US Army Extreme Conditioning Programmes: Is There An Injury Risk?

Research Paper Title

Extreme Conditioning Programs and Injury Risk in a US Army Brigade Combat Team.


Brigades and battalions throughout the US Army are currently implementing a variety of exercise and conditioning programmes with greater focus on preparation for mission-specific tasks. An Army physical therapy clinic working with a light infantry brigade developed the Advanced Tactical Athlete Conditioning (ATAC) program. The ATAC programme is a unique physical training programme consisting of high-intensity aquatic exercises, tactical agility circuits, combat core conditioning, and interval speed training. Along with ATAC, battalions have also incorporated components of fitness programmes such as the Ranger Athlete Warrior programme and CrossFit (Crossfit, Inc, Santa Monica, CA) an extreme conditioning programme (ECP).


To determine if these new programmes (ATAC, ECP) had an effect on injury rates and physical fitness. Surveys were administered to collect personal characteristics, tobacco use, personal physical fitness training, Army physical fitness test results, and self-reported injuries. Medical record injury data were obtained 6 months before and 6 months after the implementation of the new programme. Predictors of injury risk were assessed using multivariate logistic regression. Odds ratios (OR) and 95% confidence intervals (CI) were reported.


Injury incidence among Soldiers increased 12% for overall injuries and 16% for overuse injuries after the implementation of the ATAC/ECPs. However, injury incidence among Soldiers not participating in ATAC/ECPs also increased 14% for overall injuries and 10% for overuse injuries. Risk factors associated with higher injury risk for Soldiers participating in ATAC/ECPs included: greater mileage run per week during unit physical training (OR (>16 miles per week÷≤7 miles per week)=2.24, 95% CI, 1.33-3.80); higher body mass index (BMI) (OR (BMI 25-29.9÷BMI<25)=1.77, 95% CI, 1.29-2.44), (OR (BMI =30÷BMI<25)=2.72, 95% CI, 1.67-4.43); cigarette use (OR (smoker÷nonsmoker)=1.80, 95% CI, 1.34-2.42); poor performance on the 2-mile run during the Army Physical Fitness Test (APFT) (OR (=15.51 minutes÷≤13.52 minutes)=1.76, 95% CI, 1.13-2.74); Injury risk was lower for those reporting resistance training, (OR (<1 time per week÷none)=0.53, 95% CI, 0.31-0.92), (OR (1-2 times per week÷none)=0.50, 95% CI, 0.29-0.84), (OR (≥3 times per week÷none)=0.45, 95% CI, 0.24-0.85).


Given that Soldiers participating in ATAC/ECPs showed similar changes in injury rates compared to Soldiers not participating in ATAC/ECPs, no recommendation can be made for or against implementation of ATAC/ECPs.


Grier, T., Canham-Chervak, M., McNulty, V. & Jones, B.H. (2013) Extreme Conditioning Programs and Injury Risk in a US Army Brigade Combat Team. U.S. Army Medical Department Journal. Oct-Dec, pp.36-47.


This site uses Akismet to reduce spam. Learn how your comment data is processed.