Staying healthy and “off profile” is key for optimal military performance. Injury prevention should be as much a part of your workout routine as the workout itself. Take time for some simple preventive exercises now, and you can save yourself a lot of trouble and pain down the road. Read our tactics for preventing common sports and military injuries.
The knee
Figuring out knee pain can take some detective work, although injuries are a common cause. For example, sports-related injuries such as anterior cruciate ligament (ACL) tears and chondromalacia (also called “runner’s knee”) can cause pain and affect performance. You can help prevent such injuries by strengthening your lower leg muscles. In addition, strengthening your hamstrings and quadriceps, which cross the knee joint, can give extra stability and support to your knees. Leg exercises such as squats, lunges, curls, and extensions will improve muscular strength and endurance in your hamstrings and quadriceps.
Weight management is also important in preventing some knee injuries. Excess body weight only adds stress to the knees during weight-bearing activities such as walking, running, or jumping.
Listening to your body is also key to prevention. If you feel that minor symptoms are getting worse, it might be a good time to temporarily modify your training until symptoms subside. For example, if running is part of your cardiovascular routine, consider trying a few weeks of alternate activities that are less stressful on the joints, such as swimming or biking.
The illiotibial band
If you start to notice hip or knee pain during your PT runs, you might be experiencing iliotibial band friction syndrome—ITBFS for short—a common overuse injury. The iliotibial band, or IT band, is a thick band of fibrous tissue that extends down the outside of your thigh to where it attaches to your tibia (your larger lower leg bone). As with all injuries to muscles and tendons, prevention is key. In most cases, ITBFS is brought on by combinations of factors—such as increasing your training mileage too fast, running on banked surfaces or downhill, pre-existing IT band tightness, and weakness of the lateral hip muscles—so paying attention to all of these is important for prevention. Incorporate some of these methods into your daily routine to help prevent ITBFS:
- A hip-conditioning program, as recommended by the American Academy of Orthopaedic Surgeons, can help you prevent ITBFS.
- Self-myofascial release methods such as foam rolling can be helpful with this hard-to-stretch area of your leg.
- Don’t do too much too soon. Gradually increase your running mileage or workout intensity.
- Guidelines for healthy adults include: (1) Increasing the duration of your exercise program 5–10 minutes every one or two weeks over the first four to six weeks; or (2) increasing your weekly training volume by no more than 10% per week.
- Stretches for the IT band and other muscles of the thigh and lower leg should be held for 30 seconds and repeated three to five times daily.
If you already have ITBFS, you probably notice more pain in the lateral (outside) of your hip or knee when you run downhill or lengthen your stride. If left untreated, it also can lead to pain when you walk up and down stairs or sit for long periods of time with your knees flexed. Of course, you should consult with your physician for proper diagnosis and treatment. On your own, however, care usually includes the RICE and ISE methods.
The hand and wrist
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 with your 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 Postgraduate School.
The back
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 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.
The shoulder
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.
The ankle
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, “write” the alphabet in the air with each foot (one foot at a time), 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.