Monday, June 24, 2013

Does Movement Assessment Have A Place Outside of Sports?

Interestingly enough, this is a question that is asked frequently.  The assumption is that movement assessment is only for the athlete.  However, the contrary is true.  It has application across a wide spectrum of physical occupations.  This is especially true when you look at occupations that are physically demanding and where injury can mean the difference between life and death.   Taking three of the most obvious examples are fire fighters, police officers and military personnel.

Using the firefighter as an example, the physical demands of this occupation is very high.  Comparable to any high level athlete.  For example, the SCBA (self-contained breathing apparatus) that the firefighter wears weights ~75 pounds.  When you add the weight of the coat, helmet, boots, etc., you could be looking at an additional 45 pounds.  Collectively, that is 120 pounds of additional weight in protective gear and this is not including axes, hoses, or any additional equipment.  When considering carrying this amount of weight up a flight of stairs in Phoenix, Arizona where temperatures can get over 110 degrees, you can image how physically taxing this can be.  Rushing up a flight of stairs with this amount of weight, in hot weather, under stressful conditions, one can see that if pathokinematics are present, this could put this industrial athlete at risk for injury.  An injury, which if occurs at a critical juncture, could mean life or death.
 Looking at law enforcement officers, specifically at SWAT (special weapons and tactics) officers, the physical demands of their job is also that of a high level athlete.  Although their equipment is designed to be lighter, it can still weigh around 60 pounds.  That being said, depending on their location, they may be deployed up to 200 times a year and train in gear ~2 times a month.  Along with this additional training, they are also maintaining their regular job duties.  Therefore the number of “athletic exposures” are still high and during which they must carry a large amount of additional weight.  Again, if pathokinematics are present, they not only put their own life at risk but also that of their colleagues. 
So are movement related injuries occur outside of sport?  That is almost like asking if ACL injuries occur in anything other sports.  The answer is yes and they are abundant.  Looking across industries, the one that has the most data available (across the US) is the US military.  Looking at the military, the Department of Defense data shows that preventable non-contact injuries are extremely high. 
Top 10 DOD Injuries and DLD (days limited duty)

 

  • #1 LE overuse injuries – 3.8M days
  • #5 LE sprains/strains – 1.8 M days
  • #6 LE dislocations (ACL/cartilage) – 1.5M days
  • #8 Spine – 1.2 M days
 
Total this adds to 8.3 M days of limited duty for non-contact injuries in the military.  This results in $350M/year in extra labor.  The total cost is a staggering $1.5B of the $1T annual cost associated with injuries. 

Is the military alone in this struggle?  No.  Just using ACL injuries as an example, we have spent the better part of the last 12 years researching root causes and interventions.  Despite that, we have only had a 1.5% reduction in the number of ACL injuries despite all these initiatives.  The message should be clear.  We need to do it better and we need to do it now.  How do you tell a pitchers mechanics?  You watch them pitch.  How do you improve a hurdlers time?  You watch them in the hurdle.  How do you improve movement?  You watch them move. 

About the author:  Trent Nessler, PT, DPT, MPT is CEO/Founder of Accelerated Conditioning and Learning (A.C.L., LLC).  A.C.L., LLC is the developer of the Dynamic Movement Assessment™ and Fatigue Dynamic Movement Assessment™, which are athletic biomechanical analysis shown to reduce injuries and improve performance in athletics.  Trent is also Associate Editor for the International Journal of Athletic Training and Therapy and member of the USA Cheer Safety Council.  For more information, he can be contacted at info@aclprogram.com.

References:
1.      Kaufman K, Brodine S, Shaffer R.  Military Training Related Injuries.  Am J Prev Med.  18:54-63.  2000. 

2.      DoD Military Injury Prevention Priorities Working Group: Leading Injuries, Causes and Mitigation Recommendations White Paper. Defense Safety Oversight Council, Feb 2006.

3.      Army Medical Surveillance Activity, 2005.

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