By CAPT VANCIL MCNULTY, U.S. Army Center for Health Promotion and Preventive MedicineAugust 7, 2009
Injuries to the bones, muscles and tendons of the body from physical training are among the greatest health threats to our Army. Prevention of these injuries must be a priority for any Army leader (officer or enlisted) who professes to "take care of Soldiers."
The Joint Services Physical Training Injury Prevention Work Group recommends that any successful injury prevention program must have four essential elements:
1. Education of service members, especially leaders,
2. Leadership enforcement of unit injury prevention,
3. Unit injury surveillance reports, and
4. Greater investment of resources in injury prevention research.
Let's take a closer look at the effect of leadership enforcement on injury prevention.
The value of leader responsibility and accountability cannot be overemphasized. It is well understood that when someone is held accountable, the rate of progress is likely to improve. The success of any leader's PT program has, for many years, been the average PT score of the unit. Yet, leaders should assume responsibility and be held accountable for all the outcomes of PT programs conducted in their units, not just average PT scores.
Physical fitness scores are only one outcome of PT; injury rates are another equally, if not more, important outcome. Since a significant number of military injuries occur in association with PT, unit injury rates provide another important measure of the success or failure of unit PT. Leaders should focus on fitness test pass rates and injury rates as the best composite assessment of PT program effectiveness and modify their PT program as needed to reduce injuries, thereby improving readiness.
When measuring unit success on fitness tests, leaders should place more emphasis on the percent of trainees passing the test rather than the highest average unit score. The custom of achieving the highest unit average fitness test score usually causes leaders to push the least fit trainees to overreach their capability. This has two potentially detrimental effects: a greater risk of injury and diminished physical performance, two cardinal signs of overtraining.
The tradition of achieving the highest unit average fitness test score also may cause some leaders to dismiss certain unit members as injured and therefore not take them into account when assessing their unit fitness status. For example, the result looks better if the average unit fitness score does not include the injured individual who could not take the test. If average unit fitness test scores are used at all, the "zero" scores for trainees who cannot take the fitness test due to an injury should be included when computing the unit average score. This practice ensures that the fitness test average score more accurately reflects true unit physical readiness by including the effects of injury.
Ideally, leaders should consider both the unit fitness test pass rates and unit injury rates (versus just unit average fitness test scores) when rating officers and noncommissioned officers since physical readiness is a function of both physical performance and injury.
The work group recommends military and civilian leadership enforcement of injury prevention policies and programs at all levels, including accountability down to the unit for injury rates and Army Physical Fitness Test pass rates. Effective command emphasis on injury prevention includes accountability and must be consistent, lasting, and based on evidence-based strategies and common sense to reduce exposure to injury risk during combat, field training exercises, and especially PT.