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Preventing Injuries in Military Training


*Military OneSource does not provide medical counseling services for issues such as depression, substance abuse, suicide prevention or post-traumatic stress disorder. The article below is intended for informational purposes only. Military OneSource can provide referrals to your local military treatment facility, TRICARE or another appropriate resource.

Extreme weather conditions, inadequate hygiene or negligent self-care can all lead to injuries during military training. Injuries affect readiness, disrupt operations and can lead to disability. But if you take some wise precautions, prepare responsibly and learn about possible injuries, you'll be better equipped to face the physical rigors of training.

Some basics

Here are some fundamental points to think about as you prepare for military training:

  • Physical and mental conditioning — Adequate physical and mental conditioning are critical to help you face the challenges of training. They help you develop the stamina you'll need to perform your training duties. A six-week cardiovascular, strength-training and flexibility regimen can help you get ready.
  • Weather and terrain — Many training injuries involve extreme weather or terrain. Before you start training, try to get a sense of both the weather conditions and the ground you'll be walking or running on so you'll be prepared.
  • Stretching — Stretching your muscles before intense training or exercise is important, but be sure to stretch only after you've warmed up with a short walk or jog. The warm-up provides the best environment for your muscles to elongate during the stretch. Fitness trainers, physical therapists, physical training instructors, strength and conditioning coaches and websites can tell you how to stretch properly.
  • Hydration — Be sure to drink plenty of water before, during and after training. Drink only treated water from approved sources and refill your canteen whenever possible. It's smart to drink small amounts of water slowly to prevent cramps or nausea. Since thirst is an initial sign of dehydration, be sure to drink even when you aren't thirsty. Whenever possible, drink sports drinks to replace salts lost to sweating, but be careful not to consume excess salts, as this can lead to dehydration. Monitor the color of your urine to gauge whether you're sufficiently hydrated. It should be light yellow in color; dark urine is a signal that you need more water.
  • Halts — Halts are breaks in marching or training periods that allow time for rest and recovery. They are typically given in ten- to fifteen-minute increments for every forty-five to fifty minutes of training. Use this time wisely - remove or loosen your gear, refill your canteen, stretch and relax. If possible, try to lie down with your feet elevated, massage your feet, change your socks and apply foot powder.

Overuse injuries

Achilles tendonitis

The Achilles tendon is fibrous tissue that connects the heel to the calf muscles of the lower leg. Achilles tendonitis is inflammation and degeneration of this tendon, most commonly caused by over-pronation (collapsing of the arch). However, improper footwear, inadequate stretching prior to training or athletics, a short Achilles tendon, medication side effects, direct injury to the tendon and heel bone deformity can also lead to Achilles tendonitis.

Symptoms include pain in the tendon when moving, tenderness, redness, joint swelling, and creaking with up-and-down movement (known as tenosynovitis). In addition, with an inflamed Achilles tendon, you have a greater chance of rupturing the tendon.

Strengthening your calf muscles through toe raises can help prevent Achilles tendonitis. Try standing with your feet flat and then raising up on your toes. Hold the position temporarily and then slowly return to the standing position. Gentle, slow stretching of the Achilles tendons and calf muscles before exercise can also help prevent the condition.

Patellar-femoral syndrome

Also known as runner's knee, patellar-femoral syndrome occurs when the kneecap rubs against the end of the thighbone as the knee moves, causing pain around the front of the knee. Weak thigh muscles, excessive training or overuse, tight hamstrings or muscles in the back of the calf, foot pronation and tight Achilles tendons can all contribute to patellar-femoral syndrome.

Symptoms of patellar-femoral syndrome include swelling under the kneecap, a dull ache in the center of the knee, and pain during running, standing or sitting for long periods.

The best way to avoid patellar-femoral syndrome is to strengthen your thigh muscles and to wear shoes that fit well and provide support. Once you experience the symptoms of patellar-femoral syndrome, try to avoid bent-knee exercises or exercises that require you to be in a bent knee position for a long time.

Plantar fasciitis

Plantar fasciitis is an inflammation of the band of fibrous tissue running along the bottom surface of the foot (the plantar fascia) that can lead to heel pain, arch pain and heel spurs. Excessive stretching of the plantar fascia causes the inflammation, which can be brought on by sudden increases in physical activity, flat feet, poorly fitting boots or excessive weight on the feet.

Plantar fasciitis symptoms include pain in the soles of the feet near the inside, where the heel and arch meet. The pain can be sharp following rest, because rest allows the plantar fascia to return to its original shape. The most common symptom is pain following your first step out of bed in the morning. As the plantar fascia stretch with more movement, the pain often subsides.

You can reduce strain and stress on the plantar fascia by avoiding running on hard or uneven surfaces, losing any excess weight and wearing boots and orthotics that support your arch to prevent over-stretching of the plantar fascia. Wearing night splints can also help, since they can provide a constant stretch of the area during rest.

Stress fractures

Stress fractures occur when muscles become tired and can't absorb shock and repeated impacts, as in running. Over time, tired muscles transfer stress to the bone, resulting in a small crack (the stress fracture). While athletes and others who train frequently are most susceptible to stress fractures, anyone can experience them. People who begin a new exercise regimen and do too much too soon can suffer a stress fracture.

Symptoms include swelling in the fracture area, a dull ache following activity, pressure-sensitive areas, and pain that increases with activity and decreases with rest. Stress fractures can occur in any bone, but most often affect the weight-bearing bones of the lower leg and foot.

To help prevent stress fractures, the American Academy of Orthopedic Surgeons suggests athletes maintain a healthy diet with calcium-rich foods, increase mileage in training activities gradually, use proper equipment, and warm up and stretch before training.

Musculoskeletal injuries

Musculoskeletal injuries resulting from physical training are very common. They include:

  • Ankle sprains — Ankle sprains occur when the elastic ligaments connecting the bones of the ankle become stretched or torn. They usually occur when your foot rolls, twists or bends in an unnatural position. You can help prevent ankle sprains by maintaining good muscular strength and flexibility, paying attention to terrain or surfaces on which you move, warming up before exercise and using an ankle support.
  • Knee and thigh injuries — In addition to patellar-femoral syndrome, knee injuries can include ligament, tendon or cartilage tears. Thigh injuries include quadriceps (located at the front of the thigh) and hamstring (located at the back of the thigh) pulls or tears. You can help avoid knee and thigh injuries with a regular program of proper stretching, core muscle strengthening to increase stability, a well-balanced diet and proper fluid intake to avoid dehydration (which can lead to muscular injury).
  • Shin splints — Shin splints (pain in the front and inside part of the lower legs) can be caused by excessive exercise, flat feet, over-pronation, improper stretching and warm-up, worn-out shoes or exercising on hard surfaces. You can help avoid shin splints by stretching properly, varying your routine, gradually increasing stress in your routine, strengthening surrounding muscles with weight training and using properly fitted running shoes in good condition.

Some risk factors increase your chance of musculoskeletal injuries. These include low levels of previous or current physical fitness, previous injury history, too much jogging or running, extreme amounts of weekly exercise, smoking and age.

 


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