DENNIS SCOFIELD, MED, CSCS
EFFECTS OF MILD TRAUMATIC BRAIN INJURY
ON ANABOLIC HORMONES, EXERCISE,
AND RECOVERY
The views, opinions, and/or findings in this report are those of the
author and should not be constructed as an official Department
of the Army position, policy, or decision, unless so designated by
other official documentation.
Tactical athletes have a high likelihood of exposure to
physiological strain and incurrence of stressors from performing
physically demanding tasks in hostile and/or austere
environments; the physical ramification of which may or may not
be superficially observable (26). Thus, managing effective physical
training programs for this population can create unique challenges
for the tactical facilitator. In particular, the tactical facilitator
must have a clear understanding of how injuries incurred during
operations can impact physical performance and recovery.
Mild traumatic brain injury (mTBI), also referred to as a
concussion, is a common injury among both tactical and contact
sport athletes and is defined as an impact, penetration, or rapid
movement of the brain within the skull that results in an altered
mental state and damage to the brain (31). The Centers for Disease
Control (CDC) definition of mTBI includes head injuries with skull
fractures, closed head intracranial injuries, and unspecified head
injuries with periods of altered consciousness less than one hour
(5). It is estimated that 1.7 million head injuries occur in the United
States annually, and approximately 5.3 million children, women,
and men are living with mTBI-related disabilities in the U.S. (25,31).
In regards to military personnel, TBI rates have significantly
increased in U.S. Soldiers and Marines over the last decade (14).
There have been more than 287,861 diagnosed TBI cases since the
year 2000, with the majority of cases being classified as mTBI and
occurring in the non-deployed setting (8). In current deployed
military operations, Elder and Cristian report that the most
common cause of TBI is blast injury (9). Alarmingly, they further
note that estimates of 20% of the first 1.2 million service members
who served in Operation Iraqi Freedom (OIF) and Operation
Enduring Freedom (OEF) suffered a TBI; about 60% of whom
were not assessed by a he