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costs. A consensus statement from the American College of Sports Medicine has stated that psychological factors are an important antecedent to the onset of injury and can also play an important role in injury rehabilitation and return to tness.
Body composition. In the military high body weight has been associated with increased injury risk, increased risk of medical downgrading as “un t for duty”, and a reduced self-reported ability to work. A low body weight has also been identi ed to be a strong determinant of injury risk and reduced training success during arduous RM military training{Davey, 2012 #412}.
Smoking. Smoking prevalence among Army personnel is currently reported to be at 32% which compares to the prevalence among the general UK population of 19%. Smoking has a harmful impact on the musculoskeletal system and is associated with more fractures and slower healing injuries. Smokers and ex-smokers experience 60% more pain in the back, neck and legs and are at a 114% increased prevalence of disabling lower back pain.
Alcohol. Excessive alcohol consumption is detrimental to individual health and leads to a number of issues linked to MSKI. Amongst an array of health issues it leads to weight gain which increases the risk of MSKI. The body can’t store alcohol so it gets metabolised immediately and this stops other fats and sugars getting metabolised and this slowing of the metabolism leads to weight gain over time. Alcohol is a diuretic which can lead to hydration and reduced performance.
The RAPTCI as the Army Health Trainer and the Defence Health and Well-being Advisor has a signi cant part to play in all lifestyle areas. The nationwide obesity crisis, increased alcohol intake and smoking rates are all areas that have affected Army personnel and Army HQ has concerns. The RAPTCI is seen as a key in uencer and a role model in these areas. I will be working closely with Bob Taylor and HQ RAPTC To develop and implement effective strategies at a tactical level that will reduce the loss of available manpower (due to medical downgrading, discharge or time away from work for medical treatment) as a result of MSKI. This is to be approached via 3 key work strands:
Promote. Promote an environment which is favourable to good musculoskeletal health. This is based around individual and organisational change. Developing a culture where making positive lifestyle choices regarding smoking, alcohol, diet and tness is the norm and becomes business as usual.
Prevent. Prevent the occurrence of MSKI by increasing individual resilience to injury, by reducing and mitigating injury-causing behaviours and activities. This will primarily be addressed through a comprehensive review of physical development regimes to increase physical conditioning for the rigours of modern Army life whilst reducing the likelihood of overuse injuries.
Recovery and Return to Fitness. Return AP back to optimal tness as rapidly as possible following injury through an optimised, fully resourced rehabilitation pathway. This will primarily be addressed by liaison with the healthcare services.
Making the link – Fitness and Health
The theme to this year’s Comdt Study period was music to my ears. Making the link – Fitness and Health is a concept that I had been pushing hard for some time and I really believe the RAPTC should embrace health and wellbeing (HWB) fully and should make it their Main Effort. I have attended many Health Committee meetings up to 3* level at Defence and across the Army. And I can tell you that tness on its own is rarely if ever mentioned but the contribution that tness or physical activity can have on H&WB is a reoccurring theme.
The importance of health to performance and deployability is clear and has arguably never been as prominent to the chain
of command as it currently is. I have attended many 2* and 1* Health Committee meetings over the past 2.5 years and was the secretary for the 3* Army Health Committee – so am well placed to comment. The RAPTCI is considered the principal agent for change in this space and the CO relies on them to enthuse and spread and promote the message throughout the unit.
The economic upturn and the conclusion of operations in Afghanistan have severely impacted on manning levels and led to the Army recruiting from an ever dwindling pool of people. Those that do decide to take the Queens shilling are not as robust and resilient as we would wish due in the main to reduced physical activity and sport in schools. We therefore have to look after those that we have and try to ensure that they remain t and healthy.
I believe this increased awareness and emphasis on HWB is an exciting opportunity for the Corps and one that we should exploit. Upon re ection we should have always been more proactive in the HWB space but never had the opportunity or the will.
I believe the Corps can play a huge role in promoting HWB will all the associated bene ts to health, personal tness levels and ultimately deployability rates. They are ideally placed as the advisor to the CO and can take the lead in areas such as:
• Initiate, co-ordinate, manage and support health and wellbeing promotion activities.
• Assist in developing a positive culture towards health and well- being that includes physical activity.
• Increase the chain of command awareness of the bene ts and contribution that physical activity plays in deployability and operational effectiveness.
• Increasing awareness of the impact that military training and physical training events and competitions may have on incidences of MSKI.
• Increasing awareness of the importance of and contribution that diet and nutrition have on performance and operational effectiveness.
• Promote a culture that optimises physical readiness and reduces the incidence of MSKI.
Summary
Whilst it is impossible to provide a substantive gure of the savings that RAPTCIs bring as a result of their day to day business in the HWB space, what is not in any doubt is that they do and will continue to be a force multiplier in this area. The MSKI gures are shockingly high, but they could be higher if it were not for the efforts of RAPTCIs in whatever role they currently occupy.
Whether it is the Generalist PTI improving overall conditioning, resilience, physical activity levels or sport participation or the ATI contributing to the development of individual character traits and personal qualities or the ERI providing exercise based therapy to x the injured personnel or get them on the road to recovery, the RAPTCI has a vital role to play. Current and planned MSKI reduction interventions and strategic and cultural shifts will make a difference and the RAPTCI is the change agent to make that difference. The role that the RAPTCI plays in promoting, maintaining and improving individual and collective health and wellbeing cannot be overstated. I look forward to supporting RAPTCIs whatever their role.