Musculoskeletal (MSK) injuries are the most significant medical non-readiness factor in the U.S. Army. Army Public Health Center (APHC) experts addressed this issue during a Warriors Corner presentation at the recent Association of the United States Army 2019 annual meeting and exposition in Washington, D.C.
“We currently have about 8 million limited duty days inside of our total Army every year from this,” said Brig. Gen. Jeff Johnson, Deputy Chief of Staff for Support, U.S. Army Medical Command/Chief of Dental Corps. “That has a significant impact on training and on readiness.”
Aiming to help commanders understand how to get ahead of the problem and minimize MSK injuries, speakers focused on the issue’s magnitude, research indicating its causes, and management approaches to reduce injuries and improve readiness.
Dr. Bruce Jones, senior scientist in the APHC Directorate of Clinical Public Health and Epidemiology with a focus on injury prevention, cited U.S. Army active duty figures for 2017 showing over 2 million medical encounters for injuries. “That’s what we see year in and year out, so this is a big problem,” he said.
Jones explained that 75% of Army injuries are MSK injuries due to cumulative trauma, or overuse injuries, including stress fractures, Achilles tendonitis, patellar-femoral syndrome, plantar fasciitis, and back and knee pain syndromes. These are mostly from training and strenuous operational activities reflecting actions necessary for mission preparedness, with running the leading cause of MSK injuries.
Jones emphasized that over 30 years of Army injury prevention research has shown the strong connection between both aerobic fitness and body composition as related to increased risk for MSK injury.
Todd Hoover, Army Wellness Center Operations Division Chief, APHC, quantified these risk factors in terms of both two-mile run times and body mass index ratings out of compliance with Army Regulation 600-9, either too low or too high. But the primary MSK risk factor is slow run time, meaning males with a two-mile run time greater than 15 minutes or females with a two-mile run time greater than 18 minutes.
These are the soldiers, Hoover said, who would benefit most from intervention to increase aerobic capacity in order to decrease MSK risk.
Hoover highlighted the capabilities of the Army Wellness Centers, an integrated network of 35 facilities located across the U.S. and overseas. With a primary focus on prevention, the centers provide soldiers personalized fitness assessments utilizing a wide range of advanced technology that measures aerobic capacity and metabolic functions combined with expert health coaching to optimize individual results.
Additionally, Hoover described the enhanced capabilities of the recently-introduced K-5 technology into Army Wellness Centers. The portable, wearable metabolic analyzer can be taken out to units where soldiers can wear it on a two-mile run, gathering advanced data on aerobic capacity and performance. Currently being tested at 22 wellness centers, Hoover said the largest test is a validation analysis working with Appalachian State University at Fort Campbell, Kentucky.
Other modifiable health behaviors associated with MSK injury risk are smoking and poor sleep, and the Army Wellness Centers also address these factors with soldiers if appropriate.
With the goal of decreasing MSK injuries and increasing readiness, Hoover said, “What we’re trying to educate leaders on is if you have soldiers in your formation that meet these run time criteria, those are the soldiers that would best benefit from a visit to an Army Wellness Center.”