019 - Predicting Re-Injury After Return to Duty: Who’s Actually Ready?
38% of service members sustained another injury within a year of being medically cleared.
The Data-Proven Red Flags for Re-Injury
Poor movement & balance scores (Y-Balance, Functional Movement Screen, Triple Hop Test).
Slower 2-mile run times—each extra minute = higher injury risk.
Asymmetries in ankle dorsiflexion & weight-carrying ability.
Pain during movement assessments.
Higher BMI, smoking, & prior deployments = increased risk.
Tactical Fixes: How to Reduce Re-Injury & Optimize Return-to-Duty
1. Integrate Injury Risk Screening Before Clearance
Use Y-Balance, FMS & Triple Hop Tests to flag mobility & strength deficits.
Identify asymmetries & inefficiencies before re-entry.
Slower run times = warning sign, not just a conditioning issue.
2. Strength & Mobility Interventions for High-Risk Personnel
Fix ankle dorsiflexion & balance deficits with targeted mobility drills.
Increase load-bearing endurance with structured carry-based strength training.
Shift from time-based clearance to performance-based reconditioning.
3. Monitor & Adjust Clearance Based on Performance Data
Reassess movement & strength metrics throughout the return process.
Use biomechanical data to refine injury prediction models.
Adopt phased reintegration instead of immediate full clearance.
Thick Necks, Strong Foundations, No Weak Links
A healed injury isn’t the same as being mission-ready. A checklist clearance doesn’t guarantee performance. If we’re not screening for movement quality, we’re sending warfighters back in unprepared.
Screen movement, not just medical history.
Train to eliminate asymmetries before they cause injuries.
Return-to-duty should be a performance standard, not just a timeline.
A thick neck with weak movement patterns is an injury waiting to happen.
Fix The Foundation. Stay Thick.
Rhon DI, Plisky PJ, Kiesel K, et al. Predicting Subsequent Injury after Being Cleared to Return to Work from Initial Lumbar or Lower Extremity Injury. Med Sci Sports Exerc. 2023;55(12):2115-2122. doi:10.1249/MSS.0000000000003257