Injury Prevention for Active Duty Personnel

 Military Activity Related Injuries

Last Updated: February 12, 2024

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

  • Basic Training
  • Deployment
  • Fitness Testing
  • Obstacle Courses and Combatives
  • Parachuting
  • Road Marching​
  • What can help prevent injuries? 

Basic Training

The initial basic training required by the military prior to a recruit's assignment to an active unit involves intense physical activities that can result in especially high rates of musculoskeletal injuries. Physical training is a leading cause of the injuries to those in basic training, largely because new recruits are not yet physically fit and are not used to such levels of daily vigorous activity. Activities during basic training include running, strength training, agility exercises, road marching, and obstacle courses. Many studies have evaluated risk factors and means to reduce injuries during basic training. Read our factsheet on Traini​ng Related Injuries. Also see: 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, physical fitness, 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. During deployment, musculoskeletal injuries are the most common cause of ambulatory visits, primarily due to physical training among women and contact with the enemy among men. Also see: Technical references

Fitness Testing in the Military

The use of specific fitness tests, along with standards for body composition, is a long-established practice to monitor basic health and fitness of military personnel.External Link While the basic tests required of all members of a Service will not 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 overall physical demands needed for military combat. Historically, the use of timed runs, ranging for 1.5 to 3 miles depending on the Service, have been especially 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 attrition. 

Each military Service has established its own fitness test criteria to meet mission needs. 

  • Arm​yAs of March 2022 the Army uses the Army Combat Fitness Test (ACFT), a 6-event test that provides 5 measures of upper and lower body, core strength, and power through tests involving​​ the deadlift, push ups, plank hold, standing power throw, sprint-drag-carry, and a 2-mile run fo​r aerobic capacity. Go to: ​​External Link 

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. Also see: Technical references.


While the majority of injuries experienced by US paratroopers are due to cumulative microtraumatic injuries caused by repetitive forces on tissues over time, because military paratroopers may be more likely to experience acute injuries such as sprains, fractures, or brain injuries, they receive hazard duty once qualified and in an active paratrooper unit. Basic airborne training may result in less injuries due to safety oversight during controlled training jumps. The use of the new T-11 parachute in recent years has reduced rates of ankle injuries due to a slower descent rate. Following proper training protocol as much as possible during operational and combat activities can reduce risks. Read our​ Parachuting Injuries Factsheet and Technical Information PaperExternal Link to better understand risks and means to reduce chances of injury. Also see: Technical references.

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 the demands of modern warfare. 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 to include progressive increases in weight and distance during 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 Link Also see: Technical references.​


What can help prevent injuries? 

​​Certain products/items have been evaluated as to their effectiveness at reducing injuries to military populations.

  • ​Blister Prevention 
    Physical training and military operations like road marching can result in potentially serious injuries from blisters on the feet or other areas where there is friction, such as from the shoulder straps of a ruck sack.  Some blisters need medical attention and these injuries can limit duty for many days. A review of the literature finds that the primary prevention tactic is to use synthetic moisture-wicking socks and proper fitting shoes to reduce the risk of blister formation.  Other types of prevention are not as well scientific proven to be effective but may be considered.  Read our Blister Pr​evention Factsheet​ or articleExternal Link for more information. Also see: Technical references.
  • Mouthguards 
    The military requires the use of mouthguards for many sports as and combatives training since properly-fitted mouthguards are a proven means to reduce the risk of serious dental injuries. Read our Mouthg​uard Factsheet to help identify how to choose the best mouthguard to reduce these injuries. 
  • Parachuting Ankle Braces (PAB) – no longer needed
    In the late 1990s through 2010 several military studies demonstrated the effectiveness of the outside-of-the-boot parachuting ankle brace (PAB). Despite evidence that this device could reduce rates of ankle injuries like fractures, implementation of the device in the routine operation of paratrooper training proved to be too difficult to overcome. However, this was overshadowed by the introduction of a new parachute design (“T-11”) that slowed the descent rate and also provided to reduce the rate of ankle injuries. For more information about the history of the PAB, read this technical information paper.External Link 
  • Arch Supports and Insoles – inadequate evidence for injury prevention
    Prior military studies demonstrated inconsistent findings regarding the use of arch support or insoles to reduce injuries. For more information ​​read this report​.External Link