Risk factors for injury associated with low, moderate, and high mileage road marching in a U.S. Army infantry brigade

Schuh-Renner, Anna; Grier, Tyson; Canham-Chervak, Michelle; Hauschild, Veronique; Roy, Tanja C.; Fletcher, Jeremy; Jones, Bruce H.

doi:10.1016/j.jsams.2017.07.027

Cited by 42 publications

(37 citation statements)

References 27 publications

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“…Standardized physical training, reduced running mileage 1,5,27,42 Ability groups for running 27,49 Not effective in reducing injury risk or findings are inconsistent Back brace to prevent job or sport injury (no effect) 27 Running shoe types (no effect) 33,39 Boots versus running shoes (no effect) 7 Insoles, orthotics (inconsistent) 10 The second step of the process answers the question: What causes the problem? Because physical training injuries were a priority accounting for over 50% of Army injuries, 2 investigations to further address the causes and risk factors were warranted.…”

Section: Effective In Reducing Injury Riskmentioning

confidence: 99%

“…23,31 More recently, APHC has shown that greater amounts of weight carried and greater distances of miles marched were associated with greater risks of injury among male soldiers. 32 These findings represent a dose response effect; the more physical stress to which soldiers are exposed, the more likely it is they will be injured.…”

Section: Effective In Reducing Injury Riskmentioning

confidence: 99%

See 1 more Smart Citation

Musculoskeletal training injury prevention in the U.S. Army: Evolution of the science and the public health approach

Jones¹,

Hauschild²,

Canham-Chervak³

2018

Journal of Science and Medicine in Sport

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Injuries cause more morbidity among soldiers in the U.S. Army than any other health condition. Over two-thirds of U.S. soldiers' injuries occur gradually from cumulative micro-traumatic damage to the musculoskeletal system as a result of physical training activities. Paradoxically, the very physical training activities required to improve soldier performance also result in injury. Determining the amounts and types of physical training that maximize performance while minimizing injuries requires scientific evidence. This evidence must be incorporated into a framework that ensures scientific gaps are addressed and prevention efforts are evaluated. The five-step public health approach has proven to be an effective construct for Army public health to organize and build an injury prevention program. Steps include: 1) surveillance to define the magnitude of the problem, 2) research and field investigations to identify causes and risk factors, 3) intervention trials and systematic reviews to determine what works to address leading risk factors, 4) program and policy implementation to execute prevention, and 5) program evaluation to assess effectiveness. Dissemination is also needed to ensure availability of scientific lessons learned. Although the steps may not be conducted in order, the capability to perform each step is necessary to sustain a successful program and make progress toward injury control and prevention. As with many U.S. public health successes (e.g., seatbelts, smoking cessation), the full process can take decades. As described in this paper, the U.S. Army uses the public health approach to assure that, as the science evolves, it is translated into effective prevention.

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Section: Effective In Reducing Injury Riskmentioning

confidence: 99%

Section: Effective In Reducing Injury Riskmentioning

confidence: 99%

Musculoskeletal training injury prevention in the U.S. Army: Evolution of the science and the public health approach

Jones¹,

Hauschild²,

Canham-Chervak³

2018

Journal of Science and Medicine in Sport

Self Cite

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“…Military personnel are routinely required to carry additional weight during training and in the field [10], and runners will often wear a weighted vest to increase training intensity. It is possible that these additional body-borne loads may influence PFJS; however, our understanding of the effects of additional body-bone loads on patellofemoral joint mechanics is limited.…”

Section: Introductionmentioning

confidence: 99%

Patellofemoral Joint Stress during Running with Added Load in Females

et al. 2020

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Patellofemoral joint (PFJ) pain syndrome is a commonly reported form of pain in female runners and military personnel. Increased PFJ stress may be a contributing factor. Few studies have examined PFJ stress running with added load. Our purpose was to analyze PFJ stress, PFJ reaction force, quadriceps force, knee flexion angle, and other kinematic and temporospatial variables running with and without a 9 kg load. Nineteen females ran across a force platform with no added load and 9.0 kg weight vest. Kinematic data were collected using 3D motion capture and kinetic data with a force platform. Muscle forces were estimated using a musculoskeletal model, and peak PFJ loading variables were calculated during stance. Multivariate analyses were run on PFJ loading variables and on cadence, step length and foot strike index. Differences were shown in PFJ stress, PFJ reaction force, peak knee flexion angle and quadriceps force. Joint specific kinetic variables increased between 5–16% with added load. PFJ loading variables increased with 9 kg of added load without changes in cadence, step length, or foot strike index compared to no load. Added load appears to increase the PFJ loading variables associated with PFJ pain in running.

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“…The effects of such loading are exacerbated with fatigue due to the deterioration of local muscular control 33 . It is therefore not surprising that marching has been identified as one of the principal activities associated with injuries in army populations 34 …”

Section: Introductionmentioning

confidence: 99%

Muscle‐tendon morphology and function following long‐term exposure to repeated and strenuous mechanical loading

Bissas

Havenetidis

Walker

et al. 2020

Scandinavian Med Sci Sports

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We mapped structural and functional characteristics of muscle‐tendon units in a population exposed to very long‐term routine overloading. Twenty‐eight military academy cadets (age = 21.00 ± 1.1 years; height = 176.1 ± 4.8 cm; mass = 73.8 ± 7.0 kg) exposed for over 24 months to repetitive overloading were profiled via ultrasonography with a senior subgroup of them (n = 11; age = 21.4 ± 1.0 years; height = 176.5 ± 4.8 cm; mass = 71.4 ± 6.6 kg) also tested while walking and marching on a treadmill. A group of eleven ethnicity‐ and age‐matched civilians (age = 21.6 ± 0.7 years; height = 176.8 ± 4.3 cm; mass = 74.6 ± 5.6 kg) was also profiled and tested. Cadets and civilians exhibited similar morphology (muscle and tendon thickness and cross‐sectional area, pennation angle, fascicle length) in 26 out of 29 sites including the Achilles tendon. However, patellar tendon thickness along the entire tendon was greater (P < .05) by a mean of 16% for the senior cadets compared with civilians. Dynamically, cadets showed significantly smaller ranges of fascicle length change and lower shortening velocity in medial gastrocnemius during walking (44.0% and 47.6%, P < .05‐.01) and marching (27.5% and 34.3%, P < .05‐.01) than civilians. Furthermore, cadets showed lower normalized soleus electrical activity during walking (22.7%, P < .05) and marching (27.0%, P < .05). Therefore, 24‐36 months of continuous overloading, primarily occurring under aerobic conditions, leads to more efficient neural and mechanical behavior in the triceps surae complex, without any major macroscopic alterations in key anatomical structures.

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Risk factors for injury associated with low, moderate, and high mileage road marching in a U.S. Army infantry brigade

Cited by 42 publications

References 27 publications

Musculoskeletal training injury prevention in the U.S. Army: Evolution of the science and the public health approach

Musculoskeletal training injury prevention in the U.S. Army: Evolution of the science and the public health approach

Patellofemoral Joint Stress during Running with Added Load in Females

Muscle‐tendon morphology and function following long‐term exposure to repeated and strenuous mechanical loading

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