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Telling kids about their parent’s injury

Talking with your children about their other parent’s injury can be hard because there’s no good way to share bad news. Find out what helps ease the conversation.

Returning home after a deployment can be exciting but stressful. Still, coming home might present even greater challenges, especially when a service member is injured. Explaining an injury—either visible or invisible—to your children can seem overwhelming, but there are ways to help them cope with things.

It’s normal to worry about your children’s reaction to physical or mental injuries. If possible, talk with them about their other parent’s injuries before your family reunites. Children, family dynamics, and injuries are all unique. So, keep these in mind during your talk:

  • Use age-appropriate words to describe the other parent’s injury. For example, what you say to your six-year-old is different than what you discuss with your sixteen-year-old.
  • Talk about what happened. Be honest when explaining the injury, how it occurred, and any expectations about recovery. Not knowing what’s going on might cause kids to imagine scary, wrong, or bad things.
  • Give it time. Everyone responds differently to difficult news. Don’t force things. Be patient with your kids and yourself too. Support your children however they respond. And encourage them to share their feelings and ask questions.
  • Be a role model. Children take cues from their parents. If you cope well with your service member’s treatment, your kids are more likely to as well.
  • Reassure your children. They’ll want to know that even though their injured parent looks or acts differently, he or she is still the same person who loves and cares about them.

Remember: There’s no perfect explanation you can give your children. What’s most important? Talk, listen, and avoid judging their responses. And visit HPRC’s Returning Home/Reintegration and Post-Deployment sections to learn more.

DOMS: Post-workout delayed muscle soreness

A tough workout can leave you sore for days. Find out how to prevent and reduce delayed onset muscle soreness (DOMS).

Muscle pain a day or so after exercise—known as delayed onset muscle soreness (DOMS)—is common among athletes. Do you wonder why this happens—even when your workout went great—or what you can do about it?

DOMS results from damage to muscle fibers that occurred during exercise. You might experience DOMS after a hard workout, or even simple activities such as running and/or walking downhill or jumping. It also can occur when you’re starting a new workout routine or just getting back into shape after an illness or injury. The good news is DOMS can be treated at home—and sometimes prevented—with simple techniques, including stretching, protein/carbohydrate recovery drinks, and cold-water immersion. Sports massage and foam rolling can help reduce muscle soreness too.

Over-the-counter medications also can provide some relief. But use these at the lowest effective dose. Visit your doctor if the pain worsens or swelling occurs. In the meantime, read HPRC’s article, “Delayed Onset Muscle Soreness,” to learn about the difference between DOMS and other musculoskeletal pain.

Blisters: Sock it to ‘em

Get off on the right foot! Learn how to prevent blisters.

There are “steps” you can take to protect your feet from blisters. Common among athletes and service members, they might seem like a minor nuisance. However, if left untreated, they can lead to serious infections, sepsis (blood infection), and knee, ankle, or hip injuries.

Blisters result from a combination of friction and moisture. They’ve been blamed on shoe fit or lacing style, but scientific research has shown this isn’t necessarily the case. Common remedies—such as applying antiperspirant or drying powders to the bottom of the foot—aren’t very effective. And in some instances, they can cause irritation, increasing your chances of developing more blisters.

So if friction and moisture are causing problems, then wearing proper socks can bring relief. Look for ones made from acrylic fibers or materials other than cotton, which tends to stay wet. Synthetic materials (nylon, neoprene, and polyester) reduce the amount of shoe-to-sock and sock-to-foot friction by wicking moisture away from your skin. Padded socks also help because they allow for movement within the yarn, reducing frictional forces.

Some evidence suggests wearing a synthetic nylon or polyester liner with an outer-padded wool sock can help prevent blisters. Tip: Try finding your ideal sock before buying boots or shoes because the added bulk might affect the shoe size you need.

You also can reduce your risk of blisters by planning ahead, especially on extremely hot or rainy days. Avoid puddles. Remember to bring an extra pair of socks too. And avoid pouring water on your head since it can drip down into your shoes. Keep your feet happy and blister-free. 

Recovery Care Coordinators can help!

Learn how Recovery Care Coordinators help service members during their recovery, rehabilitation, and reintegration process after a serious or catastrophic wound, illness, or injury.

Recovery Care Coordinators (RCC) help wounded, ill, and injured service members, their caregivers, and their families navigate the recovery, rehabilitation, and reintegration process. They help ensure a smooth transition from a recovery and rehabilitation setting back into the civilian community or, in some instances, back to military duty. An RCC is the first point of contact within each of the military services’ wounded warrior programs. RCCs are located at military treatment facilities and installations throughout the country and overseas. Referral to RCCs can come from the service member, a caregiver, a family member, medical personnel, or a wounded warrior program. For more information on the referral process (and for contact numbers), read this factsheet.

How do RCCs help support service members, their caregivers, and their families during what is often a difficult and stressful period in their lives? The RCC develops a comprehensive recovery plan (CRP) with the service member, caregivers, family members, and the recovery team to identify goals and resources needed to achieve those goals, such as assistive technology, education, employment, or housing.

The DoD Office of Warrior Care Policy is responsible for oversight, policy of the Recovery Coordination Program, and standardized training for all RCCs, but each military service branch implements its own Recovery Coordination Program in accordance with DoD policy. The terminology may differ with service (for example, advocate, care coalition, recovery care), but the mission and the standards are the same. Check out the following links for service-specific information:

Is your Achilles tendon an uphill battle?

