Page 94 - Journal of Special Operations Medicine - Summer 2014

Operational Stressors on Physical Performance in
Special Operators and Countermeasures to Improve Performance:
A Review of the Literature

Kyle Hoedebecke, MD; Will Brink, ALB

n the article “Operational Stressors on Physical Per- combination of glucosamine HCl (1500mg/day), chon-
Iformance in Special Operators and Countermeasures droitin sulfate (1,200mg/day), and manganese ascorbate
to Improve Performance: A Review of the Literature,” (228mg/day) and the other half received placebo. Al-
O’Hara and colleagues* performed a literature search though there was no significant back pain improvement,
for “specific countermeasures to reduce or prevent sig- the researchers found this combination to be effective
nificant decrements in physical performance and re- for treating DJD of the knee pain. 2
duce musculoskeletal injuries” with the conclusion that
“specific countermeasures for these known decrements Last, perpetual operational and training noise exposures
are lacking in the scientific literature.” This deduction, cause decreased operator effectiveness secondary to per-
however, proves inaccurate as evidence within the mili- manent hearing impairment. Evidence exists showing
tary community does exist and, unfortunately, has been the effectiveness of oral magnesium supplementation.
undervalued. Provided here are only a few examples of Among the multiple available articles on this subject,
present Special Operations Force (SOF)-relevant supple- Attias et al. specifically identifies the military relevance
ment research. in their placebo-controlled, double-blind study of 300
healthy, normal-hearing recruits undergoing 2 months of
O’Hara et al. appropriately and thoroughly emphasized repeated high-level impulse noise exposure (gunfire, ex-
the multiple physical health risks associated with the plosives, etc.). The subjects received either 167mg mag-
high training and operational tempo of the SOF com- nesium aspartate or placebo daily, with results showing
munity. One military study performed by Flakoll et al. permanent hearing damage was significantly reduced
showed that postexertional protein supplementation in the magnesium group compared with their placebo
decreases these risks. Their study evaluated Marine re- counterparts. 3
cruits who were randomly assigned to three treatment
arms: (1) placebo, (2) control, or (3) protein supplemen- This is just a small sampling of the plethora of data for
tation. After 54 days, the protein-supplemented group various inexpensive and safe supplements with SOF rel-
had an average of 33% fewer total medical visits, 28% evance. Numerous other studies exist that may further
fewer visits due to bacterial/viral infections, 37% fewer benefit the Special Operations community through re-
visits due to muscle/joint problems, and 83% fewer vis- duced training dropout rates, increased operator lon-
its due to heat exhaustion compared with the placebo gevity, and decreased medical expenditures. In the near
and control groups. Furthermore, the study found mus- future, additional research may even be able to identify
cle soreness immediately postexercise was reduced by cost-effective supplement combinations targeted for spe-
protein supplementation versus the placebo and control cific SOF units, branches, or mission requirements.
groups. 1

O’Hara et al. also discussed other common musculo- Disclosure
skeletal and joint pains, one of which is chronic knee The authors have nothing to disclose.
pain. A 16-week randomized, double-blind, placebo-
controlled crossover trial conducted by the Medical
Department of Naval Special Warfare Command evalu- References
ated 34 men from the U.S. Navy SOF community with 1. Flakoll P, et al. Post exercise protein supplementation im-
chronic lumbar or knee pain who carried the diagnosis proves health and muscle soreness during basic military train-
of degenerative joint disease (DJD). Half the men took a ing in Marine recruits. J Appl Physiol. 2004;96:951–956.

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