Filed under: Injuries
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:
- Rest your injured shoulder! It is important to allow adequate time for healing.
- Use the RICE and ISE methods.
- Strengthen the muscles that control shoulder movement.
- 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.
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.
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.
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.
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.
Warfighters involved in Operation Desert Storm to current missions in Iraq and Afghanistan may be experiencing what the Institute of Medicine is calling “Chronic Multisymptom Illness.” Research suggests that it is connected to toxins and contaminated environments in Middle East combat zones. Those who appear to be suffering from it have apparently unexplainable symptoms lasting at least six months in two or more of the following categories: fatigue, mood and cognition issues, musculoskeletal problems, gastrointestinal problems, respiratory difficulties, and neurologic issues. Dust storms and smoke from burn pits may be the vehicles for transporting toxic metals, bacteria, viruses, and perhaps the nerve gas sarin. Experts suggest that high temperatures and low humidity in the Middle East cause people to breathe more through their mouths than through their nose, carrying the pollutants deeper into the lungs, especially during rigorous physical activity. New legislation has recently set up burn pit registries to track the medical histories of those who may have been exposed to smoke from the practice of burning waste (human, plastic bottles, etc.) using jet fuel. With the rise of unexplained medical conditions among younger veterans of recent conflicts, researchers are looking for more conclusive evidence as to what exactly is causing this chronic illness. In the meantime, the IOM has just published a report with extensive information and recommendations for treatment.
Barefoot-style, or minimalist, running shoes are still growing in popularity in the military, and the debate continues over whether this style of running prevents injuries or just causes different injuries. There is new research on minimalist running shoes (MRS) and their impact on lower leg and foot injury. After a 10-week study, runners who transitioned to Vibram FiveFinger minimalist running shoes showed signs of injury to their foot bones, while the runners who used traditional running shoes showed none. The types of injuries the MRS runners demonstrated were early signs of inflammation, which may or may not be associated with pain or joint dysfunction. If they are, it might be difficult for the runner to know he/she is actually injured until it is too late and the injury has progressed. More research is needed to determine if other factors (weight, running form/style, mileage, running surface) contribute to injuries associated with barefoot-style running. At least one recent study suggests running style may be a factor. For more in-depth information, read
Pain is a sensation of both the body and the mind—and it’s within your power to use strategies such as meditation to control the mental aspect to decrease the physical sensation of pain. Meditation can teach you to have a focused, calm mind, and rhythmic breathing. It may sound easy, but it requires practice. The payoffs can be improved well-being, reduced pain, and relaxation. Want to know more? Check out HPRC’s new Pain Management section, where you can find strategies such as meditation that you can use on your own or with the help of a healthcare provider.
Being overweight puts you at risk for a whole host of health issues, but most people don’t think about the risk posed to their knees. The anterior cruciate ligament, or ACL, is one of the major ligaments of the knee and one of the most susceptible to injury. Injury information on more than 1,600 men and women at the U.S. Naval Academy showed that those with a higher body mass index (BMI) had a greater incidence of ACL tears. A difference in BMI of only 1.2 (25.6 versus 24.4) made the difference between having and not having this kind of injury. (To learn more about BMI, read HPRC's explanation.)
Like the adage “You don’t know what you’ve got until it’s gone,” knees are something we generally take for granted. To stay on top of your game, you need your knees. An easy way to protect them is to drop the extra weight you’re asking them to carry around.
Physical and mental rehab for wounded warriors can come in the form of an undersea adventure. A 2011 study at Johns Hopkins University looked at the effects of a four-day scuba certification class on a group of veterans with spinal injuries. The benefits noted included improved muscle movements, reduction of post-traumatic stress disorder symptoms, and improved sensitivity/sensation for those with certain spinal cord injuries.
Being in the water offers a zero-gravity environment that enables Warfighters to develop the confidence and ability to do activities they may not feel comfortable doing on land. There are organizations that provide scuba lessons and outings for wounded veterans and their families free of charge, such as Adaptive Heroes, Soldiers Undertaking Disabled Scuba (SUDS), and Divers4Heroes, to name a few. Check for programs in your area and explore the great unknown!