Methodology used to develop the minimum common data elements for surveillance and Reporting of Musculoskeletal Injuries in the MILitary (ROMMIL) statement.

Background: The objective was to summarize the methodology used to reach consensus for recommended minimum data elements that should be collected and reported when conducting injury surveillance research in military settings. This paper summarizes the methodology used to develop the international Minimum Data Elements for surveillance and Reporting of Musculoskeletal Injuries in the MILitary (ROMMIL) statement.

Methods: A Delphi methodology was employed to reach consensus for minimum reporting elements.

Perceived barriers and facilitators to implementation of injury prevention programs in the military: Feedback from inside the trenches.

Background: Musculoskeletal injuries enact a substantial burden in military settings, incurring high costs, long-term disability, and impacting military readiness. This has led to a prioritization of injury prevention programs. Understanding the challenges faced by those trying to implement these programs could help standardize and better inform future efforts.

Prevalence of Pain With Movement in Active Duty US Army Soldiers.

Introduction: Soldiers must be able to perform a multitude of physically demanding tasks as part of their regular duty, but their physical readiness is often degraded due to pain and musculoskeletal injury (MSKI). The presence of pain with movement has been associated with increased MSKI risk in Soldiers. Improved awareness of the prevalence of painful movements in uninjured Soldiers could help inform Army injury mitigation efforts.

Predicting Postoperative Injury and Military Discharge Status After Knee Surgery in the US Army.

Background: Researchers have assessed postoperative injury or disability predictors in the military setting but typically focused on 1 type of surgical procedure at a time, used relatively small sample sizes, or investigated mixed cohorts with civilian populations.

Purpose: To identify the relationship between baseline variables and injury incidence or military discharge status in US Army soldiers after knee surgery.

Study Design: Case-control study; Level of evidence, 3.

The Presence of Hip Joint Effusion on MRI Is Predictive of a Grade 4 Femoral Neck Stress Injury.

Introduction: One of the most debilitating types of bone stress injuries is those occurring at the femoral neck. This problem occurs in the military population with much higher incidence than in the normal population and is of great concern to military medical providers. Early detection and accurate diagnosis are key in protecting soldiers and recruits from sustaining a potentially career-ending fracture.

A Population-Level Summary of Health Care Utilization for the Management of Patellar Tendinopathy in the Military Health System.

Patellar tendinopathy (PT) is a common nontraumatic orthopaedic disorder of the knee suffered by many service members. Understanding the make-up of usual care for PT at the system level can better frame current clinical gaps and areas that need improvement. Exercise therapy is recommended as a core treatment for PT, but it is unclear how often it is used as a part of usual care for PT within the Military Health System (MHS).

Differences in Outcomes between Patellar Dislocations Managed in Emergent versus Non-Emergent Care Settings.

Patellar dislocations occur at a much higher rate in military than civilian populations. Past population-level studies have shown that surgical management is as good as or superior to conservative care and may reduce future reoccurrences. Although in acute cases and in civilian clinics, patellar dislocations are usually managed first in an emergent care setting, previous work suggests this can lead to increased costs.

Fractures and Chronic Recurrence are Commonly Associated with Ankle Sprains: a 5-year Population-level Cohort of Patients Seen in the U.S. Military Health System.

Background: Whereas ankle-foot injuries are ubiquitous and affect ~16% of military service-members, granularity of information pertaining to ankle sprain subgroups and associated variables is lacking. The purpose of this study was to characterize and contextualize the burden of ankle sprain injuries in the U.S.

Self-Reported Musculoskeletal Injury Healthcare-Seeking Behaviors in US Air Force Special Warfare Personnel.

Purpose: This study evaluated the musculoskeletal injury (MSKI) self-reporting behaviors among active-duty Air Force Special Warfare personnel to explore potential limitations of injury surveillance approaches.

Methods: Participants completed a 47-item survey between December 2018 and March 2019 regarding their MSKI history. Participants were asked if they sought medical care for symptoms consistent with MSKIs and reasons they did or did not report their injuries.

Upper Extremity Superficial Vein Thromboses Presenting as Acute Neck Pain in a Young and Healthy Male: A Case Report.

Background And Purpose: Neck pain in the United States is pervasive and contributes to disability. While the majority of neck pain in young and healthy individuals is neuromusculoskeletal in nature, screening for red flags is necessary for ruling-out serious medical pathologies. The purpose of this case report is to describe a young and healthy male subject with a primary complaint of acute neck pain with multiple underlying upper extremity superficial vein thromboses (UESVTs).

Increased Glenoid Retroversion Is Associated With Increased Rotator Cuff Strength in the Shoulder.

Background: The rotator cuff muscles are critical secondary stabilizers in the shoulder. Increased glenoid retroversion and rotator cuff strength have been associated with the risk of posterior shoulder instability; however, the effect of increased glenoid retroversion on rotator cuff strength remains unclear.

Purpose/hypothesis: The purpose was to examine the association between glenoid version and rotator cuff strength in the shoulder in a young and healthy population with no history of shoulder instability.

Cervical Fracture With Posterior Ligamentous Injury While Skydiving.

