Musculoskeletal injury concerns - Fitness, Sports and Deployed

October 2012
Inside this issue:
Nick’s Nutrition
2
Exercise of the Month
3
Importance of Walking
3
Group Exercise
4
Site Events
4
The Dispatch
SHAPE Monthly Newsletter
Musculoskeletal injury concerns
Did you know that musculoskeletal injuries
are among the leading causes of disability
and morbidity among military personnel? In
fact, as highlighted in a recent article by
Taanila et al. (2010), although “health clinic
visit rates are approximately equal for injuries and illnesses in the military environment, the morbidity associated with injuries
is over five times greater than that associated with illness.” Cohen et al. (2010) explains,
“Anticipation of the types of injuries that
occur in modern warfare is essential to plan
operations and maintain a healthy military.”
Therefore, implementation of preventive
measures for service members could reduce
the effect of non-battle-related injuries and
disease on military readiness.
especially since this type of injury contributes greatly to the prevalence of morbidity
and disability among the military population
(Taanila et al., 2010).
Recent epidemiological studies have focused
on identifying the risk factors most consistently associated with sustaining injuries,
particularly during military training. Taanila
et al. (2010) explains that previous research
studies have highlighted “previous history of
injury, low levels of physical fitness and activity, high amount of weekly exercise, high
mileage running, biomechanical factors, and
tobacco use” as common risk factors. Although this information is useful, more research is needed to better understand the
specific risk factors and/or causes related to
sustaining musculoskeletal injuries,
The magnitude of musculoskeletal injuries
among military and civilian personnel, has
contributed to current and emerging research on functional movement screening
(FMS) and injury prevention. The military
and civilian population are seeking ways to
prevent injuries “upstream” in order to
maintain “readiness” for work. The FMS is a
testing tool used by many practitioners to
evaluate dysfunctional human movement
patterns among athletic individuals as well
as high-risk workers (e.g., military service
members, firefighters). Although the FMS
has demonstrated to be a reliable tool in
predicting injury among certain groups or
populations, more research is warranted to
determine its effectiveness.
Closer to home
Our very own Lisa Sexauer, Fitness, Sports
and Deployed Support Program Manager,
and Dr. Kennedy-Armbruster, IU-Navy
SHAPE Project Director attended the 2012
CHAMP/HPRC, ACSM, and NASM conference
on functional movement, which was held in
September at the Uniformed Services University of the Health Sciences in Bethesda,
MD. The conference objectives included the
following:

The epidemiological review of musculoskeletal injuries in military and civilian athletic communities

Functional fitness for the Warrior Athlete (WA)

Key functional movement patterns
critical to functional fitness in the WA

Assessing the current functional assessment tools used in the sports
medicine and WA communities

Current concepts with regards to functional movement assessment and
functional fitness, as well as required
areas for future research.
Visit the Human Performance Resource
Page to find more information on
armed forces injuries, functional assessments and Total Force Fitness.
http://hprc-online.org/
Continued on pg. 2
Page 2
The Dispatch
Musculoskeletal Injury continued...
There were several exceptional speakers at
the conference. Here are some key facts
highlighted during the presentations:
Dr. Jones reported “33.8% of injuries are
non-battle injuries, 54.8% are due to running, and 67% from running to sport injuries.”
Dr. Steve Marshall stated “There are more
sport injuries than transportation injuries
in the civilian population.”
There was a major discussion on how to
screen for injuries in order to prevent
them. The FMS was discussed as a possible testing tool for prevention. In fact a
study shared regarding army recruits revealed an association between a high FMS
score and injury rate (www.ncbi.nlm.nih.
gov/pubmed/21606876).
Dr. Padua stated, “66% of injuries are lower extremity.”
Dr. McGill highlighted that “Pain can be
avoided by not mimicking the movement.”
Dr. McGill went on to explain, “If running
is a major injury area, we need to find
another cardio outlet.”
Dr. Teyhen stated that “Injuries don’t go
away over time, they are bigger than what
we think they are.”
Lieutenant Colonel Pendergrass reported
that the “Not ready rate for 2012 was 17.5
% with 33% being associated with musculoskeletal issues.”
Navy fitness has done an exceptional job of
incorporating progressive movement options specifically designed to prevent injury
through the NOFFS program (http://
navyfitness.org/fitness/noffs/). Indiana
University will be working with MWR
Fitness to evaluate the effectiveness of
NOFFS training in relation to traditional PT
training in order to lend more insights into
this ongoing dilemma regarding preparing
for readiness while preventing injuries. You
will hear more about this in future newsletters. We wanted you to know that MWR
Fitness programmers have your health and
safety as an utmost priority in the programming of fitness services which is why
we took the time to attend this conference
and learn more about helping you prevent
injury while at the same time remaining fit
and ready to serve.
To learn more about research on the culture of injuries please visit these links:
http://www.biomedcentral.com/14712474/11/146#B1
http://www.thelancet.com/journals/lancet/
article/PIIS0140-6736(09)61797-9/abstract
Nick’s Nutrition: Focusing on the right fats
For years, it has been perceived that consuming fat
leads to weight gain and heart disease, and that fat
should be avoided in our diets. But, similar to carbohydrates and protein, there are different types of
fats, and some are simply better than others. The
truth is, too often we consume too much of the
wrong type of fat.
Fat is one of three nutrients that provides energy,
while it also has a variety of other positive roles and
functions in our body, including:

