Training and Overuse Injuries

UllG of the hazards of physical training is becoming injured. Sustaining either a sudden injury or an overuse injury can mean loss of work days, forced rest, and pain for a period of days to weeks. The goal of this chapter is not to have you treat your own injuries, but rather to be informed so that you will seek appropriate help when needed. Central to rapid recovery from training-related injuries is a step-wise reconditioning program which starts immediately after the injury. Such programs are designed to arrest the inflammatory process, promote healing and accelerate the return to full duty.

Injuries: Treatment and Prevention

A variety of injuries can occur during physical training. Table 13-1 has a brief description of acute and overuse injuries, as well as their treatment and prevention. Both sudden-onset and recurring injuries can result in inflammation (localized warmth, swelling, redness and pain). If left unchecked the inflammatory response rapidly leads to:

♦ Tissue swelling. ♦ Stiffness.

♦ Loss of normal function. ♦ Weakness.

♦ Decreased range of motion of the joint.

Table 13-1. Injuries, Treatments, and Prevention

Injury	Treatment	Prevention
Delayed-Onset Muscle Soreness - Muscle pain occurring in deconditioned muscle 12-72+ hours after training.	Ice, stretch, warm-up. Do not use NSAIDs.	Resolves as muscle adapts to training. Slowly increase training intensity.
Contusions - Swelling and bleeding (bruising) in the muscle, tendon, or bone due to a direct blow.	Ice	Wear protective gear.
Muscle Cramp - Muscle pain caused by prolonged activity, high heat or humidity, dehydration, and poor conditioning.	Rehydrate (Chapter 2), stretch, massage with ice.	Allow time to adjust to training and climate; drink frequently.
True Fractures - Break or chip in the bone.	Seek medical help.	Use protective gear; recondition.
Stress Fractures - Pain and weakening of the bone caused by excessive stress and use.	Seek medical help.	Reduce high-impact activities, cross-train, use proper gear, slowly increase training.
Sprains - Acute or overuse injury to ligaments (connective tissue that joins bone to bone).	RICE.* Seek medical help.	Follow medical advise; slowly increase training intensity, use proper gear.
Strains, Tendonitis - Acute or overuse injury to muscle or tendons (connective tissue that joins muscle to bone).	RICE. Seek medical help.	See "Sprains."

Heat Injuries (cramp, exhaustion, heat stroke) - Painful muscle contractions, nausea, fatigue, fever, or dizziness from dehydration and electrolyte depletion; fevers >104°F can damage vital organs and result in death.

Place person in a cool location and rehydrate. Seek medical help.

Acclimate to climate, avoid exercise in extreme heat, avoid substances that cause dehydration (Chapter 12), stay well hydrated (Chapter 2).

Cold Injuries (hypothermia, frost bite, trench foot) - Body temperature <95°F causing shivers, slurred speech, clumsiness, and freezing of exposed body parts.

Gently place the person in dry blankets with another warm person.

Wear proper gear, stay dry, avoid exercise in extreme cold, stay well hydrated (Chapter 2).

The treatment of any injury should focus on controlling the inflammation and allowing full joint range of motion for a rapid return to daily activities. To accelerate healing, you must first decrease the inflammatory process. Treatment steps to achieve this include:

RICE = Rest + Ice + Compression + Elevation

♦ Rest - partial or no weight-bearing of the extremity,
using crutches for locomotion. "Relative Rest" means
decreasing activities that cause pain and replacing
them with activities that are pain-free.

♦ Ice - as soon as possible apply ice, wrapped in a bag
or towel, to the injured area. Ice for 20 minutes every
two hours on the first day, then 3 times a day until
the swelling has decreased. To prevent nerve
damage, do not ice for longer than 20 minutes at a
time. Never apply ice directly to the skin or to an
open wound!

♦ Compression - wrap the injury for periods of 2-4 hours. Never
sleep with a compression wrap unless medically advised.

♦ Elevation - place the injury above the level of the heart,
allowing gravity to reduce the swelling.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

In addition to RICE, non-steroidal anti-inflammatory drugs (NSAIDs) are often used to decrease the symptoms due to inflammation and fever associated with injury. Although NSAIDs are usually available over-the-counter, these medications should not be taken lightly. In the case of an acute injury which involves bleeding, bruising, or swelling, NSAIDs should not be started until after the bleeding has stopped (may take days) and the swelling has stabilized. Some side-effects of NSAIDs include:

♦ Nausea, heartburn, vomiting, ulcers, and bleeding.

♦ Increased blood pressure.

♦ Decreases the ability of blood to clot.

♦ Worsening of asthma.

♦ Potential kidney damage with long-term use.

Some of the most common NSAIDs are aspirin (Bayer, Aspirin, Ecotrin),

ibuprofen (Advil, Motrin), and ketoprofen (Orudis). Remember: NSAIDs should not be used with alcohol. If you have stomach or gastrointestinal problems, check with your doctor for the appropriate pain reliever.