The Achilles tendon is stronger than you think, even when running hills.

The Achilles tendon (on the back of your ankle) is a common site for injury, especially for runners. And many people think running hills increases the likelihood of injuring their Achilles. Hill running provides many health benefits (cardiovascular endurance, strength, performance, etc.), but do the benefits outweigh the risk to your ankles? For the most part, the answer is, yes! The effects on your Achilles tendon while running on a flat surface, uphill, and downhill are all similar, meaning the risk of injury is no greater when running uphill or downhill than on the flat. Achilles injuries usually happen because of a combination of internal (ankle misalignment, muscle weakness, decreased flexibility) and external factors (footwear, over training, humidity, altitude). With movement, however, the Achilles tendon becomes more flexible, so a proper warm-up before exercise will help prevent injury.

What this suggests is that running hills isn’t necessarily a cause of injury to the Achilles tendon. More likely causes include progressing too quickly as a new athlete or not properly recovering from an injury. If you’re recovering from a previous injury to your Achilles tendon, talk to your doctor or therapist about when it’s safe to run again and how much hill running you are able to do. Be gradual in your return to running, especially hills. Don’t try to sprint up or down anything too steep too soon. But as long as you’re healthy, at your next hill encounter, be confident and take it on; your body is more likely to benefit than not.

National Veterans Summer Sports Clinic

Calling injured veterans to sign up for the National Summer Sports Clinic in San Diego, CA, September 13–18, 2015.

Spring is just around the corner, so it’s time to start thinking about sports and outdoor recreation. In keeping with the Mission ReDefined campaign (a joint effort of the U.S. Department of Veterans Affairs and the U.S. Paralympics), VA encourages eligible veterans (those injured within the last six years) to apply for the 2015 National Veterans Summer Sports Clinic.

The purpose of the Clinic program is “early intervention for Veterans battling back from injury, not only strengthening their bodies but improving overall well-being and self-worth.”

Spend a week in San Diego learning about adaptive sport and recreational activities such as sailing, surfing, track and field events, kayaking, and cycling (hand and tandem). This is a national event open to Veterans from all across the country with combat injuries ranging from TBI and polytrauma to spinal cord injuries and loss of limbs.

The clinic will be held in San Diego, CA, from Sept 13–18. 2015. The deadline to sign up is May 1, 2015; visit the Registration tab at the Clinic link above for details and forms.

Think like a survivor, not like a victim

Some individuals who have devastating injuries or illnesses are able to enjoy a good quality of life. Learn some factors that can help you think like a survivor, not a victim.

Why do some people with devastating injuries do well in their recoveries and others do not? People often focus on the negative fallout, but there can be positive consequences called post-traumatic growth. Scientists use the term “disability paradox” to refer to how some people with devastating illness or injuries are still able to enjoy a good quality of life. The characteristics of these folks describe someone with a “survivor mentality.” Characteristics include:

  • Subscribing meaning to one’s disability or lot in life and sharing this meaning with others.
  • Not choosing to live as a victim but instead to feel empowered and motivated to deal with struggles and come out as a victor.
  • Being flexible, adaptable, resilient, and rolling with the punches.

Many factors play into developing a survivor mentality. Here are some tips to help:

  • Create a strong support system: family, church, community, fellow Warfighters, healthcare providers, etc. A support system should be just that—supportive, encouraging, and a promoter of independence, not an enabler for being or feeling like a victim.
  • Maintain a “can do” attitude. See challenges or setbacks as an opportunity to learn and grow. Focus on strengths and abilities, not on limitations. Survivors exhibit the 4 Cs of mental toughness.
  • Maintain hope and optimism; focus on the future and move from thinking about the negative aspects of injury/illness to focusing on the positives or possibilities.  

The latest on antigravity treadmills

Check out our updated information on antigravity treadmills and their use in injury prevention and rehabilitation.

Antigravity treadmills are becoming increasingly popular in injury prevention and rehabilitation settings. These special treadmills reduce the stress placed on the lower body during rehabilitative exercises, like running and walking, while still conditioning muscles. However, there are still questions as to whether the scientific evidence supports their considerable cost. For more about the use, evidence, and cost of these devices, read HPRC’s “Effectiveness of Antigravity Treadmills for Injury Rehabilitation.”

Intimacy after an injury

Combat injuries such as PTSD and TBI can impact your ability and interest to be sexual with your partner. Two fact sheets provide more information and suggestions.

Being able to be close and sexual are key aspects of intimate relationships. Warfighters struggling with PTSD, TBI, or other combat injuries may be surprised to find that injuries can impact their ability to have sex, derive pleasure from sex, or be intimate by connecting emotionally with their partner. Or conversely there might be too much emphasis on sex (engaging in or talking about it inappropriately).

To learn more, check out these two fact sheets from the Uniformed Services University: “Reintegration and Intimacy: The Impact of PTSD and Other Invisible Injuries“ and “Physical Injury and Intimacy: Managing Relationship Challenges and Changes.” Both include suggestions for how to improve intimacy.

To learn more about other specific mental-health conditions, check out HPRC’s Mental Health & Suicide Prevention section. Also check out HPRC’s section on Relationship Enhancement.

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.

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.

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