Types of Injuries on the US Army’s Special Forces Assessment & Selection (SFAS) Course

Research Paper Title

Medical Encounters During the United States Army Special Forces Assessment and Selection Course.


The Special Forces Assessment and Selection (SFAS) is an extremely physically and mentally demanding 19- to 20-day course designed to determine whether Soldiers are qualified to enter the Special Forces Qualification Course.

As a first step to understand medical problems during SFAS, this study examined injuries, illnesses, and activities associated with injuries during the course.


Medical events during the SFAS course were compiled from Sick Call Trackers (a log of medical encounters maintained by medical personnel in the field) and Chronology of Medical Care (Standard Form 600).

Descriptive statistics were calculated for each injury and illness and injuries were compiled by the activities performed when the injuries occurred.


Of the 800 Soldiers who volunteered for the study, 38% (n = 307/800) and 12% (n = 97/800) experienced one or more injuries and/or illnesses, respectively.

The most common injuries were blisters and abrasions/lacerations with incidences of 20% (n = 158/800) and 13% (104/800), respectively.

The most common illnesses were respiratory infections, other infections, contact dermatitis, and allergies with incidences of 7% (n = 57/800), 2% (n = 14/800), 2% (n = 14/800), and 2% (n = 13/800), respectively.

Among all injuries recorded (n = 573), the most common were:

  • Blisters (46%);
  • Abrasions/lacerations (24%);
  • Pain (not otherwise specified) (19%);
  • Tendonitis (3%); and
  • Sprains (3%).

Among all illnesses recorded (n = 133), the most common were:

  • Respiratory infections (56%);
  • Allergies (11%);
  • Contact dermatitis (11%); and
  • Other infections (11%).

Most injuries were experienced during:

  • Land navigation (44%);
  • Team events (20%);
  • Foot marching (11%);
  • Running (6%); and
  • The obstacle course (5%),

…but when the estimated time involved for each event was considered, activities with the highest injury rates were:

  • The obstacle course (65 injuries/hr);
  • Running (27 injuries/hr);
  • The Combat Readiness Assessment (activity involving combat-related tasks) (20 injuries/hr); and
  • Foot marching (16 injuries/hr).


The major limitations of this investigation were:

  1. The low specificity with regard to many of the diagnoses/complaints; and
  2. The fact that the medical problems reported here are only those seen by medical care providers and are likely an underestimate of the total morbidity in the SFAS course.

Soldiers often self-treat and some may be reluctant to see medical personnel because of how it might affect their rating in the course.

Nonetheless, this investigation alerts medical personnel to the injuries and illnesses to expect, and public health workers and leadership with activities to target for injury prevention measures during SFAS.


Knapik, J.J., Farina, E.K., Ramirez, C.B., Pasiakos, S.M., McClung, J.P. & Lieberman, H.R. (2019) Medical Encounters During the United States Army Special Forces Assessment and Selection Course. Military Medicine. 184(7-8), pp.e337-e343. doi: 10.1093/milmed/usz056.


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