Basic and Initial Entry Training
The initial entry or basic combat training (BCT) required by the military involves intense physical activities over varying durations that can result in especially high rates of musculoskeletal injuries. Activities include running, strength, and agility exercises, road marching, and obstacle courses. Physical training is a leading cause of the injuries. Many studies have evaluated risk factors and means to reduce injuries during basic training.
Though military training is intended to prepare Soldiers for the physical and mental demands placed on them during combat operations, the combined impacts of the many stressors in austere deployment settings is still not well understood. Soldiers' health and body composition can be impacted by nutrition, hydration, fatigue, environmental extremes (heat cold, altitude), environmental pollutants, physical hazards (animals, insects), infectious and noninfectious disease, and mental stressors. Physical fitness, especially aerobic capacity, is adversely impacted by these stressors. Musculoskeletal injuries pose the most substantial type of injury, in large part due to excessive load carriage and non-battle activities such as sports and physical training.
Obstacle Courses and Combatives
These activities are required as part of military training to ensure readiness of our troops. Because orofacial and dental injuries that occur during these activities are highly preventable with proper mouthguard use, Army regulations now require mouthguards (per
AR 600-63 ) during these training events. Established policies and procedures are also designed to ensure these activities are conducted in the safest manner possible to reduce risk of injury. For information about combatives training safety, and why it is so important to wear mouthguards, read these
two articles . Ongoing investigations are attempting to identify additional opportunities to reduce injury risk during these activities.
Though many types of injuries, including some fatalities, have occurred during Army parachuting operations and training, the majority of injuries are associated with improper landing and result in injuries to the lower extremities (ankle, foot). Injuries can be reduced with use of the newer T-11 parachute as well as use of external (out-of-the-boot) ankle braces. Read our Parachuting Injuries Factsheet to better understand risks and means to reduce chances of injury. Technical references.
Physical Fitness Testing
The use of specific fitness tests (e.g., running, push-ups) is a long-established practice to monitor basic health and fitness of military personnel as well as employees in other physically demanding occupations (such as firefighters and police). While these tests are not expected to predict the degree to which complex physical tasks are successfully performed, they provide measures of basic fitness levels that are relevant to key job tasks and/or overall job physical demands. For example, use of the current Army Physical Fitness Test (APFT), especially timed runs, have been useful indicators of those at higher risk of injury and even attrition. Technical references.
Military mission success often depends on the efficiency by which troops access remote or unstable environments on foot. Unfortunately, the military carried load has continued to increase due to improvements in weaponry and protective equipment. Weights ranging from 75 to 125 pounds were not uncommon during recent deployments in Afghanistan. Foot blisters, stress fractures, foot pain and tingling, knee problems, and back problems are among the most common road marching related injuries. Using proper equipment, improving load distribution, and ensuring proper physical fitness training as well as progressive increases in weight and distance during road march training can reduce the risk of injuries. For more information read our
Foot Marching and Load-Carriage Injuries Factsheet; our more detailed
Technical Information Paper (TIP); Army Techniques Publication (ATP) No. 3-21.18 (FM 21-18) Foot Marches (Apr 2017); Technical references.
Mouthguards are required for many sports as a proven means to reduce the risk of serious orofacial and dental injuries. Read our
Mouthguard Factsheet to help identify the best mouthguard to reduce these injuries