Carries vitamins (A,D,E,K) that are critical to
good health

Aids in cellular repair among joints, organs,
skin, and hair

Provides satiety (sense of feeling full) and
helps regulate blood sugar

Impacts cognitive ability, memory retention,
mental clarity, and reduces inflammation
So while we cannot avoid fat, we have to choose the
proper types of fat in proper portions. This includes
focusing on nuts, seeds, fish, olives, avocadoes, nut
butters, and a variety of oils including olive and
canola. These types of fats are considered unsaturated, and typically contain essential fatty acids
which may help lower cholesterol, reduce inflammation, and possibly decrease the risk of heart disease.
We should avoid or limit the saturated fat in our diet,
which typically is abundant in animal products as
well as condiments and dressings. Trans fat, which
is found in processed foods such as chips and cookies, should be avoided completely. Choosing lean
meat products and low fat dairy products will be
extremely helpful in reducing the amount of total
saturated fat intake.
Throughout the day, there are plenty of opportunities to add a small amount of good fat to our diet.
Choices high in saturated fat
Sour cream or butter on baked potato
French or Ranch style dressings on salads
Potato chips
Bagel and cream cheese
Fruit salad with whipped cream
This could include adding two teaspoons of sunflower
seeds to a salad, sprinkling a handful of sliced almonds to an entrée, or sprinkling a tablespoon of
crushed walnuts over a low fat cup of yogurt. While
it is important to consume adequate amounts of
healthy fats, always remember that fat still provides
9 kcal per gram compared to both protein and carbohydrate foods which provide 4 kcal per gram. The
table below provides a few examples of how to reduce the total saturated fat while increasing the
amounts of unsaturated fats.
For additional nutrition information or related questions, please contact Nicholas Aures, MS, RD, CSCS
202-433-0721, or by email [email protected]
Alternative choices…
Try using salsa or guacamole as a topping
Try using light italian or oil based dressings in moderate amounts (1-2 tbsp)
A handful of raw, unsalted mixed nuts
or trail mix with dried fruit
1 slice Whole wheat toast & 1 tbsp peanut butter
1 C low fat greek yogurt, 1/2c fresh
fruit, & 2 tbsp seeds
The Dispatch
Page 3
Exercise of the Month: Single Leg Romanian Dead Lift
Why do this Exercise? This movement will improve core and lower body strength, as well
as improve flexibility and balance.
Starting Position: Begin in an upright position. Use a bench or chair for balance if
needed.
Procedure: Hinge at the waist as your non-supporting leg lifts behind you. The torso and
leg should move as one unit. Keep your non-supporting foot in dorsiflexion and toe pointed toward the floor. Return to the beginning position by contracting your hamstring and
glute. Perform 2 to 3 sets of 8-12 repetitions.
Key Points: You have reached the end of the exercise when your torso and leg no longer
form a straight line or your non-supporting dorsiflexed foot begins to externally rotate
You Should Feel It: You should feel this exercise in your glutes, hamstrings and lower
back.
Thank you Rob Williamson,
Health Fitness Specialist in
Pearl Harbor, for your excellent
research article on the importance of
daily physical activity and for the Exercise of the Month!
Increase Your Physical Activity with Walking
Chances are, you're reading this
article sitting down. And if you're like
most computer users, you've been in
your chair for a while.
You're probably inactive for more of
your day than you realize. Do you sit in
your car while commuting to an eighthour-a-day desk job, then unwind in
front of the television all evening? Do
you depend on email, direct-deposit
paychecks, and online shopping to
accomplish tasks that would have
required you to run errands 10 or 20
years ago? If so, then you may have
"sitting disease." That's the new
buzzword for a sedentary lifestyle,
which may put your health at risk.
Recent studies, including Katmarzky
(2009), Patel (2010) and Van Der
Ploeg (2012) all found association
between sitting time and mortality
from all causes independent of leisure
time exercise.
The workplace is a large contributor
to our lack of daily physical activity.
There has been a progressive decrease in the percent of individuals
employed in goods producing and
agriculture occupations and an in-
crease in the percent of individuals
employed in service occupations.
Most occupations in the U.S. today are
