Injury Prevention for Active Duty Personnel

 Military Activity Related Injuries

Last Updated: April 13, 2023

​Information pertaining to prevention of injury from military activities, including: Basic and Initial Entry Training; Deployment; Obstacle Courses and Combatives; Parachuting; Physical Fitness Training; Road Marching; and more.

  • Basic and Initial Entry Training
  • Deployment
  • Obstacle Courses and Combatives
  • Parachuting
  • Physical Fitness Testing
  • Road Marching​
  • General Topics

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. Technical references.



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. Technical references.

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 600-63External Link) 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 this articleExternal Link. Ongoing investigations are attempting to identify additional opportunities to reduce injury risk during these activities. Technical references.


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 and Technical Information PaperExternal Link to better understand risks and means to reduce chances of injury. Technical references.

Physical Fitness Testing

The use of specific fitness tests is a long-established practice to monitor basic health and fitness of military personnelExternal Link 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. Historically, the use of timed runs such as the 2-mile run in the 3-event Army Physical Fitness Test (APFT), have been useful indicators of aerobic capacity, and have been used to show that those with slow run times tend to be at higher risk of injury and even attrition. Though the APFT is now being replaced with the Army Combat Fitness Test (ACFT), a more rigorous 6-event test that provides additional measures of strength and power, the ACFT still includes a 2-mile run. Though the run event is the last of the 6 events and thus times are expected to slower than with the APFT, the run test will continue to be a valuable measure of aerobic fitness. The final revision of the ACFT was posted 23 March 2022External Link – of its six events, the plank now replaces the leg tuck, and it has gender- and age-adjusted standards. Though different from its initial developmentExternal Link, basic tactics for preventing injuries associated with the ACFTExternal Link are the same.​

Road Marching

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)External LinkArmy Techniqu​es Publication (ATP) No. 3-21.18 (FM 21-18) Foot Marches (Apr 2022)External LinkTechnical references.​


General Topics 

  • Mouthguards

    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.