A 46-year-old male soldier reported to an emergency department with severe acute neck pain immediately following a hyperflexion injury during recreational skydiving. He was evaluated in the emergency department, including radiographs, and released with a diagnosis of "acute neck strain." After presenting with continued neck pain, he was sent for consultation with a physical therapist.

Surveyed Reasons for Not Seeking Medical Care Regarding Musculoskeletal Injury Symptoms in US Army Trainees.

Introduction: Musculoskeletal injuries (MSKIs) pose a significant threat to military readiness and are difficult to monitor due to Soldiers' reluctance to seek medical treatment. There is high risk of developing MSKIs while going through initial entry training (IET), many of which go unreported. The purposes of this study were to identify the contributing factors that influence US Army trainees to not seek medical care for self-reported symptoms of musculoskeletal injury (SMSKI) and establish how those factors may differ by sex, training school, and installation site.

DIAGNOSTIC IMAGING IN A DIRECT-ACCESS SPORTS PHYSICAL THERAPY CLINIC: A 2-YEAR RETROSPECTIVE PRACTICE ANALYSIS.

Background: While advanced diagnostic imaging is a large contributor to the growth in health care costs, direct-access to physical therapy is associated with decreased rates of diagnostic imaging. No study has systematically evaluated with evidence-based criteria the appropriateness of advanced diagnostic imaging, including magnetic resonance imaging (MRI), when ordered by physical therapists. The primary purpose of this study was to describe the appropriateness of magnetic resonance imaging (MRI) or magnetic resonance arthrogram (MRA) exams ordered by physical therapists in a direct-access sports physical therapy clinic.

Diagnosis and expedited surgical intervention of a complete hamstring avulsion in a military combatives athlete: a case report.

Background And Purpose: Hamstring injuries are frequent injuries in athletes, with the most common being strains at the musculotendinous junction or within the muscle belly. Conversely, hamstring avulsions are rare and often misdiagnosed leading to delay in appropriate surgical interventions. The purpose of this case report is to describe the history and physical examination findings that led to appropriate diagnostic imaging and the subsequent diagnosis and expedited surgical intervention of a complete avulsion of the hamstring muscle group from the ischium in a military combatives athlete.

Morel-Lavallée lesion of the lumbar region.

The patient was a 21-year-old male cadet at a military academy who was evaluated by a physical therapist in a direct-access capacity for a chief complaint of low back pain that began the previous day after falling directly onto his back while snowboarding. Given the patient's history of trauma, worsening low back pain, and enlarged soft tissue mass in the lumbar region, the physical therapist ordered magnetic resonance imaging. The findings were consistent with a Morel-Lavallée lesion of the lumbar region.

Treatment of subacute posterior knee pain in an adolescent ballet dancer utilizing trigger point dry needling: a case report.

Study Design: Case Report.

Background And Purpose: Dry needling (DN) is an increasingly popular intervention used by clinicians as a treatment of regional neuromusculoskeletal pain. DN is an invasive procedure that involves insertion of a thin monofilament needle directly into a muscle trigger point (MTP) with the intent of stimulating a local twitch response.

Lisfranc injury in a west point cadet.

Background: Lisfranc joint injuries are fairly uncommon; however, few injuries hold such an elevated potential for devastating chronic secondary pain and disability. It is imperative when evaluating an injury to the ankle or foot to have a high clinical index of suspicion for Lisfranc injury, as physical examination findings are often subtle.

Case Description: An 18-year-old military cadet reported to a direct-access sports physical therapy clinic with foot pain.

Isometric shoulder strength reference values for physically active collegiate males and females.

Background: It is common clinical practice to assess muscle strength during examination of patients following shoulder injury or surgery. Strength comparisons are often made between the patient's injured and uninjured shoulders, with the uninjured side used as a reference without regard to upper extremity dominance. Despite the importance of strength measurements, little is known about expected normal baselines of the uninjured shoulder.

Bony avulsion injury of the pectoralis major in a 19 year-old male judo athlete: a case report.

Background And Purpose: Bony avulsion of the pectoralis major muscle is a rare but potentially devastating injury for athletes. Pectoralis major rupture typically occurs in 20 to 39 year-old males. The shoulder region is one of the most frequently injured areas in Judo athletes.

Isolated posterior cruciate ligament injury.

The patient was a 19-year-old male cadet at a military academy who was evaluated by a physical therapist in a direct-access capacity for a chief complaint of right knee pain and giving way after falling onto his right knee while snow sledding at a high rate of speed 2 weeks earlier. Knee radiographs were ordered by the physical therapist, which demonstrated a large suprapatellar joint effusion. Due to concern for a posterior cruciate ligament injury and to assess for concomitant injury, magnetic resonance imaging was ordered, which revealed disruption of the posterior cruciate ligament without injury to surrounding tissues.

Posterior labral tear with a paralabral cyst causing suprascapular nerve compression.

The patient was a 21-year-old man who was currently enrolled in a military academy. He was seen by a physical therapist in a direct-access capacity for a chief complaint of right shoulder fatigue and discomfort that was present for the past week. Due to marked atrophy and weakness with no history of injury, an orthopaedic surgeon was consulted and diagnostic imaging was requested.