sedentary. According to Church et al,
over the last 50 years in the U.S. it is
estimated that daily occupationrelated energy expenditure has decreased by more than 100 calories,
and this reduction in energy expenditure accounts for a significant portion
of the increase in mean U.S. body
weights for women and men.
Our leisure-time activities of today
are also primarily sedentary. Sitting
while watching television, playing
video games, and surfing the web have
taken the place of more physically
active leisure time activities that burn
calories and promote healthier lifestyles . According to the National
Institute of Health (NIH) the average
American adult only walks between
3,000 – 5,000 steps a day. This is less
than half of what the NIH suggests for
a physically active person. The recommended number of steps for a physically active person is 10,000 a day.
Since counting every step throughout
your day would be nearly impossible, a
good way to keep track of your step
count is to invest in a pedometer.
Pedometers are fairly inexpensive and
are a great way to keep yourself
accountable for your daily activity.
Studies show that taking three 10
minute walking breaks throughout the
day can be just as beneficial as jogging for 30 minutes once a day. A
study done at Arizona State University
showed that three 10 minute walking
sessions spread out evenly throughout the day decreased the systolic
blood pressure more in prehypertensive individuals, than one single 30
minute walking session. (Bhammar
DM, 2012) If you are pressed to spend
30 minutes working out, just break it
up into three 10-minute walking sessions throughout your day: Once before work, once at lunch, and once
after dinner.
How can you increase your step
count? Here are some suggestions
to get you on your way:
1. Take your one-hour lunch break and
spend half of it walking.
2. Instead of looking for the closest
parking space, park your car as far
away as you can.
3. Take the stairs instead of the elevator or escalator
4. If you work in a two-story building,
use the restroom on the opposite
floor.
5. The next time you have a meeting
with someone, make it a walking
meeting.
Group Exercise Schedule
Norfolk , VA
Day
Mon
Tues
Wed
Thurs
Fri
San Diego , CA
Time
Class
Call 757-443-6115
for locations of
group exercise in
Norfolk, VA
Day
Time
Class
Location
Mon
0600-0630
Total Conditioning
APFH
Tues
1815-1915
Zumba
APFH
Wed
0600-0630
Total Conditioning
APFH
0615-0700
Cycling
1130-1230
Circuit Training
0615-0700
Core
1130-1145
Core
Thur
1815-1915
Zumba
APFH
1145-1230
Cycling
Fri
0600-0630
Total Conditioning
APFH
1615-1715
Running Clinic
0615- 0700
Cycling
San Diego , CA
1130-1230
Circuit Training
Day
Time
Class
Location
1615-1730
Triad (cycle, strength,
stretch)
Mon
0600-0630
Total Conditioning
APFH
Tues
1130-1200
Lunch Time Express
APFH Track
0615-0700
Core
Wed
0600-0630
Total Conditioning
APFH
1130-1145
Core
Thur
1130-1200
Lunch Time Express
APFH Track
1145-1230
Cycling
Fri
0600-0630
Total Conditioning
APFH
1615-1715
Running Clinic
0615-0700
Total Body TRX
To view all group exercise classes going on in the San Diego area visit:
http://navylifesw.com/sandiego/fitness/groupexercise/
Site Events
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Pearl Harbor
10/7
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Wounded EOD Warrior Undefeated 2-Day Bike Ride
www.active.com
Del Mar Mud Run
Del Mar Fairgrounds
http://www.delmarmudrun.com/
Raptor Ridge Trail 1/2 Marathon Escondido, CA
www.active.com
SHERox Triathlon
San Diego, CA
www.active.com
Halloween 5k
Oma’s Pumpkin Patch
sunstrides.com/Halloween.html
Spootacular 10k/5k
Lake Murray, San Diego, CA
http://www.spooktacular10k.com
Light The Night 5k
Balboa Park
sdcrimestoppers.com lightthenightagainstcrime.html
Awesome 80s Run
Fiesta Island
http://www.awesome80srun.com/
Halloween Boot Camp
NBPL
http://navylifesw.com/sandiego/
Free 5k
Ride to a Wish Run, Ride & Rock 8k/5k run/duathalon
Peroni Crawlin’ Crab Half Marathon & 5k
All Access 5k
Theater: Free Showing of Frankenweenie
Fleet Fest
Free 5k
Blue Moon Wicked 10k
ING Direct 25k
Gunstock Trail Half Marathon
Gunstock Trail 5k
Tantalus 10-miler
Peacock 100k
General "Howlin' Mad" Smith 5k
P.F. Chang's 30k
Ko Olina Triathlon
NMCP
Chesapeake, VA
Hampton, VA
VA Beach
Naval Station
Naval Station
VA Beach
Kailua Beach Park 05:30am
Gunstock Ranch
07:00am
Gunstock Ranch
07:00am
Makiki Heights Drive
06:30am
Peacock Flats
06:00am
Kailua Beach Park
07:30am
Kapiolani Park
05:00am
Ko Olina Resort ?
TBA
0800
0900-1500
0800