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7-22 | 50 | Chapter 4
under load, and casualty extraction. Low-load resistance training using body weight across relatively long
periods with high repetitions will not permit this type of muscle fiber development. In fact, strength training
begins with a measurement of one repetition maximum—the maximum amount of weight that a Soldier can
lift, squat, pull, or push one time. Therefore, Soldiers must train and be tested with weighted resistance above
their own body weight. Once Soldiers develop new strength, they must sustain it with consistent, repeated
exposure to the same or progressive levels of resistance. In some cases, detraining of maximal strength can
occur after a three to four week pause in training.
4-25. The development of strength training flows from the one repetition maximum measure. As the one
repetition maximum increases over the duration of the Soldier’s career, so will the weight. If the goal of a set
is 6 repetitions and the Soldier completes 12, the weight should be increased until no more than 6 repetitions
can be completed in one set. To reduce the amount of trial and error required to hit these targets, the repetition
maximum formula for calculating one repetition maximum can be used: one repetition maximum = (0.033 x
repetitions x weight lifted) + weight lifted. Using the repetition maximum formula, if the three repetition
maximum was 100 pounds, then the one repetition maximum would be 110 pounds. The three repetition
maximum is 90 percent of the one repetition maximum. As the Soldier’s one repetition maximum improves,
then the three repetition maximum increases. A new one repetition maximum of 150 pounds would translate
to a three repetition maximum of 135 pounds. If the Soldier was able to deadlift 250 pounds five times in one
set, then the one repetition maximum would be 291 pounds.
4-26. When preparing to engage in high physical demand tasks (HPDTs), Soldiers must understand the
difference between “absolute” and “relative” workloads. An absolute workload is the work required to
complete a physical task. For example, to perform a casualty evacuation or to lift a 95-pound (lb) artillery
shell into a rack requires a specific and measurable amount of strength; a long distance foot movement with
a 100-lb ruck, requires a fixed amount of endurance as well as the muscular strength to carry the load. These
tasks represent absolute workloads. Higher absolute workloads require higher physiological capacity. In
establishing training goals an individual must know his or her physiological capabilities and the absolute
workload of the task. The goal should be to increase the rate-limiting physiological capacities (for example,
strength, speed, and endurance) to be able to accomplish higher absolute workloads.
4-27. The second aspect of physical work is the “relative workload.” The relative workload compares a given
task or absolute workload to an individual’s maximal physiological capacity. In other words, relative to the
maximum amount an individual could do, how much of that individual’s potential is needed. Relative
workload is defined as “percent of maximum;” it is a way to calculate the “strain” on the physiological
systems. If an individual needs to lift a 100-pound object, and his or her maximal strength or lifting capacity
is 200 pounds, the relative workload for this task would equal 50 percent. If performing a foot march with a
loaded pack requires an oxygen consumption of 2.0 liters per minute and the individual’s VO max is 3.0
2
liters per minute, the relative workload would equal 66 percent. Therefore, improving absolute workload
lowers the relative workload for fixed-demand tasks and reduces the risk of injury. Musculoskeletal injuries
are often linked to repeated physical exercise at higher relative workloads.
4-28. Soldiers need to know the relative workload, especially for the endurance tasks. Relative workload is
directly related to “time to fatigue.” The higher the relative workload, the sooner an individual will fatigue.
For an endurance event, if a person is working at 50–70 percent relative workload (of VO max), he or she
2
will be able to continue this work for a prolonged period. If the relative workload is greater than 70 percent,
an individual will not be able to continue this task for long, and the time needed to recover will increase.
Since a higher relative workload may be associated with an increased potential for musculoskeletal injuries,
leaders need to extend the Soldier’s rest/recovery time after very high intensity workouts. As Soldiers train
and increase their physiological capacities, their increased absolute workload will result in a lower relative
workload.
NERVOUS SYSTEM
4-29. The nervous system consists of the brain and the spinal cord (the central nervous system) and the
nerves branching from them (peripheral nervous system). The nervous system is the body’s master system
that governs the activities of all the other systems including movement, thought, emotions, sensation, illness,
and health. Through this system the Soldier senses and responds to the world. Workload accumulates across
the training day if, for example, a Soldier does Squats in the morning and then stands all day in body armor |
7-22 | 51 | Physiology
as a range safety. If the Soldier cannot recover properly from the acute training load (the Squat), then the
training load will accumulate and not be absorbed. The continued volume and intensity of the workload
becomes chronic. This failure to properly progress the workload increases risk of underperformance and
tissue damage.
CENTRAL NERVOUS SYSTEM
4-30. The right and left halves of the brain, called hemispheres, are divided into lobes. The lobes form an
integrated system that supports all conscious and unconscious functions. The following descriptions of each
lobe impact these Soldier function:
* Frontal lobe contains the premotor cortex and motor cortex, which are the areas that plan and
perform movements and contains the Broca’s area for speech production.
* Parietal lobe processes sensory information, sensory discrimination, and body orientation.
* Occipital lobe processes signals for visual reception and interpretation.
* Cerebellum coordinates of voluntary movement, to include walking in a straight line.
* Brain stem controls breathing, digestion, heart control, blood vessel control, and alertness.
* Temporal lobe processes auditory reception, expressed behavior, receptive speech, and memory
information retrieval; it contains Wernicke’s area for speech comprehension.
4-31. The size and anatomy of the adult brain is fully developed by age 26. However, this does not mean
that learning ceases. When awake, people are constantly learning. The 12 pairs of peripheral nerves that
branch directly from the brain but remain largely inside the skull are called cranial nerves. They innervate
(such as supply with nerves) the muscles and sensory organs of the face and head. The sensory input that the
cranial nerves transmit to the brain during daily activities and training become memory. Most of the
information about these activities becomes short-term memory, stored for a few seconds to allow
understanding of immediate or near-term events and then discarded.
4-32. A fair amount of information is stored as long-term memory. Storage is particularly efficient after
sleeping for more than 6 hours the night after the event. These memories last for a few minutes or as far into
the past as it is possible to remember allowing the conscious recall of episodes and facts. Other memories
(sometimes called skills) help with the repetition of tasks performed subconsciously such as walking, eating,
and driving. Fundamental physical training develops fundamental Soldier skills—move, shoot,
communicate, survive, and protect or treat—and the long-term memories to support them. Soldiers who have
highly developed motor skills will have very extensive “neural wiring” in their brains related to those
activities. In the well-trained Soldier, particularly the ones who practice the fundamentals, the motions and
continual decision making needed to perform these combat functions happen without conscious awareness.
4-33. Deep in the two lobes of the brain sits the limbic system. This collective term for the structures near
the middle of the brain includes the hippocampus and amygdala. This connection allows the limbic system
to impact the endocrine and autonomic motor systems. The limbic system may affect motivation and mood.
4-34. The spinal cord is the other major anatomical part of the central nervous system. This thick bundle of
nerve fibers connects the brain to the peripheral nerves. It originates in the brain stem and ends in the lumbar
spine, protected by the vertebrae.
PERIPHERAL NERVOUS SYSTEM
4-35. At each level of the spine, smaller bundles of nerve fibers split off to form the peripheral nervous
system. After leaving the spine, the peripheral nerves split and re-form into major nerves such as the median
and radial nerve in the arms and the sciatic and femoral nerves in the legs. The peripheral nerves branch into
progressively smaller bundles until a single nerve fiber meets with the part of the body it innervates. If the
nerve supplies a muscle cell it is a motor neuron. Where the nerve ending meets the muscle, the connection
or synapse is called a neuromuscular junction (known as an NMJ). The types and size of the chemical
reactions that occur at the junction drive the amount of force the muscle can generate.
4-36. The peripheral nerves originating in the neck (cervical spine) supply sensation and muscle control to
the shoulders, arms, and hands. The largest of these upper extremity nerves are the median, radial, and ulnar
nerves. The nerves that supply sensation and muscle control to the legs originate in the lower back. The |
7-22 | 52 | Chapter 4
sciatic nerves pass behind the buttocks and backs of the thighs before dividing to innervate parts of the calf
and foot. The femoral nerve courses through the front of the hip and innervates the quadriceps muscle on the
front of the thigh.
4-37. Motor neurons regulate how much force is generated by each muscle fiber. If the motor neuron is
severed, the signal from the brain cannot travel along the motor neuron to the muscle. No force will be
generated. The muscle is said to be paralyzed. Any interruption of the signal along the nerve’s path from the
brain to the muscle due to injury, fatigue, or lack of training will impact the amount of force generated. If the
nerve is intact, signals can be sent at increasing speeds to excite the muscle fibers innervated by that nerve.
Faster signaling causes more frequent muscle fiber contraction and more force to be generated. Some motor
neurons innervate more muscle fibers than others. Those motor neurons involved in large movements or
gross motor patterns may innervate a dozen muscle fibers. If a muscle produces complex, small movements
or fine motor patterns, its motor neurons may contact several hundred fibers.
NEUROENDOCRINE SYSTEM
4-38. The neuroendocrine system coordinates the response to exercise across multiple organs and hormone
systems. The neuro part of this system is the autonomic nervous system. The endocrine part is the collective
name for glands that can release hormones into the bloodstream. Hormones are chemicals that can alter the
way an organ functions. For example, the body releases epinephrine (adrenaline that affects the heart) and
norepinephrine (affects the blood vessels) in response to physical stress.
4-39. Like the peripheral nervous system, the autonomic nervous system also lies outside the central nervous
system. As its names suggests, the autonomic system functions without conscious input to stimulate and
control the muscle tissue in the heart, organs, glands, and blood vessels. It therefore impacts the respiratory
system (lungs), cardiovascular system (the heart, blood vessels, and blood), and organs (kidneys, liver, and
stomach), endocrine system, and lymphatic system. The autonomic system has two parts: the sympathetic
and parasympathetic systems.
4-40. The sympathetic system stimulates cardiac muscle to increase heart rate, whereas the parasympathetic
slows it down. Both systems impact the same tissue at the same time to maintain homeostasis, but either can
be turned up to cause a change in response. When the body reaches a resting state, the parasympathetic system
is dominant. In this state, the Soldier can better digest calories more efficiently, repair muscle tissue, and
sleep.
4-41. When the sympathetic nervous system is stimulated by increased activity or threat (physical and
psychological stress), it reacts with the fight or flight response. The sympathetic nerves signal—
* The adrenal gland to release epinephrine and norepinephrine causing the arteries to the heart and
muscles to dilate.
* The liver to secrete glucose and fatty acids into the blood for quick energy.
* The pupils to dilate.
* An increase in sweat to reduce a raised body temperature.
CARDIORESPIRATORY SYSTEM
4-42. The cardiorespiratory system includes the heart, lungs, and blood vessels. This system takes oxygen
from small air sacs in the lungs and delivers it through the blood to the muscles so that they can perform
work. The amount of oxygen consumed or metabolized is a measure of how well the respiratory and
cardiovascular systems are working during exercise—or how well they are trained. Oxygen is used in
chemical reactions inside cells to produce energy. If oxygen is available, muscles can do more work.
4-43. During prolonged exercise, the heart must pump more blood to supply and maintain the high levels of
oxygen required by the working muscles. The frequency of heart beats is referred to as the heart rate. The
frequency of heart beats at rest is called the resting heart rate which is normally about 70 beats per minute
(bpm). The resting heart rate for Soldiers with high levels of physical readiness may be well below 70 bpm.
Frequency of heart beats during exercise is called exercise heart rate. The exercise heart rate can more than
double in young adults during maximal effort with a maximum approaching 200 bpm. |
7-22 | 53 | Physiology
4-44. The amount of blood pumped (in liters) per beat is the stroke volume (SV) and the cardiac output (Q)
is the liters of blood pumped per minute. Q = heart rate (100 bpm) x SV (0.1 liters per beat). Q can be as
much as 25 to 30 liters of blood per minute in healthy, young Soldiers. As Soldiers become better trained,
exercise heart rate goes down and stroke volume goes up, which means Soldiers can work at a higher rate or
work longer at a constant rate with less effort. The Soldiers are fitter. Their relative workload is less and
therefore, the work is easier for them to perform. An example would be, when a Soldier finds it much easier
to dig a foxhole after a period of training.
Physiology
Balanced training has, at its core, an appreciation for how the human body works—its
anatomy and physiology. Knowledge of these sciences supports training that is
rational, scientific, and most effectively enhances physical performance while
minimizing injury risk. |
7-22 | 55 | Chapter 5
Periodization
Aspects of and approaches to training that were developed in the twentieth century
included components of fitness, principles of training, and new training methods such
as intervals, circuits, and periodization. Periodization is the division of training into
blocks of time (periods) that focus on building readiness. This chapter describes how
all the domains of readiness are included in the periodized approach to training of the
H2F System.
FUNDAMENTALS OF PERIODIZATION
5-1. Periodization is the systematic planning of long- and short-term readiness training and testing in
preparation for combat. This logical method of planning training maximizes training outcomes at specific
periods or points in time. In the H2F System, periodization integrates the domains beyond physical
readiness—mental readiness, spiritual readiness, nutritional readiness, and sleep readiness—that prepare a
Soldier for combat. The idea of integrating more than just physical training in the periodized model is a more
recent development, especially when applied to team or collective preparation for physical tests or events.
5-2. Periodized training divides physical training into logical time periods. Each period—base, build, taper,
combat, and recovery—has a specific training goal that builds on the preceding period. Periods can be weeks
to months long with an individual’s periodized plan lasting for a year or more. Progress is measured across
the different domains of readiness, energy systems, and components of fitness. Adjustments are made to
avoid plateaus or reversals in fitness due to injury, illness, and unplanned life events. In a periodized plan,
goals change over time from general fitness to a narrower focus on specific task performance.
5-3. Sometimes, to help understand a concept like periodization, it helps to describe its opposite. In an
unplanned or random training program, the Soldier does whatever he or she feels like. The workout is based
on intuition, gut feel, tradition, and the time available to train, not the standard for the training. There is no
attention to a written, individualized plan that has sequenced, structured targeting of fitness components.
Performance goals center around getting the workout done and are performed with little attention to achieving
peak performance. Test proficiency, not task proficiency, drives training choices and the culture of fitness.
Hard effort tends to dominate the level of exertion. Work-to-rest ratios seldom follow validated approaches.
This approach is common among novices. There is no attempt to assess the needs of each individual Soldier
and design a program to meet those needs. This approach leads to varied, non-standardized programming
and suboptimal outcomes.
5-4. In the sustaining phase, the duration of the Soldier’s physical training plan and training session length
should prepare Soldiers for expected deployment duration and the specific physical tasks of combat. If these
are not known or scheduled, then staffs use previous deployment experience to guide planning. In the
previous version of FM 7-22, phases of deployment preparation were divided into six-month segments. These
can still be useful, but more flexible approaches are possible with periodized programming.
5-5. Periodized blocks of training can last from several days to several months. They can be progressed
over several years. This long-term approach suits the different lengths of Soldier careers. The H2F training
phases—initial and sustaining—contain training cycles that last from a few days (microcycles) to several
months or more (macrocycles). The H2F System facilitates more deliberate, customized, and comprehensive
approaches to readiness training for smaller groups and individual Soldiers.
5-6. The challenge for commanders is optimizing readiness in spite of the frequent changes in the unit’s
training schedule, Soldier population, and deployment timeline. See Part Four beginning on page 13-1 for |
7-22 | 56 | Chapter 5
different training scenarios that provide a basis for specific unit and individual training programs. For all
these templates, the performance objective has success in combat.
5-7. Across a Soldier’s career span, periodization will guide optimal medical and performance readiness.
This approach to building the Soldier promises to avoid costly, unprogrammed attrition and suboptimal
readiness measures such as undertraining, excessive fatigue, overtraining, illness, and injury.
TRAINING CYCLES
5-8. Peak performance is attained and maintained by scheduling training through deployments with varying
periods or cycles of maximal and submaximal training. If the Soldier has no scheduled combat deployment,
the cycles can repeat at sub-peak levels to build or sustain very high foundational readiness. These cycles
cause changes in the Soldier’s physiological and psychological statuses that lead to improved readiness.
Training schedules are built on the following progressively longer periods of micro-, meso- and macrocycles.
MICROCYCLE
5-9. The microcycle consists of the detailed daily training structure across two to fourteen days. The days
in the microcycle alternate between endurance and strength sessions as well as between training and recovery
sessions. Leaders develop these training cycles in conjunction with the operations planning process described
in FM 7-0. FM 7-0 uses the operations process conducting training events in a step-by-step approach to help
commanders and other unit leaders train their Soldiers. With a focus on readiness and high levels of training
proficiency, FM 7-0 provides the how-to processes of unit training along with practical applications. Leaders
complete this meticulous planning well prior to the start of training. For subordinate units to develop their
own training plans, each headquarters publishes their unit training plan well in advance. This is done not just
for subordinates to plan training, but to allow time for leaders to get certified and to reserve the necessary
training resources. For training to be effective, the necessary resources must be available at the right point in
the training cycle. Prior to the start of training, detailed planning for each training event must occur. The
company commander refers back to each event’s training objectives and uses weekly training meetings to
assess the training that has occurred and to coordinate activities for future events. There is little difference
between unit training plan development and building a physical readiness plan.
MESOCYCLE
5-10. Within the macrocycle, shorter periods of training called mesocycles are the main, medium-sized
building blocks of training. The mesocycle lasts from two to six weeks. Each mesocycle aims to establish a
new level of physical readiness—residual fitness—that carries over into the next cycle. As the training is
accumulated and absorbed, the Soldier gets fitter. As deployment nears, physical readiness begins to peak
and mesocycles are structured to allow accumulated fatigue to dissipate without a loss of residual fitness.
This pre-deployment period of one to two weeks, often known as a taper, keeps the intensity and specificity
of exercise high while reducing frequency and duration of training. The physiological response is called
supercompensation.
MACROCYCLE
5-11. The longest period, usually lasting a year or more, is referred to as a macrocycle. This duration of
training builds readiness towards a single peak within that time span. A twenty-year Army career would
include multiple macrocycles. The goal for all Soldiers should be to complete their service in peak condition.
5-12. Training periods described in this doctrine feature base period characterized by higher training volume
and more training variety. Base periods transition to build periods and then to pre-combat and combat cycles
that feature much less volume and higher intensity. These later periods feature training specific to the
essential physical and nonphysical tasks required in the combat mission (see table 5-1). |
7-22 | 57 | Periodization
Table 5-1. Training periods
Period Characteristics
Base High volume, low intensity training
Build Moderate to high volume training at high intensity
Taper / Peak 1 Low volume training at high intensity and high levels of skill
Combat / Peak 2 Peak levels of skill with low levels of volume; for example deployment
Recovery Reconditioning after prolonged absence from H2F System or as a deload
after Peak 2
H2F holistic health and fitness
INTEGRATED PERIODIZATION
5-13. Integrated periodization allows the coordinated inclusion of multiple domains of readiness into
multiple phases of a Soldier’s physical training program. This approach allows better management of the
training load required to optimize performance and control the fatigue, injury risk and misconduct behaviors
associated with high operational tempo and high physical and nonphysical demands (see table 5-2). Integrated
periodization prepares Soldiers in ways similar to high-performance, competitive athletes who also have to
sustain peak fitness over athletic careers that span several decades.
Table 5-2. Features of training periods by domains of readiness
Base Build Peak 1 Combat / Peak 2 Recovery
(4–12 weeks) (4–8 weeks) (2–3 weeks) (2 weeks +) (4–8 weeks)
1 October 2020 FM 7-22 5-3
lacisyhP
High volume Moderate to high Low volume Peak skill Active rest
Low intensity volume High intensity Low volume Physical
General strength, High Intensity High skill Multi-hour, day, rehabilitation
endurance and Specific strength, week or month Goal assessment
movement skill endurance and operations
Needs movement skill
assessment
lanoitirtuN
Needs Energy intake Energy intake Support or fueling Goal assessment
assessment adapted to adapted for high for combat Nutrition adapted
Periodized energy changes in intensity training including recovery for light activity
and macronutrient training to avoid weight between varying levels
intakes for body Specific support gain lengths of Minimal weight
composition for key sessions Monitoring for engagements and gain
Energy availability o cor ne dn iv tii oro nn sm (he en ata t,l o cop mtim pa ol s b itio od ny p rior p vaa rt yro inls g and Elimination of
Education for cold, altitude) to combat environmental supplements and
strategic timing of conditions ergogenic aids
nutrient intake Body composition and performance
Nutrition
around training refinement enhancers
supplementation
sessions Practice of field practices Active nutrition for
Macronutrient training, recovery or
availability training operational or Nutritional rehabilitation
to stimulate combat nutritional strategies for
metabolic strategy travel across
multiple time
efficiency |
7-22 | 58 | Chapter 5
Table 5-2. Features of training periods by domains of readiness (continued)
Base Build Peak 1 Combat / Peak 2 Recovery
(4–12 weeks) (4–8 weeks) (2–3 weeks) (2 weeks +) (4–8 weeks)
5-4 FM 7-22 1 October 2020
latneM
Needs Perception work Optimal arousal Maximal trust, Goal review and
assessment Video Concentration or confidence and new goal setting
Purposeful biofeedback for focus adaptability Deliberate,
motivational skill physical and Maximized Written combat effective re-
training physiological emotional self- coping plan evaluation of self,
Biopsychosocial control management Spiritual self-identity
pain control skill Daily self- Occupational and justification self- Counseling to
training awareness log combat-specific talk mitigate or treat
Values-based mental rehearsal Mindfulness (See posttraumatic
self-assessment Chapter 13) stress
Technique Reachback or
practice (mental counseling to
review,
rehearsal, arousal
control, deliberate accommodate,
breathing) assimilate
experiences
lautiripS
Needs Refine individual Sustain group and Support unit Goal assessment
assessment spiritual fitness individual spiritual members spiritual Self-assessment
Understand the practices to build fitness practices fitness needs in Repair spiritual
spectrum of individual Review spiritual challenging and fitness
options that strength. fitness topics stressful
individuals have Understand before and after conditions
to observe free shared practices stressful training
exercise of to build mutual events
spiritual fitness or respect and group
not cohesion
Emphasize basis
or basics of
spiritual fitness
Rehearse
individual spiritual
fitness practices
peelS
Needs Practice of field Increased sleep to Implementation of Goal assessment
assessment training, maximize sleep strategies to of short and long-
Appropriate sleep operational or recovery from manage recovery term sleep
to maximize base combat sleep previous build and preparation strategy—what
period training strategies period and the for travel, jet lag worked?
adaptations Specific sleep high-intensity and high
May involve strategies to training of the operational load
withholding sleep maximize taper period.
to maximize absorption of
adaptation training and
improve recovery
5-14. The training period is best developed by identifying the objective (deployment, field training, or test
for example) and working back from that point. The pattern of preparation to reach that goal can then be
broken down into commonly used periods—base, build, peak 1, combat and peak 2, and recovery.
Foundational abilities are maintained across these periods while each new period builds on the previous ones.
Each domain is integrated in order to reach optimal readiness as the objective nears. For example, nutritional
readiness manages the intake of calories in each period to match the energy expenditure of that period,
knowing in advance what the ideal body weight is for optimal performance during the mission.
5-15. Strict adherence to the periodized approach should not drive training. The prescription of periods |
7-22 | 59 | Periodization
5-16. Effective H2F performance teams and Soldiers prepare to adapt readiness training in the light of new
training data and new mission sets. Situation-specific, individualized training accounts for the Soldier’s own
strengths and vulnerabilities. Like an athlete with specific position skills, the individual Soldier may respond
to stress by recruiting a range of biological, sociological, and psychological (known as BSP) skills. These
significantly influence physical training adaptations. If physical and nonphysical stress exceeds these skills,
the Soldier and leaders should anticipate degradation in performance and medical readiness. Responding will
require the insight of the H2F performance team and the modification of the periodized plan.
BASE
5-17. This is the period when the basic abilities of endurance, strength, speed, and movement skill are
emphasized. This period is the longest of all the periods lasting up to twelve weeks. As most training in this
period is relatively low intensity, it may be predominate in Soldier populations that do not have any pending
primary missions, deployments, or high-intensity schooling.
BUILD
5-18. This is the four to eight week period when the abilities from the base period are built upon with higher
intensity and increased volume of training. Training effort begins to mimic the primary goal or mission and
the period ends with a simulation of the mission or a test. Leaders might implement a FTX or a practice
ACFT.
PEAK 1
5-19. This is the two- to three-week period immediately before a primary mission when leaders deliberately
reduce training volume while maintaining or increasing the intensity. This period is designed to create a peak
level of physiological and psychological readiness while reducing the potential for injuries and stagnation.
Maximum effort testing or mission simulation is appropriate during this period. Recovery from the most
intense sessions of the training will take longer; therefore, the volume of training may be reduced by 50
percent when compared to the later weeks of the build period.
COMBAT AND PEAK 2
5-20. This is the two-week to multi-month period of the primary mission or highest intensity training when
the goal is to reach peak levels of readiness and sustain these levels for the duration of the mission or training
event. Arriving fresh and ready to perform requires focused attention on recovery during this period. Training
mistakes that lead to illness and injury during this period become more critical since time before the primary
mission is reduced and will therefore lead to a degradation in readiness.
RECOVERY
5-21. This is the period of four to eight weeks when the Soldier is in recovery from the primary mission. It
is characterized by low workloads and general adaptation and recovery. This period precedes a return to the
base period and is where recovery occurs that allows the absorption of higher volumes and intensity of
training later in the macrocycle. In the Soldier lifespan, this would equate to the FSP period as the civilian
begins the physical and mental transition to becoming a Soldier. It would also be the period of recovery after
a deployment, injury, or illness or following a demanding functional course, such as Ranger School.
5-22. Low volume and easy-to-moderate intensity endurance exercise is designed to improve aerobic
endurance. Movement skill training is developed through shorter Running Drills and strength training
sessions. Total body strength is improved through various resistance training modalities (body weight,
medicine ball, landmine, suspension training, and free weights) that target muscular endurance. Maximal
effort testing and training should be delayed until later in the base period to avoid overtraining, illness, and
injury. |
7-22 | 60 | Chapter 5
Integrated Periodization
Integrated periodization allows the coordinated inclusion of multiple domains of
readiness into multiple phases of a Soldier’s H2F program. This approach allows better
management of the fatigue and injury risk associated with high operational tempo and
high physical demands. Each period emphasizes different levels of volume, intensity,
frequency, and time for training. Physical and nonphysical domains of readiness can
be integrated and balanced to train the whole Soldier. |
7-22 | 61 | Chapter 6
Program Design
Program design is completed by H2F performance teams and approved by the unit’s
command. The design must address the unit’s METL in accordance with the
commander’s guidance. The program must be designed to assist Soldiers with their
individual performance needs. Individualization is the principle that drives
programming. The training cycle is dictated by an individual needs analysis and by
follow-up assessments of the Soldier’s training objectives, performance level,
proximity to combat, and ability to recover.
SOLDIER ASSESSMENT
6-1. There is no single unified assessment that works for every Soldier. Designing a program will depend
on the current status of the Soldier and an evaluation of the physical and nonphysical demands of his or her
job. At a minimum, the assessment includes movement analysis, physiological analysis, training status,
physical testing and injury screening, nutrition strategies, sleep history, spiritual needs, and mental readiness.
COMPONENTS OF PHYSICAL FITNESS
6-2. Fitness is often broken down into and measured by commonly accepted parts often labeled
components. These components have evolved with advances in exercise science and technology. The H2F
System’s physical readiness training enhances the components of physical fitness and measures them in the
OPAT and ACFT. Higher raw scores due to improved performance on the ACFT give commanders
information about the absolute capacity of each of their Soldiers’ components of fitness. Leaders who know
about fitness components understand how to regulate and apply training intensity. Soldiers need to train
across all components to meet an infinite range of operational challenges and physiological demands.
STRUCTURAL REQUIREMENTS
6-3. Structural requirements are the physical and cognitive characteristics that provide the foundation for
increased work capacity. They allow work capacity to increase through regular systematic participation in
physical training that creates a healthy body composition, optimal weight to height ratios, strong bone
density, good static flexibility and balance, quick reaction time, and perception. In short, Soldiers need these
structural requirements to start and complete more work. Without structural integrity, training cannot
commence or proceed. Table 6-1 on page 6-2 lists structural requirements.
PHYSIOLOGICAL CAPACITY
6-4. The H2F System is designed to progress a Soldier through regular and progressive training that builds
movement lethality and mental toughness. Soldiers should aspire to achieve their absolute best. Some may
achieve world-class performance levels and will inspire others to do the same, but it is the maximal
physiological capacity (strength and endurance) of the whole formation that primarily concerns the
commander, not the exemplary performance of a single Soldier.
6-5. A lift that requires movement of 150 pounds is relatively easy for a Soldier who can carry 350
pounds—his or her absolute workload. This high level of strength allows the Soldier to use relatively less
effort to complete the task so that he or she can conserve energy for next effort. That same lift is harder and
much more intense for someone whose absolute workload is 200 pounds. As relative work capacity
approaches a Soldier’s absolute workload, the risk of injury is much higher. Leaders have to differ— |
7-22 | 62 | Chapter 6
individualize—the training program to improve absolute workload to avoid injury. Commanders who
understand and apply the concepts of absolute workload and relative workload can better direct their H2F
personnel and align resources to meet their units’ missions.
Table 6-1. Structural requirements
Structural Requirement Description
Agility The ability to bend, rotate and twist in the frontal, transverse and sagittal
planes and use that ability to change direction.
Coordination The accuracy and speed of limb and trunk movement.
Dynamic balance The ability to move under control at speed and with varying load.
Kinesthesia The perception of the body’s position in space during movement.
Pace The ability to set the correct speed of an activity to manage fatigue.
Load tolerance The ability of the skeletal system to bear weight.
Flexibility The range of motion across single or multiple joints that allows the body to be
positioned for optimal movement.
Static balance The ability to maintain a stable position over a base of support.
Body composition The percentage of lean muscle and other body tissues.
Bone density The thickness and quality of the bone that provides its strength.
Perception The understanding of correct technique and effort that builds skill.
Frontal plane Divides the body front and back.
Transverse plane Divides the top and bottom.
Sagittal plane Divides the body left and right.
PHYSICAL COMPONENTS
6-6. Physical readiness includes the following components:
* Muscular strength.
* Hypertrophy.
* Muscular endurance.
* Aerobic endurance.
* Anaerobic endurance.
* Power.
6-7. Muscular strength is the amount of force a muscle or a group of muscles can generate. Examples
include a Flexed Arm Hang for fifteen seconds, one repetition of a Bench Press at maximum weight, or
extracting a casualty from a turret. The gold standard for measuring muscular strength is the one repetition
maximum. It is the heaviest weight a Soldier can lift and is best calculated with weight training exercises
such as the Bench Press, Squat, or Deadlift. High levels of strength that support the mission can certainly be
achieved without lifting this amount of weight. In fact, leaders need to use the one repetition maximum
approach sparingly. Leaders can use the repetition maximum formula (paragraph 4-25) to calculate one
repetition maximum without complete a one repetition maximum testing. The heaviest weight a Soldier can
lift 3 times or 10 times would be a three repetition maximum or ten repetition maximum, respectively.
