Neuromusculoskeletal (NMSK) injuries are ubiquitous in the United States Armed Forces and pose a substantial threat to operational readiness. Many service members who sustain an NMSK injury progress to develop chronic conditions that may result in substantial decrease in function and physical activity across a lifetime. Both social and psychological factors may drive care-seeking and treatment compliance in service members following NMSK injury, contribute to the chronification of injury, which likely result in long-term cardiovascular consequences that contribute to morbidity and mortality. The decision to seek care following NMSK injury is ultimately related to the knowledge, beliefs, attitudes, and values of individual service members that are influenced by the military culture in which they serve. In this clinical perspective, the authors provided a theoretical framework on how psychosocial determinants of care-seeking may contribute to chronification of NMSK conditions and how this may influence long-term cardiovascular health. Cultural shifts and changes in health care delivery in the military may help to mitigate barriers to care and promote care-seeking with the clinician being viewed as a “force multiplier” or optimizer of readiness. Because there are substantial gaps still remaining in the evidence, the authors hope that this perspective will facilitate future research related to this topic.
To determine the associations between sport specialization, running-related injury, and menstrual dysfunction in high school distance runners. Methods: A total of 126 female runners competing in crosscountry and distance track events in southern California during the 2003-2004 interscholastic sport seasons were prospectively followed. Baseline questionnaires assessed sport participation, menstrual history, demographic characteristics, and anthropometric measurements. Low back and lower extremity musculoskeletal running-related injuries were recorded using daily injury reports. Results: Fifty-seven (45.2%) runners incurred at least one musculoskeletal running-related injury. At baseline, 27 (21.4%) runners were highly specialized athletes, 38 (30.2%) were moderate specialization athletes, and 61 (48.4%) were low specialization athletes. Compared to low specialization athletes, the risk of musculoskeletal running-related injury was 75% greater (relative risk = 1.75; 95% confidence interval [CI]: 1.1 to 2.7) and menstrual dysfunction was four times more likely in highly specialized athletes (relative risk = 4.22; 95% CI: 1.7 to 10.8). Conclusions: High sport specialization was associated with increased running-related injury risk and menstrual dysfunction in female interscholastic runners.
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