Vitamin and Mineral Needs

In addition to increased energy requirements, increased intakes of many of the vitamins and minerals may be useful for maintaining performance when working for prolonged periods in the cold. Vitamin and mineral recommendations have been developed to account for possible increased requirements based on intake data from field studies, urinary excretion of nutrients, and other measures of "nutrient status". Table 12-2 presents the suggested additional amount of some nutrients that may be needed when working in the cold. See Chapter 2, Table 2-2 and Table 2-3 for a list of food sources for these nutrients. In most cases, if you meet your energy requirements by eating all ration components, you should be meeting your vitamin and mineral needs.

Table 12-2. Suggested Additional Intakes of Micronutrients During Cold Weather Training

Nutrient

Suggested Increase*

Nutrient

Suggested Increase

Vitamin B₁ (Thiamin) 3 mg

Vitamin B₂ (Riboflavin) 2 mg

Vitamin B₃ (Niacin) 5 mg

Pantothenic Acid 5 mg

Folic Acid 200 µg
Vitamin B₁₂ 1 µg

Magnesium 200 mg

Zinc 5 mg

Adapted from Reynolds RD. (1995) Effects of Cold and Altitude on Vitamin and Mineral Requirements. In: Marriot BM (Ed). Nutrient Requirements for Work in Cold and High Altitude Environments. Washington, DC: National Academy Press. *Amounts in addition to the RDA (see Chapter 2).

Tips for Maintaining Performance in a Cold Environment

♦ Check weather conditions, dress appropriately, and avoid profuse
sweating.

♦ Allow for a longer warm-up.

♦ Replenish CHO and electrolyte losses.

♦ Drink plenty of fluids and try to avoid substances that cause
dehydration (see page 93 and Table 12-1).

♦ Be aware of the signs of cold injury (see Chapter 13).

♦ Eat snow only after melting and purifying it.

Altitude

Ascent to altitude can cause a variety of physiologic disturbances due to the drops in temperature and humidity, and the lack of oxygen. Some major concerns are weight loss, disturbances in digestion, and vitamin, mineral and fluid needs.

Physical performance can suffer dramatically with changes in altitude. The lower oxygen concentrations at altitude can reduce aerobic capacity by 1-2% every 100 meters (328 feet) above 1,500 meters (4,918 feet). Many adaptations occur during extended exposure to high altitudes including:

♦ Increased number of oxygen-carrying proteins in the blood
(hemoglobin) and muscle.

♦ Increased density of blood vessels to and within the muscle.

♦ Increased rate of respiration.

Adequate nutrition can play a crucial role in maintaining performance.

Energy Needs

Energy requirements are 15-50% greater than at sea level

Virtually all persons who go to altitude experience weight loss and loss of lean body mass. At altitudes below 5,000 m weight loss can be prevented by increased caloric intake; whereas above 5,000 m, a 5-10% weight loss is inevitable. Some reasons for weight loss at high-altitude are:

♦ Energy requirements are 15-50% greater than at sea level.

♦ Decreased appetite and sense of taste.

♦ Loss of body water from increased breathing rate and dry air.

♦ Impaired absorption of nutrients.

♦ Acute Mountain Sickness (AMS) - symptoms include headache,
nausea, vomiting, fatigue and poor appetite.

Worksheet 12-3. Calculate Your Energy Requirements at Altitude

Your Estimated Energy Requirement (EER) =____________ kcal/day

(see Chapter 1)

A 50% increase in energy requirements equals:

_________ EER x 0.50 =__________ kcal/day

Your total energy requirement equals:

__________ EER +________ 50% increase=________ kcal/day

У

A high-CHO diet (60% of total daily kcals) is preferred at altitude because it restores glycogen, requires less oxygen to metabolize than a high-fat diet, and can blunt or delay the severity of AMS symptoms.

Vitamin and Mineral Needs

Vitamin and mineral needs are likely to increase at altitude. In particular, the increased metabolic rate and the lack of oxygen can increase the production of harmful free radicals. These free radicals can slow blood circulation and impair physical performance. Preliminary findings in men indicate that taking 400 IU per day of vitamin E, an antioxidant, at high altitude reduces free radical production and maintains aerobic energy production. Increased amounts of many other nutrients should be considered, especially since food intake usually decreases (see Table 12-2).

Tips for Maintaining Performance at Altitudes

♦ Plan on decreased physical performance the first few weeks.

♦ Drink plenty of fluids. Fluid requirements may be as high as 4.25
quarts, or more, each day.

♦ Listen to your body, be aware of any warning signs of illness or
symptoms of AMS and seek medical attention.

♦ Try to avoid substances that cause dehydration (Table 12-1).

As noted throughout this chapter, meeting energy and fluid requirements are vital for maintaining physical performance in adverse environmental conditions. Being physically fit and eating a healthy diet prior to deployment will greatly improve your acclimation and adaptation to the new environment.

Hot Environments

How hot is too hot? Heat advisories are

announced when a wet bulb-globe

temperature (WB-GT) is over 87° F (30.5°

C) or when temperature and humidity are

over 85° F and 60%, respectively. Under

these conditions exercise should be

performed indoors or undertaken with

caution. Any time you perform physical activities in the heat, you will lose a lot of water and electrolytes through sweat. Only the sweat that evaporates effectively cools the body; sweat that "drips" provides little cooling effect. As you adapt to the heat, you will start producing more dilute sweat (less salty) to conserve electrolytes. Factors that can limit "effective cooling" include high humidity, impermeable clothing, and skin conditions, such as sunburns or rashes.

