V E TE R AN S AFFAI R S & M I LITARY M E D I CI N E O UTLO O K
ARMY WELLNESS CENTERS FOCUS ON REDUCING MUSCULOSKELETAL INJURY RISK By Gail Gourley
n THE THEME OF READINESS IS PROMINENT in the 2020 Posture of the United States Army Statement, in which senior Army leaders emphasized to the Senate Armed Services Committee that warfighting readiness remains the Army’s top priority as it increases lethality to prepare for the future. A key element is that soldiers must be ready to deploy and able to train. Injuries, and specifically musculoskeletal (MSK) injuries, are the most significant medical non-readiness factor in the U.S. Army, according to Army Public Health Center (APHC) experts and the Army’s “2018 Health of the Force” report. Research has shown that these are primarily due to cumulative trauma, or overuse injuries, including stress fractures, Achilles tendonitis, patellar-femoral syndrome, plantar fasciitis, and back and knee pain syndromes. They are mostly sustained from training and strenuous operational activities, reflecting actions necessary for mission preparedness, with running the leading cause of MSK injuries. To tackle this problem, Army Wellness Centers (AWCs), an integrated network of 35 facilities located across the United States and overseas, are utilizing research combined with technology, health promotion, and wellness programs to minimize soldiers’ MSK injury risk factors. AWC services include metabolic testing, fitness testing, body composition analysis, biometrics, biofeedback, health coaching, and health education. The AWCs were designed and implemented around 2005, with the last implementation completed about 2018, according to Laura Mitvalsky, director of Health Promotion and Wellness, APHC. “It was the Army’s response to fragmented health
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promotion program delivery,” she said. “We actually did a largescale evaluation looking at health promotion and wellness programs across the Army, and they’ve done that in the DOD [Department of Defense] as well. What they found was that there are a lot of programs out there, but they can’t be evaluated because they don’t have the component pieces in place to be evaluated.” The AWCs were devised to address that fragmentation, Mitvalsky explained, by building a standardized model to look at not only the facilities, but also programs, staffing, and equipment. “That standardized model delivers key readiness support capabilities to soldiers and community members. And they do that in several ways,” she said. “Typically, health promotion and wellness programs are based on the disease, like a high blood pressure class or a high cholesterol class or weight management. But that’s not how the wellness centers program standardized model is designed. It’s based upon targeting the behaviorally modifiable factors most likely to result in chronic disease, injury, and/or performance issues. So, our core programs are based upon, ‘How do we get after the behaviors that lead to those problems?’” In addition to the distinctive program model, Mitvalsky also described AWC staff as unique, composed of a variety of allied health sciences professional backgrounds and national certifications, and cross-trained in health coaching applications “so that they have competencies in all of the assessments that we do in the wellness center.” So, for example, an exercise physiologist can also do the metabolic testing, or
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