Overuse Injuries in Military Personnel

Hoffman, Jay R.; Church, David D.; Hoffman, Mattan W.

doi:10.1007/8415_2015_187

Cited by 4 publications

(5 citation statements)

References 66 publications

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“…Future research is needed to determine the physiological and metabolic responses of women to the cumulative stress of SUSPOS, and to what extent these responses differ from men. Nonetheless, current evidence indicates that military personnel are, at times, exposed to multi-stressor environments for sustained periods that can decrease muscle and whole-body protein [5,6,9,10,11,12,33,59]. Borrowing from clinical stress examples, greater physiological stress is associated with an absence of anabolic influence on muscle, and further, the resistance of muscle to the effects of nutrition/protein.…”

Section: Discussionmentioning

confidence: 99%

“…In this regard, it is important to note that an increased protein intake is necessary to help retain body nitrogen during energy deficit [32]. Military personnel also traditionally carry large loads in the field, and this has only increased over time [33]. This often includes rations and occupational items required to carry out the mission.…”

Section: Military Operational Energy Deficitsmentioning

confidence: 99%

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Mitigation of Muscle Loss in Stressed Physiology: Military Relevance

et al. 2019

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Military personnel may be exposed to circumstances (e.g., large energy deficits, sleep deprivation, cognitive demands, and environmental extremes) of external stressors during training and combat operations (i.e., operational stressors) that combine to degrade muscle protein. The loss of muscle protein is further exacerbated by frequent periods of severe energy deficit. Exposure to these factors results in a hypogonadal state that may contribute to observed decrements in muscle mass. In this review, lessons learned from studying severe clinical stressed states and the interventions designed to mitigate the loss of muscle protein are discussed in the context of military operational stress. For example, restoration of the anabolic hormonal status (e.g., testosterone, insulin, and growth hormone) in stressed physiological states may be necessary to restore the anabolic influence derived from dietary protein on muscle. Based on our clinical experiences, restoration of the normal testosterone status during sustained periods of operational stress may be advantageous. We demonstrated that in severe burn patients, pharmacologic normalization of the anabolic hormonal status restores the anabolic stimulatory effect of nutrition on muscle by improving the protein synthetic efficiency and limiting amino acid loss from skeletal muscle. Furthermore, an optimal protein intake, and in particular essential amino acid delivery, may be an integral ingredient in a restored anabolic response during the stress state. Interventions which improve the muscle net protein balance may positively impact soldier performance in trying conditions.

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Section: Discussionmentioning

confidence: 99%

Section: Military Operational Energy Deficitsmentioning

confidence: 99%

Mitigation of Muscle Loss in Stressed Physiology: Military Relevance

et al. 2019

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“…Although further research is needed to disentangle the inconsistent relationships that we observed between these two types of analyses, one plausible explanation is that airmen with high ACs may have less risk over a relatively shorter period of time because of physical inactivity, but that likelihood of overuse injury may increase over longer periods of time (e.g., multiple years) as airmen must engage in some amount of physical activity to meet AF-FA requirements. The higher rate of overuse injuries among a more fit population may perhaps be the result of higher levels of physical activity or, in some cases, overtraining (Hoffman, Church, and Hoffman, 2016;Wheeler and Wenke, 2018).…”

Section: Relationship Between Fitness and Injury Diagnosesmentioning

confidence: 99%

Physical Fitness Standards to Support Readiness and Deployability: An Examination of Department of the Air Force Policies and Culture

Matthews¹,

Sims²,

Robson³

et al. 2022

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Building a more comprehensive understanding of how different factors influence exercise habits, test preparation, and the perceived importance of fitness is critical to promoting a ready and deployable force. Therefore, the Department of the Air Force (DAF) engaged the RAND Corporation to evaluate the validity and perceived relevance of the U.S. Air Force's (AF's) fitness assessment (FA) to support the readiness and deployability of airmen and guardians by examining the possible impact of the AF-FA on military career and future military health experience.To address this objective, we examined the empirical associations between AF-FA scores and various health-related and professional outcomes. We also conducted interviews with DAF commanders and military personnel to identify perceptions of current policies, objectives, communication, and leadership support for fitness and exercise. During the production of this report, the DAF made changes to the AF-FA, which are not reflected in our data analysis or interviews with subject-matter experts.The research reported here was commissioned by the AF's Force Management Policy Directorate (AF/A1P) and conducted within the Workforce, Development, and Health Program of RAND Project AIR FORCE as part of a fiscal year 2020 project, "Fitness Standards to Support Readiness and Deployability."The RAND Corporation is committed to the ethical and respectful treatment of RAND research participants and complies with all applicable laws and regulations, including the Federal Policy for the Protection of Human Subjects, also known as the "Common Rule." The research described in this report was screened and, if necessary, reviewed by RAND's Human Subjects Protection Committee, which serves as RAND's institutional review board (IRB) charged with ensuring the ethical treatment of individuals who are participants in RAND projects through observation, intervention, interaction, or use of data about them. RAND's Federalwide Assurance (FWA) for the Protection of Human Subjects (FWA00003425, effective until June 22, 2023) serves as our assurance of compliance with federal regulations.The views of any unnamed sources are solely their own and do not represent the official policy or position of any department or agency of the U.S. government.

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“…Reported acute and overuse injury incidence in the British army is 49% and it is 53% for military personnel in the USA (Sharma et al, 2015;Grier et al, 2020). The majority of reported MSKI among different military populations are injuries due to cumulative repetitive microtrauma (Hoffman et al, 2015). Repetitive highintensity training with a short recovery period is a significant contributor to injury with gradual onset -overuse injury (Kaufman et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Peak Plantar Pressure as a Risk Factor for Lower Extremity Overuse Injury Among Infantry Soldiers

Nesterovica

Stepens

Vaivads³

2021

Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.

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The majority of reported injuries among military populations are injuries due to cumulative repetitive microtrauma — overuse injuries. Plantar pressure measurement is a simple tool to analyse lower limb biomechanics through the assessment of forces applied to the foot. This study aimed to determine the relation between peak plantar pressure and lower extremity overuse. Sixty-six active-duty infantry male soldiers, with mean age 29.7 years (range 22–40 years), and mean service time 5.2 years (range 1–15 years) participated. The highest peak plantar pressure (PPP) at the forefoot occurred at the hallux (cases: 50.82 n/cm2, SD = 38.84; control: 34.39 n/cm2, SD= 28.03) and 3rd metatarsal head (cases: 54.40 n/cm2, SD = 33.83; control: 49.16 n/cm2, SD=28.87). The study demonstrated elevated PPP among cases. Statistically significant results were found at the hallux (χ2(1) = 6.8; p = 0.01), medial heel (χ2(1) = 5.18; p = 0.02) and lateral heel (χ2(1) = 12.12; p < 0.01) regions. The results show that plantar pressure assessment could be used as a useful screening tool for early lower extremity overuse injury detection.

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Overuse Injuries in Military Personnel

Cited by 4 publications

References 66 publications

Mitigation of Muscle Loss in Stressed Physiology: Military Relevance

Mitigation of Muscle Loss in Stressed Physiology: Military Relevance

Physical Fitness Standards to Support Readiness and Deployability: An Examination of Department of the Air Force Policies and Culture

Peak Plantar Pressure as a Risk Factor for Lower Extremity Overuse Injury Among Infantry Soldiers

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