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Caring for Recruits' Injuries is Key to Success at Basic Training

Image of U.S. Marines wait for instruction from their Senior Drill Instructor after concluding a motivational run at Marine Corps Recruit Depot San Diego, on March 11, 2021. . U.S. Marines wait for instruction from their Senior Drill Instructor after concluding a motivational run at Marine Corps Recruit Depot San Diego, on March 11, 2021. (U.S. Marine Corps photo by Sgt. Sarah Ralph)

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Editor's Note: This is the second in a series of articles about recruit and trainee training, and how the Military Health System supports the military services in maintaining optimal health as these young men and women go through basic training and recruit training and enter the military.

There are all sorts of reasons why a new recruit might wash out of their initial military training.

Some just decide that enlisting in the military wasn't for them, and they cannot adjust to military life.

Others are unable to meet the basic standards and requirements to become a service member.

But among the most common reasons that young people fail to complete recruit training successfully and on time is injury.

That's why today's recruit trainers and drill instructors take many precautious to avoid injuries that can leave new enlistees to languish for weeks in a rehabilitation unit or simply sent back home.

"Injury is extremely frustrating and can crush morale and motivation," said Army Capt. Lydia Blondin, assistant chief of physical therapy at the General Leonard Wood Army Community Hospital at Fort Leonard Wood, Missouri.

The most common injuries are overuse injuries of the lower extremities and include stress fractures and muscle strains, she said.

"Occasionally, we also see more acute injuries like fractures or ligament tears," she added.

These can result in delayed training due to prolonged bone healing times, which typically range from six to 12 weeks.

Still, despite the best mitigation efforts injuries do occur.

Medical experts say today's recruits are at higher risk of injury because they live a more sedentary lifestyle than prior generations. Some of them struggle to adjust to the rigors of recruit training.

That's why it's more important than ever to encourage recruits to get in shape before shipping out. And they need access to top-notch medical care if they get injured to ensure their entire military career doesn't get derailed at its earliest phase.

The physical therapy, medical, and Fitness Training Unit staff at Fort Leonard Wood, Missouri, serve approximately 80,000 Army trainees annually, providing on-site primary care and evaluation services at the Consolidated Troop Medical Clinic.
The physical therapy, medical, and Fitness Training Unit staff at Fort Leonard Wood, Missouri, serve approximately 80,000 Army trainees annually, providing on-site primary care and evaluation services at the Consolidated Troop Medical Clinic. (Photo: Lori Newman, U.S. Army)

Responding to Injuries

Once injuries happen, the health care team at each training facility is there to help. At Fort Leonard Wood, the staff at the Richard G. Wilson Troop Medical Clinic offers primary care as well as physical therapy.

The installation has a fitness training holding unit for injured soldiers. That provides access to the Warrior Training and Rehabilitation Program, which helps injured soldiers rehabilitate and recover, said Army Maj. Jon-Marc Thibodeau, a clinical coordinator and chief of the medical readiness service line at Fort Leonard Wood.

"The soldier can continue healing while staying fit and healthy until they are ready to return back to training," explained Blondin.

For their part, medical providers can schedule individual briefs with a company or battalion to review injury prevention, discuss running form, or any other topic, Blondin explained. Physical therapists provide injured soldiers with crutches, braces, medication, manual therapy, exercises, stretches, dry needling, joint mobilization, or blood-flow restriction, among other treatments.

When necessary, orthopedic doctors may need to get involved for more significant injuries to assess the need for surgery.

Additionally, the trainees have access to behavioral health resources to address the psychological or emotional aspects of injuries.

"Behavioral health therapists or the chaplain are great resources to help these trainees figure out how to mentally cope with the stress and frustration of injury in the training environment."

Rest is Also Good

Advanced technologies help reduce and treat injuries from military training. But sometimes, the best treatment for training injuries can be as simple as rest, said Blondin.

If a trainee undergoes surgery or suffers significant injury, they may be granted convalescent leave and be allowed to return home temporarily. But this is an option military leaders prefer to avoid, as it takes the recruit out of the basic training environment.

"During convalescent leave, they don't have access to rehab. There's less of a safety control, and unfortunately, sometimes soldiers will get into trouble or lose their motivation to come back," said Blondin.

"Our first goal is to stay in training when safe and feasible," said Blondin. "Sometimes this can mean just taking it easy and modifying training for a week or two while things calm down."

Getting Back Into It

Following an injury, recruits gradually return to exercise. Close monitoring of their gait when performing exercises is key to ensuring trainees are ready to resume full training, said Thibodeau. Limping, for example, is an indication of injury and reveals it's not yet time to increase their running, walking, or rucking time.

"Going from zero to 100 is a recipe for re-injury," added Blondin. "Re-injury is tough in training, not only physically, but mentally. It can affect the ability to remain in the Army depending on the type and severity of the injury, and where they are in training."

Editor's note: Military services refer to entry-level service members as either 'recruit' or 'trainee'. Entry-level training also uses various names – 'basic training', 'recruit training' and 'boot camp' being the most common. For this article, theses terms are used interchangeably.

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