6-8. Hypertrophy is increase in muscle size, which can be achieved through a blending of muscular strength
and muscular endurance training. When Soldiers use moderate to heavy loads (65–85 percent of one
repetition maximum), a greater number of repetitions and a variety of speeds, they are building muscle mass.
6-9. Muscular endurance is the ability of a muscle or muscle group to repetitively perform work for an
extended period. Examples include lifting duffel bags onto truck beds, loading 155-millimeter rounds, or
performing Climbing Drill 1. Muscular endurance, in combination with aerobic and anaerobic endurance, is
required to tolerate carrying progressively heavier loads over greater distances on uneven and steeper terrain
and at faster speeds. |
7-22 | 63 | Program Design
6-10. Aerobic endurance is the ability to exercise large muscle groups for sustained durations of time longer
than a few minutes. At this level of effort, slow-twitch muscle fibers use oxygen to produce energy while
conserving glycogen and glucose through greater metabolism of fat (fatty acids or triglycerides) for energy
needs. Examples include long-distance triathlons, long Foot Marches, patrols, and Unit Formation Runs.
Although aerobic training is low intensity, high volumes of aerobic training without the proper progression
and balance of strength training can cause overtraining. High loads carried during aerobic activity tend to
shift the fitness component from aerobic to anaerobic if the same pace is maintained. Soldiers, first the
untrained and then the trained, will begin to slow down when carrying heavier loads. This significantly
decreases the aerobic training effect and increases injury risk.
6-11. Anaerobic endurance is the ability to tolerate short bursts of high-intensity activity. At this level of
effort, fast-twitch muscles are the greatest contributors. Examples include moving rapidly with a heavy ruck,
sprinting, heavy lifting, and combatives. Fuel for this level of intense exercise is primarily derived from
glycogen. Anaerobic endurance is finite and therefore associated with complete fatigue. High levels of
anaerobic endurance are essential for carrying heavy loads.
6-12. Power is the application of strength over time. Muscular power is a result of both the strength and
speed requirements of an activity, which is also described as the rate of work per unit of time. The duration
of power training is in seconds, or fraction of seconds, and is characterized by maximal effort. Power
workouts include five to six repetitions of short, explosive work against high levels of resistance followed by
long rest intervals—broad jumps, heavy sled drags, or the Seated Power Throw. Other examples that require
power include casualty evacuation or pushing a vehicle stuck in mud.
TRAINING SESSIONS
6-13. Army training is organized into deliberate actions, or training sessions, that clearly define goals as well
as the activities required to accomplish them. H2F programs follow the same logic, incorporating proven
civilian and military training strategies and approaches to both physical and nonphysical domains of H2F.
STRATEGIES
6-14. Physical readiness training has evolved over decades based on military and civilian approaches to
physical fitness. This historical record as well as contemporary concepts influence H2F programming. As
described in the preceding chapters, H2F programs are designed to meet the readiness goals of the Soldier,
the unit, and by extension the Army. While there are parallels to civilian fitness programs in the H2F System,
the combat specificity and hazards of the profession demand a different approach. This approach is called
readiness. This approach integrates legacy training concepts such as—
* Low-intensity steady state: once intensity is achieved, the exercise can continue as long as the
Soldier can maintain his or her heart rate within a prescribed zone and energy continues to be
available.
* Pace/tempo training: exercising at lactate threshold, lasting between twenty and thirty minutes.
Intermittent pace/tempo is similar to interval training.
* Circuit training: a combination of resistance and aerobic training activity used for active recovery
sessions.
* Cross training: rotating different exercises throughout the week or rotating different exercise
modes in a training session.
* Interval training: short periods of high-intensity endurance training separated by longer rest
periods.
* Push-pull: strength training sessions that alternate between agonist and antagonist muscles
exercises such as chest and upper back muscles.
* Upper-lower: strength training sessions that alternate between upper body and lower body
exercises such as Squat and Bench Press.
* Superset: strength training sessions that work two opposing muscle groups. |
7-22 | 64 | Chapter 6
EXERCISE SELECTION
6-15. Depending on the phase of training, leaders select exercises based either on the collective needs of the
unit or on the needs of the individual Soldier. Exercise selection for strength training should include upper
body pushing, upper body pulling, lower body pulling, lower body pushing, resisted trunk rotation, and
loaded carry. Once fundamental movement competency has been achieved in the initial phase through
instruction and training on the Strength Training Circuit, Climbing Drills, and Guerilla Drills, Soldiers will
be properly prepared to progress to heavier free weights in the sustaining phase.
6-16. Lifting routines in the H2F System use Squat, Deadlifts, and Bench Press as core exercises with
emphasis on precise movement technique over the number of repetitions completed. These free weight core
(known as FWC) exercises are programmed to target large muscle groups across multiple joints. These
exercises are selected to support specific occupational tasks, especially those that have a high physical
demand. A Free Weight session may include a weight goal for a core lift that is the primary goal of that
session. Soldiers will be properly prepared to progress to heavier load, higher volume and increased intensity
free-weight training in the sustaining phase.
6-17. Assistive exercises for resistance training target single muscles or limbs, or small muscle groups that
move single joints. These free weight assistive (known as FWA) exercises complement and prepare for the
Core Free Weight sessions. They involve lighter weight than the Soldier’s maximum capacity and a larger
number of repetitions.
6-18. Endurance activities are selected based on the results of aerobic and anaerobic tests. Aerobic tests
include the Interval Aerobic Run and the 2-Mile Run. Anaerobic activities include agility tests, sprints, and
shuttle runs.
6-19. There are 38 Drills with a total of 201 exercises in the H2F physical training domain (see table 6-2).
Modifications in weight, numbers of repetitions, distances and range of motion provide an even greater
variety to accommodate the widest range of Soldier physical readiness. See ATP 7-22.02 for the standards,
modifications, and illustrations for each drill.
TRAINING FREQUENCY
6-20. Training frequency, the number of training sessions over time, depends on intrinsic factors including
age, training experience, and health status of each Soldier. The H2F performance team also considers
extrinsic factors. These include time available to train, the planned intensity of the session, occupational
tasks, unit mission, the environment, nutrition options, and access to H2F resources. Soldiers can change or
modify some factors such as nutrition and sleep habits. A six-day training schedule with one to two sessions
per day that is appropriate for one group of Soldiers may not be appropriate for another. Leaders will have to
modify the schedule to accommodate intrinsic and extrinsic factors. In some cases the factors that are
modifiable will have to change in order to optimize performance.
6-21. This doctrine has schedules for Soldiers who can tolerate almost daily training. This frequency is high.
Therefore, recovery days are programmed with shorter sessions, lower RPE goals, and less intense drills and
exercises. Most of the Army’s conventional force is categorized as able to tolerate moderate levels of physical
tasks associated with each MOS. Units with significant or heavy levels of physical tasks associated with
MOSs, such as combat arms, use significant or heavy training—higher intensity and higher frequency.
EXERCISE ORDER
6-22. The order of exercises and activities in a training session focus on properly preparing for the main
activity of the session before performing proper recovery from those activities. The duration of the session
depends on time available to train, the assessment of the Soldier, and the targeted component of fitness. For
example, in a session focused on hypertrophy, Soldiers should try to maintain a 1:1 ratio of preparation and
recovery to the activity. For example, in a one-hour session, preparation and recovery lasts for fifteen minutes
each and the main activity lasts for thirty minutes. In a thirty minute session focused on muscular strength,
the preparation for a close-to-maximum effort takes a larger proportion of the session, perhaps twenty
minutes before the main activity. A 3 repetition maximum Bench Press set uses ten minutes of a thirty-minute
session. Post-session recovery would have to happen throughout the rest of the day. |
7-22 | 65 | Program Design
Table 6-2. H2F drills
Drill (Exercises) Physical Component
Preparation Drill (10) Muscular Endurance
Four for the Core (4) Muscular Endurance
Shoulder Stability Drill (5) Muscular Endurance
Hip Stability Drill (5) Muscular Endurance
Conditioning Drill 1-3 (20) Anaerobic Endurance
Suspension Training Drill 1 and 2 (10) Muscular Strength
30:60s and 60:120s (2) Anaerobic Endurance
Guerilla Drill (3) Anaerobic Endurance
Climbing Drill 1 and 2 (10) Muscular Strength
300 Meter Shuttle Run (1) Anaerobic Endurance
Military Movement Drill 1 and 2 (6) Aerobic Endurance
Medicine Ball Drill 1 and 2 (10) Muscular Strength
Strength Training Circuit (10) Power
Running Drill 1–7 (45) Aerobic Endurance
Landmine Drill 1 and 2 (10) Muscular Strength
Release Run (1) Aerobic Endurance
Terrain Run (1) Aerobic Endurance
Hill Repeats (Up and Down) (2) Anaerobic Endurance
Recovery Drill (8) Muscular Endurance
Preventive Maintenance Checks and Services (6) Muscular Endurance
Foot March (1) Aerobic Endurance
Free Weight Core and Assistive (18) Power
Army Water Survival Training (7) Muscular Endurance
Pregnancy and Postpartum (6) Muscular Endurance
PREPARATION
6-23. Preparation includes the Preparation Drill, Stability Drill, Military Movement Drill, and other dynamic
warm-up activity that appropriately prepares Soldiers for more intense physical activities. The exercises use
body weight, on-ground and off-ground (jumping) activity, and all three planes of movement. Soldiers
conduct exercises at a cadence that permits full range of movement, precise execution, and gradual increase
in heart rate and RPE. Paying attention to the timing, intensity, repetitions, and range of motion during
preparation is the best way to get ready for the main activities. If the main activity requires specific
physiological demands, then Soldiers should use less intense, assistive movements, and exercises in
preparation.
ACTIVITIES
6-24. Physical readiness activities address specific physical training goals across all components of fitness.
They take up most of the time in the session. Weekly schedules alternate days of endurance-focused and
strength-focused activities. To balance both endurance and strength activities, schedules cover at least ten
days. Chapter 14 provides sample multi-week schedules to illustrate the training required for physiological
adaptation and periodized training approaches. In the future, platforms provide modifiable physical training
schedules that integrate the other domains of readiness. These serve to guide Soldiers remote from H2F
personnel and facilities for ten days or for a single microcyle. |
7-22 | 66 | Chapter 6
6-25. When the main activity of the session focuses on strength training, the order of the exercises are—
* Power exercises before multi-joint exercises.
* Multi-joint before single joint exercises.
* Larger muscles before smaller muscles.
RECOVERY
6-26. Recovery includes all the rest intervals between exercises and the time between exercise sessions.
Recovery includes walking after performing running activity and continues with the performance of the
stretches in Recovery Drill or the checking for joint stiffness and soreness in preventive maintenance checks
and services (PMCS). See ATP 7-22.02 for exercises. The Central Army Registry website provides CIMT
demonstration drills at https://atiam.train.army.mil/catalog/dashboard. The Army Combat Fitness Test
website at https://www.army.mil/acft/ provides detailed descriptions and instructional videos for each testing
event.
INTENSITY OF TRAINING
6-27. Using RPE expediently gauges the intensity of effort in strength and endurance training programs. RPE
describes how intense the workout should feel as a Soldier completes it. It allows exercise leaders to properly
dose intensity across the training session and period. Sticking to the recommended levels of perceived
exertion allow effort to be more properly dosed across a training period to avoid overtraining and injury. RPE
works on a 10-point scale with the higher rating representing more intense effort. Table 6-3 includes another
expedient measure of effort that applies in strength training—repetitions in reserve (known as RIR). This
number represents how many repetitions of a movement or lift a Soldier could perform before having to stop.
Easier efforts have higher repetitions in reserve. A one-repetition maximum lift, by definition, should have a
repetitions in reserve of zero—the Soldier should be unable to perform any more repetitions. Prescribed RPE
and repetitions in reserve let a Soldier know what effort is required in advance of the workout so that he or
she can better prepare mentally.
Table 6-3. Rating of perceived exertion and repetitions in reserve scales
RPE Intensity Activity Description RIR
1 No effort at all Sitting, lying down or stretching 20
2 Extremely little Intermittent walking with little effort 15
3 Very easy Sustained walking, light carrying—could maintain the effort all day 10
4 Easy Marching, running slowly, light lifting—could maintain the effort for hours 8
5 Moderate Running long, ruck marching—breathing heavily as challenge increases 6
6 Somewhat Sustained circuit training, running above aerobic endurance—feeling it 4
hard
7 Hard Short of breath—using short sentences to speak. Approaching 3
maximum weight.
8 Very hard Pushing limits of weight, pace and distance—cannot maintain the pace 2
9 Very, very hard Close to maximum—can barely breathe to speak 1
10 Maximum effort Reached maximum weight, reps, distance or pace—cannot do any more 0
RIR repetitions in reserve RPE rating of perceived exertion
STRENGTH TRAINING LOAD, REPETITIONS, SETS AND REST PERIODS
6-28. Training load, sometimes called training stress, refers to either the weight lifted or the amount of work
performed over time. As load accumulates across a short-term of one session or one day (acute load), the
physical and nonphysical stress on the Soldier builds. This longer-term or chronic load occurs over days or
weeks and has to be monitored and adjusted to include all other physical activity in the Soldier’s schedule in
order to avoid overload. |
7-22 | 67 | Program Design
6-29. If Soldiers use Free Weight exercises, the Strength Training Circuit, Strength Training Machines,
Landmine Drills, and Medicine Ball Drills, the amount of load depends on the component of fitness they are
targeting—muscular endurance, muscular strength, hypertrophy, or power. The load for strength training is
described as a percentage of the maximum weight a Soldier can lift one time—his or her one repetition
maximum. As a general rule, starting a strengthening program with an emphasis on muscular endurance or
hypertrophy will safely develop a Soldier’s foundational strength and allow progression to heavier training
loads (see table 6-4).
Table 6-4. Training load as a percentage of one repetition maximum for strength training goals
Goal Load Repetitions Sets Rest Recovery
Muscular endurance 60% 12 or more 2 to 3 Up to 30 secs 24 hours
Hypertrophy 70–85% 6 to12 3 to 6 30 to 90 secs 48 hours
Muscular strength 85–100% Up to 6 2 to 6 2 to 5 mins 48 hours
Power (repeat efforts) 90% 3 to 5 3 to 5 2 to 5 mins 48 hours
Power (single effort) 80% 1 to 2 3 to 5 2 to 5 mins 48 hours
mins minutes secs seconds
6-30. Assigning rest during sets of strength training exercises depends on the fitness component being
targeted, the percent of maximum weight being lifted (one repetition maximum), the size of the muscle group,
the number of joints and regions of the body being exercised, the period of training, and the current physical
readiness of the Soldier. In general, the heavier the weight, the fewer the repetitions, and the longer the rest
interval. The amount of rest between sets drives the onset of fatigue, and therefore is an important
consideration when performance degrades or when injury occurs. In general, the principle of precision suffers
in the presence of fatigue.
ENDURANCE TRAINING LOAD
6-31. The type of endurance training chosen is driven by the targeted type of cardiovascular fitness
component. Endurance training load is built aerobically or anaerobically.
6-32. Aerobic endurance is built with sustained activity of more than 3 minutes at submaximal levels of
intensity. Soldiers can sustain training at this pace for minutes or hours. This type of training recruits slow
twitch or type I muscle fibers and is the primary means of recruiting fat for fuel. Over time, this type of
activity reduces the Soldier’s lean muscle. Because common Soldier tasks and HPDTs require more power
and strength than endurance, sustained endurance training should not comprise the majority of a Soldier’s
physical training program.
6-33. Anaerobic training recruits type II muscle fibers and uses glucose (sugar) for fuel from 30 seconds to
three minutes. During this time, glycolysis predominates over oxidative phosphorylation. This type of
training is for very short bouts of effort. Leaders can identify the crossover when a Soldier begins to slow
down after sprinting at maximum effort beyond 150 meters.
6-34. The intensity of training heavily impacts the ability to recover. For example, following the Army Ten
Miler, an event many Soldiers train intensely for, it may take three to five days to recover before re-restarting
a training program. Besides RPE, Soldiers can measure the endurance training load by using devices such as
power and heart rate monitors. Power monitors often come with road and mountain bicycles and stationary
bikes. Newer chest and wrist monitors provide running power. Although appropriate in some special
programs and laboratory settings in the Army, they are not feasible for training large groups. Other biometric
devices or heart rate monitors with wrist or chest-straps provide simple ways to track intensity. |
7-22 | 68 | Chapter 6
6-35. When Soldiers monitor heart rate, they can control the level of effort to keep the heart rate at a desired
level. These levels, or zones, do not tell much about movement skill but can indicate which energy system is
being utilized. Table 6-5 lists targeted heart rate zones and their associated physical fitness components.
Table 6-5. Endurance heart rate zones, fitness components, and levels of effort
Zone % HRmax Fitness Component Level of % of Total Distance /
Effort Endurance Training Time
5 90–100 Anaerobic explosive speed Maximum 10 200 m / 0:30
4 80–90 Anaerobic endurance Very Hard 30 400 m / 1:15
3 70–80 Aerobic endurance Hard 10 800 m / 3:45
2 60–70 Aerobic endurance Moderate 40 1MR / 7:30
1 50–60 Active recovery Easy 10 2MR / 20:00
HRmax heart rate maximum m meter MR mile run
6-36. Resting heart rate monitoring can be a good way to measure recovery period immediately after a
workout and again the following morning. Consistent monitoring upon waking over several months is an
easy way for a Soldier to know his or her state of recovery each day. Resting heart rate should be lower over
time in well-trained Soldiers. Daily spikes above the normal range may be an indicator of overtraining or of
the need to reduce intensity of the next session. Poor sleep, nutrition, hydration, and stress control will all
negatively impact the daily results, causing the resting heart rate to increase.
6-37. Heart rate monitoring during endurance exercise depends not only on the measurement device, but also
on knowing the target heart rate for the workout and unit training plan. Using the Karvonen formula, which
is based on predicted maximum heart rate, a zone of 60–80 percent effort in a 30-year-old Soldier is between
138 to 164 bpm (see table 6-6). As with the monitoring of the resting heart rate, the best results often come
from consistent self-monitoring and repeated testing over many months and years.
Table 6-6. Target heart rates using maximal heart rate formulas
30 year old Soldier with a RHR of 60 beats per minute has a target heart rate of
60% to 80% of age-predicted MHR
Karvonen Formula
220 - age - RHR = 220 - 30 - 60 = 130
MHR = 130 bpm
60–80% of 130 = 138 to 164 bpm
Target is 151 bpm
bpm beats per minute MHR maximum heart rate RHR resting heart rate
Program Design
Program design is completed by holistic health and fitness (H2F) performance
readiness experts and approved by the unit’s command. The design must address the
unit’s mission-essential task list (METL) in accordance with the commander’s
guidance. The program must assist Soldiers with their individual needs.
Individualization is the principle that drives programming. The training cycle is dictated
by initial needs analysis and follow-up assessments of a Soldier’s level of development,
ability to recover and training objectives. |
7-22 | 69 | PART THREE
Build
This part describes the details of each of the five domains used to build the physical
and nonphysical training programs of H2F. The domains are physical readiness,
nutritional readiness, mental readiness, spiritual readiness, and sleep readiness. It
also discusses the special conditioning requirements.
Chapter 7
Physical Readiness
Physical readiness is a critical component of Soldier readiness, unit readiness, and
Army readiness. Effective Soldiers can overcome ever-changing and complex
challenges in both strategic and operational environments. They must possess the
physical and nonphysical capabilities to fight and win in multi-domain operations. The
chapter describes the principles of physical readiness, as well as the fundamentals of
movement for the execution of Army physical training. Ruck marching, running and
swimming serve as the foundations of physical readiness and enable Soldiers to
perform their occupational tasks and endure the physical demands of combat.
PRINCIPLES OF PHYSICAL READINESS
7-1. The principles of physical readiness training are precision, progression, and integration. Effective
Soldiers can precisely execute the program’s exercises and drills. These Soldiers progress from physical
proficiency in WTBD to being able to integrate those skills into tasks required for their MOSs and combat.
PRECISION
7-2. Precise movement depends on having the structural capabilities, proper flexibility, tolerance of extra
weight, body composition, and the connection of the brain to muscles—motor patterns—that allow Soldiers
to learn the standard and perceive the difference between correct and incorrect techniques. The quality of the
movement is as important as the weight lifted, repetitions performed, or speed of the movement. Movement
skill develops through the repeated execution and deliberate practice of foundational drills and exercises.
Rehearsal using mental imagery can assist in refining precise movement patterns without the cost of physical
exertion. The principle of precision ensures the development of perception and awareness of the body’s
position in space—kinesthesia—to improve training, testing, and battlefield performance. See ATP 7-22.01
for H2F testing, and ATP 7-22.02 for drills and exercises.
PROGRESSION
7-3. Progression refers to the proper dose of frequency, intensity, duration, and type of exercise required to
overload the body without causing overtraining, plateauing, or reversal of fitness. The goal is to develop
physical capacity to support the mastery of occupational and combat-specific tasks. Task analysis includes |
7-22 | 70 | Chapter 7
the physiological demands of the task and potential performance and injury issues the Soldier might have.
Proper progression of the weight, repetitions, speed, and variety of exercises builds from the initial phase to
sustaining phase. Initial phase training creates foundational fitness that Soldiers use to safely progress from
the sustaining phase to higher levels of operational physical capacity. It is important to remember that all
movement skill requires consistent revisiting of the basics before and after progressing to higher levels.
INTEGRATION
7-4. The integration principle focuses on tasks and drills Soldiers perform that enable them to fight and
win. The Army trains Soldiers and units to fight and win in combat using a specific list of WTBD. Warrior
tasks are a collection of individual skills linked to a Soldier’s ability to shoot, move, communicate, survive,
and protect and treat. Examples include weapons training, tactical communications, urban operations, and
first aid. Battle drills are group skills designed to teach a unit to react and survive in common combat
situations. WTBD establish a minimum standard for all Soldiers independent of age, sex, and MOS. All
commanders ensure that their Soldiers can execute all WTBD. Soldiers demonstrate this ability by regularly
training and testing on the tasks to ensure they have been integrated into the Soldiers’ skill sets.
7-5. Soldiers following this doctrine will become more physically fit, but it is not a prescription for
recreational fitness or for fitness for fitness’ sake. This fitness aims to develop physical capacity to support
the mastery of MOS and combat-specific tasks. Once Soldiers reach high foundational readiness standards
in the initial phase, they continue to build foundational fitness and METL-specific physical capabilities.
7-6. This doctrine integrates physical training with nonphysical training. Leaders consider the nonphysical
domains integrating with the physical training plan. Training goals need to account for Soldiers’ ability to
physically and mentally perform in extreme environments of heat, cold, and humidity, and while carrying
heavy personal protective equipment. Recovery between training sessions must also be trained, measured,
and scheduled. Leaders also manage obstacles to goal achievement. For example, a unit will not gain much
from having 24-hour access to a gym if an assessment of the unit’s sleep readiness shows an average of below
six hours per night. Similarly, if a unit readiness measure is a reduction in ABCP enrollees, then unhealthy
fast food options in the unit’s life support area contradicts that goal.
7-7. H2F drills and exercises balance different energy systems and components of fitness for each Soldier.
That Soldier’s movement skill and physical capacity create the unit’s ability to deliver force. The Soldier’s
goal for readiness will include the demands of the MOS, the unit’s METL, and the likely environmental,
physical, and nonphysical challenges of the unit’s deployment mission. The physical activities of combat
may include more than those listed in WTBD and must be trained for. Examples include repeated forcible
entries, quick pursuits, close combat, sustained mountain patrolling, and sustained load carriage.
7-8. A fully integrated Soldier can complete 16-mile ruck marches, load gun turrets, replace large tires,
extract and evacuate casualties, move over and around obstacles, react to man-to-man contact, and load
155-millimeter rounds onto a bustle rack. Table 7-1 illustrates the integration of H2F physical training and
test events into critical combat tasks. The training activity and the test events are reverse-engineered from
the combat tasks. Therefore, H2F training takes care of those test events as well. |
7-22 | 71 | Physical Readiness
Table 7-1. Integrating combat tasks into physical training and testing
Combat Task Physical Movement Physical Training Drill Physical
Test Event
Casualty Squat, lunge, flex, extend, rotate, PD, 4C, CD1/2/3, GD, CL1 & SDL, IAR,
evacuation walk, run, lift and carry CL2, STC, MB1 & MB2, LM1 & MDL, SDC
LM2, FW, MMD1 & MMD2,
30:60s, 60:120s, 300SR, RR,
TR, HR, FM, RD
Casualty Pull, lift, carry, squat, lunge, flex, PD, SSD, CD1/2/3, GD, CL1 & MDL, SPT,
extraction extend CL2, STC, FW, RD LTK
Movement Run fast under load, jump, bound, PD, HSD, CD1/2/3, GD, CL1 & SLJ, IAR,
under fire crawl, push, pull, squat, roll, stop, CL2, STC, FW, RUD1–6, MMD1 HRP, SDC,
start, change direction, and get up & MMD2, 300SR, 30:60s,
and down 60:120s, TR, HR, RD
Movement March and run under load, jump, PD, 4C, SSD, CD1/2/3, GD, CL1 IAR, HRP,
over obstacles bound, high and low crawl, climb, & CL2, STC, FW, MMD1 & SDC, LTK
crawl, pull, squat, jump, land, roll, MMD2, RUD 1–6, 300SR,
stop, start, change directions, get up 30:60s, 60:120s, AGR, RR, TR,
and down HR, FM, RD
Construct a Squat, lift, carry, pull, push, flex, PD, 4C, SSD, CD1/2/3, GD, CL1 SDL, MDL,
fighting extend, & CL2, STC, FW, RD HRP, LTK
position
Assess and React to man-to-man contact: push, PD, CD1/2/3, GD, CL1 & CL2, SPT, SDL,
respond to pull, run, roll, throw, land, manipulate STC, FW, MMD1 & MMD2, MDL, HRP,
threats body weight, squat, lunge, rotate, RUD 1–6, 30:60s, 60:120s, TR, SDC
bend, block, strike, kick, stop, start, HR, RD
change direction, and get up and
down.
Navigate from March and run under load, jump, PD, CD1/2/3, GD, CL1 & CL2, SPT, SLJ,
point to point bound, high and low crawl, push, STC, FW, MMD1 & MMD2, SDL, HRP,
pull, squat, roll, stop, start, change RUD1–6, 60:120s, AGR, UFR, MDL, LTK,
direction, and get up and down. RR, TR, HR, FM, RD 2MR
Employ hand Run under load, jump, bound, PD, CD1/2/3, GD, CL1 & CL2, SDL, HRP,
grenades high/low crawl, climb, push, pull, STC, FW, RUD1–6, MMD1 & MDL, SPT
squat, lunge roll, stop, start, change MMD2, 300SR, 30:60s, 60:120s,
direction, get up/down and throw TR, HR, RD
Physical Training Abbreviations
4C four for the core HR hill repeats RUD1 running drill 1
30:60 30 second sprint: 60 second walk HSD hip stability drill RUD2 running drill 2
60:120 60 second sprint: 120 second walk LM1 landmine drill 1 RUD3 running drill 3
300SR 300-meter shuttle run LM2 landmine drill 2 RUD4 running drill 4
AGR ability group run MB1 medicine ball drill 1 RUD5 running drill 5
AWST Army water survival training MB2 medicine ball drill 2 RUD6 running drill 6
CD1 conditioning drill 1 MMD1 military movement drill 1 RUD7 running drill 7
CD2 conditioning drill 2 MMD2 military movement drill 2 SSD shoulder stability drill
CD3 conditioning drill 3 PD preparation drill STC strength training circuit
CL1 climbing drill 1 PMCS preventive maintenance ST1 suspension training drill 1
CL2 climbing drill 2 checks and services ST2 suspension training drill 2
FM foot march RD recovery drill TR terrain run
FW free weight training RR release run UFR unit formation run
GD guerilla drill
Occupational Physical Assessment Test (OPAT) and Army Combat Fitness Test (ACFT) abbreviations
2MR 2-mile run MDL maximum deadlift SDL strength deadlift
HRP hand-release push-up (3 repetitions) SLJ standing long jump
IAR interval aerobic run PWT seated power throw SPT standing power throw
LTK leg tuck SDC sprint-drag-carry |
7-22 | 72 | Chapter 7
RUCK MARCHING
7-9. This section illustrates how to develop a program to train for the occupational task of ruck marching.
A combat arms unit preparing for dismounted operations during an upcoming deployment uses the following
principles and template to develop a training approach. The four-week ruck marching program outlined in
table 7-2 and table 7-3 uses the following considerations to develop the first mesocycle in a longer training
schedule:
* Once per week progressive ruck march: progress one factor each week of either weight of the load,
distance of the march, speed of the march, gradient of the terrain or roughness of the terrain.
* Loads above 30 percent of body weight should be increased with caution.
* Do not do long marches, endurance runs, or heavy leg strength workouts on consecutive days.
* Strength training performed with free weights and strength training machines (STMs) at least three
days per week, moving from high repetitions (12+) with less weight (muscular endurance) and
RPE of 6–7 to lower repetitions (3–6 reps) with heavier weight and RPE of 8 and working up to 3
sets per core exercise (Bench, Deadlift, Squat) and complementary exercises (for example
Overhead Push Press, Lat Pull Downs, Leg Press).
* Aerobic endurance training with progressive increases in distance (running 20-30 minutes based
on RPE, pace, and or heart rate) and running skill drills, along with interval training with
progressive decreases in rest (60:120s progressing to 30:60s; or 2 x 300-meter shuttle run [known
as 300SR] in 3 minutes progressing to 4 x 300-meter shuttle run in 1 minute).
* Adhere precisely to pace, effort, and movement goals with each road march and across each
session.
* Progressively integrate terrain, loads, and distances that replicate conditions likely to be
encountered in combat environments. To do this—
Vary the time of day of the march and training sessions.
Replicate the nutrition and hydration plan (timing and choices) available in combat.
During the ruck march, include short, unplanned physical activity such as 3–5 second rushes,
Shoulder Stability Drill, or 5 repetitions of the 8-count T Push-up (to replicate getting into
and out of prone firing positions).
Change directions or move to cover.
Skip rest breaks.
Rotate or remove squad leadership.
Incorporate proper nutrition and sleep strategies to be able to consistently train.
Table 7-2. Ruck marching training template
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Week 1 Upper Rest Upper body Aerobic Lower body Rest Aerobic
body push pull endurance push/pull endurance
Week 2 Ruck Rest Loaded carry Aerobic Resisted Rest Aerobic
march endurance trunk rotation endurance
Week 3 Upper Rest Upper body Aerobic Lower body Rest Aerobic
body push pull endurance push/pull endurance
Week 4 Ruck Rest Loaded carry Aerobic Resisted Rest Aerobic
march endurance trunk rotation endurance |
7-22 | 73 | Physical Readiness
Table 7-3. 20-week ruck marching progression
Week Recommended Load Distance (miles) Time Standard Pace
1-2 15–20 lb 2 35 min +/- 5 min 3 mph
4 25–30 lb 4 65 min +/- 5 min 3 mph
6 30–35 lb 4 90 min +/- 5 min 3 mph
8 50–60 lb 6 None 3 mph
12 60–70 lb 6 None 3 mph
16 60–80 lb 6 None 3.5 mph
20 60–80 lb 8 None 3.5 mph
lb pounds mins minutes mph miles per hour
RUNNING SKILL
7-10. Running instruction has challenged the U.S. Army for the last decade. It has been one of the most
common concerns of Soldiers leaving IMT. Numerous individual variations in running skill exist, however,
some common principles can help Soldiers run better and reduce injuries. Various running instructional
models and programs exist. This publication and ATP 7-22.02 use the Pose Method® as a method for the
running skill program and drills. Scientific literature does not explicitly support a single running style that is
optimal for all individuals. Many other running technique instructional methods exist through commercial
organizations and sanctioned governing bodies. Instructors can use other techniques they deem more suitable
for the population they are instructing.
7-11. Soldiers who need foundational running skill or who want to improve their running performance may
benefit from standardized drills that develop running skill. Soldiers understand that standards and skill
development are key factors in the optimal performance of any physical readiness activity and any Soldier
task. Running is no different. The amount and variety of running activity are controlled in the H2F System
to provide time to improve running and other movement skills, and to prevent misuse injuries that arise from
poor skill combined with too much run frequency and intensity. A balanced approach applies to running just
as it does to the other skills across the H2F System. Commanders who control the amount of running can
spend more time developing strength and the other skills that further enhance readiness domains. Figure 7-1
depicts the discrete elements of running skill: the dominant position/pose, fall and pull.
Figure 7-1. Running skill—the dominant position/ pose, fall, pull |
7-22 | 74 | Chapter 7
7-12. In the H2F performance team, MFTs develop training plans and lead physical training sessions that
incorporate Running Drills. MFTs teach the running skill in the classroom as well as on the training field.
THE RUNNING PARADIGM
7-13. Paragraphs 7-14 through 7-25 describe the paradigm behind the Running Drills. A paradigm describes
a way of thinking about an issue or problem. It provides a useful way to analyze and understand a problem
and usually includes common language or terms. The running skill paradigm described in figure 7-2 supports
the concept that leaders can teach running skill as a technique using drills and exercises.
Figure 7-2. The running skill paradigm
7-14. Just like any skill position in a team or individual sport (swimming, baseball, soccer, cycling), any lift
in the gym, Soldiers develop technique—the applied skill of the movement—over time by purposeful and
deliberate practice. Movement skills such as switching from rifle to pistol or close quarters combat requires
a skilled coach as well as repeated practice. High-level skill in running is no different. Running drills and
exercises aim to progressively build and correct running skill. They build the physical capacity and mental
awareness of the position of the body while running.
7-15. Gravity is the arbiter of movement. Although not seen, Soldiers can see and feel its effects. They stay
at rest because of it and lose balance because of it. All forces on Earth are derivatives of gravity. As a force
of nature, it cannot be overcome. Gravity is the one force that allows Soldiers to go from standing still to
moving forward. As a pencil falls from a desk, a rocket arcs towards its target, and a Soldier trips through
the Sprint-Drag-Carry, gravity is predominant.
7-16. During running, as the body moves, it rotates around its point of support on the ground—where the
foot meets the ground. The angle between the body starting position as the foot contacts the ground and the
new angle of the body as the foot leaves the ground can be measured. The greater the angle, the greater the
speed of the movement. Using classical geometry and mechanics, this angular velocity can be translated into
forward or linear velocity in two equations. In the first, v = rω where v is linear velocity, r is the radius of
rotation (leg length), and ω is the angular velocity of a given rotation. In the second equation,
𝜃
𝜔=
𝑡
where θ is the angle of deviation of the body from the vertical and t is the time of passing through that angle.
7-17. Therefore, v = r θ/t. The Soldier’s running speed depends on his or her angle of fall—the greater the
angle, the greater the speed. Keeping the center of mass over and then moving it ahead of the base of support
requires maintaining the dominant running position, which requires muscles to be strong enough to maintain
the body’s position during the fall. Changing support from one foot to the other requires an active pull of the
foot from the ground to increase the speed of movement through the fall angle. Running Drills increase the
specific strength required to do this. If the fall angle is greater, so will be the acceleration and subsequent
speed of the body over the ground. Acceleration is a = g ∙ sin θ, where g is gravity, and sin is sine (ratio of
the shortest to the longest sides of the angle). A larger angle generates an increase in acceleration. Figure 7-3
illustrates the body’s translation of angular velocity into horizontal velocity. |
7-22 | 75 | Physical Readiness
Figure 7-3. Translation of angular velocity of the body into horizontal velocity
7-18. In the case of human movement, gravity has to be worked with. When standing still, muscles support
body weight, maintain a state of rest, and balance under the influence of the downward force of gravity. The
muscle works to maintain the balanced position or to reposition the body to be able to change support. Unless
an external force acts upon the body’s weight or muscles reposition that weight, the body remains at rest. If
Soldiers lose balance, either because muscles have relaxed or an external force acted upon them, they begin
to fall—they move. Classical mechanics and geometry give a mathematical explanation of how this
movement happens. Figure 7-4 describes the effect of gravity on movement.
Figure 7-4. A schematic demonstrating gravity’s influence on movement
7-19. Like the rocket example, our movement is initially in the horizontal plane—forward—via gravitational
torque. The body becomes a lever as its mass pivots around the base of support—the foot. The pivot ends as
the toes are pulled from the ground. If the front of the foot is used as the base of support throughout the
duration of contact with the ground, less time will be spent pivoting on the ground, allowing an earlier pull.
The point is not to simply land on a specific part of the foot, the point is to reach a position to continue
moving forward as efficiently as possible. The movement forward—the fall—can conclude only when the
foot no longer supports the body’s weight. Falling over can be prevented only by rapidly reestablishing
balance—a new base to support the body’s weight. To move forward from this new base of support, the body
must reach a position where it can pull the foot from the ground to fall again. Repeating this action at higher
frequencies increases speed.
7-20. Similar to the command “STARTING POSITION, MOVE,” in Conditioning Drills, or the predominant
poses taught in ballet and dance, or ready positions in martial arts, Soldiers can master the dominant running
position, or pose, through drills and exercises. They can also master the action required to move quickly in
and out of this position. The action of the hamstring as it contracts to pull the support foot from the ground
and under the hip, positions the body for the next fall. The three words—pose, fall, pull—concisely describe
the “how” of “how to run.” These are the essential elements of running skill. They form a standard against
which a Soldier’s running skill can be measured. |
7-22 | 76 | Chapter 7
Running
Running is a recurring change of support from one foot to the other.
This change begins as the runner’s center of mass falls forward of the support foot that
the runner then pulls from the ground.
The foot is pulled up toward the hip by the hamstring muscles while the opposite foot
moves to the ground to provide a new support.
As the pulled leg passes the support leg, the body reaches a new position from where
it can continue acceleration.
RUNNING MEASUREMENT
7-21. Measurement of this standard using readily available video feedback does not take much time. The
H2F performance team can quickly analyze a Soldier’s running stride to show the Soldier his or her deviation
from the standard. This visual and verbal feedback, like any coaching, increases the Soldier’s perception of
how he or she is running. Leaders can prescribe drills and exercises for the Soldier based on specific
deviations from the standard. Such drills and exercises reduce excess strain on the body and increase running
speed and distance (see figure 7-5).
Figure 7-5. The anatomy of a running stride
7-22. Running Drills may be performed collectively or individually. Table 7-4 summarizes Running Drills
used to develop running skill. ATP 7-22.02 discusses and illustrates the purpose and execution of all seven
Running Drills in detail. Soldiers perform the drills at least once per week to develop proper form. As with
all physical training exercises, consistent adherence to precise execution provides optimal results.
7-23. After conducting a block of instruction, commanders who want to progress running skills should
schedule Running Drills two times per week for fifteen to twenty minutes during endurance activities.
Running Drills should precede or follow running activities. Running Drill 1 is used to increase awareness of
improper running form. Leaders do not have to use Running Drills in order. They may be prescribed to
address individual and unit deficits in running skill.
7-24. The Soldier’s perception of any movement—whether it be running, weightlifting, or shooting—is
developed through physical repetition and attention to form. Repetition improves skill by connecting the
brain to the body part. By asking questions about perception, performance experts, MFTs, and unit leaders
promote faster adoption of improved skill. |
7-22 | 77 | Physical Readiness
Table 7-4. Running drills
Type Description
Running Drill 1: Foot Strike These exercises enhance perception of the forces generated when the
foot hits the ground.
Running Drill 2: Strength Develops the specific strength needed to prepare the body properly to
run or sustain running.
Running Drill 3: Pose Every runner goes through the Pose position on every step. The Pose
precedes a fall that is necessary to initiate forward motion.
Running Drill 4: Fall As the runner falls, gravity accelerates the runner forward from the
Pose position.
Running Drill 5: Pull In order to increase efficiency and reduce impact force, the foot is
quickly pulled from the ground and back into the Pose position.
Running Drill 6: Combinations This drill challenges the runner’s ability to incorporate lessons of the
previous running drills into a smooth, sustained run.
Running Drill 7: Corrections After feedback from MFTs or H2F performance team, Correction Drills
are used to improve proper form.
H2F holistic health and fitness MFT master fitness trainer
ARMY WATER SURVIVAL TRAINING
7-25. H2F physical readiness training builds skills that help Soldiers survive in water. Water survival skills
are critical Soldier combat tasks. Commanders can incorporate these skills into physical training schedules,
or treated as special training events and programmed accordingly. The inclusion of pool or aquatics training
in special conditioning requires that commanders know whether their Soldiers can swim and have completed
drown-proofing. Paragraphs 7-26 through 7-47 discuss Army Water Survival Training (AWST). See
ATP 7-22.01 for more details.
7-26. Soldiers who successfully complete AWST identifies possess the requisite swimming skills to
complete more advanced waterborne training and testing. When AWST is conducted to standard, Soldier
safety is ensured while performance is enhanced. AWST builds Soldier confidence prior to special
conditioning pool workouts and increases survivability in operations in and around water.
7-27. Two levels of classification in the AWST program inform the commander the water survivability levels
of his or her Soldiers: basic survival swimmer (known as BSS) and combat survival swimmer (known as
CSS). All Soldiers complete combat survival swimmer annually. Qualification at the combat survival
swimmer level is necessary only for units that anticipate extensive operations in and around water. These
units conduct operations over the shore, maritime transportation, and the Army diver program.
7-28. The Combat Water Survival Test (CWST) accurately records a Soldier’s ability to safely function in a
water environment. The CWST certifies Soldiers who intend to lead AWST and for other trainers in the H2F
System. AWST trainers must be certified annually in the CWST. Soldiers who wish to maintain the validation
must re-certify on the CWST every two years.
SAFETY
7-29. Safety is the first concern when training Soldiers in and around water. Unit standard operating
procedures for swim instruction, aquatic rehabilitation, and water survival training must be developed to
ensure safe and effective training. SOPs describe the training area, uniform, personal equipment, formation,
leadership, commands, and safety. Leaders use, review, and rehearse written safety and emergency action
plans prior to conducting training. AWST trainers and assistant instructors perform risk management
following installation policy and DA Pam 385-30. Qualified lifeguards attend and have standard sets of pool
safety and rescue equipment on hand at all times. A standard set of equipment consists of—
* Shepherd’s crook and reaching poles.
* Heaving line.
* Ring buoy with rope. |
7-22 | 78 | Chapter 7
* Back board with tie down straps and cervical collar.
* Whistles.
* First aid kit.
* Automatic electronic defibrillator (known as AED).
7-30. Lifeguards must have a current American Red Cross Lifeguard Training certificate and must be
certified in first aid and cardiopulmonary resuscitation (known as CPR). Lead and assistant instructors should
be strong swimmers. Ideally all instructors have cardiopulmonary resuscitation training and Water Safety
Instructor certificates and have passed the CWST.
7-31. Non-swimmers require extra training time. Those who do not self-declare as non-swimmers should be
given extra swim training if they fail the two minute buoyancy test—treading water and sculling for two
minutes in ACUs and boots without going underwater or touching the bottom of the pool. Extra swim training
time provides Soldiers training to perform the two strokes necessary to pass the basic survival swimmer—
the sidestroke and breaststroke.
BASIC SURVIVAL SWIMMER
7-32. Soldiers must successfully complete the following three training tasks to for basic survival swimmer.
Soldiers will wear ACUs, boots, and improved outer tactical vest (IOTV) without plates. Soldiers will carry
an M16 or M4 series training aid for tasks 2 and 3:
* Task 1: Trouser inflation and float.
* Task 2: Bob and travel.
* Task 3: Two-Stroke test (sidestroke and breaststroke).
TASK 1: TROUSER INFLATION AND FLOAT
7-33. Task 1, trouser inflation and float, consists of the following four steps:
* Perform stride entry by leaping off the edge of the pool deck into the water with the trunk leaning
forward, the head up, the legs spread in a stride position (one forward, the other back), and the
arms extended sideward (palms facing downward). Immediately upon entry, the legs move
together and the arms move vigorously downward slapping the water upon entry. This technique
keeps the head above water and allows the Soldier to maintain visibility.
* Use the emergency pull strap on the IOTV to release it, allowing the parts IOTV to fall to the
bottom of the pool. Soldiers collect the IOTV after completing Task 3.
* Perform a hanging float and remove one boot at a time. Place the first boot under an arm while
untying the other boot. Tie the laces together and put the boots around the neck, resting each boot
on each side of the chest. Remove trousers, button the fly, and tie-off each trouser leg individually
using an overhand knot.
* Inflate the trousers using the sling or splash method. Once the trousers are inflated, gather-in the
waist band and twist to seal the air inside the trousers. While grasping the twisted waist band,
climb in between the trouser legs and place one leg under each arm. Float for two minutes.
Sling Method
7-34. The sling method consists of the following steps:
* Place the trousers on top of the water as if they are to be put on.
* Grasp the waistband, forming a circular opening on the surface of the water.
* Maintaining hold of the waistband, cross the right arm over the left, then rotate the trousers counter
clockwise above and behind the head.
* Maintain the circular opening of the waistband with both hands.
* Perform a large scissor kick while forcibly extending the arms overhead.
* Sling the trousers quickly forward and downward, trapping air under the water.
* Immediately gather in the waistband to maintain inflation of each trouser leg. |
7-22 | 79 | Physical Readiness
* Continue to hold the waistband together with one hand, while bringing the opposite arm around
and over the same side trouser leg.
* Change hands continuing to hold the waistband together with the other hand while bringing the
opposite arm around and over the other trouser leg.
Splash Method
7-35. The splash method consists of the following steps:
* Place trousers in front and hold the waistband open at the fly with one hand.
* While using the scissors of frog kick to stay afloat, splash water and air toward the waistband
opening with a downward motion of the hand, stopping the stroke at the opening.
* Immediately gather in the waistband to maintain inflation of each trouser leg.
* Continue to hold the waistband together with one hand, while bringing the opposite arm around
and over the same side trouser leg.
* Change hands while continuing to hold the waistband together with the other hand, bringing the
opposite arm around and over the other trouser leg.
TASK 2: BOB AND TRAVEL
7-36. Task 2, bob and travel, consists of the following steps:
* Sling weapon over the right shoulder, grasping the sling close to the sling clamp with the left hand
at the chest and the weapon butt plate with the right hand. The weapon is then pulled tight to the
back. Stand with toes on the edge of the pool deck and face toward the water. Step off the edge of
the pool deck into the water, with the knees slightly flexed to absorb the impact upon hitting the
bottom of the pool. Submerge to the bottom of the pool, slowly exhaling air through the nose while
maintaining control of the weapon. Place the weapon on the pool floor.
* Assume a squatting position and push off the bottom of the pool with both feet, extending the arms
overhead and hands together, traveling forward at a 45-degree angle toward the surface (travel).
Upon reaching the surface, take a full breath and rotate the hips forward, drawing the knees toward
the chest (bob). Re-submerge to the bottom of the pool by straightening the legs and bringing the
arms forcefully overhead with the palms turned inward, slowly exhaling air through the nose.
Repeat the travel action, continuing to bob and travel for fifteen meters.
TASK 3: TWO-STROKE TEST
7-37. When performed correctly, the sidestroke and breaststroke enable the Soldier to move through the
water quickly and efficiently. The sidestroke is one of the most efficient strokes because it allows the Soldier
the ability to rest on top of the water. It is also the stroke used in the Collar Tow. The breaststroke is the most
useful stroke for military swimming. It is efficient when swimming through debris and in full clothing and
gear, and it provides good visibility.
7-38. Soldiers enter the water at the deep end of the pool using the stride entry. They swim for the length of
the pool or 25 meters using the sidestroke. Soldiers exit the shallow end of the pool and walk back to the
deep end starting point. They then re-enter the water at the deep end using the stride entry, and swim the
length of the pool performing the breaststroke. Soldiers exit the shallow end of the pool.
COMBAT SURVIVAL SWIMMER
7-39. Soldiers must successfully complete the following four tasks to become classified as combat survival
swimmers. Uniform is ACUs, boots, and IOTV without plates. Soldiers carry an M16 or M4 series training
aid for all four tasks:
* Task 1: Equipment removal.
* Task 2: Collar tow.
* Task 3: 15 Meter underwater swim.
* Task 4: 3 Meter drop and pool exit. |
7-22 | 80 | Chapter 7
7-40. AWST leaders select a location on the deep end of the pool where the water is a minimum of nine feet
deep. Soldiers wear ACUs with boots, IOTV, and M16 or M4 training aid slung over their back. A safety
line may be attached to the Soldier and controlled by the AWST leader or assistant instructor. A shepherd’s
crook will also be available. If at any time the Soldier shows signs of undue fear, stress, panic, or fatigue, the
AWST leader or assistant instructor will use the safety line or crook to pull the Soldier from the water.
TASK 1: EQUIPMENT REMOVAL
7-41. Soldiers will practice equipment removal while on the deck prior to entering the water using the
following steps:
* The Soldier moves to starting point at the deep end of the pool. The Soldier moves to the entry
line with his or her back facing the water and slings the weapon over the left shoulder, grasping
the sling close to the sling clamp with the right hand at the chest and the weapon butt plate with
the left hand. The Soldier pulls the weapon tight to the back.
* The Soldier stands with heels on the edge of the pool deck and back toward the water. He or she
then performs a rear water entry bending forward slightly at the waist, transferring body weight to
the heels, and falling rearward into the water while maintaining control of the slung weapon. He
or she then breaks the water with the rear of the thighs and buttocks.
* After performing the rear entry, the Soldier submerges to the bottom of the pool while exhaling
through the nose and mouth. Upon reaching the bottom of the pool, the Soldier removes his or her
weapon from its slung position and places it on the bottom of the pool.
* The Soldier then removes the IOTV and places it on the bottom of the pool. The Soldier surfaces
and continues to swim any stroke to the side of the pool and exit. If the Soldier shows signs of
panic, the assistant instructor pulls the Soldier to the side of the pool using the safety line or
shepherd’s crook.
TASK 2: COLLAR TOW
7-42. The collar tow is used to help swimmers who are tired, but not struggling. For this task, one Soldier
acts as rescuer while a partner acts as victim. The Soldiers then reverse roles using the following steps:
* AWST leaders select a location on the deep end of the pool where the water is a minimum of nine
feet deep. The Soldiers perform this task wearing ACU, boots, IOTV, and M16 or M4 training aid
slung over the back. Soldiers are paired with a partner. Prior to entering the water, Soldiers practice
a dry run of the event including the stroke mechanics for the sidestroke while on the pool deck.
* The rescuer slings weapon over the left shoulder, grasping the sling close to the sling clamp with
the right hand at the chest and the weapon butt plate with the left hand. The Soldier pulls the
weapon tight to the back. The rescuer stands with toes on the edge of the pool deck while facing
toward the water. The rescuer performs stride entry by stepping off the pool deck into the water
with trunk leaning forward, head up, legs spread in a stride position (one forward, the other back),
and weapon slung across the back. Immediately upon entry, the rescuer moves legs together. This
technique keeps the head above water and allows the rescuer to maintain visibility. The rescuer
will stabilize buoyancy, roll onto left side, and breaststroke toward the victim.
* The rescuer grabs the tired swimmer’s collar at the back of the neck and pulls him or her to a
horizontal position on his or her back. The rescuer maintains hold of the victim’s collar, keeping
his or her arm fully extended. The rescuer uses a modified sidestroke while towing, swimming on
the side that feels most natural, using a sidearm pull and scissor kick. The Soldier should aim to
master the stroke on both sides.
* Following the sidestroke sequence, rescuers exit the pool in the deep end by placing their rifle on
the deck while maintaining contact with the victim on the side of the pool. This is best
accomplished by securing one or both arms of the tired swimmer against the pool deck while
exiting the pool. Once on the pool deck, the rescuer squats and grasps the tired swimmer’s IOTV
and rotates him or her so their back is against the side of the pool. The rescuer simultaneously
stands up from the squat position and lays the tired swimmer onto the pool deck. |
7-22 | 81 | Physical Readiness
TASK 3: UNDERWATER SWIM
7-43. The underwater swim measures Soldiers’ confidence and ability to enter the water, submerge to the
bottom of the pool, successfully swim fifteen meters underwater with their equipment, surface, and exit the
pool. They use the following steps:
* AWST leaders select a location on the deep end of the pool where the water is a minimum of nine
feet deep. The Soldier performs this task wearing ACUs, boots, IOTV, and M16 or M4 training
aid slung over the back. Prior to entering the water, Soldiers should practice breaststroke
mechanics while on the pool deck.
* The Soldier slings weapon over the left shoulder, grasping the sling close to the sling clamp with
the right hand at the chest and the weapon butt plate with the left hand. The Soldier pulls the
weapon tight to the back. The Soldier stands with heels on the edge of the pool deck and back
toward the water.
* The Soldier performs a rear water entry by bending forward at the waist, transferring body weight
to the heels, and falling rearward into the water while maintaining control of the slung weapon.
The Soldier breaks the water with the rear of the thighs and buttocks. The Soldier submerges to
the bottom of the pool and slowly exhales air through the mouth and nose.
* The Soldier pushes off the bottom of the pool with both feet, bobs to the surface, and grasps the
edge of the pool deck. Upon command of the AWST leader, the Soldier rotates facing the pool,
takes a full breath, and drops under the surface of the water. Immediately pushes off the wall and
begins the underwater swim with arm and leg movements used in the breaststroke.
* The Soldier remembers to slowly exhale air through the mouth and nose while underwater
swimming to the opposite side of the pool. Upon reaching the opposite pool wall, the Soldier
surfaces and performs a pool exit.
TASK 4: 3-METER DROP AND POOL EXIT
7-44. The 3-meter drop with rifle and equipment measures a Soldier’s ability to enter the water, swim to the
side of the pool, and exit with weapon and equipment.
7-45. AWST leaders select a location on the side of the pool where the water is a minimum of nine feet deep.
The Soldier performs this task wearing ACUs, boots, IOTV, and M16 or M4 training aid. A shepherd’s crook
or safety line will be attached to Soldier and controlled by AWST leader or assistant instructor. If the Soldier
shows signs of undue fear, stress, panic, or fatigue, the AWST leader or assistant instructor will use the safety
line or crook to pull the Soldier from the water.
7-46. The Soldier performs a stride entry by stepping off the 3-meter diving board or platform into the water
with the trunk leaning forward, the head up, the legs spread in a stride position (one forward, the other back),
and the arms extended overhead holding the M16 or M4 training aid. Immediately upon entry, the Soldier
moves legs together and the arms vigorously downward slapping the water with the weapon. This technique
keeps the head above water and allows the Soldier to maintain visibility.
7-47. Upon entry into the water, the Soldier will stabilize buoyancy and simultaneously transfer weapon to
the right side of the body grasping the sling close to the forward sling clamp with the right hand. The Soldier
places the weapon near the lower sling clamp onto the right hip while rolling onto left side. The Soldier
performs the sidestroke to the edge of the pool and exits. |
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Nutritional Readiness
The demands imposed by Army training, combat, and contingency operations are
unique and challenging. Nutritional readiness is the attainment of an individual
nutritional strategy that supports optimal physical and cognitive function as well as
lifelong disease and injury prevention. Nutritional readiness is a critical component of
holistic health, and contributes greatly to mission success. The development of a
comprehensive performance nutrition program, tailored to organizational
requirements, can improve individual Soldier performance, overall unit readiness, and
mission success. This chapter describes basic nutrition concepts and integrates them
into performance nutrition plans and practical nutrition recommendations for the
Soldier.
FOUNDATIONAL NUTRITION
8-1. The Army’s comprehensive performance nutrition program concept and framework encompasses three
components—proactive, active, and reactive. The proactive component, or foundational nutrition, entails
chronic disease prevention and immune system enhancement. The active component, or operational
(occupational and environmental task-specific performance) nutrition, focuses on event fueling and post-
event recovery and arduous environment preparedness. The reactive component, or therapeutic nutrition,
centers on specific nutritional interventions to treat (as opposed to prevent) an illness, injury, or condition.
When tailored to organizational requirements, unit- and culture-specific nutrition education and services can
optimize individual Soldier performance, overall unit readiness, and ultimately, mission success.
8-2. For Soldiers to perform optimally throughout their careers in assignments with varying levels of mental
and physical requirements, they must be proactive and place as much emphasis on foundational health as
they do on task-specific performance. This entails chronic disease prevention and immune system
enhancement.
HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION
8-3. The nutritional foundation established by a Soldier’s usual dietary intake, or “everyday diet,” can
greatly reduce preventable future disease. More than 60 years of peer-reviewed research has demonstrated
the importance of the everyday diet to the health and longevity of an individual. Soldiers can capitalize on
these findings by consuming more whole-grain products, fruits and vegetables, legumes, nuts, seeds, dairy
products, and fish, and less processed grains, added sugars, and processed meats.
DIETARY GUIDELINES FOR AMERICANS
8-4. The United States Department of Health and Human Services (known as HHS) and the United States
Department of Agriculture (known as USDA) jointly publish the Dietary Guidelines for Americans every 5
years. The Dietary Guidelines for Americans provides evidence-based food and beverage recommendations
for Americans ages 2 and older. These recommendations aim to promote health, prevent chronic disease, and
help people reach and maintain a healthy weight, and should be used to develop the Soldier’s baseline healthy
eating pattern.
8-5. An eating pattern represents all foods and beverages consumed. All foods consumed as part of a
healthful eating pattern unite to meet nutritional needs that promote a healthy weight, enhance performance,
and prevent chronic disease. Soldiers aim to meet their nutrient needs through healthful eating patterns |
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comprised of primarily nutrient-dense (such as essential vitamins and minerals, complex carbohydrates, lean
protein, and healthy fats) whole foods. A healthy eating pattern includes the following:
* A variety of vegetables from all of the subgroups—dark green, red and orange, legumes (beans
and peas), and starchy (potatoes, corn, and winter squash).
* Fruits, especially whole fruits.
* Grains, at least half of which are whole grains.
* Fat-free or low-fat (1 percent) diary, including milk, yogurt, cheese, fortified soy beverages, or
combination of these.
* A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and
peas), and nuts, seeds, and soy products.
* Oils high in polyunsaturated and monounsaturated fats.
A HEALTHY EATING PATTERN
8-6. A healthy eating pattern limits—
* Added sugar—consume less than 10 percent calories per day from added sugar.
* Saturated and trans fats—less than 10 percent calories per day from saturated fats.
* Sodium—consume less than 2300 milligrams per day from sodium.
Importance of calorie balance within a healthy eating pattern
Managing calorie intake is fundamental to achieving and maintaining calorie balance—
the balance between the calories taken in from foods and the calories expended from
metabolic processes and physical activity.
KEY COMPONENTS OF HEALTHY EATING PATTERNS
8-7. All foods and many beverages contain calories, and the total number of calories varies depending on
their macronutrients. On average, carbohydrates and protein contain 4 calories per gram, fats contain 9
calories per gram, and alcohol has 7 calories per gram. The total number of calories a person needs each day
varies on factors including the person’s age, sex, height, weight, and level of physical activity. A need to
lose, maintain, or gain weight and other factors such as recent injury or illness affect how many calories to
consume each day.
8-8. Eat a variety of vegetables that meets the following requirements:
* Recommended intake: Vegetables from all of the subgroups—dark green (for example, spinach,
kale, and broccoli), red and orange (for example, bell pepper, carrot, and sweet potato), legumes
(for example, beans and peas). These include fresh, frozen, canned, and dried options in cooked
or raw forms, including vegetable juices.
* Key nutrients: Vegetables are important sources of many nutrients, including dietary fiber,
potassium, vitamin A, vitamin C, vitamin K, copper, magnesium, vitamin E, vitamin B6, folate,
iron manganese, thiamin, niacin, and choline. Each vegetable subgroup contributes different
combinations of nutrients, making it important for Soldiers to consume vegetables from all the
subgroups. For example, dark-green vegetables provide the most vitamin K, red and orange
vegetables the most vitamin A, legumes the most dietary fiber, and starchy vegetables, the most
potassium. Vegetables in the “other” vegetable subgroup provide a wide range of nutrients in
varying amounts. Include each vegetable subgroup weekly to meet nutrient needs because each
subgroup provides different nutrients.
* Considerations: Soldiers consume vegetables with limited additions such as salt, butter, or creamy
sauces. When selecting frozen or canned vegetables, choose those lower in sodium. At every meal,
strive to make half of the plate fruit and vegetables.
8-9. Eat fruits that meet the following requirements: |
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* Recommended intake: The fruit group includes whole fruits and 100 percent fruit juice. Whole
fruits include fresh, canned, frozen, and dried forms. One cup (8 ounces) of 100 percent fruit juice
counts as 1 cup of fruit. Although fruit juice can be part of healthy eating patterns, it is lower than
whole fruit in dietary fiber, and when consumed in excess can contribute extra calories. When
juices are consumed, they should be 100 percent juice, without added sugars. Also, when selecting
canned fruit, choose options that are lowest in added sugars. One-half cup of dried fruit counts as
one cup-equivalent of fruit. Similar to juice, when consumed in excess, dried fruits can contribute
extra calories.
* Key nutrients: Fruits provide nutrients that include dietary fiber, potassium, and vitamin C. Include
each fruit subgroup weekly to meet nutrient needs because each subgroup provides different
nutrients.
* Considerations: At every meal, strive to make half of the plate fruit and vegetables.
8-10. Eat grains, especially whole grains, that meet the following requirements:
* Recommended intake: At least half the grains Soldiers consume should be whole grains. Healthy
eating patterns include whole grains and limit the intake of products made with refined grains,
especially those high in saturated fats, added sugars, and sodium, such as cookies, cakes, and some
snack foods. The grains food group includes grains as single foods (for example, rice, oatmeal,
and popcorn), as well as products that include grains as an ingredient (for example, breads, cereals,
and pasta). Grains are either whole or refined. Whole grains (for example, brown rice, quinoa, and
oats) contain the entire kernel, including the endosperm, bran, and germ. Refined grains lack bran
and germ, which removes dietary fiber, iron, and other nutrients.
* Key nutrients: Whole grains are a source of nutrients, such as dietary fiber, minerals, and vitamins.
Whole grains vary in their dietary fiber content. Most refined grains are enriched, a process that
adds back iron and four B vitamins (thiamin, riboflavin, niacin, and folic acid). The term “enriched
grains” often describes these refined grains.
* Considerations: When consuming whole grain products, the whole grain should be the first or
second ingredient. For foods with multiple whole-grain ingredients, they should appear near the
beginning of the ingredients list.
8-11. Consume dairy products that meet the following requirements:
* Recommended intake: This group includes milk, yogurt, cheese, and fortified soy beverages. Soy
beverages fortified with calcium, vitamin A, and vitamin D are part of the dairy group because
they are similar to milk based on nutrient composition and in their use in meals. Other products
sold as “milks” but made from plants (for example, almond, rice, and coconut) may contain
calcium and be consumed as a source of calcium. However, these plant products are not part of
the dairy group because their overall nutritional content is not similar to dairy milk and fortified
soy beverages. The recommended amounts of dairy are 3 cup-equivalents per day.
* Key nutrients: The dairy group contributes many nutrients, including calcium, phosphorus,
vitamin A, vitamin D (in products fortified with vitamin D), riboflavin, vitamin B12, protein,
potassium, zinc, choline, magnesium, and selenium.
* Considerations: Fat-free and low-fat (1 percent) dairy products provide the same nutrients, but less
fat (and thus, fewer calories) than higher fat options, such as 2-percent and whole milk and regular
cheese. Fat-free or low-fat milk or yogurt, in comparison to cheese, contain less saturated fats and
sodium, and more potassium, vitamin A, and vitamin D. Choose fat-free or low-fat dairy foods to
limit the amount of saturated fat while still benefitting from the potassium, Vitamin A and Vitamin
D provided by these foods. Limit cheese as a dairy choice to further limit saturated fat and sodium
intake. Soldiers who are lactose intolerant can choose low-lactose and lactose-free dairy products.
Those who do not consume dairy products should consume foods that provide nutrients generally
obtained from dairy, including protein, calcium, potassium, magnesium, vitamin D, and vitamin
A (for example, fortified soy beverages). |
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8-12. Consume protein sources that meet the following requirements:
* Recommended intake: Foods in the protein group include choices from both animal and plant
sources and includes several subgroups: seafood; meats, poultry, and eggs; and nuts, seeds, and
soy products. Legumes may be considered part of the protein foods group, as well as the vegetables
group. Protein also is found in some foods from other food groups (for example, dairy). A specific
recommendation for at least 8-ounce equivalents of seafood per week is also recommended as part
of a healthy eating pattern. One-half ounce of nuts or seeds counts as 1 ounce-equivalent of protein
foods, and because they are high in calories, Soldiers eat them in small portions and used to replace
other protein foods rather than being added to the diet.
* Key nutrients: Protein foods are important sources of nutrients in addition to protein, including B
vitamins (for example, niacin, vitamin B12, vitamin B6, and riboflavin), selenium, choline,
phosphorus, zinc, copper, vitamin D, and vitamin E. Nutrients provided by various types of protein
foods differ. For example, meats provide the most zinc, while poultry provides the most niacin.
Seafood provides the most vitamin B12 and vitamin D, in addition to heart healthy fats. Eggs
provide the most choline, and nuts and seeds provide the most vitamin E. Soy products are a source
of copper, manganese, and iron, as are legumes.
* Considerations: When selecting protein foods, nuts and seeds should be unsalted, and meats and
poultry should be consumed in lean forms. Processed meats and processed poultry are sources of
sodium and saturated fats. Processed meats are meat products that have been transformed through
salting, curing, fermentation, smoking, or other processes to enhance flavor or improve
preservation (for example, hot dogs, bologna, salami, pepperoni, and bacon). Saturated fats, added
sugars, and total calories are within limits in the resulting eating patterns. Choose fresh meat
options more often than processed meats to limit intake of sodium and saturated fats. The inclusion
of protein foods from plants allows vegetarian options to be accommodated.
8-13. Consume oils that meet the following requirements:
* Recommended intake: Oils are fats that are liquid at room temperature. Although they are not a
food group, oils are emphasized as part of healthy eating patterns because they are the major source
of essential fatty acids and vitamin E. Commonly consumed oils extracted from plants include
canola, corn, olive, peanut, safflower, soybean, and sunflower oils. Oils also are naturally present
in nuts, seeds, seafood, olives, and avocados. The fat in some tropical plants, such as coconut oil,
palm kernel oil, and palm oil, are not included in the oils category because they do not resemble
other oils in their composition. Specifically, they contain a higher percentage of saturated
(unhealthy) fats than other oils.
* Key nutrients: Oils supply calories and help absorb the fat-soluble vitamins A, D, E, and K.
OTHER DIETARY COMPONENTS
8-14. Limit consumption of added sugar. Added sugars include syrups and other caloric sweeteners. When
sugars are added to foods and beverages to sweeten them, they add calories without contributing essential
nutrients. Consumption of added sugars can make it difficult for Soldiers to meet their nutrient needs while
staying within calorie limits. Naturally occurring sugars, such as those in fruit or milk, are not added sugars.
Examples of added sugars that can be listed as an ingredient include brown sugar, corn sweetener, corn syrup,
dextrose, fructose, glucose, high-fructose corn syrup, honey, lactose, molasses, raw sugar, and sucrose:
* Recommended intake: Healthy eating patterns limit added sugars to less than 10 percent of calories
per day. This recommendation is a target to help Soldiers achieve a healthy eating pattern, which
means meeting nutrient and food group needs through nutrient-dense food and beverage choices
and staying within calorie limits. When added sugars in foods and beverages exceed 10 percent of
calories, a healthy eating pattern may be difficult to achieve.
* Considerations: Replacing added sugars with high-intensity sweeteners may reduce calorie intake
in the short-term, yet questions remain about their effectiveness as a long-term weight
management strategy. High-intensity sweeteners approved by the United States Food and Drug
Administration (FDA) include saccharin, aspartame, and sucralose. Based on the available
scientific evidence, FDA determined these high-intensity sweeteners safe for the general
population. |
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8-15. Soldiers need to limit sodium consumption. Healthy eating patterns limit sodium to less than 2,300
milligrams per day for adults. Sodium is an essential nutrient and is needed by the body in relatively small
quantities, provided that substantial sweating does not occur.
8-16. Soldiers need to limit alcohol consumption. In the strictest sense, alcohol is not a performance nutrient.
If Soldiers consume alcohol, it should be in moderation—up to one drink per day for women and up to two
drinks per day for men—and only by adults of legal drinking age. One alcoholic drink-equivalent consists
of—
* 12 fluid ounces of regular beer (5 percent alcohol).
* 5 fluid ounces of wine (12 percent alcohol).
* 1.5 fluid ounces of 80 proof distilled spirits (40 percent alcohol).
The amount of alcohol and calories in beverages varies. Soldiers account for alcohol within the limits of
healthy eating patterns so that they do not exceed calorie limits.
BODY COMPOSITION
8-17. The body is comprised of water, protein, minerals, and fat. A two-compartment model of body
composition divides the body into a fat component and fat-free component. The total amount of body fat
consists of essential fat and storage fat. Fat in the marrow of bones, heart, lungs, liver, spleen, kidneys,
intestines, muscles, and certain tissues throughout the central nervous system is called essential fat. Non-
essential body fat is called storage fat. Normal bodily function requires essential fat. Women have higher
essential fat than men because it includes sex-characteristic fat related to child bearing. Storage fat is located
around internal organs (internal storage fat) and directly beneath the skin (subcutaneous storage fat). It
provides bodily protection and serves as an insulator to conserve body heat. The relationship between
subcutaneous fat and internal fat may not be the same for all individuals and may fluctuate during the life
cycle.
8-18. Lean body mass represents the weight of your muscles, bones, ligaments, tendons, and internal organs.
Lean body mass differs from fat-free mass (known as FFM). Since there is some essential fat in the marrow
of your bones and internal organs, the lean body mass includes a small percentage of essential fat. However,
with the two-component model of body composition, these sources of essential fat are estimated and
subtracted from total body weight to obtain the fat-free mass. Practical methods of assessing body
composition such as skinfold thickness (or caliper) testing, bioelectrical impedance analysis, air displacement
plethysmograph, and hydrostatic weighing are based on the two-compartment (lean body mass and fat-free
mass) model of body composition. The three-compartment model of body composition includes a third
component where the fat-free mass is further divided into lean tissue mass and bone mineral content. The
dual-energy X-ray absorptiometry (known as DEXA) scan is an example of a three-compartment model of
body composition assessment. Soldiers should consult with a registered dietitian or the Army Wellness
Center for assistance with body composition assessments and interpretation of results.
8-19. Optimal lean body mass to fat-free mass ratios for Soldiers differ depending upon their primary and
secondary mission roles. Dietitians consider chronic disease risk, individual illness and injury patterns, body
composition history, ethnicity, and specific mission requirements when determining their most effective task-
specific body composition. Soldiers should be reminded that physical performance cannot be accurately
predicted solely based on body weight and composition. A single and rigid optimal body composition should
not be recommended for any physical training event or unit of Soldiers.
8-20. Following a healthy eating pattern (consuming the number of servings of carbohydrate, protein and
healthy fats from the food groups to meet individual calorie needs) supports a healthy body composition. The
frequency, intensity, and type of physical activity also impact body composition. To perform optimally at
any physical task requires proper nutrition combined with physical training. All Soldiers are encouraged to
achieve and maintain body composition. See AR 600-9 for standards for body fat. |
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BODY MASS INDEX
8-21. Body mass index (BMI) is a population screening measure commonly used to rapidly assess health
and classify individuals as underweight, normal, overweight, or obese.
BMI = weight (in kilograms) / height (in meters) squared = kg/m2
8-22. Reference standards developed for the United States population by race and gender, so that individuals
at risk for obesity can be easily identified. However, the reference value for the U.S. population does not
always apply to special populations, such as Soldiers, who may have a higher BMI but acceptable body
composition. BMI is a screening tool that just assesses height to weight ratio but does not indicate body
composition. Leaders may refer their Soldiers to a registered dietitian or the Army Wellness Center for more
accurate body composition analysis to track progress. AR 600-9 indicates the weight for height ratio
screening tool for Soldiers. Leaders can use monthly weigh-ins and taping to keep track of changes in a
Soldier's body composition. However, all Soldiers must adhere to the body fat guidelines outlined in
AR 600-9.
WEIGHT LOSS
8-23. For some Soldiers, injury, stress, lack of time, frequent travel, or other reasons might contribute to a
higher-than-optimal weight. They need to determine what might contribute to a body composition higher in
body fat. It is important to evaluate the amount of food and calorie-containing beverages consumed each day
and to reduce the total number of calories per day to reduce body fat. It takes dedication to make adjustments
to eating habits, portion sizes, food choices, physical activity, sleep hygiene, and stress management.
Nutrition goals should be realistic as weight loss does not happen overnight. Soldiers can generally sustain a
weight loss of 0.5-1 pound per week. To prevent lean muscle loss and nutrient deficiencies, women should
consume no less than 1200 calories per day; men should consume no less than 1500 calories per day.
8-24. Soldiers use the following tips to achieve a healthy weight:
* Track food intake using a daily food log.
* Focus on an eating plan that consists of nutrient rich, lean sources of protein—including fish,
poultry, beans, nuts, and dairy products—and incorporate whole grains, fruits, and vegetables.
* Choose low calorie beverages such as water, low-fat milk (or soy milk), and unsweetened
beverages with and between meals to stay hydrated.
* Be mindful of hunger and fullness cues, keeping in mind it takes 20 minutes to feel full, so eating
slowly and mindfully is helpful to prevent eating more calories than intended.
* Keep a food log to stay aware of the number of calories consumed and to know whether the calorie
goal is met or not. This supports understanding whether further changes in eating habits are
required to support weight loss.
* Stay hydrated and do not starve yourself. There is a balance in caloric consumption and
expenditure to achieve the right amount of weight loss while not affecting physical performance.
Goals change depending on work schedules. For example, trainees who struggle to have enough energy to
perform the physical components in BCT should not focus on losing weight; their current goal should focus
on fuel to perform. Once they have passed the physical standards, then they can shift their focus to weight
loss.
WEIGHT GAIN
8-25. Combat missions and training require muscular strength and endurance. To optimize performance and
prevent musculoskeletal injuries while attempting to gain weight, Soldiers need to combine an appropriate
strength training program with a well-planned nutritional strategy. The most effective method to increase
muscle mass is to encourage a positive energy balance, for example, by consuming more calories than
required to maintain current body weight. Theoretically consuming an additional 250–500 calories per day
above typical requirements would result in a gain of one half to one pound per week.
8-26. Many Soldiers may believe more protein is the best way to gain weight, when in fact, eating more
protein than the established recommendation does not provide any additional benefit. To encourage lean body |
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mass growth, daily protein consumption should increase to 1.2–2.0 grams/kilograms (~0.55–0.9
ounces/pound) body weight.
8-27. Soldiers use the following tips to help add more calories to their eating plan:
* Eat frequently. Plan to eat or drink a food or beverage that provides nutrition to the body every
few hours, especially after a workout.
* Consume protein-rich foods. The best sources of protein come from whole foods such as lean
meats, poultry, fish, beans, nuts, eggs, and low-fat dairy.
* Try smoothies, shakes, or soups. Liquids can be an easy way to load up on calories in a small
volume. However, these food items should be nutrient dense, meaning they have a high amount
of beneficial nutrients (for example, vitamins, minerals, fiber, and lean protein) in relation to their
weight and low in added sugars. Add Greek yogurt, milk, soymilk, powdered milk, flaxseeds, or
chia seeds to smoothies, shakes, and soups.
* Add healthful fats. Use avocado or nut butter in sandwiches or smoothies, and add a little extra
olive oil, canola oil, or oil-based spreads during meal preparation.
OPERATIONAL NUTRITION
8-28. With a focus on foundational health through a deliberate everyday diet, Soldiers are better positioned
to optimize task-specific performance nutrition through event fueling and post-event recovery, and arduous
environment preparedness.
EVENT FUELING AND POST-EVENT RECOVERY
8-29. Soldiers consider some factors when choosing pre-event, during, and post-event fueling and recovery
nutritional strategies. Although not all-inclusive, these factors include—
* Usual macronutrient intake (such as carbohydrate, protein, and fat).
* Time lapse between macronutrient intake and start of physical activity.
* Duration and intensity of physical activity.
* Environmental conditions.
* Individual gut tolerance.
* Personal taste preference.
* Duration of fueling.
* Body composition goals impact performance.
8-30. Energy or calorie needs increase with increases in exercise frequency, intensity, time, and type.
Soldiers should adjust needs based on the type of exercise completed. These four variables are often referred
to as the F.I.T.T. principle. Energy needs will fluctuate as changes in frequency, intensity, time, and type
occur, therefore Soldiers should consult with a registered dietitian to determine their energy needs and how
to adjust for alterations in physical activity, physical demands of duty, or both.
NUTRIENT TIMING
8-31. Nutrient timing involves proper fueling strategies before, during, and after physical training sessions
and other strenuous activity. If done correctly, solid strategies can help to prevent energy deficits and aid in
adequate recovery. When Soldiers consume nutrients is just as important as what nutrients they consume.
Each and every body functions differently in response to fueling for training, so it is recommended that each
Soldier practice with nutrient timing while training. Dietitians do not recommend applying recommendations
for nutrient timing right before an ACFT or a performance event. Remember to train like you fight. The
Warfighter Nutrition Guide contains strategies and recommendations for all aspects of performance nutrition
for Soldiers. |
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Before Exercise
8-32. Before strenuous activities, consuming carbohydrate-rich foods and fluids in the 2-4 hours before
exercise helps to restore liver glycogen, increase muscle glycogen stores, and prevent hunger. Soldiers who
lose appetite or feel nauseated shortly before training or ACFT should allow at least 3-4 hours between a
meal and performance. Eating before gastric distress occurs allows the athlete to get the calories needed and
can prevent vomiting related to nervousness. The same guidance applies to Soldiers who get diarrhea shortly
before or during training. Anxiety increases gastric contractions that move food through the gastrointestinal
tract. Eating can stimulate the bowls even more, so dietitians recommend eating well ahead of a physical
event.
8-33. Research suggests a pre-exercise meal containing 1 to 4 grams of carbohydrate per kilogram of body
weight, consumed 1 to 4 hours prior to exercise provides improved performance. Table 8-1 provides
examples of pre-exercise meals. If unable to consume a meal prior to early morning exercise, consuming
approximately 30 grams of easily digested carbohydrate-rich food or fluid (for example, banana, applesauce,
or toast with peanut butter) one hour prior to exercise is beneficial.
Table 8-1. Examples of pre-exercise meals
Time Between Eating and
Suggested Pre-Exercise Meals
Performance
1 hour or less before exercise Choice of:
Fresh fruit such as apples, watermelon, peaches, grapes, oranges, or a
sports energy bar and/or
½–1 ½ cups (4–12 ounces) of carbohydrate electrolyte beverage
2–3 hours before exercise Choice of:
Fresh fruit, 100-percent fruit or vegetable juices and/or
Breads, bagels, English muffins with limited amounts of butter or
margarine or cream cheese, yogurt, oatmeal, pancakes with limited
amounts of butter and syrup, or a sports energy bar and/or
2–4 cups (16–32 ounces) of carbohydrate electrolyte beverage
3–4 hours before exercise Choice of:
Fresh fruit, 100-percent fruit or vegetable juices and/or
Breads, bagels, baked potatoes, cereal with milk, yogurt, sandwiches
with a small amount of peanut butter, lean meat, or cheese, spaghetti
with a tomato sauce and/or
4–7 ½ cups (32–60 ounces) of carbohydrate electrolyte beverage
During Exercise
8-34. Consuming carbohydrates during exercise lasting greater than 60 minutes can delay the onset of fatigue
and improve endurance capacity by maintaining blood glucose levels. Table 8-2 outlines the recommended
carbohydrate intake during exercise.
Table 8-2. Recommended carbohydrate intake during exercise
Type of Activity Recommended Carbohydrate Intake
Exercise lasting less than 45 minutes None necessary or practical
High-intensity exercise lasting 45 to 75 minutes Small amounts of sports drink or
carbohydrate-rich snacks or foods
Endurance and intermittent, high intensity exercise lasting 1 30–60 grams per hour
to 2.5 hours
Endurance and ultra-endurance exercise lasting 2.5 to 3 80–90 grams per hour
hours or longer |
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After Exercise
8-35. Using an effective refueling strategy after exercise can help to optimize recovery and promote the
desired adaptations to training. Replenishment of glycogen occurs faster after exercise due to the increased
blood flow to the muscles, the increased ability of the muscle cell to take in glucose, and the muscle cells
sensitivity to the effects of insulin during this period. As such, exercise promotes glycogen synthesis
(restoring glycogen in the liver and muscle).
8-36. It is critical to provide the body with 50–100 grams of carbohydrate (2 grams of carbohydrates per
kilogram of body weight) and 15–25 grams of high-quality protein (5–9 grams protein per 100 grams of
carbohydrates) within 30–60 minutes after exercise. This protein helps replenish muscle glycogen stores,
stimulate muscle protein synthesis, and repair damage caused by intense exercise. If unable to eat a meal
within 60 minutes of completing exercise, Soldiers might snack on 8 ounces (1 cup) low-fat chocolate milk,
8 ounces (1 cup) 100-percent fruit juice and a handful of nuts (about ¼ cup), 2 slices whole grain bread with
peanut butter and a banana, or 8 ounces (1 cup) low-fat yogurt and a piece of fresh fruit (for example, 1
medium apple, 1 medium orange, 1 banana). When refueling, Soldier should eat a combination of foods and
fluids with carbohydrates and protein to refuel targets.
HYDRATION
8-37. It does not take much water loss for performance to suffer. A mild dehydration (as measured by a
change in body weight) of less than 1 percent can have a slightly negative influence on cognitive function.
This involves slowed working memory, increased tension or anxiety and fatigue, and increased error-related
to visual vigilance. A 2-percent dehydration more severely impacts mental function, mood, and energy level.
Fluid Recommendations
8-38. Fluid requirements can vary from 2–16 liters per day depending on workload, level of heat stress, and
sweat rate. Sweat loss varies depending on age, training, and acclimation status, exercise intensity and
duration, air temperature, humidity, wind velocity, cloud cover, clothing, and individual sweat rates.
8-39. On average, 20–25 percent of fluid intake comes from food and 75–80 percent from beverages. Plain
water, coffee, tea, soups, fruits, and vegetables provide fluids to support hydration. A small amount of
caffeine in tea or coffee (< 200 milligrams) should not negatively affect hydration status, but if Soldiers drink
more caffeine, their fluid balance may be negatively affected.
8-40. Typically, voluntary consumption of fluids—drinking to thirst—restores only some lost fluid.
Whenever possible, dietitians should use weight loss to quantify fluid loss during physical activity. Table 8-3
shows fluid recommendations before, during, and after exercise. TB MED 507 provides a comprehensive
guide for fluid replacement and work/rest guidelines for warm weather training conditions.
Table 8-3. Fluid recommendation before, during, and after exercise
Recommendation
Before Drink at least 8–16 oz. (1–2 cups) of fluid 2 hours prior to exercise. Drink at least 4–8 oz.
(1/2–1 cup) of fluid immediately prior to exercise.
Drink 1–2 mL per pound body weight (for example, 2/3—1 ¼ cups for 150 lb.) 2 hours prior
to exercise.
During Drink at least 4–8 oz. (1/2–1 cup) of fluid every 15–20 minutes during exercise.
Do not exceed 1.5 liter (~6 cups) per hour.
After Drink at least 8–16 oz. (1–2 cups) of fluid after exercise.
For rapid rehydration, drink ~3 cups of fluid per lb. of body weight lost.
L liter lb pound mL milliliter oz ounce
Electrolyte Recommendations
8-41. Electrolytes control the fluid balance of the body and are important in muscle contraction, among many
other essential functions. Electrolytes (such as sodium, potassium, calcium, magnesium, and chloride) come |
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from food and fluids. The loss of sodium and potassium in sweat can be quite high during prolonged physical
activity, especially in warm weather. Replacing these elements is an important part of the recovery process.
Most commercially available fluid replacement beverages contain electrolytes. Roughly, 1–2 grams of
sodium per liter of fluid (0.25 teaspoons per quart—32 ounces) effectively replaces the sodium lost during
exercise or a mission. Also, sodium is widely present in various foods and fluids, such as bagels, tomato
juice, sports drinks, and milk.
Carbohydrate and Electrolyte Beverages (“Sports Drinks”)
8-42. Fluids providing carbohydrate, electrolytes, sodium, and potassium can sustain athletic performance.
The drinks aim to—
* Maintain hydration during exercise.
* Ensure rehydration after exercise.
* Replace electrolytes lost during sweating.
* Supplement carbohydrate stores and provide fuel for the working muscles during exercise.
* Minimize muscle fatigue from strenuous workouts.
* Protect the immune system.
8-43. Although sports drinks containing electrolytes enhance endurance performance, many Soldiers use
these drinks as a recreational fluid. This only adds calories, artificial coloring and flavors to their dietary
intake. Dietitians recommend sports drinks when exercise lasts longer than 60 minutes and then, Soldiers
should only ingest 237 milliliters (eight ounces or one cup) every 15 minutes. For activities less than one
hour, water is the best choice for hydration needs. Short, low intensity workouts do not lose minimal sodium
and potassium through sweat and do not deplete glycogen stores. The ideal sports drink contains—
* 82–163 milligrams sodium per 237 milliliters (8 ounce) serving.
* 18–46 milligrams potassium per 237 milliliters (8 ounce) serving.
* 12–24 grams carbohydrate per 237 milliliters (8 ounce) serving.
8-44. Soldiers should drink sports drinks if a training event is strenuous and takes place greater than 4 hours
before or after a meal (such as before breakfast or at night). These recommendations are especially important
for personnel not acclimatized to the environment and for activity with heavy sweating. Dietitians encourage
Soldiers to consume salty foods at meal time, choose foods high in water content (such as fruits and
vegetables), and not restrict carbohydrate intake. If Soldiers choose to drink juice, they dilute the juice with
water to 50/50 solution which dilutes the sugar content to prevent diarrhea.
Oral Rehydration Solutions
8-45. Oral rehydration solutions (known as ORS) are classified as medical materiel by the FDA and are
available as subsistence supply (Class VIII) items. Dietitians use these solutions to treat and prevent
dehydration due to diarrhea. These solutions contain approximately three to five times the amount of sodium
and potassium found in typical carbohydrate-electrolyte beverages. If used improperly, oral rehydration
solutions may lead to various adverse health effects. Leaders do not use rehydration solutions for IMT
trainees for routine hydration to prevent heat illness or heat injury. However, for training that includes
purposeful food restriction (for example, Ranger or Special Forces), unit surgeons decide to supplement
intake with rehydration solutions. Regular consumption of meals and recommended drinking protocols
adequately provides a Soldier with a good electrolyte-sodium balance for most physical training activities.
Leaders can use sports drinks or rehydration solutions if the training situation dictates the need for such
products in the prevention or treatment of heat illness, and most especially hyponatremia incidents. |
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OVERHYDRATING
Overhydrating can cause excessive dilution of sodium in the
blood, a potentially life-threatening condition called hyponatremia.
In situations where Soldiers are drinking to a schedule or regimen
over prolonged periods of less intense physical activity, it is
important to consider risk factors, signs, and ways to mitigate this
condition.
RISK FACTORS:
Cool and less humid conditions that make fluid loss
considerably less than expected
Overconsumption of beverages that have low sodium content
Inadequate food consumption along with over hydration
SIGNS:
Swollen fingers
Disorientation
Abdominal bloating
Reduced urine output
MITIGATION STRATEGIES:
Adequate food consumption
Carbohydrate–electrolyte beverage consumption after more
than 60 minutes of activity
DIETARY SUPPLEMENTS (CAFFEINE, SPORTS DRINKS, ENERGY DRINKS, ELECTROLYTE
DRINKS)
8-46. The most common reasons military personnel give for using dietary supplements include improving
performance, increasing muscle mass, enhancing energy level, accelerating recovery, increasing alertness,
boosting the immune system, and improving joint function. The best sources of information on dietary
supplements are dietitians, certified specialists in sports dietetics, health care providers, or pharmacists.
8-47. Soldiers who purchase supplements should be aware that these products target our human desire for
health and performance shortcuts. Some may be damaging and dangerous: if a product or claim sounds too
good to be true, it probably is. Soldiers need to consider the consequences of taking various supplements,
either alone or in combination. They also need to check that the source of the information obtained for making
that decision is trustworthy.
Dietary Supplements and the Law
8-48. Well over 50 percent of the U.S. population takes some type of dietary supplement. To understand why
dietary supplements use is a concern, one must appreciate the history. In 1994 the Dietary Supplement Health
and Education Act (DSHEA) was passed by Congress to—
* Limit barriers to marketing and promoting dietary supplements.
* Provide for wide availability of supplements to consumers.
* Enhance information available to consumers.
8-49. The passing of DSHEA gave the FDA regulatory control over dietary supplements, and the law
required that the label of a dietary supplements provide the name and quantity of each ingredient. It is the
role of the manufacturer to provide this information; however, this is often not the case. (See discussion
beginning in paragraph 8-53 for guidance on informed selection of supplements.) |
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8-50. The FDA also regulates whether new ingredients can enter the marketplace or existing ones should be
removed for safety reasons. However, federal rules do not require dietary supplement makers to test
supplement ingredients. The FDA also regulates what claims may (or may not) be made, but it does not
monitor claims. The regulations within DSHEA contain many gaps. Some of the concerns include—
* The responsibility of ensuring products are properly labeled lies with the manufacturer.
* Supplement ingredients sold in the United States before October 15, 1994 are presumed safe and
are therefore not subject to review by the FDA for safety.
* The responsibility of providing evidence of safety lies with the manufacturer.
* If a product is already on the market, the FDA must provide evidence that it is not safe.
* Government resources to check dietary supplement quality are limited.
8-51. In June 2007, FDA imposed new regulations that had been mandated by DSHEA. The FDA established
regulations that dietary supplements must be produced in a quality manner, do not contain contaminants or
impurities, and are accurately labeled. Supplement manufacturers are now required to test all the ingredients
in their products to make sure they are not contaminated but that does not mean the ingredients are safe.
Combining and Stacking Supplements
8-52. Once dietitians know what a supplement contains, they consider what might happen when multiple
supplements are combined, or “stacked.” The concept of “stacking” is a concern. The number of potential
stacking combinations is staggering and the effects of combinations of ingredients are, for the most part,
unknown. One stacking approach that has proven deadly is the “EAC” stack, with ephedra, aspirin, and
caffeine. Now that the FDA has banned ephedra, Soldiers use ephedra-free products (promoted as safe)
despite the fact that they are as unsafe as ephedra-based supplements. Ephedra-free supplements are
dangerous because—
* The supplements contain high levels of stimulants often in combination with caffeine.
* FDA does not require the makers of the supplements to list the quantity or amount of the stimulants
in their products.
Consumer Safety Tips
8-53. Operation Supplement Safety (known as OPSS) is a joint initiative between the Human Performance
Resources Center (known as HPRC) and the DOD to educate Service members, retirees, their family
members, leaders, healthcare providers, and DOD civilians about dietary supplements and how to choose
supplements wisely. The Operation Supplement Safety website at https://www.opss.org/ provides easy access
to materials and databases for Soldiers to stay informed and make healthy dietary supplement choices. The
Army Public Health Center site at https://phc.amedd.army.mil/topics/healthyliving/n/Pages/default.aspx also
has information on nutrition and dietary supplements.
8-54. FDA requires manufacturers to list all product ingredients on the “Supplement Facts” panel of a dietary
supplement label as well as the amount of each by weight, except when the ingredients are part of a
“proprietary blend.” A proprietary blend is a collection of ingredients often unique to a particular product
and sometimes given a special name on a product’s Supplement Facts panel. A proprietary blend might be
listed as a “blend,” “complex,” “matrix,” or “proprietary formulation.” Many proprietary blends contains
stimulant (or stimulant-like) ingredients. Stimulants found in supplements can include caffeine, yohimbe,
and phenethylamines, as well as illegal ingredients such as DMAA (1,3-dimethylamylamine), DMBA (1,3-
dimethylbutylamine), BMPEA (beta-methyl-phenethylamine), and methylsynephrine. Laboratory testing is
the only way to know contents in any particular dietary supplement product, which is why Soldiers need to
look for third-party certification.
8-55. Soldiers identify third-party certification by seals that appear on some supplement products. These
seals confirm independent testing and evaluation of dietary supplements and their ingredients and ensure that
manufacturing and storage facilities comply with good manufacturing practices requirements. The companies
that conduct such reviews vary widely in how they certify and how they test products. Certification seals
confirm that a product contains the ingredients listed on the label, but they do not ensure a product’s
effectiveness or safety. |
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8-56. The Natural Medicines database, a resource accessed through the Operation Supplement Safety
website, is free for Soldiers. It provides in-depth information about dietary supplement products and
ingredients based on the best available scientific evidence.
ENVIRONMENT
8-57. Nutritional requirements largely depend on environmental conditions. Hot or dry environments require
different levels and types of nutrition than cool or moist environments. High altitudes demand different
nutritional requirements than low altitudes, and so on. This section describes how nutritional requirements
vary between environments as well as the conditions in those environments that drive specific nutritional
needs.
NUTRITION FOR MISSIONS IN THE HEAT
8-58. Repetitive movement along difficult terrain with heavy gear, such as during land warfare operations,
is challenging under any environmental condition, but is particularly grueling with extreme heat and
humidity. Land warfare scenarios where Soldiers carry heavy loads or injured comrades increase overall
effort and energy expenditure, as well as fluid and electrolyte needs. The major concerns during operations
in a warm or hot environment are fluid and electrolyte balance.
8-59. Working or exercising in the heat intensifies water and electrolyte loss through sweating. The amount
of sweat and fluid lost depends on—
* Environmental temperature and humidity.
* Work rate.
* Fitness level and acclimatization.
* Volume and rate of fluid replacement.
8-60. When the same task carried out in thermo-neutral environment (such as a range of temperatures of the
immediate environment in which a standard healthy adult can maintain normal body temperature) is
performed in a hot environment, energy requirements increase slightly due to the increased work to maintain
thermal balance. When living or working in temperatures ranging from 86–104° F (30–40°C), energy intakes
typically increase by 2.5–10 percent unless activity level decreased accordingly. However, heat-acclimated
individuals likely will not have an increase in energy requirements.
8-61. High work rates in hot, humid surroundings can significantly increase fluid and electrolyte losses.
Losses of one to two quarts per hour or even more are likely when special clothing, such as chemical
protective gear, body armor, or both are worn. The highest sweat rates reported exceed over five quarts (160
ounces) per hour.
8-62. Soldiers need fluids and need to drink early and drink often. Starting any operation without being
adequately hydrated may increase the risk of performance mishaps. Some believe that relying on thirst is
adequate for sustaining hydration, whereas others believe that thirst itself is an indicator of dehydration. For
certain, failure to replace lost fluids from sweating results in dehydration and possibly heat injury.
8-63. Leaders avoid forcing Soldiers to drink throughout training in a warm environment to ensure adequate
fluid replacement. Too much water can result in hyponatremia. Effective leaders have a pre-determined
drinking schedule to ensure Soldiers consume enough fluids. Soldiers ideally drink ¼–½ quart or liter (8–16
ounces or 1–2 cups) of fluid every 30 minutes, and no more than 1 quart or liter (32 ounces or 4 cups) per
hour.
8-64. Obtaining body weights before and after activity can help determine fluid replacement needs. One
kilogram weight loss requires 1,000 milliliters of fluid to restore fluid balance (or 16 ounces per pound weight
loss). A fluid loss of 2-percent body weight can impair physical performance and mood, decrease appetite,
and increase the risk of heat injuries. A 5-percent loss of body weight can decrease work performance by 30
percent.
8-65. Soldiers monitor their hydration in the field. In the field when it is difficult, if not impossible, to obtain
a body weight, Soldiers use their urine color and smell to gauge hydration status. Dark yellow or smelly urine
suggests some degree of dehydration. Soldiers then increase fluid consumption until urine becomes pale |
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yellow. If taking B vitamins, Soldiers may have bright yellow urine, not pale, regardless of hydration status.
Another method for assessing hydration is frequency and volume of urination with a goal of urinating every
2–3 hours.
8-66. Excessive loss of electrolytes from sweating can lead to muscle cramping or severe medical problems.
Being in excellent physical condition helps minimize electrolyte losses, but Soldiers given free access to
water when exercising in the heat replace only one half to two thirds of their fluid losses. Additionally,
electrolyte balance may be compromised due to the use of hydration packs which provide only water. Soldiers
may need to consume snacks, fluids, or both with electrolytes during and after missions or periods of grueling
and prolonged training. Due to limits to how much sodium and potassium should be provided in sports
beverages, fluid replacement alone may not be adequate for restoring or maintaining electrolyte balance.
8-67. Foods that naturally provide sodium and potassium should be selected. Dried fruits are optimal food
choices for potassium. Even if heat acclimatization has occurred, leaders must understand the importance of
salt: 200–400 milligrams of sodium can be lost per pound of sweat, along with sodium excreted in the urine.
Adding salt to foods (1/2 teaspoon provides 1,200 milligrams) or including sodium-rich foods in the diet
helps retain water and avoid a sodium deficit. Sodium is the most critical electrolyte for maintain fluid
balance.
NUTRITION FOR MISSIONS IN THE COLD
8-68. Exposure to a cold environment seriously challenges the human body. Blood vessels tighten to
conserve heat and shivering is initiated to generate heat and guard against hypothermia. Side effects of these
responses are an increase in urine output and an increase in energy metabolism. Therefore, the most important
nutritional considerations for a cold environments are—
* Energy intake.
* Glycogen stores.
* Fluid status.
* Vitamin and mineral needs.
See also ATP 3-90.97 for guidance on nutritional requirements in cold weather and high-altitude
environments.
Energy Intake
8-69. Energy requirements can increase 25–50 percent during cold weather operations as compared to warm
weather operations. Even mildly cold temperatures (32–57° F) can increase energy requirements 5–10
percent. Factors that increase caloric intake include—
* Added exertion due to wearing heavy gear.
* Shivering, which can increase resting metabolic rate by two to four times the normal level.
* Increased activity associated with traveling over snow and icy terrain.
* Increased activity to keep warm.
8-70. Many studies have shown Soldiers tend to progressively lose weight when conducting two- to three-
week field exercises in the cold. Because significant weight loss can result in fatigue and declined
performance, energy intake should meet the increased energy demands.
8-71. Energy expenditure for Soldiers during periods of physical exertion in the cold may range between
4,200 to 5,000 calories per day. When temperatures justify high levels of cold-weather protection (for
example, Extreme Cold Weather Clothing System and the Vapor Barrier Boot), energy requirements may
increase to approximately 54 calories per kilogram of body weight. Energy needs are higher (approximately
62 calories per kilogram of body weight) when Soldiers maneuver for prolonged periods (2 hours or more)
with heavy gear on their feet (for example, snowshoes and skis) over snow- and ice-covered terrain. These
increased energy requirements do not apply to troops located in cold climates with limited exposure to
outdoor temperatures.
8-72. Although carbohydrate consumption is critical, a diet that provides 35 percent of the energy as fat may
be necessary to match energy needs. Ideally, during cold weather operations, 50–60 percent of energy should |
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come from carbohydrate, 30–35 percent from fat, and 10–20 percent from protein, high carbohydrate snacks
should be eaten between meals. Both fat and carbohydrate are important energy sources in a cold
environment. A high protein diet is not advised as it may increase fluid requirements.
8-73. Missions in cold weather require foods that produce heat. Foods high in carbohydrate produce more
heat through digestion than either fat or protein. Hot beverages, such as cocoa, provide carbohydrate and
other warm beverages, to include coffee, teas, and broth, increase body temperature, enhance mental
awareness and provide comfort.
Glycogen Stores
8-74. Prior to deploying to a cold environment, the pre-mission diet should ensure that glycogen stores are
optimized. Likewise, a high carbohydrate diet is preferred during cold exposure, as carbohydrates are needed
to replenish glycogen being used to maintain core temperature. A minimum of 400 grams of carbohydrate
are necessary in the cold. Thus, Soldiers should eat regular meals and snacks providing carbohydrate to
maintain carbohydrate intake. Including a liquid or solid carbohydrate supplement may be critical for
maintaining energy balance and performance.
Fluid Status
8-75. Becoming dehydrated in cold environments is easy because of the cold-induced increases in urine
output, increased fluid losses through breathing, involuntary reduction in fluid intake, and sweating. Because
dehydration decreases performance and potentially may lead to various medical problems, maintaining fluid
status by drinking plenty of fluids and monitoring hydration is absolutely critical. Table 8-4 provides tips for
maintaining fluid status in cold environments.
Table 8-4. Tips for maintaining fluid status
Force yourself to drink 480–960 mL (16–32 ounces) of warm fluid at hourly intervals (240–480 mL or
8–16 ounces per 30 minutes).
Avoid alcoholic beverages: alcohol tends to increase heat and urine losses.
Drink beverages with CHO to increase energy intake (5-8% CHO and some electrolytes is best).
Do not eat snow without first melting and purifying it.
Moderate caffeine consumption.
CHO carbohydrate mL milliliter
Vitamin and Mineral Needs
8-76. The requirements for some vitamins and minerals increase when working in the cold due to increases
in energy metabolism and urinary losses. The amount of daily vitamin and mineral needs may increase during
cold weather operations. In most cases, Soldiers can meet energy requirements and vitamin and mineral needs
by eating all ration components.
NUTRITION FOR MISSIONS AT HIGH ALTITUDE
8-77. High altitude missions, to include flying, can cause bodily distress. Adequate nutrition is crucial for
maintaining performance. The major nutritional concerns at high altitude are—
* Weight loss.
* Carbohydrate intake.
* Dehydration.
* Oxidative stress.
8-78. Virtually all people who perform at high altitudes experience weight loss and loss of lean body mass.
At altitudes below 5,000 meters, Soldiers can prevent weight loss by vigilantly eating on a regular basis.
Above 5,000 meters, a 5–10 percent weight loss is inevitable. The only way to minimize weight loss is by
being vigilant about maintaining energy intake. Energy intakes should range from 3,500–6,000 calories per
day, which is equivalent to eating at least four Meals, Ready-to-Eat (known as MREs) or two high-calorie |
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individual rations daily. The latter is a compact, eat-on-the-move individual ration intended to be consumed
during initial stages of intense conflict. Leaders should consider using high-calorie individual rations for
short duration (for example, 1–3 days), highly-mobile dismounted missions. Leaders may also consider
augmenting (not replacing) operational rations with modular operational ration enhancement (known as
MORE) Type I for high altitude or cold weather (Type II for hot weather) training events. Leaders should
consider using the modular operational ration enhancement when missions require extra calories due to heavy
activity in extreme environments. Some reasons for weight loss at high altitude include the following:
* Increased energy requirements to 115–150 percent of sea-level requirements.
* Decreased sense of taste, which causes a reduction in food intake.
* Changes in metabolism of fat and carbohydrate.
* Loss of body water from increased breathing rate and dry air.
* Impaired absorption of nutrients.
* Acute mountain sickness, which can cause nausea, vomiting, headache and decreased appetite.
Carbohydrate Intake
8-79. High carbohydrate foods are the preferred energy source at altitude and in flight because they—
* Restore glycogen.
* Require less oxygen to produce energy than fat.
* Are the most efficient energy source.
* Can diminish and delay the progression or severity of acute mountain sickness symptoms.
* Maintain blood glucose.
Diets should provide at least 400 grams of carbohydrate and carbohydrate should contribute 50–70 percent
of total energy. This can be accomplished by eating high carbohydrate snacks between meals and drinking
beverages containing carbohydrate during strenuous activity, long flights, and recovery.
Dehydration
8-80. Exposure to high altitude is associated with significant levels of dehydration because water losses are
increased. If Soldiers do not replace these losses, dehydration will result. Some studies suggest that vigorous
hydration may decrease the incidence and severity of acute mountain sickness. The reasons dehydration
occurs at high altitude include the following:
* Increased respiratory losses due to increased ventilation (such as increased supply of air to the
lungs).
* Increased urine output due to altitude and cold temperatures.
* Possible diarrheal fluid losses.
* Failure to drink water.
* Poor access to water.
8-81. Fluid requirements may be greater than 3700 milliliters (4 quarts or 128 ounces) per day at high
altitude. To avoid acute mountain sickness, Soldiers maintain a drinking schedule and monitor hydration
status daily.
NUTRITION FOR MISSIONS IN WATER AND AT DEPTH
8-82. Like exposure to altitude and cold environments, water operations, especially cold water operations,
are associated with increased energy expenditure and fluid losses. Thus nutritional concerns for diving are
maintaining—
* Energy intake.
* Fluid intake.
* Mineral balance.
* Antioxidant balance. |
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Energy Intake
8-83. When working at the same rate in water as on land, the energy expenditure to accomplish the same
task is greater in water. The reasons for this increased energy expenditure during water operations include—
* Greater resistance offered by water.
* Decreased efficiency of movement when thermal protective clothing are worn.
8-84. Soldiers rapidly use glycogen stores when performing hard work in cold water. They must replace
these stores between operations to prevent performance decrements. Increasing carbohydrate intake before
an anticipated dive has been shown to improve and extend exercise performance during prolonged dives.
Fluid Intake
8-85. Immersion in water increases urinary excretion by 2–10 times above normal. Without adequate
hydration, a diver can quickly become dehydrated and suffer from decline in performance. For example,
immersion during a single dive for 3–6 hours can result in a 2–8 pound loss in body weight by urination; this
is equivalent to losing 1–3 quarts of fluid. Importantly, a diver must drink fluids with carbohydrate whenever
possible to maintain blood glucose. A decline in blood glucose is known to negatively affect performance.
Mineral Balance
8-86. Immersion in water, especially cold water, increases urinary losses of magnesium, calcium, zinc, and
chromium. Soldiers need to consume foods high in these important minerals to restore immersion-included
losses.
THERAPEUTIC NUTRITION
8-87. Fundamental risks associated with mission requirements, and the environments in which Soldiers’
operate, increase the potential for medical treatment over a Soldier’s career. Medical nutrition therapy is the
use of specific nutritional interventions to treat an illness, injury, or nutrition-related condition. Continuous
nutrition support from the time of diagnosis, to management or remission, is essential for rapid return to duty.
INJURIES
8-88. Good nutrition aids in recovery. Management of calories and essential nutrients—based on pre-injury
nutrition status and severity or type of trauma suffered—helps the treatment of common combat- and training-
related injuries. These injuries include burns, minor and traumatic wounds, and traumatic brain injuries.
8-89. Though wound healing often increases calorie and protein needs, dietitians need to balance these
requirements with decreased needs associated with long periods of injury-induced reductions in physical
activity. If body fat and muscle mass changes are not monitored closely by a registered dietitian throughout
the rehabilitation process, the Soldier’s return to full duty may be delayed. Soldiers should seek nutrition
counseling from a registered dietitian for wound healing, delayed rehabilitation outcomes, and unintentional
body composition changes related to recovery.
MEDICAL CONDITIONS
8-90. Beyond acute injuries and illnesses, medical nutrition therapy for the treatment of familial-and
lifestyle-associated conditions also contribute to a Soldier’s readiness and longevity. These conditions can
include hypertension (high blood pressure), insulin resistance (high blood sugar), and dyslipidemia (high
cholesterol and/or triglyceride (fats) in the blood). Soldiers should seek nutrition counseling from a registered
dietitian for the treatment of familial- and lifestyle-associated conditions. |
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Mental Readiness
Soldiers must be capable of overcoming adversaries at a moment’s notice. To do this,
Soldiers must be mentally as well as physically ready. They must possess the physical,
cognitive, emotional, and interpersonal capabilities to fight and win in multi-domain
operations. This chapter provides tools, techniques, and resources for leaders and
individuals to maximize Soldier and team performance through the development,
sustainment, or restoration of mental readiness. This chapter discusses the purpose,
impact and the components of mental readiness as well as strategies for mental
readiness development.
MENTAL READINESS CONCEPTS
9-1. Mental readiness is an individual’s or team’s ability to think, feel, and act in a manner that optimizes
performance in a demanding environment or with occupational and combat-specific tasks. Mental readiness
includes the ability to integrate cognitive, emotional and interpersonal capabilities. Mental readiness, like
physical readiness can be improved and requires intentional training to achieve peak levels of performance.
Optimizing Soldier readiness requires maximizing the mental and physical readiness of the Soldier and his
or her team. Many organizations, from professional sports teams to special operations groups, value mental
readiness. Leaders in these organizations play an active role in creating and sustaining a climate that
encourages individual and team mental readiness in accordance with unit needs.
9-2. Unlike physical, sleep, and nutritional readiness, mental readiness is difficult to standardize and
measure. Conceptual notions of what makes a mentally ready Soldier often differ with empirical findings.
Moreover, reconciling stable personality traits with fluid Army roles and assignments is a daunting task. For
example, what might appear to be the perfect mental readiness profile for success in BCT might not be
appropriate for the operational force or a specific MOS.
9-3. Soldiers’ roles and jobs change, complicating the requirements for sustained character and
psychological training across a Soldier’s lifecycle. Individualized intervention has enormous value in crisis
situations such as the prevention of drug and alcohol abuse, misconduct behavior, safety violations, and
suicide. Therefore, commanders must consider this doctrine as providing best solutions and messaging for
the collective mental health of the unit—procedures and tactics that allow Soldiers to prepare for, thrive in,
and recover from the ordinary and extraordinary stressors that might degrade readiness.
9-4. Mental readiness doctrine provides tools, techniques, and resources for Soldiers and teams engaged in
the development, sustainment, or restoration of mental readiness. Soldiers must possess exceptional mental
flexibility and endurance, morals and ethics, self-initiative, and an ability to operate within the commander’s
intent. Mental readiness is a foundational consideration in the H2F System. It includes the integration of
cognitive, emotional, and interpersonal capabilities. Leaders must incorporate individual and unit mental
readiness training into the unit’s battle rhythm.
9-5. Within the H2F System, teams are staffed and resourced to support leaders and individuals in the
training of mental readiness. Leaders should seek their assistance to enable them to focus time and energy on
primary functions while mental readiness improvement can be trained by experts in an appropriate, effective,
and efficient manner.
9-6. Optimal mental readiness is required for optimal team or unit cohesion. Mentally ready Soldiers can
leverage protective factors against physical and environmental stressors typically encountered in complex
military environments. |
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9-7. Mental readiness is required to achieve capabilities the Army must possess to win in multi-domain
operations. These capabilities include, but are not limited to—
* Train Soldiers and leaders to ensure they are prepared to accomplish the mission across the range
of military operations while operating in complex environments against determined and adaptive
enemy organizations.
* Develop resilient Soldiers, adaptive leaders, and cohesive teams committed to the Army
professional ethic who can accomplish the mission in environments of uncertainty and persistent
danger.
* Develop agile, adaptive, and innovative leaders who thrive in conditions of uncertainty and chaos,
and are capable of visualizing, describing, directing, leading, and assessing operations in complex
environments and against adaptive enemies.
* Understand, visualize, describe, direct, lead, and assess operations consistent with the philosophy
of mission command to seize the initiative over the enemy and accomplish the mission across the
range of military operations.
MENTAL READINESS CAPABILITIES
9-8. Mental readiness includes three interrelated capabilities—cognitive, emotional and interpersonal. Just
as physical readiness requires training and integration of a variety of components (for example, muscular
endurance, muscular strength, balance, flexibility, and agility), optimizing mental readiness requires the
training and integration of a variety of capabilities. See figure 9-1.
Figure 9-1. Mental readiness capabilities
9-9. One approach to developing mental readiness capabilities involves using the Goal, Plan, Do, Check
strategy. Leaders can use the strategy to coordinate mental readiness capability development in a variety of
circumstances.
9-10. Goals are established by the Soldier in collaboration with the mental readiness experts on the H2F
performance team. Goals are specific to a task. Goals must be clearly articulated using the SMART
principles—S for specific, M for measurable, A for attainable, R for relevant, and T for the time period in
which the goal must be attained.
9-11. Leaders develop plans to accomplish the goal. The plan consists of the way a Soldier will be coached—
the tactics, techniques, and procedures used to promote or optimize the development of the mental capability.
These are individualized for the Soldier.
9-12. Doing the plan is the action or actions taken by the Soldier and the team to achieve the goal. The doing
part of the strategy involves teaching, training, practice, and implementation. |
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9-13. Finally, the leader checks the strategy for effectiveness. The check makes sure that the goal has been
met and if it has not, is retrained.
COGNITIVE CAPABILITY
9-14. Cognitive capability is the ability to expand and integrate knowledge into decisions with an
understanding of how values and beliefs influence a Soldier’s thoughts and ultimately his or her performance.
It is the acquisition and demonstration of knowledge and understanding through processes such as memory,
attention, problem-solving, decision-making, judgment, reasoning, and learning.
9-15. Soldiers and leaders require the ability to process large amounts of information and make sound
decisions—a process that can be complicated by the rapid evolution and intensity of combat. Self- and team
awareness of personal, spiritual, and cultural beliefs and values can assist with self and team accountability.
This awareness combined with an understanding of the commander’s intent can lead to improved problem
solving and more effective decision making. When leaders discuss ethics and values in the context of the
mission, they are positively influencing cognitive capability.
COGNITIVE LOAD
9-16. Cognitive load is the amount of information a Soldier can memorize in the short-term in order to learn
something new. During the learning process, Soldiers indicate mastery of new information by how much of
that information they can recall and apply. Cognitive skills training uses various methods to optimize
cognitive load. These methods include limiting divided attention, breaking down new information into parts,
and using visual and auditory strategies.
9-17. When learning new tasks, the capacity of the Soldier may aid or degrade mastery of processing new
information and creating long-term memories. Soldiers must optimize short-term memories to create long-
term memories, which is referred to as optimizing cognitive load. Cognitive load overwhelms the Soldier
when the incoming information is greater than the available cognitive resources. Soldiers forget the new
information resulting in poor performance.
9-18. There are three types of cognitive load: intrinsic, extraneous, and germane. Intrinsic cognitive load
refers to the amount of information Soldiers need to hold in their working memory to comprehend a situation.
Working memory is the short-term memory storage for selection and interpretation of new information. The
ability to master new tasks depends on how quickly Soldiers can acquire, store, and retrieve information
especially for a key task. If the task is complex, Soldiers with more capacity to optimize intrinsic load can
process and complete the task more effectively. Soldiers with less capacity may have to break the task into
smaller steps to complete it. Soldiers can improve intrinsic load by reducing or simplifying tasks, using
learning cues, or applying memory cues such as an acronym.
9-19. Extraneous cognitive load refers to how information is presented and the cognitive demands placed on
the Soldier during task performance. For example, if instructions for a technical task are poorly presented,
presented in a noisy distracting setting, or presented out of sequence, then the Soldier may be less able to
properly execute the task. Improving the delivery of the task instructions or training content may decrease
extrinsic cognitive load and result in more rapid mastery of the task. Some Soldiers may prefer getting
extensive, detailed instructions for a task whereas others may do better when provided with only an end goal
and key cues on how to execute. For example, when learning a front squat, Sergeant (SGT) Jones receives
multiple specific instructions on proper form: keep shoulder blades back and engaged, keep spine straight,
keep torso upright, place feet shoulder width apart. However, SGT Jones finds the information overwhelming
and cannot perform the lift comfortably. The next day, SGT Jones receives one simple instruction to lower
to the floor as if going to sit. While lowering, SGT Jones is cued to keep chest up. SGT Jones performs the
task with increased comfort. In this example, SGT Jones extraneous cognitive load was decreased and
performance improved.
9-20. Germane cognitive load refers to the Soldier’s comprehension, application, and coordination of
information. This is the goal of learning. It is the ability of the Soldier to conceptualize and use information
to improve different skills. Long-term learning requires sustained deliberate mental effort. This conscious
cognitive processing improves the transfer of knowledge across different situations. Optimizing Soldier |
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cognitive performance occurs when Soldiers practice cognitive skills in ways that minimize extraneous load,
manage intrinsic load, and maximize germane load.
ATTENTION
9-21. Attention is the ability to sort through irrelevant information and thoughts (for example, “I’m hungry”)
or surroundings (for example, weapons firing in the distance) to concentrate and focus on a specific task.
Irrelevant or distracting thoughts divide attention and lead to decreased information retention, poor
performance, and safety violations. Attention also has a time component that can impact performance. For
example, a Soldier’s attention may focus on a mistake made several months ago rather than focusing on the
present task. Additionally, a Soldier’s attention may focus on a future mission, causing increased worry and
decreased performance of the present task.
9-22. Attention is important in both garrison and operational settings. It requires deliberate, daily practice
for mastery. Practice can take many forms ranging from personal reflection in quiet moments to following
directions precisely during physical training. Personal reflection allows Soldiers to understand why or how
they react to certain triggers or feelings and to craft a response that allows improved performance. Spending
several minutes each day reflecting on triggers, beliefs, and reactions can improve the ability to sort through
sensory input. For example, if Sergeant James knows he fires his weapon more accurately when in a relaxed
mental state, he can take actions to prepare his mind prior to firing. With practice, SGT James’ awareness
and ability to relax his mind becomes a reflexive skill that transfers into operational settings, improving
lethality.
9-23. Leaders can use intense physical training to recreate the same physiological arousal that happens in
high-risk situations. Application of mental performance training during intense physical training improves
Soldiers’ abilities to pay attention and make better decisions when under physical duress. This is applied in
familiar training events such as a stress shoot.
9-24. Adding mental skills training does not have to be physically or resource intensive. For instance,
combine the task of entering and clearing a building with attentional control skills using a deck of playing
cards. Without letting Soldiers see it, set up an area (blank wall or board) with 2–3 playing cards. Instruct the
Soldiers to identify a specific set of information on each turn. At a signal, the Soldiers enter the area, observe
the cards for 5 seconds, and return to the starting position. Soldiers must recall the set of information for each
card. Gradually increase the difficulty by adding information to recall (number or face, suit, or other details),
increasing number of cards staged, and/or decreasing observation time. The outcome of this exercise
increases mental skills in attentional control, visual scanning, self-awareness, arousal control, and situational
awareness. Training these tactical mental skills can make large differences in success or failure during high-
risk situations.
9-25. When thoughts interfere with performance, a routine can help Soldiers improve their attention. For
example, Second Lieutenant Doe is worrying about her finances and is underperforming during physical
training. Her mental readiness routine involves loosening and retying her sneakers. When she starts that
process, she mentally cues herself, “Once I lace up my sneakers, my only focus for the next hour needs to be
physical readiness training.” This enables her to temporarily suppress the other thoughts affecting her
performance.
9-26. Additional training to assist with attention includes concentration grids (see table 9-1) and other tools.
Using the grid below as an example, find the numbers in ascending order and note time to complete. As
performance improves, add rows or columns to the grid or external distractors to increase the level of
difficulty.
EMOTIONAL CAPABILITY
9-27. Emotional capability is influenced by abilities such as arousal control, heart rate control, stress control,
performance imagery, motivation, and self-talk. Leaders can train these abilities to optimize normal
physiologic and emotional responses. These abilities help Soldiers combat intensely stressful, physical, and
complex situations. Regularly implementing strategies that improve emotional capability helps Soldiers to
achieve optimal mental readiness. |
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Table 9-1. Concentration grid
27 16 24 33 13
11 3 25 7 34
28 8 20 31 17
4 19 14 21 29
32 26 5 27 10
15 30 9 12 23
ACTIVATION
9-28. Arousal refers to the amount of energy devoted to an individual’s level of physical and mental
activation. Activation levels vary along a spectrum from low (being asleep) to high (awake, active and
intensely excited). Activation levels shift across this spectrum throughout the day in response to actual and
perceived demands and level of training. For example, a Soldier participating in a six-mile foot march during
morning physical training will likely have a significantly lower activation level than a Soldier performing
airborne operations for the first time. Activation levels also vary depending on the Soldier and the context.
Some individuals appear to remain “cool and collected” even during activities that would “psych out” other
individuals. Some Soldiers may not worry about rappelling from a tower while others may feel extreme
stress. Activation levels required to optimize task performance can vary between Soldiers. Figure 9-2
illustrates this between two Soldiers, A and B performing the same high-stress occupational tasks.
Figure 9-2. Activation levels in different Soldiers performing the same task
9-29. Understanding the physiological activation and mental operations that coincide with those states are
crucial to overall mental readiness. By bringing awareness to the connection and communication between
the body and brain, Soldiers can better control their state of activation. Involuntary or automatic physiological
responses in the body—such as heart rate, blood pressure, and hormone levels—measure activation level.
Subjective measures of activation include self-talk, confidence, and motivation. Both combat and operational
stressors can lead to activation of these physical and mental responses, inducing the sympathetic nervous
system’s fight or flight response (see paragraph 4-41 for more on fight or flight response). |
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9-30. Any threat, whether it be real or perceived, can result in this sympathetic response. Even non-combat
stressors such as a physical readiness test, a short-suspense deadline, family stressors, or a difficult commute
can activate these physiological responses. They are inherently protective, increasing activation, reflexes,
and chances of survival in life or death situations.
9-31. One of the hormones released as a result of this protective response is cortisol, often referred to as the
“stress hormone.” Excessive production of cortisol contributes to chronic disease, poor executive cognitive
function, and increased susceptibility to injury and infection. When Soldiers are trained to control their
activation levels, they can mitigate the negative impact of this physiological reaction. It helps Soldiers if they
can understand how they react to stress at its initial onset. Table 9-2 outlines common physiological acute
and chronic stress responses.
Table 9-2. Physiological changes associated with the stress response
Acute, early phase of the stress response (duration in minutes to hours) symptoms:
Increased heart rate
Increased blood pressure
Increased respiration
Mobilization of energy from liver and body fat
Sharpening of attention and cognition
Increased fear conditioning (learning)
Blunting of pain
Altered intestinal motility
Release of cortisol and adrenaline
Chronic, later phases of the stress response (duration in days to weeks) symptoms:
Suppression of immune system
Suppression of appetite and digestion
Suppression of growth factors
Suppression of reproductive factors
Persistence of increased heart rate and blood pressure for certain cases
Persistence of increased cortisol levels for certain cases
Release of stress hormones
Excessive muscle atrophy (muscle wasting) and redistribution of fat
HEART RATE CONTROL
9-32. An effective way to inhibit or enhance the fight or flight response and aide in activation control is by
monitoring heart rate. Intentional breathing can influence heart rate. By inhaling for a five- to seven-second
count and exhaling for a five- to seven-second count, Soldiers can slow heart rate, and increase time for
increased oxygen exchange to take place in the lungs. Soldiers repeat this slow inhalation and exhalation for
a few repetitions several times per day. Practicing this type of intentional, controlled breathing throughout
the day improves activation control.
9-33. Soldiers can practice activation control immediately before or after performance of the target task.
Adding an activation control skill such as intentional breathing in mid-performance can improve performance
of the target task by helping to optimize a Soldier’s physiological state when optimal performance is critical.
The difficulty is incorporating these techniques into deliberate, routine practice so that it becomes a reflex in
the midst of performing a drill or mission. One technique is simply paying attention to the feeling of air
moving in and out of lungs for several seconds. This awareness acts as a checkpoint for the performance,
helping to control breathing and monitoring levels of mental and physical activation. Breathing control is a
familiar component of several Soldier tasks and can be leveraged for activation control. For example, it is a
fundamental component of marksmanship. |
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9-34. The example of the relationship between heart rate and task performance in table 9-3 applies only to
extreme stress (for example, stress associated with combat operations) or fear-induced increase in heart rate.
Increases induced by exercise will not be the same as when fear or extreme stress cause an increase.
Combining fear or extreme stress with physical exertion can result in heart rates that table 9-3 will not capture.
Soldier heart rate responses vary. However, every Soldier can train to modulate heart rate response for
different scenarios. Training that incorporates heart rate control with physical readiness training is important
so that Soldiers can perform occupational tasks with less stress-induced distraction.
Table 9-3. The effects on task performance of increasing levels of stress as measured by heart
rate (bpm)
Low Stress Moderate Stress High Stress
Task
115–145 bpm 145–174 bpm 175+ bpm
Motor skill Enhanced Deteriorated Shut down
complexity
Visual reaction Enhanced Decline Diminished
time
Cognitive Improved Declined Irrational response with
response time shut down of high function
Decision Quicker Deteriorated Reduced ability to
making speed communicate
bpm beats per minute
STRESS CONTROL
9-35. Stress control is essential for mental readiness. As described in paragraph 9-34, stress is the body and
brain’s response to a threat. The interpretation of that threat is based on the perspective of the individual
Soldier. Thus, the same stressor may cause a positive stress reaction in one Soldier and a negative stress
reaction in another. Soldiers need to develop and cultivate individualized, group, and organizational resources
for adapting to the unique demands of military tasks.
9-36. Practicing stress control strategies optimizes stress adaptability in what is known as the Yerkes-Dodson
Law. This law explains a relationship between stress and performance. Without any stress, performance will
be quite poor. As a Soldier experiences low to moderate levels of stress, performance will begin to increase.
However, as a Soldier’s stress increases beyond his or her capacity, he or she becomes overwhelmed and
performance begins to degrade. This point is known as a tipping point and is unique to the individual. Routine
practice of self-regulation and emotional control strategies helps Soldiers adapt to various stressful demands
within potentially prolonged high-consequence situations.
PERFORMANCE IMAGERY
9-37. Performance imagery is a mental readiness skill. It is the mental rehearsal or re-creation of an
occupational task or experience to improve performance of that task. Similar to the way dynamic stretching
primes the Soldier’s nerves and muscles for exercise, performance imagery primes the Soldier’s brain to be
ready for mental challenges. Performance imagery rehearses every step of a task, including reactions to
potential obstacles. This preventive action can increase confidence and improve outcomes in individual or
team performance. It works best when the brain attempts to mentally replicate all the sensory inputs possible:
sight, smell, sound, texture, and proprioception (awareness of where the body is in space). The act of mental
practice promotes neural pathways between the brain and muscles involved in the task.
9-38. To practice performance imagery, Soldiers create an image of the environment and location where the
task is actually taking place. Performance imagery is even more effective when physical movements are
rehearsed at the same time. If Soldiers will perform the task under high stress conditions, then they should
try to imagine themselves under control, confident, or relaxed during the task. For example, to perform
successfully on a combat testing lane for the Expert Field Medical Badge (known as EFMB), the Soldier will
imagine the lane at the test site. He or she will visualize all the details of the lane and each step of every task.
He or she will imagine the smell of the smoke and the noise of simulated mortar rounds. He or she will |
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rehearse the physical movements required to hold a sling and tie it around a shoulder. He or she will imagine
the steps of setting a fracture in a sling and visualize executing each task confidently and in a controlled
manner.
9-39. A script can be developed for different tasks and can help with efficient performance imagery and can
be easily performed in preparation for an event. Two examples are described in the following scripts.
Firing M4 Script
“I will go up to my firing point and assume a prone supported firing position. My
breathing is calm. I position my weapon inside my shoulder and under my collar bone.
I place my body at slight angle behind my weapon, legs shoulder width apart with laces
in the dirt. My breathing is calm. I look at my target. Breathe in—breathe out. Rear sight
aligned on my target. Body relaxed. At the command of the range operator, I load the
magazine, place my weapon from safe to semi, and take a deep breath. I align my
target and breathe in, exhale, hold, and deliberately, smoothly squeeze the trigger.”
3 Repetition Maximum Deadlift Script
Imagine smelling the grass, feeling the wind, hearing your battle buddies around you.
Imagine being at your optimal level of energy—heart is beating fast but under control.
Your body is warmed up and feels ready. Imagine the texture of the bar grip as you
assume the starting position for the lift. Think about setting your shoulders and feet in
preparation for the lift. Think about you and the weight becoming one and raising
smoothly and together from the ground as you exhale. Imagine your body straightening
at the top of the lift as your hips move under you. Imagine the controlled movement
down to replace the weight quietly on the ground.
POSITIVE EMOTIONS
9-40. Positive emotions include feeling enthusiastic, active, and alert. They include optimism, a sense of
humor (ability to find humor under stress or when challenged), hope, and flexibility about change. Positive
emotions can impact overall health and wellness, rate, and completeness of recovery from injury and the
sustainment of abilities during a setback. Feelings that are typically pleasant and energizing for a person are
considered positive affect—the term used to describe how a person feels and how those feelings are
expressed. In a general sense, Soldiers tend to experience more positive affect than negative affect. They feel
enthusiastic, active, and alert. They have high levels of vitality and approach their daily tasks with vigor.
Soldiers are proficient at generating positive emotions. The most frequently occurring positive emotions are
love, joy, gratitude, serenity, interest, hope, pride, amusement, inspiration, and awe.
9-41. Goal-setting is an effective tool for maintaining positive emotions. By defining short-term and long-
term goals, small accomplishments are recognized along the way to overall achievement. Goal-setting
provides a road map for success that can increase commitment towards achieving an objective. Progressively
more difficult goals encourage improvements in physical and mental readiness. A clearly defined goal that a
Soldier has built on his or her own improves acceptance and the likelihood of reaching the goal. Examples
of the SMART process—S for specific, M for measurable, A for attainable, R for relevant, and T for the time
period—for goal-setting are described in table 9-4. |
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Table 9-4. Sample SMART Goals
Goal SMART process SMART goal
Run Every week, I will perform one to Short range:
faster two running interval sessions and In 3 months, I will reduce my 2-mile run time by 30
one sustained run at or near my secs.
goal pace.
I will conduct a 5–10-minute
Long range:
warm-up and 10–15-minute cool-
down to include Running Skill In 6 months, I will reduce my 2-mile run time by 1
Drills before and after each run to minute.
prevent injury and maximize
recovery.
I will drink 8 oz. of chocolate milk
after every workout to promote
recovery and to fuel future
performance.
Increase I will lie down in bed no later than Short range:
sleep 2200 each night. In 3 weeks, I will increase my sleep from 5 hours to 6
I will stop using electronic devices hours per night on at least 5 nights per week.
within 30 minutes of going to bed.
I will stretch or meditate for 10- Long range:
minutes prior to sleeping.
In 6 weeks, I will increase my sleep from 6 hours to 7
hours per night at least 6 nights per week.
oz ounces sec second
9-42. Focusing on success even during stressful situations is an important aspect of mental readiness. It
reflects a Soldier’s perceived confidence or ability to perform, which strongly correlates with successful
outcomes. Maintaining a positive mindset, or using positive self-talk, can make the difference in
performance. Negative thoughts such as “I have never been a runner,” or “I have never been athletic” result
in a defeatist attitude and submaximal exertion.
9-43. Productive instructional self-talk helps to maintain focus on performing a task correctly, especially
when learning a new skill. A brief short phrase can be used with each activity to encourage optimal
performance. For example, “my arms are strong” or “I am prepared.” Soldiers with positive attitudes are
more able to cope with adversity and be successful with challenging tasks. Motivational self-talk can improve
attitude and focus on the task.
9-44. Cognitive reframing is a type of self-talk strategy. If Soldiers are more open to recognizing the positive
in an otherwise suboptimal situation, they are more likely to respond in a productive way. Potentially negative
situations can be viewed as an opportunity to learn. The more frequently Soldiers employ this strategy, the
more likely that it will become their first course of action (see table 9-5).
Table 9-5. Examples of productive self-talk
Type of self-talk When to use it Example
Instructional When learning, Squatting: inhale, knees out, exhale and squat.
progressing or Prone firing: straight line from weapon to firing hip
perfecting a skill pocket, cheek to stock weld, high grip of firing hand, C-
grip with non-firing hand.
Motivational Before or during an Deadlift: my body is strong and I am ready to lift heavy.
event to increase focus Sling Load Test: I have thoroughly studied the necessary
and confidence materials to succeed.
Cognitive Before an event or Running up hills: hills are my friend. They only make me
Reframing task that has negative stronger.
connotations Hot weather training: this training is preparing me to be
more lethal in the desert. |
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INTERPERSONAL CAPABILITY
9-45. Interpersonal capability is the ability to facilitate team cohesion and the development and sustainment
of healthy, trusting relationships. Interpersonal capability includes effective communication techniques,
caring for others, conflict resolution, and team building.
RELATIONSHIPS AND COMMUNICATION
9-46. Developing and maintaining good relationships requires effective communication. Poor
communication leads to isolation and difficulty coping with daily stressors. When Soldiers encounter
challenges or stress, they find it much easier to cope if they have the support of unit, family, or community.
Soldiers are more effective in their professional mission if they can completely resolve conflicts with other
Soldiers and with their own doubts about the mission. Self-awareness, self-confidence, assertiveness, and
conflict resolution skills allow Soldiers to successfully navigate normal interpersonal problems.
9-47. Soldiers that communicate assertively and honestly with each other while demonstrating empathy
(understanding the situation from another’s perspective) can better develop strong relationships with other
team members. Assertive communication is objective, specific, and empathetic. This type of communication
can also lead to strong team cohesion, making it easier to work through stressful or chaotic situations.
9-48. Communication in its basic form is a loop that involves one person sending an intended message
through a shared space to another person who receives a perceived message, and ideally provides feedback.
Many barriers exist that complicate communication. The barriers include, but are not limited to the following:
* Physical.
* Environment.
* Emotional management of both the sender and receiver.
* Culture.
* Gender.
* Communication channel (face to face, email, text message, radio, and so on).
* Experience levels.
* Physiological states.
9-49. The primary components of communication are nonverbal and verbal cues. The majority of
communication is nonverbal, meaning body language and facial expressions. Another major component of
communication is tone. The same message can have multiple meanings based on the pitch, speed, and
intonation. The meaning of the verbal messages, both the way it is intended and received, greatly depends on
each component. Increased awareness of importance of verbal and nonverbal communication can improve
perception of self and others, increase team dynamics, and enhance overall team performance.
9-50. Assertive communication is key when handing conflict because it is objective, specific, and
empathetic. Objective communication focuses on the task, not the Soldier performing it. When conflicts
move from being objective to subjective communication, the resulting conflict can damage future team
dynamics. Assertive communication focuses on one or two specific corrections. The empathetic aspect of
assertive communication acknowledges that with each discussion, there are multiple people involved. Each
person involved has his or her own point of view, needs, and goals. Empathetic communication responds to
each person’s concerns to create a positive relationship. Leaders who regularly reflect on their
communication styles and behaviors are more inclined to use assertive communication in stressful situations,
when communication styles have the biggest impact.
ENGAGEMENT
9-51. Engagement is a Soldier’s willingness and tendency to fully contribute to the mission and remain
committed to the team’s objectives. Engagement is required to achieve optimal individual and unit
performance. Engagement requires that the Soldier understands the importance of being physically, mentally,
and spiritually ready. An engaged Soldier chooses behaviors that lead to team cohesion, performance, and
mission success. |
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9-52. Cohesion can be either socially-based or task-based. Task cohesion represents the amount of work
Soldiers perform together to accomplish common goals. Social cohesion the term used to describe the affinity
Soldiers have for one another in the form of mutual respect. High social cohesion results from working
together toward shared goals and having respect for one another.
Mental Readiness
To optimize performance, Soldiers need to be mentally ready. Mental readiness is
deliberately assessed and developed like any other skills through education, training,
and practice. To use a computing analogy, addressing both physical and mental
readiness is a “systems check” on both the “hardware” and the “software” that makes
an effective Soldier. The H2F System incorporates training techniques to develop
individual and unit mental readiness. |
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+Spiritual Readiness
This chapter discusses spiritual readiness, the fourth domain in the H2F System. It
provides tools and techniques for leaders and individuals exercising spiritual readiness
development, sustainment, or repair. It discusses what spiritual readiness is, the
purpose for spiritual readiness, who conducts or enables spiritual readiness, how
spiritual readiness is developed, and the aspects of spiritual readiness. Lastly, this
chapter lists resources available.
INTRODUCTION TO SPIRITUAL READINESS
10-1. Spiritual readiness develops the personal qualities a person needs in times of stress, hardship, and
tragedy. These qualities come from religious, philosophical, or human values and form the basis for character,
disposition, decision making, and integrity. People develop their spiritual readiness from diverse value
systems that stem from their religious, philosophical, and human values. The spiritual readiness domain is
inclusive and universally vital to all personnel no matter their background, philosophy, or religion. It applies
to both religious and non-religious persons and concepts. Leaders play an active role in creating and fostering
a climate that encourages individual spiritual readiness according to their respective worldviews, while at the
same time communicating respect and dignity for diversity in a pluralistic setting. (See AR 600-63 for more
on spirituality.)
10-2. Spirituality is often described as a sense of connection that gives meaning and purpose to a person’s
life. It is unique to each individual. The spiritual dimension applies to all people, whether religious and non-
religious. Identifying one’s purpose, core values, beliefs, identity, and life vision defines the spiritual
dimension. These elements, which define the essence of a person, enable one to build inner strength, make
meaning of experiences, behave ethically, persevere through challenges, and be resilient when faced with
adversity. An individual’s spirituality draws upon parts of personal, philosophical, psychological, and
religious teachings or beliefs, and forms the basis of their character. (See AR 350-53 for more on spirituality.)
Understanding the general spiritual readiness enables leaders to encourage personal spiritual readiness in a
climate where mutual respect and dignity encourage dialogue, foster team cohesion, and enable healthy free
exercise of religion or no religion by all personnel. This approach enables and supports collective and
individual readiness as Soldiers endure challenging and stressful conditions in training or operational
environments.
10-3. People enhance their spiritual readiness through reflection and practice of a lifestyle based on the
personal qualities they need during times of stress, hardship, and tragedy. When their actions deviate from
their stated values, then they may experience inner conflict. Those struggling for integrity and congruity often
only find inner peace after overcoming the struggle. They develop spiritual readiness by studying, connecting
with, and understanding the value systems that mold their personal qualities. As their spiritual readiness
grows, they become a leader of character and build the resilience necessary to navigate crises.
FREE EXERCISE AND RELIGIOUS LIBERTY CONCERNS
10-4. The First Amendment of the U.S. Constitution begins “Congress shall make no law respecting an
establishment of religion, or prohibiting the free exercise thereof….” This clause is a constitutional bedrock
providing grounding for religious support and spiritual readiness. The Army values Soldiers’ rights to
observe tenets of their respective religions, or to observe no religion at all. Free exercise of religion supports
the Army mission of sustaining Soldiers’ short- and long-term readiness, building ethical and moral strength,
and motivating Soldiers to meet present and future challenges. |
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10-5. The word ‘accommodation’ describes whether the Army and its commanders will prohibit, or permit
and accommodate, particular desired exercise or expression of religion that would otherwise be at odds with
other military requirements, objectives, and policies. The Religious Freedom Restoration Act generally
provides that a request for religious accommodation from a military policy, practice, or duty that hinders a
Service member’s exercise of religion may be denied only when the military policy, practice, or duty furthers
a compelling governmental interest, and is the least restrictive means of furthering that compelling
governmental interest. Leaders grant or deny accommodations according to specific procedures and
directives such as those laid out in DODI 1300.17 and AR 600-20. Accommodation policy provides further
support for Army leaders making ample allowance for individual practice of religious exercise in the Army
workplace to support spiritual readiness.
ESTABLISHMENT CLAUSE AND PLURALISTIC CONCERNS
10-6. The Establishment and Free Exercise Clauses of the First Amendment act as guideposts for developing
spiritual readiness. The Establishment Clause prohibits unfair use of governmental authority, force, or
influence to mandate or unduly promote any particular form of religion, religious belief, or practice.
10-7. Religion may be described as a set of beliefs concerning a divine or transcendent cause, nature, and
purpose of the universe typically accompanied with devotional and ritual observances along with an
accompanying moral code governing the conduct of human affairs. (See ATP 1-05.03 and ATP 1-05.04 for
more on religion.) Most Army professionals identify with some form of religious belief underlying the
spiritual dimension. Since religion is often the most important factor in individual moral outlook and
motivation, leaders must respect religious and spiritual beliefs to develop spiritual readiness appropriately in
Army organizations. Leaders accommodate diverse religious and spiritual practices but do not apply undue
influence, coerce, or harass subordinates about religion.
10-8. Pluralistic concerns represented by the Establishment Clause are reinforced in other mandates of law
and policy. Civil rights and equal opportunity law and policy undergird an Army commitment to provide
equal opportunity and fair treatment for military personnel and Families without regard to race, color, gender,
religion, sexual orientation, or national origin. Army commanders seek to provide environments free of
unlawful discrimination and offensive behavior to those categories (addressed in AR 600-20). Similarly,
DODD 5500.07-R requires all Army leaders and Soldiers to “adhere strictly to (this) policy of equal
opportunity.”
THE CHAPLAIN CORPS ROLE IN SPIRITUAL READINESS
10-9. UMTs and chaplain sections support and advise on spiritual readiness development for both religious
and non-religious personnel. Chaplains represent particular faith traditions as religious leaders while serving
the spiritual needs of their assigned units’ Soldiers. Chaplains unable to perform specific religious support
needs due to their own religious commitments provide supplemental religious or spiritual leaders and
resources to meet those needs.
SPIRITUAL READINESS DEVELOPMENT
10-10. Spiritual readiness development involves improving one’s spiritual posture to sustaining one’s self
through all aspects of life. The improvement process is generally self-directed and informed by religious,
philosophical, or human values forming the basis for character, disposition, decision-making and integrity.
While individuals approach spiritual readiness from both non-religious and religious perspectives, both
categories creates similar comparative practices.
GENERAL SPIRITUAL READINESS PRACTICES
10-11. Informed leaders understand the requirements for time, space, materiel, and other conditions
required to support spiritual readiness practices within particular organizations. Individual spiritual readiness
obligations can vary widely. Paragraphs 10-12 through 10-21 provide examples of spiritual readiness
disciplines non-religious and religious personnel both follow. Leaders consult with a chaplain or UMT to
regarding these practices. |
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CORPORATE AND INDIVIDUAL MEETINGS
10-12. A central practice of spiritual readiness is regular meetings to receive instruction, observe tenets of
belief, and gather with people of similar values. Meetings often occur weekly and can last thirty minutes to
several hours. Some groups require dedicated sacred space in garrison settings, while other groups require
dedicated space free of external distractions. Army chapels are designated as dedicated space for this purpose
in both garrison and operational environments. Leaders help subordinates de-conflict operational
requirements and spiritual practices within constraints of operational tempo and mission requirements.
SERVICE AND CHARITY
10-13. Most spiritual traditions emphasize service to others for the sake of both charity and understanding
one’s relationship to other human beings and the transcendent. This might involve serving in a homeless
shelter, conducting work projects in the local community, visiting the hospital, donating funds or material
goods, or helping people in the unit in need.
HOSPITALITY
10-14. Hospitality refers to generously receiving and providing a sustaining environment for family,
neighbors and strangers. It is a spiritual readiness practice in many traditions. In practicing hospitality, a guest
receives anything from water and shade to lodging, clothing, and food. Closely related to service and charity,
this spiritual readiness practice is more intimate in nature since providing hospitality is in person and
generally involves engaged social interaction between the host and guest. Many traditions view the practice
as a mark of heightened spiritual maturity as it involves vulnerability of the host and investment in another’s
well-being and basic sustenance. The practice of hospitality towards those considered the most vulnerable in
society includes the orphaned, widowed, homeless, injured, physically handicapped, and prisoners.
JOURNALING
10-15. Many people use journaling as a spiritual readiness practice. Journaling often involves an individual
maintaining a written record of thoughts, prayers, feelings, beliefs, and reflection on life, philosophy, or other
matters. The journal is either handwritten or digitally recorded. Usually the journal is a private document not
intended for disclosure. Journals might also have recorded thoughts and words with no particular association
or logic, often referred to as free journaling. Free journaling releases one’s mind to enable focused reflection.
Journaling is a means of incorporating cognitive, spiritual, and physical activities as part of an integrated
approach to spiritual readiness. Authors might review their journals to gain perspective on life.
MEDITATION
10-16. Meditation is the practice of contemplation and reflection by an individual or group. It generally
requires few external distractions. For this reason, ensuring a dedicated space away from ongoing training or
operations is preferable to facilitate individuals’ ability to practice this spiritual readiness activity.
PRAYER AND CHANTING
10-17. Religious people tend to practice prayer and chanting to address one or more god, deity, divine being,
or spirit. Prayer might follow a set form of words and rhythm or a free-form pattern. Chanting is often a
modified form of prayer or song uttered in a rhythmic manner with or without repetition. Some traditions
prescribe prayer according to the time of day, a pattern of prayers using beads, or a specific physical posture
assumed during prayer. Some prayer is designed for individuals while other prayers are for groups ranging
from a few to a large gathering.
10-18. Leaders ask subordinates what space, time, and materials they require to facilitate individual prayer
practices. Some prayers require preparation in the form of ceremonial washing or fasting. For example,
leaders may be asked to provide a dedicated space with ceremonial washing (ablution) capabilities and
limited distractions. Some individuals pray during routine daily activities while others pray only at a
dedicated time in a space free from distractions. |
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BELIEF (VALUES)-BASED EDUCATION (RELIGIOUS EDUCATION)
10-19. Belief-based education occurs for non-religious and religious groups. The education often occurs
during group gatherings, but it also occurs as part of an individual’s study habit. Groups provide times that
allow belief-based education to young and more mature adherents. Trained leaders or lay volunteers provide
instruction on topics and information related to core beliefs and the practice of those beliefs. Belief-based
education varies from formal instruction with published curricula and examination to informal tutoring and
mentoring. Training may happen throughout the week or as part of a formal education program with group
meetings.
BELIEF-BASED READING AND REFLECTION
10-20. Non-religious and religious traditions usually reflect on a text, a group of texts, an author, or authors.
These traditions often consider these texts or authors authoritative. Members use them for teaching, learning,
personal reflection, spiritual growth, and normative practices in personal and public life.
10-21. Some religious traditions consider the texts sacred. Such texts require reverent and dignified
handling ranging from careful handling, to physical touch only by trained clergy reading the document for
adherents. Texts vary in ease of purchase and cost. Texts regarded as sacred often require special storage and
handling considerations. Reading and reflection of spiritual or religious texts varies from one group to
another, with some groups reading these texts on special holy days or in collective gatherings, while other
groups carry paper or digital copies of their texts for daily reading, reflection, or prayer. Some religious
groups require a dedicated space for reading and reflection; other groups might read or listen to their
respective spiritual texts while conducting other activities.
RELIGIOUS SPIRITUAL READINESS PRACTICES
10-22. Individuals who practice certain spiritual resiliency disciplines tend to identify with a specific
religious group. Paragraphs 10-23 and 1-24 cover the more common disciplines.
SACRAMENTS, RITES, AND ORDINANCES
10-23. Some religious traditions practice a sacramental understanding that imparts common objects with
divine significance. Often, these traditions follow a rite or ordered pattern when observing sacraments. Those
people with a sacramental understanding often view the objects as sacred or consecrated. Leaders and
Soldiers treat those items according to the rites, rituals, or laws of the respective religious tradition. Alongside
sacraments and rites are practices by some religious traditions of ordinances. While similar in manner,
believers do not treat the ordinances as sacred or consecrated. Even so, all people treat those items with
appropriate dignity and respect. The practice of sacraments, rites, and ordinances requires specific materials
to satisfy that group’s religious requirements. Successful free exercise might require leaders to use
appropriated funds to facilitate these spiritual readiness practices.
HOLY OR SPECIAL DAY OBSERVANCES
10-24. Most religious groups have key dates celebrating significant events by members of that group in
individual, familial, or collective observances. Holy day observances range from a simple group meeting to
an elaborate event over several days with specific dietary, travel, and preparation requirements. Each tradition
has a calendar identifying holy day observances. Each calendar varies in whether it is lunar, solar, or
Gregorian based. Some calendars are set with numerical specificity whereas others are based on conditions
interpreted and defined by religious leaders within that tradition. Some traditions have holy day obligations
that require certain activities for their members as part of the holy day observance. Similar traditions might
observe the same holy day but on a different date. Effective leaders facilitate dialogue and flexibility
regarding free exercise of spiritual readiness practices. While special day observances are typically associated
with religious observance, other non-religious spiritual traditions may also have certain special days. Soldiers
desiring to observe special spiritual days plan with leaders in advance. |
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DIETARY PRACTICES
10-25. Dietary practices vary widely across religious traditions. Some follow no specific dietary practices
while other groups might follow stringent dietary regimens synchronized with a religious calendar. The Army
places a high priority on individual Soldiers’ rights to exercise their religion, to include following religious-
based dietary practices. Each person in a religious group has unique dietary practices. Accordingly, effective
leaders engage in open and continued dialogue with subordinates regarding dietary practices so to
accommodate the free exercise of religion in this area.
CLOTHING AND APPAREL
10-26. Spiritual readiness practices can include the wear of religious apparel. Religious accoutrements
include but are not limited to headgear, tassels, special garments, or rules regarding modest dress. The Army
places a strong emphasis on facilitating free exercise in the least restrictive manner as possible. See AR 670-1
and AR 600-20 for further information on religious accommodation of clothing and apparel.
PHYSICAL APPEARANCE
10-27. Similar to clothing and apparel, some religious groups require specific practices in regards to hair.
The Army uses an established process for requesting waivers to accommodate free exercise of religion with
regard to physical appearance. See AR 670-1 and AR 600-20 for religious accommodations to grooming
standards.
SPIRITUAL READINESS ASSESSMENT
10-28. Unlike a physical readiness test that assesses established form and repetition of tasks in a set time, a
spiritual readiness assessment is subjective and based on self-selection and self-assessment. Paragraph 10-29
describes sample methods of self-assessment that are not exhaustive in nature, nor intended as authoritative
or definitive. Soldiers may freely choose to use assessment tools regarding spiritual readiness without
repercussion or the perception of negative consequences.
10-29. Spiritual readiness assessments can come across as artificial, judgmental, rigid, and subjective. For
this reason, each Soldier creates an assessment based on personal aspect and perception of spirituality. For
example, Soldiers who find hope in their own personal achievements when experiencing hardship or
adversity, base their assessment on the degree to which achievement is effective in bringing that hope and
thereby reinforce their belief in personal achievement. Others who find hope in religious beliefs may base
their assessments on connection to those beliefs or practices that reinforce those beliefs. Table 10-1 helps
Soldiers assessing their own spiritual readiness to focus on relevant factors.
Table 10-1. Sample spiritual readiness assessment factors
Factor Questions
What perceptions do I have about myself Do I believe that my life has
Personhood that give me inherent value? purpose? If not why not?
What gives my life meaning if anything? If so, what purpose?
What do my worldviews and associated beliefs say about who I am in relation to
Identity others?
How would I answer the question, “Who am I?”
What mindset do I use to progress In what do I engage that shapes
Growth through life? this mindset?
Orientation On what do I base this mindset? What am I reading to reinforce this
mindset?
Over what do I have the ability to What can I do about adverse
Personal exercise control? situations in my life over which I
Agency What aspects of my life are completely have no control?
out of my control? How do I handle guilt and shame? |
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Table 10-1. Sample spiritual readiness assessment factors (continued)
Factor Questions
How do I typically respond when What has not worked?
Coping experiencing adversity?
How can I improve my ability to
Strategies
What, if anything, has worked well? cope with adversity?
To what or whom do I feel most If disconnection is impossible, how
connected? can I manage the connection to
minimize the distress?
How am I reinforcing those connections?
Connection What connections cause significant How can I re-establish damaged
connections?
distress?
Who, if anyone, do I need to
How can I healthfully disconnect from
forgive to include myself?
those?
RESOURCES
10-30. Several offices, agencies, and individuals have staffs and resources to support leaders and the H2F
Performance Team in facilitating spiritual readiness. Generally, leaders are not expected to be experts on
spiritual and religious practices, nor should they function as such. Assistance from qualified staff enables
leaders and individuals to focus time and energy on primary Army functions while building and maintaining
their personal spiritual readiness. The resources listed in paragraphs 10-31 through 10-37 is not exhaustive
in nature.
COMMANDERS AND LEADERS
10-31. Unit leaders foster spiritual readiness by providing space in schedules, battle rhythms, and training
plans for individual self-development to include the spiritual dimension. Unit and organizational leaders can
encourage spiritual readiness by discussing the spiritual dimension or spiritual development goals in
developmental counseling, individual development plans, or their leadership philosophies. Unit leaders may
also direct spiritual or moral leadership training, often with support from the chaplain section or UMT, to
ensure contextualized training respects the diversity and pluralistic needs in the unit. (See ATP 1-05.04 for
fostering spiritual training.)
CHAPLAIN SECTION OR UNIT MINISTRY TEAM
10-32. Chaplains and religious affairs specialists are assigned to units down to the battalion level. Called a
chaplain section above brigade and the UMT at the brigade and below, chaplains and religious affairs
specialists have specific training and education. They support command requirements to facilitate free
exercise of religion and to provide spiritual assistance for all assigned, attached, or authorized personnel. The
chaplain section or UMT advises the commander on broad issues regarding religion, morals, ethics, and
morale. A key aspect of this advisement is the ability to conduct research and provide advice and resources
on spiritual and religious practices. (See FM 1-05 and ATP 1-05.04 for details on religious advisement.)
GARRISON CHAPLAIN’S OFFICE
10-33. Most installations have a garrison chaplain section assigned to support an installation-wide, senior
commander’s command master religious program. This office is responsible for planning, developing,
executing, and assessing religious support for the entire installation. As such, this office generally maintains
lists of broad spiritual and religious support programs on the installation, engages spiritual leaders to facilitate
comprehensive religious support, and leverages Chaplain Corps assets to research and support spiritual
readiness practice requests for all assigned, attached, or authorized personnel. Garrison chaplain sections
typically include a director of religious education. That individual oversees all religious education
requirements on the installation and supports the garrison chaplain’s research and provision of appropriate
support for spiritual readiness practices. See AR 165-1 for more information on the garrison chaplain’s office. |
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EQUAL OPPORTUNITY ADVISOR OR OFFICE
10-34. Religion is a category covered under the Equal Opportunity Program of the Army. As such, equal
opportunity representatives and advisors can assist leaders and individuals with facilitating spiritual readiness
without discrimination. The equal opportunity advisor or officer can advise on various religious or spiritual
practices as well as indicators of a healthy climate in which leaders emphasize spiritual readiness without
creating adversarial or unhealthy conditions within a unit.
ARMY FIT WEBSITE
10-35. The Army currently maintains the Army Fit website (https://armyfit.army.mil) that provides
resources for teams, leaders, and individuals. The resources cover five dimensions: physical, emotional,
social, spiritual, and family. There are articles under the spiritual dimension that provide insights into various
spiritual readiness practices as well as discussions of potential obstacles or challenges an individual might
experience in the exercise of a particular spiritual readiness practice.
LOCAL ORGANIZATIONS
10-36. In the immediate area surrounding military installations, several civilian religious and secular
organizations often provide spiritual readiness education and direction. Leaders seeking information
regarding spiritual readiness practices of their subordinates or looking for places to refer subordinates looking
for specific spiritual advisement and practices might benefit from contacting these organizations. The
chaplain section or UMT maintains a list of various local organizations to facilitate ease of referral.
Maintaining these diverse lists does not constitute official government endorsement of any particular
organization, but rather as a way to aid individual spiritual development.
INTERNALLY ASSIGNED ASSETS
10-37. Spiritual or religious practices of Soldiers and their Family members are diverse and often represent
a cross-sectional demographic of the U.S. population. As such, leaders can benefit from learning about
respective spiritual or religious groups from assigned Soldiers and their Family members. Those who practice
a particular spiritual or religious tradition often understand nuances within that tradition. Providing regular
opportunities for these individuals to provide information on their respective spiritual beliefs, practices, and
customs can create a climate of understanding, dignity, and respect. Such classes also provide an opportunity
for Soldiers to develop professional briefing and teaching skills. Identifying individuals in the unit who
exercise a specific spiritual or religious tradition can prove beneficial for supporting other members of the
team in a time of crisis or stress.
Summary
Spiritual readiness is a vital domain in the H2F System, and it directly impacts the
resiliency of individuals and organizations. Encouraging Soldiers to connect and reflect
on the worldview or value system that informs their core beliefs, principles, ethics, and
morals can empower them to endure and overcome stress, hardship, and tragedy.
Leaders have a responsibility to support spiritual readiness practices and create a
climate where dignity and respect guide the process. Understanding common spiritual
readiness practices enables leaders to support individual spiritual readiness
development, sustainment, maintenance, and repair. |
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Sleep Readiness
The brain is the only organ or body part that requires sleep. Sleep is crucial for tissue
repair and hormone synthesis to maintain peak performance mentally and physically.
Sleep sustains brain and physical health, cognition, the immune system, and recovery
after physical activity. This chapter provides tools and techniques for leaders and
individuals exercising sleep readiness tactics, techniques, and procedures for a range
of occupations and operational environments.
PRINCIPLES
11-1. There are three basic interrelated principles of sleep health: sleep duration, sleep timing, and sleep
continuity. Of these, sleep duration is paramount because the health and functioning of the brain is primarily
a direct function of the amount of sleep obtained—the more sleep obtained the better. Sleep timing is critical
because the brain’s internal clock strongly influences the ability to initiate and maintain sleep as well as
maximize the amount of sleep obtained. The extent to which sleep is undisturbed by arousals and
awakenings—sleep continuity—is important because this influences both the duration and the depth of sleep,
with deeper sleep being more restorative. Ultimately, the promotion of sleep health in the operational
environment entails optimizing each Soldier’s sleep duration, timing, and continuity to the greatest extent
possible, given existing mission constraints. See ATP 7-22.01 for H2F testing and ATP 7-22.02 for drills and
exercises. See also ATP 6-22.5 for further discussion on the leader’s role in sleep readiness.
SLEEP DURATION
11-2. Cognitive ability and readiness vary as direct function of the amount of sleep obtained. The more sleep
Soldiers get, the greater their mental acuity, with faster response times, fewer errors, and fewer lapses in
attention. Also improved are judgment, problem-solving, situational awareness, mood, resilience, and general
well-being—to name but a few key Soldier attributes.
11-3. Soldiers and leaders frequently ask “what is the minimum amount of sleep needed to maintain military
effectiveness?” There is no clear threshold amount of sleep below which effectiveness is compromised and
above which effectiveness is sustained. Most Soldiers need 7 to 9 hours of sleep every 24 hours to maximize
health and sustain performance. The relationship between sleep duration and cognitive readiness (and thus,
military effectiveness) is best thought of as a continuum, with more sleep always producing improved
performance. Considered this way, the question becomes: “How can the amount of sleep obtained by Soldiers
be maximized, given the constraints imposed by the current mission?”
SLEEP TIMING
11-4. Human beings are diurnal, designed to be awake during the daytime and to sleep during the nighttime.
A portion of the brain that serves as an internal clock—sensitive to the timing of sunrise in the morning and
sunset in the evening—largely controls these sleep-wake tendencies. This sensitivity keeps the brain’s clock
synchronized with the outside world. During those hours that the brain’s clock has learned are local daytime
hours, the brain produces output that facilitates activity and wakefulness. During those hours that the brain’s
clock has learned are nighttime hours, it signals brain deactivation, thus promoting sleep. People who work
at night might be less productive and less well-rested since they work when their brains promote sleep; and
they try to sleep when their brains promote wakefulness. Likewise, this is what causes “jet lag.” After rapidly
crossing multiple time zones, the brain’s internal clock is initially out of synch with the local day-night cycle,
sending out signals to promote sleep during daylight hours and sending out signals to promote wakefulness |
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during the nighttime hours. Normal sleep and alertness are typically not restored in the jet-lagged brain for
several days—the time it takes for the brain’s internal clock to resynchronize to the day-night cycle of the
new, local time zone. (See paragraphs 11-34 through 11-54 for strategies to mitigate the effects of disruptions
in normal sleep patterns.)
11-5. Maintaining a consistent sleep-wake schedule on both duty and non-duty days has the benefit of
strengthening and reinforcing the internal wake- and sleep-promoting processes controlled by the brain’s
internal clock. These processes constitute the “circadian rhythm of alertness.” Individuals who maintain
consistent sleep-wake schedules (especially on arising at the same time each morning and experience their
first exposure to daylight at the same time each day) derive the maximum benefits from the circadian rhythm
of alertness, with well-consolidated sleep at night and optimum alertness during the daytime. A consistent
and regimented schedule of sleep- and wake-related activities helps to lock in other biological systems
associated with circadian rhythms. These include hormone release, digestion, muscle strength, and
cardiovascular performance. Circadian rhythms act in tandem with the need to sleep which builds throughout
a day. These rhythms optimize the process of falling asleep, staying asleep, and ensuring quality sleep.
11-6. However, Soldiers can only achieve such benefits if they get adequate sleep (for most individuals, 7 to
9 hours of sleep per night) on a regular basis. If they get less sleep (for example, 6 hours per night during the
duty week), then a “sleep debt” accrues. In such cases, it is better to sleep in on off-duty days and pay down
the sleep debt, rather than sacrificing sleep to try to maintain a consistent sleep-wake schedule and strengthen
the circadian rhythm of alertness.
11-7. Although the circadian rhythm of alertness generally promotes a 24-hour cycle of daytime wakefulness
and nighttime sleep, there is also a temporary afternoon “dip” in alertness. This dip becomes especially
noticeable in individuals who have a significant sleep debt (for example, not regularly obtaining adequate
sleep). For those able to take advantage of it, the afternoon dip provides an opportunity for obtaining good
quality daytime sleep to help pay down any existing sleep debt. Soldiers can generally take these naps without
significantly disrupting the circadian rhythm of alertness—provided that the naps are not so long or so
frequent that they begin to impair the ability to initiate sleep at night.
SLEEP CONTINUITY
11-8. The restorative value of sleep is determined not only by the duration of the sleep period, but also by
the continuity of the sleep period—that is, the extent to which the sleep period is continuous and
uninterrupted. The sleeping brain cycles through non-rapid eye movement (known as NREM) and rapid eye
movement sleep (known as REM or “dreaming sleep”) every 90–120 minutes. The full benefit of sleep occurs
when the brain completes 4–5 complete cycles. Non-rapid eye movement sleep makes up most of the first
half of the night’s sleep. During this type of sleep, the body releases hormones that help repair and rebuild
muscles and replenish energy. There are three stages of non-rapid eye movement sleep: stage 1 (the lightest
sleep stage), stage 2 (which accounts for approximately 50 percent of nighttime sleep), and stage 3 (the
deepest and the most recuperative sleep stage). During sleep, the body clears toxins that have accumulated
throughout the day (as by-products of healthy brain functioning) from the brain; it also fixes and transforms
new memories into usable knowledge. Both types of sleep are essential, and it is important that the brain
cycles appropriately between non-rapid eye movement and rapid eye movement sleep across the night. When
sleep is interrupted or shortened, natural progression of sleep cycles are disturbed reducing the beneficial
effects of the sleep.
SLEEP READINESS FUNDAMENTALS
11-9. Like the rest of the body (for example, muscles, skin, and liver), the brain has physiological needs for
food, water, and oxygen—basic needs that must be met not only to ensure proper brain functioning, but to
sustain life itself. However, unlike the rest of the body, the brain has one additional physiological need: sleep.
The brain requires sleep to maintain normal function. Sleep is necessary to sustain not only alertness, but
also higher order cognitive abilities such as judgment, decision making, and situational awareness. In short,
sleep makes Soldiers better at being Soldiers.
11-10. The brain needs sleep to restore and repair itself, to work efficiently, to fix new memories, and to
process new information appropriately. Sleep also clears away waste products from normal breakdown of |
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chemicals that accumulate in the brain during wakefulness. Prioritizing sleep, and ensuring that opportunities
for Soldier sleep are maximized in all operational environments, serves to optimize brain, psychological, and
immunological health. In particular, sleeping properly before training improves attention, understanding, and
learning. Sleeping properly after training improves the ability to both remember and appropriately utilize
newly-acquired skills and information.
11-11. Although some Soldiers may require a little more or a little less sleep, for the vast majority of
Soldiers a steady diet of 7–8 hours of sleep every 24 hours is needed to sustain normal levels of brain function
and health indefinitely. Most Soldiers who regularly obtain less than 7–8 hours of sleep every 24 hours pay
a price: they unwittingly but steadily accrue a significant sleep debt, characterized by increasingly suboptimal
alertness, reduced mental sharpness, and an impaired ability to recover from stress. These Soldiers typically
believe that they are fine and may perform most basic duties adequately. From an objective standpoint, their
alertness and mental acuity is significantly (and invariably) impaired. As a rule of thumb, any Soldier who
sleeps two or more hours longer on days off (versus duty days) carries a significant sleep debt.
11-12. Even for those who regularly obtain the generally recommended 7–8 hours of sleep per night, more
sleep can result in even better alertness and mental acuity. In brain health and mental functioning, there is no
such thing as too much sleep. Therefore, to maximize brain health and functioning in an operational
environment, Soldiers aim to maximize sleep as much as possible within the constraints of the operation. As
sleep duration increases, so does the likelihood of mission success.
11-13. Insufficient sleep degrades the brain’s function. The more sleep the brain gets, the better it functions.
The effects of inadequate sleep on brain function and performance are well-documented:
* Reduced ability to concentrate, impaired judgment, problem solving and decision making.
* Increased irritability and reduced mood.
* Reduced motivation level.
* Increased reaction time and slowed response time.
* Reduced ability to effectively cope with stress.
* Increased risk of physical injury.
* Increased time to recover from injury.
11-14. Insufficient sleep negatively affects not only cognitive performance, but emotional and social
functioning. Adequate sleep promotes an optimistic outlook and social acuity, but failure to obtain adequate
sleep on a regular basis (for example, being chronically sleep restricted) makes a person less resilient to stress
and stress-related disorders including posttraumatic stress and depression.
11-15. If the brain is starved of sleep for long enough, it will eventually fall asleep. Although severe
sleepiness can be staved off momentarily by increasing environmental stimulation (for example, increasing
the volume on the radio, opening a car window, getting up and walking around), no amount of effort or
willpower will maintain wakefulness for long. Humans cannot resist the need for sleep any more than the
need for air. In much the same way that it is impossible to hold one’s breath until consciousness is lost, it is
likewise impossible for the sleep-starved individual to resist sleep onset. At some point, the sleepy brain will
slip into sleep, regardless of any and all efforts to avoid it. Sleep onset under such conditions is not a voluntary
act. Therefore, severe sleepiness is dangerous not only to the sleepy individuals, but also to people around
them. Severe sleepiness proves more dangerous when individuals engage in monotonous activities such as
driving, pulling security, or monitoring equipment or computer screens.
11-16. In short, the brain has a physiological need for sleep, and sleep promotes and sustains the ability to
think and maintain mental toughness. And the more sleep, the better. Although obtaining 7 to 9 hours of
nightly sleep generally results in the ability to sustain normal levels of alertness and performance during the
daytime, obtaining even more sleep results in greater brain readiness—enhanced mental sharpness and
resilience in the field. |
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PROMOTING HEALTHY SLEEP
11-17. Good sleep is essential for optimal performance and readiness. Factors to consider when optimizing
sleep duration and continuity include: the sleep environment, a pre-sleep routine, and a sleep schedule that
conforms as closely as possible to the brain’s natural circadian rhythm of alertness.
SLEEP ENVIRONMENT
11-18. Sleep duration and continuity are optimized in environments that are quiet, dark, and maintained at
a comfortable ambient temperature. Some individuals believe that they sleep better with music or a television
on, that they can sleep anywhere, and that ambient noise does not bother them. Research clearly shows that
this is not the case. Soldiers do not get good sleep on a cot in the tactical operations center. Although sleepers
are not aware of it, environmental sounds cause brief arousals—a momentary speeding of the brain’s electro-
encephalograph (known as EEG) activity during sleep—that effectively disrupt sleep continuity and reduce
the restorative value of that sleep. Likewise, bright lights and excessively hot or cold environments can
disrupt sleep continuity and reduce the restorative value of sleep.
PRE-SLEEP ROUTINE
11-19. Stress is incompatible with sleep. Pre-sleep routines that promote winding down—such as listening
to soothing music, reading, or taking a warm shower or bath—30–60 minutes prior to bedtime tend to
facilitate the transition to sleep. These routines will maximize sleep duration. Conversely, activities such as
watching television, playing video games, chatting online, and similar interesting or engaging activities tend
to arouse the brain and delay sleep onset. These activities reduce the amount of sleep obtained and should be
avoided during the pre-sleep wind-down period. Tobacco product use is also antithetical to sleep. People
smoke before sleep to wind down. The stimulant in nicotine tells the body to get active while it increases
heart rate and alertness. Those experiencing significant stress often find relaxation techniques such as
meditation and mindfulness exercises helpful.
SLEEP SCHEDULE
11-20. Adequate performance is best achieved by Soldiers who consistently get adequate sleep (7–8 hours)
on a nighttime sleep-daytime wakefulness schedule aligned with the brain’s natural circadian rhythm of
alertness. Both sleep duration and sleep continuity are maximized on such schedules. However, military
operations are often continuous (24-hours per day) and influenced by random and unpredictable events and
requirements. Shift work is unavoidable for at least some deployed Soldiers, and sleep opportunities are
sometimes unpredictable for virtually all deployed Soldiers. The following situations commonly contribute
to sleep loss and decrements in waking performance:
* Shift work.
* Changing schedules.
* Social jet lag.
SHIFT WORK
11-21. The human brain is biologically hard-wired to be alert during the daylight hours and asleep during
the nighttime and early morning hours. Because of this, poor quality sleep results from night shift work even
when shift workers spend adequate time (approximately 8–9 hours) in bed during the daytime. Although such
a schedule is unnatural for the human brain, some adaptation to a nighttime-awake and daytime-asleep
schedule does occur over time, but such adaptation is never complete. Soldiers always pay a cost in their
waking performance and daytime sleep quality. This occurs even when working consistent, steady nights. In
the long term, Soldiers associate frequent shift work with weight gain and increased risks for diabetes, fatty
liver disease, and cardiovascular disease. See discussions beginning in paragraphs 11-24 and 11-30 for
strategies to mitigate adverse effects of shift work. |
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CHANGING SCHEDULES
11-22. Rapidly changing and backward shifting work-rest (duty) schedules exacerbate the problem. Leaders
should always aim to optimize the Soldier’s sleep to the extent possible given the existing operational
constraints. Toward this end, commanders consider the following two principles:
* Strive for consistency for individual Soldiers by rotating shifts no more often than twice per
month.
* Always rotate shifts in a forward direction.
These actions allows sleep to occur later on the new shift than it did on the old shift. Bodies have more
difficulty adapting to backward shift rotations because that requires earlier initiation of the sleep period. This
is also why it is easier to adapt to a new time zone (jet lag symptoms are less severe) following westward
travel across multiple time zones versus eastward travel. It is easier to stay up a little later and sleep in than
to go to bed earlier and arise earlier in a new time zone. See discussions beginning in paragraphs 11-24 and
11-30 for strategies to mitigate the adverse effects of changing schedules.
SOCIAL JET LAG
11-23. The tendency to stay up later and sleep in later on off-duty days (often the weekends when in
garrison) commonly results in a phenomenon known as social jet lag. This state of mild sleep restriction
results from the subsequent need to arise earlier on the first day back to work (for example, Monday following
a weekend off). The effect resembles that experienced by individuals who experience jet lag after traveling
eastward across a couple of time zones.
LEADERSHIP’S ROLE
11-24. While good leadership is essential for a wide range of unit outcomes, leadership behaviors that target
sleep can improve the sleep habits of unit members and the unit’s overall sleep culture. Sleep leadership
behavior includes promotion of sleep awareness and the development and implementation of local policies
that facilitate the ability of subordinates to practice good sleep hygiene. An example of sleep awareness is
ensuring that subordinates understand the importance of sleep for health and readiness, as well as the negative
consequences of sleep loss. Such practices (for example, moving physical readiness training from morning
to the afternoon or starting the duty day later, both of which allow Soldiers to sleep later) result in improved
subordinate sleep, enhanced health (reduced sick call and accident rates), and improved unit climate. The
acronym SLEEP represents the following basic sleep leadership practices:
* Set conditions.
* Lead by example.
* Educate and encourage.
* Prioritize and plan.
SET CONDITIONS
11-25. The S stands for set conditions. Leaders set conditions when they—
* Strive to create an optimal sleep environment by controlling noise, light, and temperature.
* Address work-related and other sources of stress for Soldiers that may be interfering with sleep.
* Implement duty schedules that optimize nighttime sleep and daytime alertness.
LEAD BY EXAMPLE
11-26. The L stands for lead by example. Leaders lead by example when they—
* Serve as role models for subordinates by demonstrating good sleep habits and maintaining healthy
work-rest schedule.
* Look for opportunities to show they consider sleep to be a priority for unit. For example,
emphasize sleep in remarks during Recovery Drills or other unit formations and functions.
* Remind Soldiers of the importance of sleep. |
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EDUCATE AND ENCOURAGE
11-27. The E stands for educate and encourage. Leaders educate when they—
* Establish a good sleep culture in the unit and ensure that subordinate leaders are also engaging in
good sleep leadership.
* Encourage Soldiers to look for signs of sleep problems regularly.
* Ensure all Soldiers have access to information on effective sleep habits.
* Give Soldiers permission to nap when circumstances allow, and encourage naps when appropriate,
especially during continuous operations.
PRIORITIZE AND PLAN
11-28. The P stands for prioritize and plan. Leaders do this when they—
* Ensure Soldiers have enough time to attend to their personal matters while still getting sufficient
sleep.
* Are aware of the challenges of shift work and continuous operations, and implement schedules
that mitigate their negative effects on performance and health.
* Think of sleep as an item of logistical resupply, like beans and bullets, and plan accordingly. That
is, schedule enough time for Soldiers to get sufficient (or even extra) sleep before—and recovery
sleep after—all missions.
* Consider having Soldiers perform less complex tasks in the early morning before 0900 and more
complex tasks in the late morning and early afternoon.
11-29. Sleep is essential to health and readiness. To optimize Soldiers’ alertness and performance, leaders
maintain as consistent and regimented a sleep-wake schedule as possible (optimize sleep timing) with an
adequate amount of sleep opportunity (optimize sleep duration). Leaders also ensure that the sleep-wake
schedule conforms as closely as possible to the brain’s natural circadian rhythm to optimize both duration
and quality of sleep.
PLANNING FOR PERIODS OF INSUFFICIENT SLEEP
11-30. Effective leaders consider sleep an item of logistical resupply like water, food, fuel, and ammunition.
Planning for sleep in training and tactical environments is a leader competency. Sleep management optimizes
Soldiers’ performance in austere conditions. Sleep is a force multiplier. In healthy persons, there is no such
thing as too much sleep. The goal in all operational scenarios should always be to maximize sleep duration
because more sleep always results in greater alertness, resilience, and mental acuity—greater readiness.
OVERALL STRATEGY
11-31. When mission requirements do not allow for adequate sleep, the goal becomes twofold: to optimize
alertness and performance during waking periods to the extent possible and to maximize the ability of
Soldiers to take advantage of any opportunities for sleep that do occur. Factors that determine the extent to
which alertness and performance are impacted by sleep loss include:
* Individual differences in sensitivity and resistance to the effects of sleep loss.
* Individual sleep history—those who habitually sleep more tend to be more resistant to sleep loss.
* Length of continued wakefulness—the longer the period of sleep loss, the worse the performance.
* Time of day or night—the brain’s circadian rhythm of alertness exacerbates the effects of sleep
loss during the early morning hours, and partially mitigates the effects of sleep loss during the
daytime or early evening hours.
INDIVIDUAL DIFFERENCES
11-32. No one can maintain alertness and performance indefinitely without sleep, but some individuals are
more impacted by sleep loss than others. Individual differences are determined by both genetics and sleep
history or habitual sleep duration. A Soldier’s sensitivity versus resistance to the effects of sleep loss cannot |
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be predicted before the fact; therefore, leaders need to objectively measure a Soldier’s performance since
insufficient sleep impairs the ability to self-assess. As a rule, sleep-deprived Soldiers will overestimate their
own capabilities. Leaders should expect and plan not only for reduced performance, but increasing variability
in the effectiveness of Soldiers who have increased sleep loss.
TIME OF DAY OR NIGHT
11-33. The brain’s internal sleepiness-alertness cycle directly impacts performance. Because of this, work
performed between 2300 and 0800 hours is generally less efficient (slower and with a greater number of
errors) than work performed during the daytime and early evening hours. Leaders should anticipate reduced
levels of productivity and effectiveness during these hours.
JET LAG, SHIFT WORK, AND MISSIONS
11-34. Jet lag and shift work tend to result in misalignment of the circadian rhythm. Crossing multiple time
zones tends to result in jet lag and impacts a Soldier’s ability to adjust to the time zone and obtain needed
sleep. In jet lag, circadian misalignment results from the inability of the brain’s internal clock to rapidly adapt
to a new time zone. In shift work, circadian misalignment results from shifting the wake period to that portion
of the night when sleep typically occurs and shifting the sleep period to the daytime when the brain is primed
for wakefulness.
11-35. Following travel across multiple time zones, re-adaptation can take from 3–4 days to several weeks
depending on individual differences in adaptability that are determined by factors such as age and genetics.
However, realignment of the internal clock with the new environment does not occur linearly. The greatest
daytime deficits in alertness and performance and the most severe nighttime sleep disturbances tend to occur
during the first 24 hours in the new time zone. These issues tend to be resolved in the first 3 or 4 days in a
new time zone, at which point the brain’s clock will typically have made significant progress in resetting
itself to the local day-night schedule.
11-36. The brain’s clock can more easily adapt to westward travel (to stay up later at night and sleep in
longer in the morning) than to eastward travel (to go to bed earlier and arise earlier). For the same reason, it
is easier for the brain to adapt to a forward rotating shift schedule (transitioning from the day shift to the
evening shift to the midnight shift) than to a backward rotating shift schedule (transitioning from the midnight
shift to the evening shift to the day shift). The greatest impacts from circadian misalignment seen in jet lag
and shift work are sleep disturbance, deficits in self-assessment, risk of errors and accidents, and degradation
of efficiency and productivity.
11-37. The following strategies assist Soldiers coping with jet lag, shift work, and operational missions:
* Before travel.
* During travel.
* After travel.
* Before missions.
* During missions.
* After missions.
* Continuous operations.
Before Travel
11-38. Up to two weeks prior to traveling, Soldiers pay down sleep debt and bank sleep by getting 8 or
more hours of sleep per night. They do not attempt to pre-adapt to a new time zone. Attempting to pre-adapt
by moving sleep-wake timing forward or backward is difficult to accomplish and can cause a sleep debt.
During Travel
11-39. Transcontinental flights east are generally scheduled for evening departure, allowing for in-flight
sleep during periods of minimal alertness. Transcontinental westward flights are generally scheduled for |
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morning departure when it may be difficult to fall asleep, but long-duration flights afford the opportunity for
afternoon sleep. The following tactics support in-flight sleep:
* Stop caffeine intake 6 hours prior to take-off. Do not drink caffeine until approximately 30 minutes
before landing.
* Eat a meal prior to boarding or immediately after take-off. Forego any later in-flight meal service
that will interfere with your sleep.
* Do not consume alcohol before or during the flight. Alcohol will make you feel drowsy, but it
actually impairs sleep.
* Control effects of cabin noise, light, and temperature by using foam ear plugs (or noise-cancelling
headphones), a sleep mask, and blanket. Select a window seat so that passenger and flight
attendant movements do not disrupt your sleep.
After Travel
11-40. Adjust activities in new time zone based on the following guidance:
* Schedule meetings during routine alertness cycle and avoid meetings during your routine sleep
cycle.
* Use 200 milligrams of caffeine (equivalent to two cups of coffee) prior to critical meetings to
support alertness and mental acuity. Stop caffeine at least 6 hours prior to a scheduled sleep period.
* For fast turn-around travel (1–2 days at each time zone), maintain home time schedule as much as
possible. Schedule critical meetings during peak alertness. For eastward travel, this means
scheduling meetings to occur in the late afternoon or evening of the new local time. Sleep or nap
during the new local day.
* Avoid alcohol since it exacerbates sleepiness and mental deficits as well as impairs sleep.
* Use sleep-inducing agents only under a physician’s supervision and approval.
* Avoid over-the-counter sleep aids. These compounds do not improve sleep and they can impair
post-awakening alertness and mental acuity.
* Avoid over-the-counter melatonin (marketed as a sleep aid) since it does not increase actual sleep
time.
* Manage light exposure depending on the alertness boost needed. Some sources of light found in
offices and hotels boost alertness. While this exposure may be useful to boost alertness, it may
also lead to poor sleep quality and duration.
* Make the computer’s display adapt to the time of day and use the blue light blocker during non-
daylight hours to facilitate nighttime sleep and strengthen circadian rhythms.
* Be aware of sunrise and sunset times to determine bed time. Go to bed when the sun goes down.
Be active and move around when the sun is up. Use naps to achieve 7–8 hours of sleep every 24
hours. Naps will improve alertness and performance.
Before Missions
11-41. The notion that one can adapt to sleep loss is a myth. Although Soldiers generally benefit from
training as they fight, this does not hold true for sleep loss. Soldiers cannot be trained to perform better on
less sleep. Although chronically sleep-restricted Soldiers do become accustomed to a reduced level of
alertness, which they think is normal, objective assessments to reveal deficits show that there is no evidence
of habituation or adaptation to sleep loss. The only possible benefit to training under conditions of sleep loss
is if it increases the Soldiers’ awareness and appreciation for the extent to which sleep loss impacts their
physical and mental abilities. See table 11-1 for strategies to maximize mission sleep.
11-42. Although Soldiers cannot train to perform better on less sleep, they can bank sleep. Sleep banking
is achieved by significantly extending the nightly time in bed to more than 8 hours per night. Soldiers must
bank sleep for multiple consecutive nights prior to embarking on a mission that is likely to result in inadequate
sleep. The extra sleep they obtain in this manner creates a bank of sleep they use to sustain alertness and
performance during subsequent sleep loss (acute sleep deprivation or chronic sleep restriction). |
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Table 11-1. Maximizing mission sleep
Before
Two weeks prior, get 8 or more hours of sleep per night.
Stop caffeine and alcohol consumption at least 6 hours prior to scheduled sleep.
During
Take naps whenever possible to accumulate 7-8 hours of sleep in every 24 hour period.
Caffeine can be used to reduce grogginess on awakening.
Separate day and night shift sleep areas.
After
To reduce sleep debt or deprivation, plan on additional sleep time.
Increase sleep to 8 hours every 24 hours to return to optimal alertness and performance.
11-43. Importantly, the benefits of sleep banking are not limited just to the following day; such benefits
have been shown to remain evident over days and weeks, and may last even longer. This is because the brain
saves (or banks) sleep that it does not use the next day, and it expends that sleep during future periods of
sleep loss. Increasing the amount of sleep prior to a mission improves performance during that mission and,
as a bonus, reduces the amount of sleep subsequently needed to recover from that mission. When possible,
leaders should provide Soldiers the opportunity for extended sleep (10 hours in bed per night may be optimal)
for several consecutive nights (for at least one week, if possible) prior to missions likely to involve significant
sleep loss. Leaders should encourage Soldiers to take appropriate advantage of this opportunity for extra
sleep. Soldiers best accomplish sleep extension by going to bed earlier (rather than staying in bed later)
because awakening at the same time each morning helps to sustain and strengthen the brain’s circadian
rhythm of alertness.
During Missions
11-44. Properly planned sleep management strategies facilitate alertness and performance in any
operational scenario. They can make the difference between mission success and failure during continuous
operations when the stakes are high and opportunities for sleep are restricted. The ultimate goal of these
strategies is to maximize unit readiness and lethality.
11-45. Two complementary approaches optimize Soldier alertness and effectiveness during continuous and
sustained operations when they have little or no opportunity for sleep. The first (and most effective) approach
is to optimize sleep itself, to the maximum extent is possible to do so given operational constraints. Nothing
is better, in the short- or long-term, at preventing or reversing the effects of sleep loss than sleep itself. The
second approach is to directly facilitate alertness in the sleep-deprived Soldier by using a stimulant such as
caffeine. This has to be done in a way that minimizes the counterproductive effects of the stimulant on the
Soldiers’ ability to take advantage of whatever limited opportunities for sleep may arise during the mission.
11-46. The short- and long-term goals of the first approach is to maximize sleep duration and continuity—
an approach that primarily entails optimization of work-rest schedules and optimization of the sleep
environment. The second approach aims to optimize alertness and performance directly with caffeine, albeit
in a manner that minimizes the negative effects of the caffeine on sleep duration and continuity.
After Missions
11-47. The longer an individual goes without sleep, the greater the decline in cognitive performance, and
the longer it will take to recover from the sleep debt that has accrued. In general, it takes longer to recover
from chronic sleep restriction (several nights of inadequate sleep) than it takes to recover from a comparable
level of acute total sleep deprivation (a single period of extended wakefulness). While it is difficult to predict
precisely the amount of recovery sleep required by each individual, the goal should always be to maximize
the opportunity for recovery sleep following any mission that results in sleep loss. |
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Continuous (24-hour) Operations
11-48. Continuous military operations are a mainstay of the Army. Soldiers must be prepared to conduct
operations for extended periods with limited rest and sleep deprivation to accomplish the mission. Paragraphs
11-49 through 11-54 describes proven techniques to mitigate the impact of continuous operations on Soldiers.