Energy Needs

Although appetites may be suppressed in the hot weather, especially during the first few days after arriving, adequate caloric intake is very important. Inadequate food intake will lead to weight loss which can impair both physical and mental performance. When you do the same task in a hot environment, energy requirements are increased due to the increased work of maintaining a normal body temperature. When living and working in temperatures ranging from 86° to 104°F (30° to 40°C), kcal intakes should be increased by 10%, unless your activity level decreases accordingly.

If your activity level decreases, you do not need extra kcals!

 

Worksheet 12-1. Calculate Your Energy Requirements for a Hot Environment

^ л

Your Estimated Energy Requirement (EER) =_________________ kcal/day.

(from Worksheet 1 -2)

A 10% increase in energy requirements equals:

_________ EER x 0.10 =_________ kcal/day.

Your total energy requirement equals:

__________ EER +________ 10% increase=________ kcal/day.

Tips for Maintaining Performance in a Hot Environment

♦ Prepare by maximizing aerobic fitness before your exposure.

♦ Plan your workouts to avoid the heat of the day.

♦ Plan for decreased physical performance the first two weeks.

♦ Drink plenty of fluids and eat enough kcals.

♦ Be aware of any symptoms that may predispose you to
dehydration (diarrhea, vomiting, fever).

♦ Be aware of the warning signs of heat illness. Stop if signs or
symptoms of heat injury become apparent (See Chapter 13).

♦ Avoid substances that can lead to dehydration or heat injuries.

Table 12-1. Substances that Can Cause Dehydration

Caffeine Alcohol Decongestants

Antihistamines Atropine and other anticholenergics

Check with the medical department for other substances that may affect fluid balance.

Cold Environments

What is a cold environment? It is considered cold if the air temperature is below 15° F and the wind speed is greater than 25 m.p.h, or the water temperature is below 64°F. Cold wind and cold water accelerate heat loss by replacing the warm layer of air or water surrounding the body with colder air or water.

The body responds to cold by constricting (tightening) blood vessels to conserve heat and by shivering to generate heat and guard against hypothermia. There is increased urination and increased energy metabolism in cold environments, both on land and in water.

Energy Needs

Many studies have shown that soldiers tend to progressively lose weight when conducting field exercises in the cold for two to three weeks. Because significant weight loss can result in fatigue and performance decrements, energy intake must increase to meet the increased energy demands. Energy requirements can increase by 25 to 50% because of the increased work associated with performing physical tasks in the cold and the kcal expenditure due to shivering. Factors that increase energy requirements in the cold include:

♦ Increased basal metabolic rate (BMR, see page 3).

♦ Shivering.

♦ Working in cold weather gear.

To meet energy needs consume a diet that is high in CHO (roughly 60% of your total daily kcals). This will replace glycogen stores (page 7) that are being used to maintain body temperature. Eat frequent high-CHO snacks to help meet your kcal requirements. Keep fat intakes under 30% of your total daily kcals since high-fat diets may cause stomach upset. Keep protein intakes at 10% of your total daily kcals and avoid protein and amino acid supplements because high-protein intakes increase water losses.

Worksheet 12-2. Calculate Your Energy Requirements for a Cold Environment

Your Estimated Energy Requirement (EER) =______________ kcal/day.

(from Worksheet 1 -2)

A 25% increase in energy requirements equals:

_________ EER x 0.25 =__________ kcal/day.

Your total energy requirement equals:

__________ EER +________ 25% increase=_______ kcal/day.

e.g., If your EER is 3,000 kcals/day then in a cold environment your energy needs would increase by 3,000 kcals x 0.25 = 750 kcals/day. Your total daily energy requirement would be 3,000 kcals + 750 kcals = 3,750 kcals/day.

Deployment and Altered Climates

Adapting to a

new environment, such as

extreme changes in climate

or altitude, imposes

considerable demands on

■

the body. This adaptation,

or acclimation, occurs

gradually, allowing the

individual to better tolerate and perform in that new

environment. Thus, acclimation is the gradual change

the body undergoes in order to function more efficiently

in a new environment.

Acclimating to New E n vir onments

Adapting to a new environment can take one to three weeks. During this time, endurance activities become more difficult and onset of fatigue occurs sooner. If environmental conditions permit, gradually increase the intensity of exercise until you reach your desired training intensity. Having a good aerobic fitness base will accelerate your acclimation to new environments. Factors that negatively affect acclimation include:

♦ Dehydration.

♦ Drinking alcohol.

♦ Cessation of physical activity.

♦ Electrolyte depletion.

♦ Inadequate energy intake.

♦ Illness.

♦ Infection.

♦ Injury.

♦ Loss of sleep.

General Nutrition Issues

Maintaining or improving health and fitness is more challenging in adverse conditions such as extreme heat, cold, or altitudes. Even highly, physically fit individuals can be quickly overcome by "environmental exposure" if proper preparation is overlooked or if symptoms of impending illness are ignored. The adaptation of the body to adverse environments increases energy expenditure and water losses. Furthermore, dehydration results in a loss of appetite. If energy and fluid needs are not met, then performance will be impaired. General suggestions for meeting increased energy and fluid requirements are provided below. Issues relevant to a particular environment are provided later.

Maintaining Energy Balance

♦ Eat a high-CHO diet to meet increased kcal needs,
as CHO are more readily absorbed and better
tolerated than fats or proteins.

♦ Avoid fatty foods which may not be well tolerated.

♦ Avoid high-protein intakes which will increase water loss and can
lead to dehydration. (See Chapter 2 page 9.)

♦ Eat small frequent meals.

♦ When eating field rations, eat the entrees as well as the other
food and beverage items provided in the pack.

♦ Drink a high-CHO beverage to increase your kcal intake if you
are having difficulty eating enough solid foods to meet your
energy needs.

Maintaining Fluid Balance q

Maintaining fluid balance is crucial to avoid dehydration, as stated ^^=' in Chapter 2 on page 17. Dehydration can limit performance and severe dehydration can be life-threatening. Tips for maintaining fluid balance include:

♦ Monitor hydration status by the frequency and color of your
urine. Infrequent and dark yellow urine suggests dehydration.

♦ When possible, monitor fluid status by weighing yourself prior to
and after prolonged physical activities. For every pound of weight
lost due to water losses, drink 2 cups (0.45 L or 16 oz.) of water.

♦ Thirst is not a good indicator of fluid status. Drink fluids
regularly throughout the day. When working in the heat, do not
drink more than 6 cups of fluid an hour.

♦ Avoid alcoholic beverages as alcohol increases fluid losses.

♦ Reduce caffeine consumption as caffeine increases fluid losses.

♦ Avoid salty foods as salt increases fluid needs.

♦ Drink CHO/electrolytes beverages during prolonged physical
activity or on extended missions (Chapter 11, page 90).

Nutrition for Exercise Recovery

Within 30 minutes of completing an extended or intense exercise session, consume at least 50 grams of CHO (roughly 200 kcals). Also, continue to snack on high-CHO foods for up to six hours. This will help restore your muscle glycogen for the next exercise session. Some foods and servings sizes that contain roughly 50 grams of CHO are:

♦ Bagel with jam

♦ Baked potato with skin

♦ Cooked sweet corn, 1.5 cups

♦ Cornflakes, 2.5 cups

♦ Watermelon, 4.5 cups

♦ Raisins, 0.4 cup

♦ Shredded wheat cereal, 1.4 cups

♦ Baked Beans, 1 cup

♦ Bananas (2)

♦ Cooked oatmeal, 2 cups

♦ Cooked Rice, 1 cup

♦ Orange juice, 2 cups

For more information on the CHO content of foods, check food labels (Figure 3-2), check the USDA website at http://www.usda.gov, or ask a dietitian.

Vitamin and Mineral Needs

Any increased vitamin and mineral needs can be met by eating according to the Food Guide Pyramid (Chapter 3, Figure 3-1). Particularly, increase the number of fruits and vegetables you eat as these foods are good sources of many vitamins and minerals, as well as antioxidants. (See Chapter 3 page 22, Table 2-2, Table 2-3, and Appendix A.) These antioxidants may protect you from environmental stressors and may accelerate your recovery from exhaustive exercise. Fresh fruits and vegetables also provide potassium, which is lost during prolonged strenuous exercise (see Table 2-3).

Fluid Needs

Drinking fluids at regular intervals and eating foods with a high water content (i.e., fresh fruits) are important for maintaining hydration and fluid status during training. See Chapter 2 for more information on fluid balance.

Getting Enough Fluids

♦ Drink 16 oz. (2 cups) of fluid two hours before
starting exercise.

♦ Drink 3 to 4 oz. (1/2 cup) of fluid every 15-20 minutes during
exercise.

♦ Weigh yourself before and after exercise to determine how much
fluid you lost. Drink 16 oz. of fluid for every pound of weight lost.

♦ Do not rely on thirst as an indicator of fluid needs because it is
not adequate. Once you feel thirsty you are already dehydrated.

♦ Drink water when exercising less than 60 minutes. Drink a
sports drink (5% to 8% CHO with electrolytes) when exercising
longer than 60 minutes.

♦ Monitor your urine: urine should be a pale yellow (unless you
take vitamin B supplements) and you should be urinating
frequently.

What to Drink

Many beverages can replenish lost fluids, so select a beverage that:

♦ Tastes good.

♦ Does not cause gastrointestinal or stomach discomfort.

♦ Is rapidly absorbed from your gut, especially when exercising.

♦ Contains electrolytes (see Glossary) and CHO (5% to 8%) when
performing prolonged or strenuous exercise.

♦ Rehydrate with a non-caffeinated, non-carbonated, non-alcoholic
beverage.

Although less common than dehydration, untreated overhydration can be life threatening. It is seen when plain water is used to replace fluid losses during prolonged (greater than 3 hours) strenuous exercise. Remember, water and electrolytes are lost during sweating, so both need to be replaced in this situation. Overhydration decreases the concentration of electrolytes in the body, upsets metabolism and other bodily functions, and is just as harmful as dehydration. Prevent overhydration by drinking a beverage that contains electrolytes (such as a sport drink) or by eating a light snack (e.g., oranges) with your water. Between exercise sessions, electrolytes lost through sweating can be easily replenished by eating well-balanced meals and snacks (Chapter 3).

Figure 11-1. CHO Loading for Endurance Events

CHO loading requires that you reduce your training sessions and increase your CHO intake the week prior to an event. As shown to the left, five to six days before the event train no more than 40 minutes (solid line). CHO intake (dotted line) should be approximately 50% of your total energy intake. Two to three days before the event train no more than 20 minutes a day and increase CHO intake to 70% of your total energy intake. Rest the day before the event and keep CHO intake at 70%.

CHO for Strength Training

CHO are required for strength training because the exercises rely on muscle glycogen stores for energy. The recommended CHO intake is:

55-60% of your total daily caloric intake.

This is slightly lower than the requirements for endurance activities (see Worksheet 11-1) because the total amount of energy expended is less. CHO loading is not recommended for strength training because it causes extra water to be stored in the muscle.

Protein Needs

Protein needs of strength athletes and endurance athletes are quite similar at:

0.6 - 0.8 grams of proteins per pound of body weight.

This corresponds roughly to 10-15% of your total daily kcals. It is highly likely that your diet provides adequate proteins since most Americans consume proteins in excess of their needs. Use Worksheet 11-2 or Worksheet 2-2 (Chapter 2) to determine your protein needs.

 

Worksheet 11-2. Calculate Your Protein Needs

_grams proteins.

Body Weight = 0.6 grams/lb x _

(Body weight)

_grams proteins.

0.8 grams/lb x

to

(Body weight) Your daily protein grams =

The High-Protein Myth

One of the most common myths is that eating high-protein diets and protein supplements leads to bigger muscles. Clearly, this is not the case! Muscle is only 20% proteins; the rest is water, minerals, lactic acid, and urea. (See Figure 11-2.) Moreover, excessive protein intakes, mostly from protein supplements, can cause:

♦ More waste production.

♦ Increased water needs.

♦ Greater demands on the liver and the kidneys.

♦ Imbalances in the essential amino acids.

♦ Diarrhea or abdominal cramps.

For these very reasons, avoid protein powder drinks that provide excessive amounts of proteins or selected amino acids. Although heavily advertised and endorsed by celebrities, you do not need protein supplements to build muscle. Supplements can be very expensive, dangerous to your health, and they are quite unnecessary. Spend your money on a variety of foods for a balanced diet that will sufficiently meet your protein needs. Exercise to gain muscle!

Figure 11-2. Components of Muscle

Muscle is:

20% proteins, 75% water, and 5% inorganic salts, urea, and lactate.

CHO for Endurance Training

 

The endurance capacity of an individual on a high-CHO diet is approximately 3 times greater than on a high-fat diet. When CHO intake is low, several days of rigorous training will result in a gradual depletion of muscle glycogen stores and eventually impair performance. The guidelines for CHO intake while training are:

60 - 65% of your total daily kcal intake.

Worksheet 11-1. Calculate Your Daily CHO Needs

		X	0.60	=	kcal from CHO per day.
Your EER*		X	0.65		kcal from CHO per day.
Your EER* You should	eat			to	kcals from CHO daily.

* Your estimated energy requirement (EER) was calculated in Chapter 1, Worksheet 1 -2. To calculate grams of CHO see Worksheet 2-1.

Keep a dietary log for a few days to see if your CHO intake is adequate.

CHO Loading/Glycogen Supercompensation

CHO Loading is a regimen that combines diet and exercise to "pack" more glycogen into muscle and liver (Figure 11-1). It is used by endurance athletes to optimize physical performance during prolonged endurance events. CHO loading causes temporary weight gain (2.7 grams of water are stored with every gram of glycogen). The extra weight may impair performance. CHO loading is unnecessary for individuals who eat according to

the dietary guidelines outlined in Chapter 3 and whose CHO intakes are within the range calculated in Worksheet 11-1.

Nutrition for Exercise

Y our physical performance is greatly influenced by regular conditioning and by following sound dietary practices. Both prolonged aerobic exercise and multiple bouts of high intensity exercise impose significant demands on energy and fluid balance. Failure to replace energy and fluids used during exercise can significantly impair performance in later activities.

The following recommendations are for an individual who regularly participates in at least 90 minutes of aerobic exercise each day or in multiple, strenuous bouts of exercise several times a week. This information does not apply if you exercise less than one hour per day.

Carbohydrate Needs

During heavy training you must increase your kcal intake, especially from carbohydrates (CHO), to meet your energy demands. Failure to do so may result in:

♦ Chronic muscular fatigue.

♦ A feeling of staleness.

♦ Weight and muscle mass loss.

♦ Poor sleep patterns.

Morale During Deployment

Although confined spaces can limit your Щь training options and make you feel less than I enthusiastic to train, you need to remain physically active. Stopping all physical training results in a rapid decline in muscle | strength and endurance, flexibility, and aerobic conditioning (see Chapter 4). One option to boost morale and increase participation in physical training during deployment is to create training competitions. Some ideas include:

♦ Mini-triathlons - Perform any three aerobic exercises back-to-
back for the best time. Honor the winner by engraving his/her
name on a plaque or give him/her a token that is symbolic of the
competition.

