Throughout history, US military personnel have had a hard time correlating the mechanics seen in sports to the military personnel. But is that the case in all countries. Not necessarily. For example, in Brazil the military does screen their military for the mechanics associated with non-contact lower extremity injuries. Doing so, they have had a huge impact on non-contact lower extremity injuries. Considering that this accounts for over 70% of their injuries, the financial impact is profound. Are they more progressive or know something that no one else does? Yes and no. Since Brazilian athletes are intimately integrated with the military bases, it gives the health care providers a very unique perspective in comparison of the athlete to the solider. In essence, they are one in the same. But what do the studies tell us?
According to Uhorchak et al in a study published in the American Journal of Sports Medicine in 2003, the same movement patterns that are associated with ACL injuries in athletics also predispose US military cadets for ACL injuries. Boling et al demonstrated in 2009 that these same movement patterns also lead to patellofemoral (PF) pain syndrome in military recruits and if identified can reduce risk for ACL injuries as well as PF pain. We know in high school athletics that ACL injuries results in an annual cost of ~$1.3B to $2.7B in health care costs but is there a similar cost associated with preventable injuries in the military?
According to the Defense Medical Surveillance System, 2010, musculoskeletal injuries account for the largest percentage of the 1.2M medical encounters in the US Army in 2010. 33.9% of these were the result of non-battle injuries and over 60% of those were preventable non-contact musculoskeletal injuries. In 2009, of the >1100 serious injuries that occurred at Ft. Jackson, over 85% were the result of overtraining and are therefore preventable. Sports studies show that improvement of mechanics associated with non-contact ACL injuries results in >60% reduction in all these non-contact lower limb injuries.
For example, lets look at a study by Waterman et al, published in the American Journal of Sports Medicine 2013, the authors looked at anterior compartment syndrome and what are the risk factors that predispose service members for. The intent is to identify risk factors so that prevention techniques can be employed.
Discussion: Based on the data presented, injury rates are on the rise. Many feel this may be result of a less physically fit recruit today than 10 years ago. Whatever the case may be, the net result is increased injury rates, increased short and long term cost and decreased re-enlistment rates. Although the data above makes a lot of sense, what does it tell us about “root cause”? Is this information that we can use to prevent these types of injuries in the military. Can we change one’s gender or their rank in the military? No. But it can guide us if we can correlate this data with existing research. For example, we know from Weist et al, research in 2004 that prolonged running results in fatigue in the lower kinetic chain. This adds to: