Healing the Everyday Athlete, Evaluating the Impact of Recovery

Wear Garment Use on Musculoskeletal Health in an Occupational

Setting

Kara Radzak and John Mercer

Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, U.S.A.

Keywords: Occupational Pain, Sleeve, Germanium, Overuse.

Abstract: While musculoskeletal injuries are commonly associated with sports, work-related musculoskeletal disorders

greatly impact the workforce efficacy and account for a high volume of workers compensation cases. This

study evaluated the effect of a carbonized charcoal and germanium recovery wear product on reducing

musculoskeletal discomfort among first responders, a group prone to overuse injuries. Participants included

13 firefighters and law enforcement officers who used the recovery wear product over two months. Measures

of musculoskeletal function and discomfort were assessed using the Fusionetics® Movement Health

Questionnaire. Results indicated no change in measures of musculoskeletal function and discomfort over the

2-month period. Despite a small sample size of the present study, it is important to research the potential of

recovery wear products as a practical intervention for managing work-related musculoskeletal disorders in

physically demanding professions. Further research with larger samples and objective measures is needed to

confirm these preliminary results and explore long-term benefits. This study provides a foundation for future

investigations into wearable technology for occupational health.

1 INTRODUCTION

While musculoskeletal injuries are synonymous with

“sports injuries,” work-related musculoskeletal

disorders account for 31% of workers compensation

cases in the United States and have direct cost of $1.5

billion, annually (Bureau of Labor Statistics, 2016).

In addition, each worker with a musculoskeletal

disorder requires a mean of 12 days recovery before

returning to work. (Bureau of Labor Statistics, 2016).

Similar to athletes, overuse injuries are prevalent in

an occupational setting, with 33.9 cases per 10,000

full-time workers attributed to overexertion

mechanisms of injury in 2015 (Bureau of Labor

Statistics, 2016). Thus, a large contributor to the

costly problem of work-related musculoskeletal

disorders in the “occupational athlete” are overuse in

nature and result from occupational task induced

microtrauma and its associated inflammatory

response (Barbe, Barr, 2006).

Two primary options exist for mitigating overuse

work-related pain or discomfort: 1) decrease the

microtrauma induced by the worker’s job task, and/or

2) increase the body’s ability to heal and not succumb

to the microtrauma (Barbe, Barr, 206). Often, the

worker’s tasks cannot be changed nor can exposure to

microtrauma inducing repetitive actives be decrease.

Thus, the most viable option for decreasing

musculoskeletal overuse is to mitigate the effects of

the microtrauma in hopes that the individual at risk

can maintain working below the threshold of

microtrauma that would result in a decreasing

musculoskeletal discomfort and preventing

development of musculoskeletal injuries. One

theoretical avenue of intervention is to decrease the

noxious effects of chronic inflammation associated

with work-related overuse. (Barbe, Barr, 206).

While some recovery products rely upon

compression, other wearable recovery products are

garments with semiconductors (carbonized charcoal

and germanium) interwoven into the garment’s fabric.

Body heat causes the semiconductor elements of the

fabric to release negative ions and create a localized,

micro electromagnetic field to increase circulation and

lymphatic flow (Marino et al., 2019; Lee et al., 2018)

In theory, by increasing circulation, more oxygen and

nutrients delivered to the area under the product, which

optimizes the body’s natural healing process and

Radzak, K. and Mercer, J.

Healing the Everyday Athlete, Evaluating the Impact of Recovery Wear Garment Use on Musculoskeletal Health in an Occupational Setting.

DOI: 10.5220/0012934300003828

Paper published under CC license (CC BY-NC-ND 4.0)

In Proceedings of the 12th International Conference on Sport Sciences Research and Technology Support (icSPORTS 2024), pages 155-159

ISBN: 978-989-758-719-1; ISSN: 2184-3201

155

accelerates recovery. This provides a technical

advance to the traditional compression sleeves

commonly used in athletics and occupational workers.

Thus, germanium-embedded recover wear products

hold the potential to intervene in the job task-related

microtrauma cycle, and decrease perceptions of work-

related discomfort. The current study aimed to evaluate

the impact of the recovery wear product on self-

reported measures of work-related musculoskeletal

discomfort in members of a physically demanding

profession – first responders. We hypothesize that the

use of the products will improve measures of

musculoskeletal function and readiness, as measured

using the Fusionetics® system’s Movement Health

Questionnaire.

2 METHODOLOGY

A survey-based study was designed to evaluate

perceptions of musculoskeletal discomfort and

function prior to and following the use a recovery

wear product. The study was approved by the

university’s institutional review board prior to the

initiation of data collection.

2.1 Participants

Inclusionary criteria consisted of being over the age

of 18, being in a physically demanding profession,

and being employed at one of the

companies/municipalities that allowed for recruiting

from within their employees. Participants were either

firefighters or law enforcement officers employed by

one of two large metropolitan cities in the mountain

west region of the United States.

Participants were recruited through word of

mouth and study flyers displayed at their employer’s

physical location. Individuals interested in

participating contacted the research team and were

provided a copy of the informed consent document.

Individuals then underwent the informed consent

process either in person or via telephone. During the

informed consent meeting, a member of the research

team confirmed that the individual met inclusionary

criteria, provided instructions on study participation,

answered any questions on the study protocol, and

obtained the participants verbal consent to participate.

During this meeting, baseline health quality of life

was also collected.

2.2 Survey Instruments

Health quality of life was collected using the Center

for Disease Control’s (CDC) Health-Related Quality

of Life (HRQOL) instrument. For this study, the

standard 4-item “Health Days” core questions were

used (HRQOL-4) as well as the additional 5-item

Activity Limitations Module.

Measures of musculoskeletal function were

collected via the Fusionetics® Movement Health

Questionnaire. Fusionetics® is a web-based or

mobile application platform that collects human

performance and movement quality data.

Fusionetics® has been traditionally utilized by sports

teams for injury prevention and strength and

conditioning performance improvement by members

of the sports team’s sports medicine professionals.

For the purposes of the study each participant was

listed as an “athlete” in the research study’s “team”

where only the researchers had access to the

participants’ data. Each participant was onboarded to

their own unique Fustionetics® “athlete” account

through the research study’s “team” account using the

preferred email address provided by the participant

during the consent process. The participant then

received an email instructing them on, (1) how to

access and download the Fusionetics® mobile

application if they choose to interact with the

Fusionetics® platform from a mobile device, (2) to

complete their individual account onboarding, and (3)

take the Movement Health Questionnaire. The

Movement Health Questionnaire asks questions

related to function, previous injury history over the

previous one-year recall timeframe, musculoskeletal

soreness (Figure 1), and perceived readiness (Figure

2). The Fusionetics® platform then uses a proprietary

algorithm to determine a total movement health score

with sub-scores in the categories of function, injury

history, soreness, and readiness.

Figure 1: Example of the “soreness” question item in the

Fusionetics® Movement Health Questionnaire.

icSPORTS 2024 - 12th International Conference on Sport Sciences Research and Technology Support

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Figure 2: Example of the “readiness” question items in the

Fusionetics® Movement Health Questionnaire.

2.3 Data Collection Procedures

After the informed consent meeting and collection of

baseline HRQOL data, participants were provided

with instructions on how to access the Fusionetics®

platform and directed to complete the baseline

Movement Health Questionnaire. Participants were

also provided with, or given access to a centralized

location to pick up the recovery wear product to be

used in the study.

Participants were allowed to select one recovery

wear product (Incrediwear®, Chico, CA, USA), at no

cost, of their choosing from the following products:

knee sleeve, back brace, elbow sleeve, wrist sleeve,

or crew socks. Participants were instructed to select

their study-provided product based upon what body

region they most commonly had occupation related

musculoskeletal discomfort. Participants were

instructed to wear the product in accordance to their

preference, as long as manufacture guidelines were

followed. While this added variability into the

duration and time period (e.g., at rest or during

activity) the participants wore the product, this

methodology was truer to consumer usage.

Participants were instructed to use the product over

the duration of the two-month intervention period.

Following the two-month recovery wear usage

intervention period, participants were emailed to

complete the follow-up data collection. These emails

included links to the follow-up HRQOL and

Movement Health questionnaires. Participants were

allowed to keep the recovery wear product at the

conclusion of the study.

2.4 Statistical Analysis

Data were analysed using Excel (Microsoft) and

significance set at p < 0.05. Changes from pre- to

post-intervention were evaluated using one-tailed,

paired sample t-tests. Descriptive statistics were

reported as means, standard deviations, and ranges.

3 RESULTS

A total of 13 individuals (12 males, 1 female)

participated in the two-month intervention.

Participant demographics are reported in Table 1.

Recovery wear products used included seven knee

sleeves, two elbow sleeves, two back braces, and one

pair of crew socks.

Table 1: Participant demographics (n=13).

Mean Standard

Deviation

Range

Age (years) 45.08 8.14 28 - 58

Hei

(

)

1.80 0.07 1.6 - 1.88

Body Mass

(kg)

94.10 14.03 65.77 –

117.93

For the baseline HRQOL, general health was

reported to be “fair” by one participant, “good” by

two participants, “very good” by eight participants,

and “excellent” by two participants. Total unhealthy

days were over the previous 30 days was reported as

4.6 ± 7.1 days (range: 0-23), with four participants

reporting zero unhealthy days. Six individuals

reported that they were not limited in any way in any

activities because of impairments or health problems,

three reported being “not sure” and four reported

being limited. Those that reported being limited in

activities cited the joint which they obtained a product

being the source of their limitation. Changes in the

Fusionetics® Movement Health Scores and

associated subscores, where higher scores indicate

improvements, are reported in Table 2. There were no

significant differences found between pre- and post-

scores.