♦ Organize team competitions that coincide with major sporting
tournaments, such as the NFL playoffs or the NCAA Final Four
tournament. Assign each crew member to a team and organize
the teams into tournament-style playoffs. Record the time each
team member exercises. The team with the most total exercise
time wins the tournament.

Anyone can organize these types of competitions. Such events make exercising a social and morale boosting activity for all sailors during deployment.

Finally, you may feel that the biggest barrier to working out when deployed is time limitations. In actuality, it requires less time to maintain fitness levels than to increase fitness levels. Though not ideal, you can maintain your fitness level by working at your usual intensity fewer times per week and for shorter durations than what is required to improve your fitness level. A minimum of one strength session, which includes exercises for all the major muscle groups (1 set of 8-12 repetitions), and two 20-minute aerobic sessions, within your target heart rate zone, per week will allow you to maintain your current fitness level. Though this limited amount of training is not ideal for your overall fitness, it is much better than not performing any exercise at all. Remember, detraining occurs rapidly when all training is stopped (see Chapter 4).

Workout Design

The FITT principle guidelines described in Chapters 4, 5, 7, and 9 should be followed for each type of fitness training. Since space, equipment, and time are limiting factors during deployment, one of the most effective workouts for you to perform is circuit training (described in Chapter 7). The basics of this type of workout are:

♦ Total session is 30-60 minutes, divided into 30-60 second stations.

♦ Each station is a new exercise; alternate aerobic and strength
stations, and upper and lower body exercises.

♦ Perform aerobic exercises in your target heart rate zone.

♦ Perform strength exercises with proper form and use a resistance
that you can lift 10-12 times.

♦ Stretch after your workout. (See Chapter 9.)

Table 10-2. Circuit Training Workout

Station	Exercise	Time
	Warm-up	5 minutes
1	Wall Squat with Ball	60 sec
2	Push ups	60 sec
3	Jog in place	60 sec
4	Stair step/Jog	60 sec
5	Jumping Jacks	60 sec
	Check heart rate	10 sec
6	Lat Pulldown with Band	60 sec
7	Abdominal Crunches and Lower Back Extensions	60 sec (30 sec each)
8	Biceps curl and Triceps Extension with band	60 sec (30 sec each)
9	Jumping Jacks	60 sec
10	Stair Step/Jog	60 sec
11	Jog in place	60 sec
12	Jumping Jacks	60 sec
	Check heart rate	10 sec
	Repeat Stations 1-12, 2-4 times
	Cool Down	5 minutes
	Stretch	5-10 minutes
Note: One cycle of this circuit training workout has 7 minutes of aerobic	exercises and one set of
strength exercises for each of the major muscle groups.

Inflatable Resistance Balls

These light-weight balls are becoming very popular in fitness centers and are excellent for abdominal, lower back, stability, and stretching exercises. The goal in resistance ball training is to keep your balance and stability while performing exercises on the ball, which acts as an unstable base. Resistance balls are typically 18 to 30 inches in diameter and cost about $30. Purchase a resistance ball that when you sit on it after it is fully inflated, your thighs are parallel to the deck. In addition, when you purchase these balls, you get a video of various exercises and routines. One drawback is that you need access to an air pump because, if the ball is kept inflated, it can take up a lot of storage space.

Strength Exercises

Table 10-1 shows exercises that can be performed using resistance tubing (bands) and balls. When performing elastic tubing exercises, you can use a partner, instead of an anchor, to secure the tubing during your exercise. Just be sure your partner holds the tubing at the appropriate height and distance from you (and doesn't let go!). When using the resistance bands, it is important to anchor them properly. Some examples are shown in Figure 10-1.

Figure 10-1. Anchoring Elastic Tubing

1. Wrap the band around the top and sides of both feet, then pull the handles up through the middle of your feet. This type of wrap is useful for anchoring the band during rowing exercises.

2. a. Using the 1 ft. elastic loop, sit down and place your right foot on the middle of the loop, b. Wrap the right end of the tubing over your foot, с Pull the left end of the tubing up through the right end of the tubing loop.

d. Take the left end of the tubing loop and wrap it around your left foot. This type of anchor is useful for leg lifts and leg curls.

 

Table 10-1. Exercises to Perform in Confined Spaces

X

m

Bent-Over Row with Band

Grab one end of the band in each hand. Step on the middle of the band with your left foot, step back 2 ft. with your right foot. Bend forward slightly at the waist, keep your shoulders and hips facing forward. Count 1: Lift both hands from your thighs to your waist. This should take 2 seconds. Pause for 1 second. Count 2: Return hands to thigh level in 4 seconds. Keep your elbows close to your body throughout the exercise. Works the back and biceps muscles.

Lat Pulldown with Band

Secure the middle of the band to a fixed object

above your head. Grasp one handle in each

hand. Facing the anchor, step back 1 foot and

kneel. Arms should be extended above head.

Count 1: Pull hands down to shoulder height in

front of your head, keeping chest and head up.

