WRAIR-West hosts training in new project to identify prevalent tendon injuries before they occur

Story by Zeke Gonzalez

Walter Reed Army Institute of Research

On October 3, 2024, WRAIR-West co-hosted an ultrasound training session with Dr. Dan Cushman, a professor in the University of Utah’s Department of Physical Medicine and Rehabilitation. The training, held at Joint Base Lewis-McChord (JBLM), introduced advanced techniques for using ultrasound technology to identify microscopic structural abnormalities in tendons.

This training session was part of a larger, ongoing collaboration between WRAIR-West, the University of Utah, USUHS, and the U.S. Naval Academy, aimed at addressing the pressing issue of musculoskeletal injuries in the military.

Musculoskeletal injuries, including those affecting major tendons, are among the most common non-battle injuries in the military. According to research led by Brig. Gen. Deydre Teyhen, Chief of the Army Medical Specialist Corps and Commanding General of Brooke Army Medical Center, these injuries affect approximately 1.6 million service members annually, leading to 2.4 million healthcare visits and 25 million limited-duty days (2018). Addressing this widespread issue is a priority for military health professionals, making early detection methods like ultrasound imaging especially valuable.

“We believe these tendons start to look different on imaging before they start becoming painful,” said Dr. Cushman, emphasizing the importance of proactive care. “Identifying these changes early could allow for interventions that prevent debilitating injuries, which would prevent duty-limiting profiles and long-term disability.”

The training brought together over 30 clinicians and stakeholders, including injury control directors, physical therapists, athletic trainers, and occupational therapists. Participants, both in person and virtual, engaged in a live demonstration of ultrasound technology, hands-on practice scanning, and discussions about imaging techniques. One physical therapist with a documented tendinopathy even volunteered as a test subject, offering attendees the opportunity to observe real-time scanning and interpretation of abnormalities.

“I’m happy to see so many of our local stakeholders genuinely interested in gaining these ultrasound skills,” said Dr. Brad Fawver, WRAIR-West Research Psychologist and co-investigator. “Everyone seemed really engaged and asked Dan lots of great questions, so you can see they’re eager to get trained up and eventually scan service members in their own footprint.”

Looking ahead, the team has ambitious plans for the pilot project. “Our short-term plan is to rotate this device across our various brigade teams at JBLM to conduct 5-10 minute screenings and track injuries prospectively,” Dr. Fawver explained. “This will help us capture data across a broad range of ages, sexes, ranks, and occupational specialties.”

While the pilot project represents a significant step forward, the team envisions a more comprehensive approach. “The pilot project is a great start, but our ultimate goal is not to just identify a service member at risk and tell them, ‘Good luck’,” Dr. Fawver noted. “If we can provide a pre-injury rehabilitation program that addresses those functional impairments associated with structural abnormalities, hopefully, we can mitigate future injury risk and keep them off a profile altogether.”