Filed under: 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:
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.
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.
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.
Have you ever felt great after a hard workout, only to find yourself incredibly sore a day or two later? Muscle pain a day or so after exercise is common among recreational athletes. Known as delayed onset muscle soreness (DOMS), this condition can be treated at home—and possibly even prevented—with simple techniques. Strategies to prevent or reduce DOMS include stretching, protein/carbohydrate recovery drinks, and cold-water immersion. Over-the-counter medications can also help with pain but should be used infrequently and at the lowest effective dose. For more detailed information about DOMS and how to prevent and recover from it, read HPRC’s Answer, “Delayed Onset Muscle Soreness.”
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.”
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.
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:
- Overall health: Maintain a healthy diet and weight, and check out HPRC’s Nutrition domain.
- 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.
- Maintain adequate muscle strength so your body can react to stresses you place on it.
- Maintain adequate flexibility.
- Consider proper workout gear, especially footwear.
- 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.
- Ice: Cold can help to decrease pain and swelling.
- Physical therapy: Gentle stretching and strengthening exercises, as well as massage, might help but should be done under the supervision of a healthcare provider.
- Anti-inflammatory medications: Ask your physician about medications that can help your condition.
- 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.
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.
Chondromalacia is a knee problem that can have a number of different symptoms, including pain. It can your ability to exercise, but even more problematic is that it can interfere with your ability to meet the demands of your military duties.
Here’s the basic rundown on chondromalacia: In a healthy state, the kneecap has soft cartilage beneath that allows the bone to glide smoothly against the other bones of your knee joint. When the smooth surface wears away, the back of the kneecap becomes rough and rubs the other bone surfaces, causing pain. The key to avoiding this condition is maintaining that smooth surface.
According to the American Academy of Orthopaedic Surgeons, muscle weakness, imbalance, or tightness in the thigh muscles can contribute to chondromalacia. It’s important to maintain strength in your quadriceps and hamstring muscles; follow a strength-training program to develop and maintain strong muscles. Also, make sure that you have enough flexibility in your quads; if the muscles and tendons are too tight, they can force the kneecap to move or “track” incorrectly in the natural groove of your knee joint. If you do a lot of running, make sure your footwear isn’t old and worn, because the shock-absorption of shoes decreases as they age. When it comes to knee pain, an ounce of prevention is worth a pound of cure. Strengthen and stretch your muscles, and you’ll be on your way to keeping your knees ready for action.