Back should remain straight. Press your

shoulder blades together in the middle of your

back as you pull your arms down. This should

take 2 seconds. Pause 1 second. Count 2:

Return to start position in 4 seconds. Variation:

may need to use the tubing loop instead of a band for adequate

resistance.

Seated Row with Band

Sit on deck with legs extended, knees slightly bent. Place the center of the band under your feet. Count 1: With arms extended at chest level and hands over knees, bend your elbows and pull your hands back to each side of your chest. This should take 2 seconds. Pause 1 second. Count 2; Return to start position in 4 seconds. Works back and biceps.

Lower Back on Ball

Kneel beside resistance ball, lay your

chest on top of the ball, place your

hands in front of the ball. Extend your

legs so only your feet are on the deck

and walk forward, rolling the ball back

closer to your hips. Place your hands

behind your back. Count 1: Keep your back straight and raise

your torso up off the ball until your back is extended. Count 2:

Return to the start position. Try to keep ball steady during

exercise. Works the lower back. Similar to prone back

extension performed on the deck. Variations: Can do all the

same extension exercises as on the deck.

Abdominal Crunch with Band

Anchor the middle of the band above your head. Kneel 1 ft. in front of the anchor, and grasp both ends of the band in your hands. Place your hands palms down on your shoulders. Count 1: Pull your rib cage down closer to your hips. This should take 2 seconds. Pause 1 second. Keep your hips and legs still. Count 2: Return to the start position in 4 seconds.

Abdominal Crunch on Ball

Sit on ball, slowly walk feet away from ball

as you lie back on to the ball. Ball should

be underneath your midback. Place your

hands behind your head. Count 1: Pull

your rib cage closer to your hips. Count 2:

Return to the start position. Try to keep

ball steady during exercise. Works the

abdominals. Variations: Use a towel under your lower back

instead of the ball; perform side crunches on the ball to target

the obliques.

Table 10-1. Exercises to Perform in Confined Spaces

I

M §

I

о я

| о

Chest Fly with Band

Sit on the deck with your left leg straight and

your right leg bent, with your right foot

touching your left thigh. Hold one handle of

the band in each hand. Wrap the band under

your left heel, about 1/3 the length of the

band down from your left hand. Keep your

back straight, head up, and shoulders back.

Place your right hand on the deck by your

right knee. Straighten your left arm so that

your elbow is only slightly bent and raise your

arm in front of you to chest level. Count 1:

Slowly pull your upper left arm across your

chest without bending your elbow; this

should take 2 seconds. Pause for 1 second.

Count 2: Return to the start position in 4 seconds. Your torso and hips

should not move during this exercise. Works your chest

muscles.Variations: a) perform this standing or kneeling by anchoring

the band to a stationary object at chest height; b) lie on your back on a

bench and use dumbbells; c) have a partner push (manual resistance)

against your upper arms as you do the exercise.

Chest Press with Band

Wrap the band at shoulder height around a bench

that is wider than shoulder-width (or secure with

two anchors). Keep your back straight, shoulders

down and head up. Grip one end of the band in

each hand, and place your hands on each side of

your chest. Count 1: Extend arms straight in front

of you at chest height, do not lock your elbows;

this should take 2 seconds. Pause for 1 second.

Count 2: Return to the start position in 4 seconds.

Works your chest, shoulders, and

triceps.Variations: a) have a partner hold the band in both hands,

keeping his hands at your shoulder height and wider than your

shoulder-width; b) lie on back on a bench and use dumbbells; c)

have a partner provide manual resistance against your hands as you

perform a press.

Incline Press with Band

Grab one end of the band in each

hand. Step on the band with your

right foot, step your left foot through

the band and forward 2 ft. Bring your

hands to your shoulders with your

palms facing forward. Count 1:

Extend your arms up and forward in

front; your hands should be in front of

and a little higher than your forehead.

This should take 2 seconds. Pause

for 1 second. Count 2: Return to start

position. Works the chest and shoulders. Variations: a) for

more resistance, use a second tube and place it under your

front foot; b) for less resistance, anchor the tube to a stationary

object at waist height, step forward 2 ft. and perform the

exercise.

Biceps Curl with Band

Grab one end of the band in each hand. Step on the band with your left foot, step your right foot through the band and forward 2 ft. Count 1: With hands at sides and palms up, bring your palms to your shoulders. This should take 2 seconds. Pause for 1 second. Count 2: Return to start position. Works the biceps. Variations: a) for more resistance, use a second tube (as shown) and place it under your front foot); b) use dumbbells; c) have a partner pull against your lower arm during the curl.

00

00

to

Table 10-1. Exercises to Perform in Confined Spaces

ffl

8

Triceps Extension with Band

Stand with feet hip distance apart, knees

slightly bent. Grab one end of the band in

your right hand and place it over your right

shoulder. Your right elbow should be

beside your head and the band should be

dangling down your back. Reach around

your back with your left hand and grab the

other end of the band with your left hand.

Place your left hand on your low back.

Count 1: Extend your right arm straight

above your head, keeping your left hand

still and your right elbow close to your head. Do not lock your right

elbow. This should take 2 seconds. Pause 1 second. Count 2:

Return to the start position in 4 seconds. Works the right triceps.

