Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
School of Sport, Health, and Applied Science, St Mary's University, Strawberry Hill, London, UK.
Orthop J Sports Med. 2015 Nov 13;3(11):2325967115616581. doi: 10.1177/2325967115616581. eCollection 2015 Nov.
Musculoskeletal injuries are a significant burden to United States Army Special Operations Forces. The advanced tactical skill level and physical training required of Army Special Operators highlights the need to optimize musculoskeletal characteristics to reduce the likelihood of suffering a recurrent injury.
To identify the residual impact of previous injury on musculoskeletal characteristics.
Cross-sectional study; Level of evidence, 3.
Isokinetic strength of the knee, shoulder, and back and flexibility of the shoulder and hamstrings were assessed as part of a comprehensive human performance protocol, and self-reported musculoskeletal injury history was obtained. Subjects were stratified based on previous history of low back, knee, or shoulder injury, and within-group and between-group comparisons were made for musculoskeletal variables.
Knee injury analysis showed no significant strength or flexibility differences. Shoulder injury analysis found internal rotation strength of the healthy subjects (H) was significantly higher compared with injured (I) and uninjured (U) limbs of the injured group (H, 60.8 ± 11.5 percent body weight [%BW]; I, 54.5 ± 10.5 %BW; U, 55.5 ± 11.3 %BW) (P = .014 [H vs I] and P = .05 [H vs U]). The external rotation/internal rotation strength ratio was significantly lower in the healthy subjects compared with injured and uninjured limbs of the injured group (H, 0.653 ± 0.122; I, 0.724 ± 0.121; U, 0.724 ± 0.124) (P = .026 [H vs I] and P = .018 [H vs U]). Posterior shoulder tightness was significantly different between the injured and uninjured limb of the injured group (I, 111.6° ± 9.4°; U, 114.4° ± 9.3°; P = .008). The back injury analysis found no significant strength differences between the healthy and injured groups.
Few physical differences existed between operators with prior knee or back injury. However, operators with a previous history of shoulder injury demonstrated significantly less shoulder strength than uninjured operators as well as decreased shoulder flexibility on the injured side. All operators, regardless of prior injury, must perform the same tasks; therefore, a targeted injury rehabilitation/human performance training specifically focused on internal rotation strength and tightness of the posterior capsule may help reduce the risk for recurrence of injury. Operators presenting with musculoskeletal asymmetries and/or insufficient strength ratios may be predisposed to musculoskeletal injury.
Specific fitness programs to compensate for deficiencies in strength and flexibility need to be designed that may reduce the risk of injuries in Special Forces Operators.
肌肉骨骼损伤是美国特种作战部队的一个重大负担。陆军特种作战人员需要具备高级战术技能水平和体能训练，这凸显了优化肌肉骨骼特征的必要性，以降低再次受伤的可能性。
确定先前损伤对肌肉骨骼特征的残留影响。
横断面研究；证据水平，3 级。
作为综合人体表现方案的一部分，评估了膝关节、肩关节和背部的等速力量以及肩关节和腿筋的柔韧性，并获得了自我报告的肌肉骨骼损伤史。根据先前的腰背、膝或肩部损伤史对受试者进行分层，在组内和组间比较肌肉骨骼变量。
膝关节损伤分析显示，力量和柔韧性无显著差异。肩部损伤分析发现，健康受试者（H）的内旋力量明显高于受伤（I）和未受伤（U）的受伤组（H，60.8 ± 11.5 体重百分比[BW]；I，54.5 ± 10.5% BW；U，55.5 ± 11.3% BW）（P =.014 [H 与 I] 和 P =.05 [H 与 U]）。与受伤组的健康和受伤肢体相比，健康受试者的外旋/内旋力量比明显较低（H，0.653 ± 0.122；I，0.724 ± 0.121；U，0.724 ± 0.124）（P =.026 [H 与 I] 和 P =.018 [H 与 U]）。受伤组的受伤和未受伤肢体的肩部后部紧张度存在显著差异（I，111.6°±9.4°；U，114.4°±9.3°；P =.008）。背部损伤分析发现，健康组和受伤组之间的力量无显著差异。
先前有膝部或背部损伤的操作人员之间几乎没有明显的身体差异。然而，有肩部受伤史的操作人员的肩部力量明显低于未受伤的操作人员，且受伤侧的肩部柔韧性也降低。所有操作人员，无论是否有先前的损伤，都必须执行相同的任务；因此，针对内旋力量和后囊紧张度的特定康复/人体表现训练可能有助于降低再次受伤的风险。存在肌肉骨骼不对称和/或力量比不足的操作人员可能更容易发生肌肉骨骼损伤。
需要设计特定的健身计划来弥补力量和灵活性的不足，这可能会降低特种作战人员受伤的风险。
