28th Sep2011

Injuries and the Tactical Athlete

by A.J.

Recently I was laid up for a week due to an injury and I know anyone who trains has had it happen to them. As an 18D on my team, working on injuries is probably the single most common problem I have (well injuries and giving I.V. fluid to team mates who have drank too much.) So, I have compiled a list of the more common stuff and how to deal with it. Maximizing training and minimizing down time provides the best results so let’s just get into it.

Shoulder Injury:

The shoulder is one of the more complicated and also more fragile parts of the body. Combine the relative frailty of the shoulder with the tactical athletes propensity to bench press during weight training and you have a recipe for multiple shoulder injuries. Generally speaking there are a few types of shoulder injury but instead of listing the differences I will talk about the symptoms and the treatments. First off is the typical “it hurts when I bench press and then it throbs after until I wake up the next day.” This type of pain can be caused by a great many reasons but, I usually see it because of minor ligament or tendon damage brought on by excessive weight and or just normal overtraining. A recurring theme in this post is going to be the term R.I.C.E which stands for Rest, Ice, Compress, and Elevate. If you find that the bench is very painful try switching to lighter weight and use free weights instead of barbells to see if that helps.

Whenever I go to the doctor for an injury the advice is generally “well just lay off it and don’t exercise for 4 weeks.” As a person who lives and dies by your ability to perform athletically a month of not training is not an option (unless of course the injury is severe enough, but minor boo boos won’t keep any of us out of the gym.) Another shoulder injury that I see often is the “I woke up last night and my shoulder was killing me, but I am not sure how it got hurt.” This is a textbook symptom of an impingement injury unfortunately it really will keep you from exercises that shoulder for a period of time. The impingement generally takes a couple of weeks to heal back up but, you can speed up the healing with a few NSAIDs (non-steroidal anti-imflamitories) and R.I.C.E. An impingement injury is an inflammation of the shoulder capsule that causes severe pain when moving the shoulder. One thing to keep in mind with the impingement is to keep the shoulder mobile I tell my teammates to let the arm hang while bent over leaning on a counter and make small circles with their arms while it hangs to maintain mobility.

Back Injury:

The back injury is one of the most common injuries and unfortunatly once you hurt it you can expect to hurt it again. All the ruck marches, jumping out of planes, falling out windows and being a full spectrum bad ass can lead to a heck of a lot of back pain. Resting and icing the back can provide some comfort even though I tend to see guys go straight to the muscle relaxers, for some reason people like to find a solution in a pill instead of doing any work to get better. Most of the back injury I see is mechanical in nature so I am always mistifide when people try to find a chemical solution to a mechanical problem. My advice and take it for what it cost you (free on the internet) is get a great chiropractor. The military doesn’t pay for chiropractors though I find it to be well worth the cost (if you have a 3k carbine at home and a benchmade knife on your body armour you can afford a great chiro I generally pay 35.00 per visit and would gladly pay more.)

I broke my back/neck a few years ago on an operation and besides the chiro I love home traction devices, like an inversion table. An inversion table helps to undo some of that damage from that 18 mile ruck run by literally letting gravity pull you back into your normal posture. I will see if I can link one here after I post this so you can see what I am talking about. I would get in the inversion table for about 20 minutes at the end of the day drink a big glass of water and go straight to bed to let the discs in your back rehydrate in a horizontal position.

Knee Injury:

Our knees take a ton of abuse because we depend on them to help us close with and destroy the enemy and I rarely see anyone doing the proper preventative maintenance to keep them in tip top shape. I am not talking about wrapping your knees before you squat either, in my opinion I would just lower the weight to something I don’t need to risk injury to lift. Get a good stretch and a descent pair of shoes for running in (unless you are a barefoot running guy, in which case you are running at a much lower impact by skipping the shoes altogether.) Again R.I.C.E those knees after training if they are a problem area for you and think before you just jump out of the back of a deuce and a half with your ruck sack on.

Final Thoughts:

Please Don't Do this

I know this list isn’t exhaustive and any questions you put in the comments field I will be sure to look up in the latest Special Forces Medical Handbook and get you an answer as quick as posible. If you do have an injury that is affecting your training most likely you can still find exercises you can do to stay in shape. If you injure one arm you can still exercise the other and there is a minor transference to the injured arm to give you a leg up for when you get back. Eating well will also help in the recovery as well as proper sleep and avoiding doing dumb stuff in the gym, like free weight squats while standing on a Bosu ball

4 Responses to “Injuries and the Tactical Athlete”

  • Another great post by AJ. As a former competitive martial artist and US Army Ranger I’ve experienced a number of these types of injuries. I’m currently a licensed DC ( Doctor of Chiropractic) and AJ’s advice is spot on for conservative nonsurgical treatment of injuries as well as self care for injuries.

    A couple of things I’d like to reemphasize is the application of ice, rest (not immobilization) and addressing the causes of the symptoms and not just the symptoms.

    There are different schools of thought on the application of thermal modalities (ice vs heat) but I always recommend ice. People hate ice, especially is your talking about wrapping something in it or doing an ice massage simply because it’s uncomfortable. Heat feels better but ice creates natural anti-inflammatory effects and acts as a natural analgesic. The body will heat back up to almost 100 degrees all by itself.

    The difference between rest and immobilization is crucial. Immediate and temporary immobilization is ok and actually best for up to 48 hours after an onset of an acute soft tissue injury (ligament or tendon) during which time you should be elevating and icing the injured body part as much as possible. After 48 hours however you should be actively moving the joint within the pain free ranges of motion. AJ’s recommendation for the shoulder rotations is a perfect example. The rest portion simply means not placing the joint under extreme or more than normal stresses like excessive weight. Everytime you workout you are creating small levels of microtrauma in the tendons, ligaments and muscles. The body does and will heal itself to a great extent but we have to do our part in the process by not creating an enviornment where the body can’t heal (whenever possible). The reason why we rest muscle groups between workout days when we can, is to allow the body to heal and rebuild.

    The problem with immobilization is scar tissue and the development of fibrous adhesions. As the body heals soft tissue, one of the mechanisms we see is the formation of scar tissue on a microscopic level. It forms cross bridges within the injured tissued which serves to reconnect torn tissue and LIMIT MOTION. Scar tissue is firm and fibrous, unlike pliable muscle or ligamentous structures. Scar tissue doesn’t stretch, it breaks and tears when stressed. So, a prolonged immobilization of a soft tissue injury can lead to increased scar tissue formation, resulting in painful and restricted ranges of motion. When we do try to return to full duty, we break up scar tissue, which can be painful, and start the inflammation process all over again. Injuries like the ones AJ has mention, if not treated correctly, can and often lead to long term “chronic” injuries.

    Great post AJ. This is a great site.

    Adam.
    “RLTW!”

    • Thanks Adam, What a great comment!
      You definitely got into the how and why of shoulder injury better than I could have and I really appreciate it.

      A.J.
      “De Oppresso Liber”

  • AJ,

    Your welcome. I’m glad I could contribute. Hey brother, this is a blog posted I did about your site http://www.texastacticalhats.com/texas-tactical-community/

    Keep up the great content.

    Adam.

  • Guys, BTW – I apologize for the grammatical errors in my 1st post. I typed all of that on my iPhone between patients..;)

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