Switch arms to work the left triceps.Variations: a) if you have a long

piece of tubing, grab the middle of the tubing (instead of the end)

with your left hand; b) use dumbbells.

Triceps Kickback with Band

Grab one end of the band in each hand.

Step on the middle of the band with your

left foot, step back 2 ft. with your right

foot. Bend forward slightly at the waist,

keep your shoulders and hips facing

forward. Place your left hand on your left

thigh for support. Pull your right hand up

to your right hip, keeping your right elbow

close to your body. Count 1: Straighten

your lower right arm behind your back without lifting your elbow. This

should take 2 seconds. Pause 1 second. Count 2: Return to the start

position in 4 seconds. Works the right triceps. Switch to work the left

triceps. Variations: a) use dumbbells; b) have a partner push against

your lower arm during the lift.

Lateral Raise with Band

Grab one end of the band in each hand.

Stand on middle of the band, feet

shoulder-width apart, knees slightly

bent. With arms at sides, bend elbows

90°. Count 1: raise your upper arms to

each side until your elbow (still bent

90°) is level with your shoulder. This

should take 2 seconds. Pause 1

second. Count 2: Return to start

position in 4 seconds. Keep your elbow

bent during the lift. Works the

shoulders. Variations: a) for more resistance, use 2 bands,

stand on only one band with each foot, hold one end of each

band in each hand; b) use dumbbells; c) have a partner push

down against your upper arms as you lift; d) increase the

difficulty of the exercise by straightening your elbow.

Upright Rows with Band

Stand on the middle of the band, feet

shoulder-width apart, knees slightly

bent. Cross ends of band in front of you

and grasp one end of the band in each

hand, palms facing back. Count 1: With

arms extended and hands together at

the center of your body, pull elbows up

and back to the level of your shoulders.

Your arms should form a "V". This

should take 2 seconds. Pause 1

second. Count 2: Return to start

position in 4 seconds. Do not arch your

back during the lift. Works the front of the shoulders. Variations:

a) for more resistance, use 2 bands, stand on only one band

with each foot, hold one end of each band in each hand; b) use

dumbbells.

Table 10-1. Exercises to Perform in Confined Spaces

I

 

Reverse Fly with Band

Anchor the middle of the band at chest height.

Facing the anchor, step back 4-5 ft. Grab one end

of the band in each hand. Extend your arms straight

in front of you at chest level, elbows slightly bent.

Count 1: Pull your upper arms out to each side

without bending your elbows any more. This should

take 2 seconds. Pause 1 second. Count 2: Return

to the start position in 4 seconds. Works the back of

the shoulders. Variations: a) kneel on one knee,

bend at the waist, rest chest on opposite thigh, and

use dumbbells or have a partner push against your upper arms.

Lunge with Band

Grab one end of the band in each hand.

Step on the middle of the band with your left

foot, step your right foot through the band

and beside your left foot. Bring hands up to

shoulders, palms facing forward. Band

should be behind your arms. Count 1: Take

a large step forward with your right foot,

keep your back straight and head up. Count

2: Squat straight down, dropping your left

knee, until your right knee is over your right

ankle. Count 3: Lift up. Count 4: Push off

your right foot to return to the start position. Works the leg muscles.

Switch sides. Variation: a) for more resistance, use a second tube and

place it under your front foot; b) on Count 1, step to the left or right

instead of straight ahead; c) use dumbbells.

Leg Curl with Band

Wrap one end of the tubing loop around your right foot. Hook the other end on your left foot. Lie on your stomach with both legs extended. Count 1: Lift your left heel up toward your buttocks, keeping your right knee and hips flat on the deck. This should take 2 seconds. Pause 1 second. Count 2: Lower your leg to the start position in 4 seconds. Works the hamstrings.

Leg Lifts with Band

Anchor the band at shin height. Wrap the band

around your left ankle and, facing the anchor,

step back 3 ft. Place feet side by side and point

your left foot up. Place your hand on the wall for

support and slightly bend your right knee.

Count 1: Keeping your left leg extended, pull

your left ankle back 1 -2 ft. This should take 2

seconds. Pause for 1 second. Count 2: Return

to start position in 4 seconds. Switch legs.

Works hamstring and gluteal muscles.

Variations: a) to work inner and outer thighs

and hip flexors, change the position of your body so you pull

against the band in all four directions (front, back, and two

sides); b) lie down and use ankle weights.

Squat with Band

Grasp one handle in each hand, step

on the band with feet hip-width apart,

knees slightly bent. Bring hands up to

shoulders, palms facing forward.

Band should be behind your arms.

Count 1: Slowly squat down; look

forward, keeping your shoulders back,

chest and head up. Squat until your

knees are above your toes. This

should take 2 seconds. Pause 1

second. Count 2: Return to the start

position in 4 seconds. Works the quadriceps and gluteals.

Wall Squat with Ball

Stand against a flat wall, place both feet 2 ft. from the wall hip distance apart. Place a small ball between your knees. Count 1: Slide down the wall until your knees are over your feet and squeeze the ball between your knees. Hold this position for 10 seconds. Count 2: Return to the