Reducing the risk of training injury among Soldiers

By Maj. Vancil McNulty, Staff Physical Therapy OfficerAugust 3, 2011

Injuries represent the leading health problem of U.S. military personnel including deaths, disabilities, hospitalizations and outpatient treatment. Training-related injuries have been identified as the leading cause of clinic visits and have a very real impact on the readiness of the force due to the amount of limited duty time that results from such injuries. Most of the overuse injuries are due to the combined effect of physical training activities, military training and sports.

Research has shown that the following six interventions are effective at preventing injury:

1. Stop overtraining"Overtraining occurs when the amount of exercise is out of balance with recovery or rest. In the military, running too much contributes the most to overtraining. Running more than three days a week for longer than 30 minutes can dramatically increase the risk for a lower extremity injury without much improvement in fitness. Running short distances for short periods of time at higher intensity is not only safer, but it more effectively improves fitness to perform Soldier-specific tasks.

2. Perform multi-plane, body sense, and agility exercises"Exercises that work the body in different planes (not just straight line running) and challenge stability represent the same movements required during more complex combat and sporting activities and reduce injury risk.

3. Wear mouth guards during high risk activities"Mouth guards are effective for reducing injuries and should be used for any activity with a high risk of injury to the mouth and teeth. These include combatives, obstacle course, rifle/bayonet training and contact sports such as basketball, football, etc.

4. Wear semi-rigid ankle braces for high risk activities"There is excellent evidence that semi-rigid ankle braces reduce ankle injuries in high-risk physical activity such as airborne operations (parachuting), basketball, soccer and other similar high-risk activities. Ankle braces are especially effective in reducing risk of re-injury among individuals with previous ankle sprains.

5. Eat the right nutrients to restore energy balance within one hour following high intensity activity"Research indicates that consuming a combination of carbohydrates and protein within a 60-minute window immediately following very strenuous exercise starts repairing muscles damaged during the activity. Eating 12 to 18 grams of protein and 50 to 75 grams of carbohydrate and drinking a fluid replacement beverage within one hour after very strenuous, continuous physical activity (for example, road marching/hiking lasting longer than one hour) helps to minimize muscle damage and optimize recovery. Failure to recover leads to overtraining.

6. Wear synthetic blend socks to prevent blisters"Foot blisters are among the most common injuries experienced by Soldiers and Marines, especially in recruit training. These blisters can cause infection and limitations in duty. There is good evidence that synthetic blend (for example, blends of polyester, acrylic, and nylon) socks prevent blisters to the feet, and cotton socks cause blisters, especially during long-distance marching.

Knowledge of effective interventions that reduce injury risk is only half the story. Leaders are responsible for implementation of these simple yet proven interventions to protect the physical readiness of Soldiers.