by Mitch Hauschildt, MA, ATC, CSCS
We all understand the inherent risks that our military professionals face in the field of battle. They have unimaginable dangers from weapons, fighting, and environmental concerns. But, the statistics show that war related injuries may not be the greatest risk to our overall force readiness.
Here are some interesting stats to consider regarding the US military:
- Musculoskeletal injuries are the single most significant medical impediment to military readiness.
- Musculoskeletal injuries and their long-term effects are a leading cause for medical disability and discharge.
- For over 2 decades the primary health threat to troops has been common muscle, joint, tendon/ligament and bone injuries.
- “Non-battle injuries resulted in more medical evacuations from Afghanistan and Iraq than battle injuries” – Keith Hauret (US Army Public Health Command – USAPHC).
- The leading causes of these non-battle injuries were physical training and sports.
- Low back pain and osteoarthritis are the most common causes of separation from military service during peacetime and war
To compound the issue, the majority of the medical personnel on the front lines of military have little to no training on treating these musculoskeletal injuries. Understandably, they are well trained to save lives in combat situations but they are not trained to treat the low back and ankle injuries that are common within our military, especially in training settings.
This lack of musculoskeletal training means that when that ankle sprain or low back pain occurs, the service member usually ignores the pain until they can’t any longer, at which time they are referred to more advanced care, where the wait times can be long, leaving the service member on limited duty until things get sorted out. All of this leads to an overall fighting force that is unfit and not ready to go into combat when needed, which is their ultimate goal.
Rocktape has been working hard with the various branches of the military to mitigate a lot of these issues by utilizing a combination of self-care strategies, along with basic education for main-line medics and corpsmen. These individuals are on the front line everyday with our military members and they have evolved into primary care providers. By equipping them with basic skills, they can mitigate pain, improve performance, save money and enhance force readiness.
There are 3 key treatment approaches for these individuals:
Treat Pain First: Pain causes the human body to react in unpredictable ways. Our body will restrict range of motion, decrease strength and change entire motor programs because of the perceived threat that comes along with the pain response. If the body is in pain, it can’t perform.
Utilizing simple tools such as kinesiology tape and floss bands, we can easily down regulate pain to allow our service members to train hard and perform at a high level. This isn’t an effort to cover up an underlying issue or trick the system. Rather, these are techniques that can make the nervous system feel “safe”, thus reducing the anxiety and overall threat sensation that goes along with a mild injury to help people to properly train around or through their soreness.
The key with pain mitigation for the military population is keeping things simple. The tools have to be small, compact and easy to emplement. That’s why tape and floss are so valuable in this scenario. They can be placed in any pouch or backpack and take them anywhere in the world. They are also water resistant, exercise tolerant and can complement other treatments nicely.
Oftentimes people are tempted to overcomplicate taping applications, looking for just the right amount of stretch, perfect tape placement or make elaborate configurations. The suggestion for this population is to simply place an “X” over the area of pain. Don’t worry about stretch or the direction in which the tape is applied. Simply lay it on and let the tape disrupt the pain receptors, mitigating pain in that area.
Floss bands can also be a great way to influence the nervous system and down regulate pain through compression and tissue glide. By performing a simple 50/50 application (50% stretch/50% overlap) around a sore joint or muscle, that pain can be reduced quickly, allowing people to train successfully.
Increase Mobility: Military personnel face a number of challenges that can oftentimes predispose them to decreased range of motion and mobility restrictions. This includes things like boots that have a tendency to promote ankle dorsiflexion restrictions, backpacks that can promote a flexed position in the thoracic spine, and so on. These mobility restrictions can have a ripple effect through the kinetic chain.
Flossing bands are one of the simplest and most effective means for improving range of motion around a joint or area of the body. Simply apply a 50/50 application to the area that needs to be mobilized and take it through a range of motion for 2-3 minutes. This can be simple things like flexing or extending a joint while sitting in a chair or performing closed chain activities like squats or pushups. The movement of choice isn’t as important as the fact that you are taking the joint through a full range of motion. Follow this up with moving through a range of motion without a band and you will see an increase in the overall available range.
Improve Joint Position: Improving posture and joint position for our service men and women can be pivotal when dealing with long term or chronic issues. This includes things like the low back, neck or knee pain that often follows carrying loads on uneven surfaces. Helmets lead to poor neck and shoulder positioning and ultimately drive pain and injuries. Carrying heavy, asymmetrical weighted items such as rifles or ammo cans can lead to low back pain. And the list goes on and on for military personnel, both in a training environment or in the field.
Kinesiology tape can be a great intervention for improving posture and joint position. For this application, it is most advantageous to place the body part in an optimal position and tape them there. When they move out of the optimal position, they will feel a stretch on the tape and want to naturally move back towards the starting posture. For most people if there is a choice between taping for pain or joint position, it works well to tape for position, because their pain is often linked to poor posture. Another advantage to this application is that the end user will likely experience more endurance and less fatigue overall. They will be able to stronger and longer with their daily duties.
There is no question that the military faces unique obstacles with both training and field activities. With some increased musculoskeletal training for the people on the front line and some easy and accessible tools, force readiness can be improved, lowering overall costs and making us all safer in the end.
References:
Molloy JM et al (2012). Physical training injuries and interventions for military recruits. Mil Med 177(5), 553-558.
Institute of Medicine (1998). Reducing stress fracture in physically active military women. The National Academies Press.
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