emotional distress, as they convey their story. If they express confusion, reassure them that their behavior is a natural response to the circumstances and offer healthy ways to cope with it. And make sure that your own emotional and physical reactions are not making the situation worse.
  • Connect with others. Help survivors connect with friends, family members, and other people who can support them. Relationships are invaluable to survivors during traumatic events.
  • Encourage hope. Help calm fears or worries about the future by reminding survivors that help is on the way and will continue to be available in the future as they recover.

For more information, see the “dos” and “don’ts” in this fact sheet from the Center for the Study of Traumatic Stress. Also, download the free PFA mobile app, which supplements the PFA Field Operations Guide to help you administer psychological first aid in the field. Online training and videos are also available; see links on the web page linked above. For more information on healthy ways to cope, check out HPRC’s Mind Tactics domain.

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