Filed under: 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 , compiled from our recent injury prevention series of posts.
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:
- Do exercises to keep your muscles and tendon flexible. (See the UMMC link above for detailed instructions.)
- 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.”
- Use correct posture and technique, especially wrist position when using a keyboard or hand tools.
- 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.
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.
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