Healing the Everyday Athlete, Evaluating the Impact of Recovery Wear Garment Use on Musculoskeletal Health in an Occupational Setting

157

Table 2: Comparison of Fusionetics® Movement Health Scores, including subscores, prior to and following a two-month

intervention period (mean ± SD).

Variable Pre-intervention Post-intervention p-value

Total Movement Health

Score

46.81

± 11.44 50.50 ± 17.28

0.19

Function Subscore

40.19

± 13.28 40.19 ± 16.12

0.50

Injury Subscore

46.08 ± 20.11 53.08 ± 27.98

0.14

Soreness Subscore

35.77

± 20.19 38.46 ± 20.04

0.17

Readiness Subscore

60.77 ± 14.12 58.85 ± 15.16

0.36

4 DISCUSSION

The present study aimed to evaluate the impact of a

semi-conductor based recovery wear product on self-

reported measures of work-related musculoskeletal

discomfort among first responders, a physically

demanding profession. The study's results, while

limited by a small sample size, suggest that the use of

the recovery wear products did not influence

musculoskeletal function and readiness, as measured

by the Fusionetics® Movement Health

Questionnaire, for a group that self-reported being

healthy at baseline.

This project's overarching goal was to study the

management of work-related musculoskeletal

disorders, particularly among first responders who

cannot easily modify their job tasks or reduce

exposure to repetitive activities. The use of recovery

wear products offers a practical intervention that can

be easily integrated into daily routines, providing a

non-invasive means to enhance recovery and reduce

discomfort. The recovery wear product used in the

current study has been previously found to decrease

patient discomfort and increase range of motion

following total knee replacement (Justice, Jacob,

2024). While there was no difference found in the

current study, this is not unexpected, due to the well-

documented difficulty in decreasing musculoskeletal

injuries in a tactical or first responder population. A

meta-analysis of interventions to reduce

musculoskeletal overuse injuries in tactical

populations found weak evidence to support common

injury prevention strategies, such as training load or

footwear modifications (Sinnott et al., 2023).

A challenge with interpreting the results of the

study is that the sample size was small, with only 13

participants completing the two-month intervention,

which limits the generalizability of the findings.

Additionally, the study relied on self-reported

measures of discomfort and function, which may be

subject to response bias. The variability in product

usage (e.g., duration and time of use) also introduces

a level of inconsistency in the intervention, although

this was intended to reflect real-world consumer

behaviours. Nevertheless, conducting research in a

real-world situation is important. Investigations

evaluating if there is a dosage effect for recovery wear

products, such as those used in the current study,

would aid in both practical usage and enhance future

research protocols. A previous investigation of the

use of same recovery wear product used in the current

study in a population of knee osteoarthritis patients

had the participants continuously wear the knee

sleeve for a six-month time period (Marino et al.,

2019). Those with grade 1 or 2 osteoarthritis had

significantly improved patient-reported outcome

scores and decreased pain, whereas those with grade

3 osteoarthritis did not have significant improvements

(Marino et al., 2019).

Future research should aim to further test the

hypothesis that recovery wear products, such as those

used in the current study, influence measures of

musculoskeletal function and readiness with a larger,

more diverse sample to enhance the generalizability

of the results. While individuals at all career stages

and ages were recruited to participate, the current

study’s participants had a mean age of 45 and ranged

from 28-58 years old. The higher concentration of

participants over the age of 40 could have influenced

our findings. These individuals may have had age-

associated co-morbidities (e.g., cardiovascular

conditions), as hypertension is the second most

common preventable disease in police officers and

firefighters, with musculoskeletal injuries being the

first (Santos et al., 2022). Longitudinal studies with

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extended follow-up periods could provide more

comprehensive insights into the long-term effects of

products on musculoskeletal health. Future studies

focused on one anatomical location (e.g., knee sleeve)

and incorporating control groups (e.g., sham

products, controls matched by age and gender) should

be performed. Additionally, incorporating objective

measures of musculoskeletal function and recovery,

such as biomechanical assessments or physiological

markers of inflammation, could strengthen the

evidence base and provide a more nuanced

understanding of the mechanisms underlying the

observed benefits.

ACKNOWLEDGEMENTS

Funding for this study was provided by a GOED

Catalyst grant from the UNLV Sports Research

Innovation Initiative, with included matching funds

from Incrediwear®, LLC.

The authors would like to thank Shin Hwa Noh

for his work in data collection and analysis.

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