Segregation of Soldiers by Shift
11-49. Sleep and living areas for Soldiers should be segregated by the shifts worked. This minimizes sleep
disruptions caused by waking activities of those working other shifts.
Extra Time for Night Workers and Day Sleepers
11-50. The circadian rhythm of alertness works against daytime sleep and nighttime alertness. Soldiers
working a night shift typically require more time to successfully complete tasks because they work slower or
less efficiently. These Soldiers also tend to accrue sleep debt faster than those working on normal day shifts.
Extra Monitoring on the Night Shift
11-51. Soldiers engaged in mission- and/or safety-critical tasks during the descending phase of the circadian
rhythm of alertness (between 2300 and 0800) can benefit from enhanced oversight and monitoring. During
these times, when Soldier alertness is compromised, there is an increased risk of lapses in attention and even
brief, uncontrolled sleep episodes (microsleep).
Off-duty Safety
11-52. Following nighttime work, the morning commute back home can be a time of significantly increased
risk. For example, ending staff duty or charge of quarters during the early morning hours (around 0700) can
put sleep-deprived Soldiers behind the steering wheel at a point in the circadian rhythm of alertness when
they are at greatest risk for vehicle accidents. Providing post-shift sleeping quarters, scheduling night shifts
to end during the ascending phase of the circadian rhythm of alertness (after 0900 hours), or providing post-
shift transportation home can help improve the safety of Soldiers working the night shift.
De-conflicting Schedules
11-53. Commands should schedule required briefings and dining facility availability so as to minimize
potential conflicts with the daytime sleep of Soldiers on duty during the nighttime. No Soldier should have
to choose between food and sleep.
Sleep Prioritization
11-54. The restorative effects of sleep accrue primarily to the brain and are primarily manifested as
improved cognitive performance. Accordingly, it is especially important that leaders and others engaged in
higher-order cognitive tasks—such as mission planning, decision making, risk assessment, and problem
solving—are afforded and take full advantage of opportunities to obtain adequate sleep.
INTERVENTIONS TO IMPROVE AND SUSTAIN READINESS
11-55. Depending on the situation, leaders can implement certain interventions to sustain or improve
Soldier readiness by limiting the causes of loss of alertness and results of sleep deprivation. Leaders can use
many of these methods singularly or in combination with other interventions as practicable.
NAPS
11-56. When regular nighttime sleep is not possible due to mission requirements, Soldiers can use short,
infrequent naps to restore wakefulness and promote performance. When routinely available sleep time is
difficult to predict, Soldiers might take the longest nap possible as frequently as time is available. During
periods of restricted sleep (6 hours of sleep or less per night), napping combined with appropriate doses of
caffeine may help to sustain cognitive performance and alertness. |
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REST BREAKS (WITHOUT SLEEP)
11-57. In addition to varying as a function of sleep loss and the circadian rhythm of alertness, performance
also varies as a function of time-on-task. This effect—the tendency for performance on a continuously
performed task to decline across time—is especially apparent on tasks requiring a lot of mental energy or
extended vigilance, and it is reversed by simple time-off-task (rest). Time-on-task effects interact with (are
exacerbated by) sleepiness. Therefore, when Soldiers perform such tasks under conditions of sleep loss or
during the descending phase of the circadian rhythm of alertness, leaders can expect Soldiers will need more
frequent and/or longer rest breaks. Although rest breaks reverse that portion of the performance deficit caused
by time-on-task, such breaks do not reverse deficits associated with sleepiness per se (unless, of course,
Soldiers get some sleep during the rest break). Sleep loss effects and time-on-task effects interactively impair
performance but require different interventions.
REVERSE PHYSICAL TRAINING SCHEDULE
11-58. When it is feasible, this strategy—a delayed start time to the duty day with afternoon as opposed to
morning physical training sessions—has two benefits. First, it conforms well to the brain’s natural circadian
rhythm of alertness. Second, it results in longer sleep durations, especially in younger Soldiers who almost
invariably use a later wake time to obtain more sleep. When implemented, this schedule can result in reduced
utilization of sick call and reduced accident rates.
CAFFEINE TO SUSTAIN ALERTNESS AND PERFORMANCE
11-59. Table 11-2 summarizes the caffeine doses for optimal alertness under different sleep challenges.
Table 11-2. Caffeine dose for optimal alertness
Type of sleep challenge Dose
Sustained operations 200 mg at midnight
200 mg again at 0400 and 0800 if needed
Use during daytime (1200 and 1600) only if needed
Night operations with daytime sleep 200 mg at start of night shift
200 mg again 4 hours later
Late dose: at least 6 hours prior to start of daytime sleep
Restricted sleep (6 hours of sleep) 200 mg upon awakening
200 mg again 4 hours later
Last dose: at least 6 hours prior to sleep period
mg milligram
Caffeine Dose (200 milligrams)
11-60. For many missions some degree of sleep loss is unavoidable. In these cases, Soldiers may best
accomplish short-term sustainment of alertness and performance with judicious use of a non-sleep (stimulant)
intervention. For a variety of reasons (including its wide availability, its familiarity to Soldiers, and its relative
safety and effectiveness), caffeine is recommended for this purpose. For most individuals under most
circumstances, the optimal dose of caffeine is 200 milligrams.
Caffeine Limitations
11-61. Caffeine only temporarily helps restore alertness and performance. It does not replace sleep. Nor
does it fully restore all the cognitive abilities decremented by sleep loss. In much the same way, caffeine can
help keep a Soldier from falling asleep, but it does not improve that Soldier’s judgment, coordination, or
reaction time. Because it will interfere with the ability to initiate and/or maintain sleep, Soldiers should avoid
caffeine, if consistent with mission requirements, for at least 6 hours prior to an anticipated sleep opportunity. |
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BEHAVIORAL FACTORS
11-62. In addition to operational requirements, sleep readiness also depends on the behavior of individual
Soldiers. The conditions in which Soldiers find themselves, as well as the schedules they maintain or
activities in which they participate, contribute to sleep readiness.
Exercise
11-63. Regular, moderate physical exercise facilitates subsequent nighttime sleep onset and promotes
deeper (more restorative) sleep. However, vigorous exercise immediately prior to bedtime can interfere with
sleep for some individuals, especially if that exercise is to exhaustion, producing a physiological stress
response. During the daytime, short bouts of around 30 minutes of physical activity can result in a moderate
3-hour boost of alertness in well-rested Soldiers. Such bouts do little for reversing and sustaining alertness
under conditions of significant sleep loss.
Diet
11-64. Various foods and food preparation techniques can affect sleep—both positively and negatively.
Sleep-promoting foods tend to be high in fiber and low in added sugars. High-fat, fried, or spicy foods tend
to negatively impact sleep. Such foods tax the stomach, are difficult to digest, and may cause nocturnal
esophageal reflux or heartburn. Soldiers should avoid these types of foods prior to bedtime. As a rule, Soldiers
should avoid full, heavy meals within 2–3 hours of initiating sleep. However, they should not go to bed
hungry either, since hunger can also lighten and disrupt sleep. If Soldiers need to eat just prior to bedtime,
their best options include a balanced snack or meal that includes fruits; vegetables; whole grains; fat proteins;
and foods low in added sugar. Foods that rarely disturb sleep include Greek yogurt or cottage cheese with
fruit, peanut butter on whole grain toast, cheese and crackers, milk with a small bowl of whole grain cereal,
and protein bars.
Alcohol
11-65. Although alcohol increases drowsiness and can facilitate sleep onset, it subsequently lightens and
disrupts sleep as the body metabolizes it during the night. It causes multiple arousals and awakenings, thus
harming sleep more than it helps. The body metabolizes alcohol at a rate of about one ounce per hour.
Therefore, to avoid the negative effects of alcohol on sleep, Soldiers should consume no more than one drink
one hour before bedtime, no more than two drinks two hours before bedtime, and so on. However, abstinence
is the best strategy when a good night of sleep is especially important for next-day activities or missions.
Sleep Environment
11-66. The importance of a sleep-friendly environment cannot be overstated. Living conditions and
environments vary widely, but leaders can improve most sleep areas with a few simple steps.
Ambient Noise
11-67. Sleeping quarters should be located as far away from noisy areas (such as airfields, generators, and
fueling stations) as possible. The effects of remaining uncontrollable, intermittent, random noises should be
masked with a white noise generator. Finally, Soldiers can wear noise-dampening earplugs to effectively
block noise and improve sleep.
Physical Comfort
11-68. Room temperature should be cool, ranging from 65–72 ºF. Sheets, bed, pillows, sleep surfaces (such
as mattresses and cots), and sleeping clothes should be clean and comfortable. Mattresses should be
requisitioned to fit the Soldier.
Light
11-69. Humans are not nocturnal. Soldiers are hardwired to be active during the day and to sleep at night.
The brain’s internal clock is very sensitive to light, and any amount of light that reaches the brain through |
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the eyes at night can be harmful. Even dim lights emitted from electronics such as a smart phone, computer,
or television can have a negative impact. This light confuses and resets the brain’s internal clock, which can
misinterpret such light exposures as either an early dawn or a late dusk. In either case, such exposures
incrementally weaken the brain’s circadian rhythm of alertness, negatively impacting both nighttime sleep
and daytime alertness. Therefore, sleeping areas should be kept dark. Blackout curtains or blinds should cover
all windows. Leaders need to strictly enforce the lights out policies. To improve Soldiers’ ability to avoid
unwanted light exposure and thus facilitate sleep, leaders should create separate sleep areas for each shift and
encourage the use of comfortable sleep masks.
Safety
11-70. Operational or training environments should be safe and secure for Soldiers to sleep in. This also
applies to areas where Soldiers take naps. Ensure that Soldiers do not attempt to nap in front of, behind, or
underneath trucks, tracked vehicles, or other vehicles. Soldiers need to avoid and protect against pests (for
example, use mosquito nets when appropriate). Before sleeping, Solders check that snakes, spiders, ants, and
other creatures are not in the sleeping area, sleeping bag, or shoes.
SLEEP MANAGEMENT PLANNING TOOL: 2B-ALERT WEB
11-71. Leaders have a planning decision aid to help plan missions and predict the effects of any sleep-wake
schedule on performance. This scientifically-developed mission planning decision aid, the 2B-Alert Web, is
available at http://sleep.bhsai.org. This tool can predict the effects of any sleep-wake schedule on vigilance
performance, as well as the efficacy of applying both naps and caffeine as fatigue countermeasures at any
point during a mission.
RESOURCES
11-72. Everyone occasionally experiences difficulty sleeping. Such difficulties may be due to anxiety,
excitement, physical exhaustion or discomfort, travel across multiple time zones, or overuse of caffeine.
Usually, such sleep difficulties are situational and temporary. They easily resolve with time, a change in the
situation, or good sleep hygiene practices. For example, a high operational tempo may be stressful and allow
little time for sleep, or allow for sleep only during the ascending phase of the circadian rhythm of alertness
(for example, the daytime) when the brain’s clock promotes wakefulness. However, as the operational tempo
slows and Soldiers reestablish nighttime sleep opportunities, sleep problems will typically resolve.
11-73. Sometimes, however, sleep problems are more persistent and difficult to address. For example, some
individuals are able to fall asleep easily at night but then experience early morning awakenings with difficulty
returning to sleep. Others persistently experience difficulty initiating sleep at night and awakening when they
need to in the morning. The discussion beginning in paragraph 11-74 provides some self-management
strategies Soldiers can use to address these relatively persistent sleep problems.
SLEEP PROBLEMS
11-74. When Soldiers experience persistent sleep problems despite generally good sleep habits and an
adequate sleep environment, a more concerted effort to improve sleep is warranted. First, Soldiers must
evaluate their sleep habits and sleep environment. |
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11-75. For those who persistently experience difficulty falling asleep, the following suggestions and
techniques may prove helpful:
* Establish a very regular and relaxing pre-sleep routine.
* Practice self-regulation activities such as relaxation exercises and guided meditations. DOD and
the Department of Veterans Affairs developed available applications, and the Human Performance
Resources by CHAMPS (https://www.hprc-online.org/) has various self-regulation activities:
Visualization or guided imagery exercises.
Meditation or mindfulness exercises.
Mental focusing exercises.
* Use an app. There are hundreds of apps for sleep and relaxation, which may help Soldiers fall
asleep and track sleep.
WHEN TO SEEK EXPERT HELP
11-76. Soldiers should schedule appointments with healthcare providers if they have persistent daytime
sleepiness, difficulty staying asleep, difficulty falling sleep, or disturbance of a sleeping partner with snoring
and/or gasping at night.
Sleep Readiness
Soldiers should sleep as much as they can, whenever they can, as the situation allows.
The vast majority of Soldiers require 7-8 hours of sleep per night to sustain
performance; more sleep is better. Soldiers can maximize sleep and subsequent
performance by timing sleep and caffeine use optimally. Finally, only sleep replaces
lost sleep. |
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Special Conditioning
Programs for Soldiers who are having difficulty meeting Army standards are part of
special conditioning. These programs are not punitive. They are restorative. Their
purpose is to build readiness so that Soldiers return to full duty and deploy in support
of any mission. They include training and testing improvement, ABCP, reconditioning
after completing rehabilitation for an injury or illness, and pregnancy and postpartum
physical training (P3T).
REHABILITATION AND RECONDITIONING PROGRAM
12-1. Army leaders prioritize the health and well-being of Soldiers. The focus of H2F System is the physical,
psychological, and social well-being of the Soldier. This integrated approach includes those who are rallying
back to optimal readiness after a period of illness, injury, or deconditioning. Operational unit leaders and
sustaining phase leaders have a responsibility to communicate clearly with their medical counterparts in the
Military Healthcare System when helping Soldiers through these conditions. The H2F personnel in the unit
can perform this function as well and will be the primary leaders of the unit’s special programs.
12-2. Illness occurs when Soldiers deviate from a healthy state and feel helpless, dependent, and continuous
discomfort. It leads to a narrowing of focus and goals and an increase in concern about pain. Illness differs
from disease: a Soldier can feel ill but not have a disease. An illness is a state where a Soldier has feeling of
pain or discomfort that may or may not have an identified cause. A disease might not have symptoms of pain
or discomfort, but it will have an identified cause—a pathology or diagnosis—that causes the body or parts
of the body to not work properly. Whether real or perceived, the physical and psychological responses of the
body to illness or disease is stress. When this type of stress is overlaid on daily hassles, major life events, or
high operational tempo, Army leaders use the H2F System to mitigate the impact on the Soldier and the unit’s
readiness.
12-3. Rehabilitation and reconditioning both depend on the unit’s conditioning program. If leaders do not
synchronize the rehabilitation and reconditioning program with the conditioning program, the Soldier is at
increased risk for chronic injury or re-injury. Exercises and drills for rehabilitation and reconditioning are
based upon the conditioning program. Profiles describe which exercises, drills, and activities can be done to
standard, must be modified, or cannot be performed—are restricted. If the conditioning program changes, or
other physical activity is included in the H2F program, then leaders need to consider the impact on the
rehabilitation and reconditioning programs and the profile system.
REHABILITATION
12-4. Rehabilitation is a program developed and overseen by medical providers that Soldiers begin soon
after becoming ill or injured. Rehabilitation aims to return the Soldier to a baseline of physical function in
daily activities such as personal hygiene and mobility at home and work. Once Soldiers reach this goal, they
may progress to higher levels of function under the direct supervision of a medical provider. When Soldiers
reach rehabilitation goals, the provider can discharge them to full duty or change their profiles so they can
start reconditioning.
12-5. Soldiers may continue rehabilitation, reconditioning, or both until returned to readiness for return to
full duty. Healthcare providers should communicate with H2F personnel to allow the Soldier to safely train
in the reconditioning program. They may remain on profile during this period. |
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RECONDITIONING
12-6. Reconditioning is unit-owned. Reconditioning is a unit-driven and unit-run physical readiness training
program for Soldiers who are deconditioned due to illness or injury, are new to the unit, or deconditioned
due to deployment or other circumstances. Soldiers who have completed rehabilitation and been given
permanent profile restrictions may be appropriate for certain reconditioning program elements. All Soldiers
will have progressed in their recovery to the point where they can safely train without the direct supervision
of a healthcare provider or communication between the medical provider and H2F personnel will allow the
Soldier to safely train in the reconditioning program. Reconditioning returns Soldiers safely and as soon as
possible to full duty.
12-7. In the H2F System, reconditioning drills and exercises provide a standard for Soldiers and units to
follow no matter their circumstances. With the H2F System, units can individualize the reconditioning
program. H2F trainers and healthcare providers in the unit aim to provide early identification and treatment
of injuries and to prevent injuries from happening in the first place—so-called primary injury. When units
receive H2F personnel, Soldiers will manage fewer injuries themselves. That means primary injury control
approaches initially increase in rate and number of injuries since these personnel now identify, diagnose,
record, and treat the injuries. While this increased injury rate surprises some leaders, it is a typical occurrence.
As leaders implement the H2F System—with proper conditioning program and earlier access to treatment—
the unit controls the number of injuries at lower rates or less severe conditions. The expert advice stops
chronic or more serious injuries from developing. Those units that continue with non-standardized, random,
non-periodized training often continue to have a greater need for reconditioning programs.
TRAINING AND TESTING IMPROVEMENT
12-8. When Soldiers fail to meet unit goals, leaders consider many factors that may contribute to these
failures, including physical, psychological, and social areas. These factors may include transitioning from
deployed status, time available to train, participation in H2F programming, family issues, increased stress
from external factors, and recovery from illness or injury.
Time in Training
12-9. Soldiers who just arrived from IMT or just completed professional military education, prolonged
deployment, or remote assignment may perform at or below the minimum unit standard or the baseline for
the ACFT. They may be deconditioned or overweight. They may fail to keep up with the pace of other
Soldiers in the gaining unit. In the face of new physical and psychological stress, they may require several
months to acclimate to the unit’s culture and to acclimatize to the altitude or weather at the new location. An
effective leader provides Soldiers training programs specific to their needs to transition them to optimal
readiness.
Regular Participation
12-10. Many factors influence regular participation in H2F sessions. The most common factor is operational
tempo and related mission requirements. Leaders must anticipate and plan for these and must make H2F
readiness training as important as any other programmed training, even if that means inserting it later in the
morning or afternoon. (In accordance with AR 350-1, Soldiers must participate in collective or individual
physical readiness training at least three times per week.) In the H2F System, optimal participation increases
to 5–7 hours per Soldier per week and includes both physical and nonphysical training. Leaders must
understand this and make it known. A leader excuses Soldiers from H2F programming only when they have
completed exhaustive duties with little or no rest, or have temporary or permanent profiles in accordance
with AR 40-501.
12-11. All Soldiers must understand that it is their personal responsibility to achieve and sustain a high level
of readiness. Many Soldiers are assigned to duty positions that restrict participation in collective unit
programs. Commanders must therefore develop leadership environments that encourage and motivate
Soldiers to accept individual responsibility for their own readiness. |
7-22 | 137 | Special Conditioning
Prolonged Deployment
12-12. While deployed, leaders must make every effort to equip, program, permit, and lead physical
readiness training. Detraining begins in as few as 14 days when Soldiers do not physically train. During post-
deployment, when fitness levels may have declined, leaders must give special consideration to ensure
Soldiers return to or exceed their pre-deployment readiness levels. Soldiers are almost always capable of
rallying back to this level without needing special programming. With adequate recovery, Soldiers should
prepare for the ACFT within 90 days of redeployment. In cases where a deconditioned Soldier cannot meet
this goal, he or she should continue to participate in the unit’s regular training program, modifying the
intensity and frequency of training with guidance from the H2F performance team members.
ARMY BODY COMPOSITION PROGRAM
12-13. The ABCP ensures all Soldiers achieve and maintain optimal well-being and performance under all
conditions. AR 600-9 provides the policy and procedures that apply to screening and enrollment in the ABCP.
AR 350-1 specifies that the ABCP will be kept separate from other special programs. Soldiers who fail to
meet AR 600-9 standards are enrolled in the ABCP and continue to participate in regular unit H2F
programming. The H2F programming guides applicable modifications to Solders’ nutrition and activities to
create a calorie deficit. H2F personnel review Soldiers’ sleep logs and weight loss goals. Soldiers in the
ABCP who are also recovering from injury, illness, or other medical conditions will also be in the
reconditioning program.
INJURED AND ILL SOLDIERS
12-14. Commanders faced with the challenge of controlling injuries while conducting rigorous training
must adhere to the fundamental principles of H2F. In the H2F System, each Soldier has an individual
reconditioning program, written and monitored by H2F personnel in the unit. Soldiers who are reconditioning
will continue to train with the rest of the unit, modifying the drills and exercises with the goal of performing
them to standard and returning to full duty as soon as possible.
12-15. The commander’s role in injury control is to lead by being present during physical training and
reconditioning sessions. Leader presence builds reputation and relationship with Soldiers who are working
toward being mission capable. Commanders who stand in front of their formations (and not just during unit
formation runs) demonstrate compliance with drills and exercises. No matter their level of conditioning or
physical status, commanders’ presence instills pride and “can do” cohesion in their formations. There ought
to be no gap between the commander’s intent to comply with the H2F program and the commander’s
participation in that program. This includes instances where leaders who are pregnant, injured, or
deconditioned use H2F modified drills and exercises, and train alongside the rest of their units. Leader
presence during special programs de-stigmatizes injury and demonstrates support for a key part of the Warrior
Ethos—never leave a fallen comrade.
12-16. Precise execution of all physical training activities is essential to the injury control effort.
Commanders must allow trained H2F leaders the time to teach proper execution of H2F activities. H2F
leaders must be able to recognize and offer corrective guidance to Soldiers who have not developed the
movement skills to execute drills to the standards described in ATP 7-22.02.
12-17. H2F schedules prescribed in this doctrine involve less sustained running than is currently performed
in Army units. Long runs do not have strong correlation with combat-specific physical tasks and do not
properly prepare Soldiers for those tasks. This doctrine carefully balances the requirement to build strength
and endurance to avoid over-emphasizing any single component of readiness. A reduction in running volume
will not hinder performance on two- or three-mile run assessments as long as the proper running intensity is
used. An increase in strength training builds the capability to sustain higher levels of endurance activity.
12-18. Commanders look for and resolve conflicts between the H2F schedule and the unit training schedule.
By considering the physical demands of tasks on the unit training schedule, commanders can better plan
appropriate physical training sessions. For example, if Friday involves a 10-mile foot march to a range,
commanders should not schedule speed work on Thursday. Time should be allotted for leg recovery.
Monday’s and Wednesday’s physical training should not involve Climbing Drills 1 and 2 or the Strength |
7-22 | 138 | Chapter 12
Training Circuit if Tuesday’s unit training schedule takes the unit to an obstacle course that heavily
challenges upper body strength.
PROFILES
12-19. The authorized forms for written profiles in the Army are DD Form 689 (Individual Sick Slip) and
DA Form 3349 (Physical Profile). DD Form 689 is the short form used to communicate to the commander a
Soldier’s diagnosis of minimally-limiting injuries and illnesses, less than or equal to 7 days in duration. It is
often used to place Soldiers on 24 or 48 hour quarters. After that period has ended, healthcare providers
document the Soldier’s restrictions in the Medical Readiness Portal (an electronic profile system) using
DA Form 3349. DA Form 3349 is the long form the healthcare provider must generate and sign electronically
to be valid. It provides a detailed description of the Soldier’s temporary and permanent restrictions. It lists
modifications to physical activities including the ACFT as well as those activities and exercises that can be
performed to standard. Exercises not included on the profile are not authorized. If the unit performs non-
standardized drills and exercises, the commander, healthcare provider, or both will discuss them with the
H2F performance team to avoid increased risk to the unit’s readiness.
12-20. Commanders may assign Soldiers with permanent profiles to the reconditioning program or allow
them to remain in unit physical training programs. A Soldier whose permanent profile only prohibits running
would not be in the reconditioning program—he or she would walk or use endurance training machines
(ETMs) when the unit performs running activities. Soldiers on convalescent leave may be exempted from
reconditioning at the discretion of the profiling officer. In no case can a Soldier carry a temporary profile that
has been extended for more than 12 months without positive action taken to correct the problem or effect
other appropriate disposition in accordance with a medical review board.
12-21. Once a Soldier is no longer on a temporary profile and not on a permanent profile, he or she may
continue to train with assistive devices used during rehabilitation or reconditioning. These devices include
braces, straps, tape, nasal strips, and other muscle- and joint-support devices prescribed or recommended by
the provider or the unit’s H2F performance team. Performance improvement apparel, tracking devices, and
other wearables are also authorized during training. As long as the performance apparel comply with AR
670-1 or can be worn beneath the Army physical fitness uniform (known as APFU), Soldiers do not need a
profile authorizing them to be worn and used during training. These devices aim to enhance performance and
build strength and endurance to the point Soldiers no longer need assistive devices, and performance devices
demonstrate higher levels of physical readiness. Assistive devices for a record ACFT are not authorized
unless annotated on the Soldier’s permanent profile issued after a medical evaluation board.
12-22. Once their profiles end, Soldiers may join or continue unit-based reconditioning. Soldiers on
temporary profiles will not take record ACFTs. They may train for and practice the events, but their focuses
on healing from the injury and then training to pass the test. They will take record ACFTs once the temporary
profile has ended and their command and the H2F performance team agree that they are ready.
INITIAL PHASE RECONDITIONING
12-23. Reconditioning from injury before shipping to BCT is the responsibility of the recruit.
12-24. Reconditioning in IMT is conducted in the FTU, commanded by a physical therapist, and often
includes an organic physical therapy clinic attached. Soldiers remain in the FTU until they are capable of
returning to the same phase of BCT or OSUT that they left. The FTU can also conduct ACFT improvement
for Soldiers who failed to pass the test in time to graduate from BCT. The increased recovery and focused
physical training permitted in the FTU results in high ACFT pass rates and successful completion of BCT. If
an injury is minor and only requires a few days of limitations, the Soldier receives treatment at the medical
treatment facility or from healthcare providers in the unit and continues training with profile restrictions. See
AR 612-201 for guidance on the Warrior Training Rehabilitation Program.
SUSTAINING PHASE RECONDITIONING
12-25. Executing reconditioning programs is problematic in units with a large population of Soldiers who
have profile limitations, few personnel to administer the program, and limited access to equipment and |
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facilities to comply with profile recommendations. In the sustaining phase, the H2F System meets this
challenge with new approaches and resources to permit individual programming. However, in locations that
are remote from or not yet resourced by the H2F System, leaders should tailor guidance discussed in
paragraphs 12-26 through 12-39 on governance, program, equipment and facilities for specific units.
H2F Resourced Unit
Reconditioning for all Soldiers is individualized and Soldiers train together
under the supervision of H2F personnel using H2F equipment and facilities.
Non-H2F Resourced Unit
Reconditioning is supervised by designated unit personnel or medical
providers using installation or non-unit-owned equipment and facilities.
Governance
12-26. In non-H2F resourced units, consolidation of reconditioning programs at the battalion (or equivalent)
minimizes the administrative and logistical strain on operational unit assets. The brigade surgeon should have
medical oversight of the unit reconditioning program. Battalion medical officers act as the liaisons between
reconditioning program leaders (RPLs) and the brigade surgeon. The military treatment facility with
rehabilitation services may provide a physical therapist and a physical therapy specialist as consultants to
oversee the gym-based reconditioning program Category 1 (see paragraph 12-32). The physical therapist can
assist or coordinate training efforts with the RPL.
12-27. The medical platoon leader is the RPL, and the medical platoon sergeant is the assistant RPL. If this
is not possible, then the leader chooses the RPL and assistant RPL based on the following criteria:
* Certified as a MFT.
* Knowledgeable in the Army’s H2F System.
* Able to instruct all physical training activities.
* Understands the regulations and processes that govern profiling (see AR 40-501).
* Able to modify activities in accordance with profile recommendations.
* Able to effectively interact with medical personnel to ensure that Soldiers are fully capable of
returning to the unit conditioning program.
12-28. It is recommended that each company in the battalion provide an NCO to assist the RPL on a daily
basis. These NCOs should meet criteria mentioned in paragraph 12-27 for the assistant RPL. In addition, the
MFT, physical therapist, or physical therapy specialist need to provide quarterly training sessions to ensure
units observe proper supervision and optimal safety practices. Trained NCOs provide supervision and group
instruction to Soldiers in the reconditioning program. To meet supervision requirements, at least two NCOs
per company are trained to conduct and supervise the reconditioning program. Units should constantly recruit
NCOs for the MFT Course to ensure continuity of the physical training and reconditioning programs.
Program
12-29. The reconditioning program aims to return a Soldier to full duty as soon as possible. Group
reconditioning programs with governance and equipment challenges use modifications (known as mods) to
standardized physical readiness drills and activities so Soldiers safely progress and comply with exercise
modifications in their profiles. Using non-standardized exercises and drills confounds this approach and
prevents Soldiers from complying with the rehabilitation plan developed with the healthcare provider. These
drills and activities, learned in the initial phase of training, include foundational movements that Soldiers
must maintain throughout their career. These drills and activities are pre-habilitative and rehabilitative. For
reconditioning Soldiers, these drills and activities provide the best solutions in the absence of easy access to
coaching or rehabilitation personnel who can devise an individual’s customized program. |
7-22 | 140 | Chapter 12
12-30. Group reconditioning meets scheduling challenges and helps Soldiers avoid re-injury.
Reconditioning that has to be performed in groups due to limitations in personnel or facility support can be
delivered by profile category (see paragraphs 12-33 through 12-37). Schedules for group reconditioning are
designed to control the risk of re-injury. Weeks A and B are intended to alternate throughout a Soldier’s
reconditioning until he or she returns to the unit’s physical training program (see table 12-1, table 12-3 on
page 12-7, and table 12-5 on page 12-8).
12-31. Modified exercises are described in discussions of Preparation Drill, Recovery Drill, Conditioning
Drill 1, and to a lesser extent for the drills that incorporate strength training equipment. Not every possible
modification can be illustrated for every injury across every exercise.
Note. The overarching principle for exercise modifications is that the injured Soldier should
continually attempt to perform as close to the standard as possible.
This means Soldiers will perform the largest range of motion and lift the maximum amount of weight
possible, as well as perform as close to the correct number of repetitions and cadence as possible, without
hurting themselves. When a Soldier is profile-restricted from doing an exercise, the Soldier selects another
exercise with similar cadence and, in collective situations, performed along with the rest of the unit. This
approach maintains cohesion with other Soldiers, reduces the likelihood that the injured Soldier will be
stigmatized, and increases the likelihood of the Soldier returning to the unit’s standard.
Category 1: Severe Profile Restrictions
12-32. Entry into Category 1 is directed by the healthcare provider during the Soldier’s initial visit. The
Soldier’s program is a gym-based program that includes a mix of specific rehabilitation exercises and clinic
visits. The Category 1 profile involves any body part affected by a recent severe injury such as fracture, acute
or severe sprains or strains, disc herniation, or recent surgeries (see table 12-1). A Category 1 Soldier may
be—
* Using crutches, braces or a sling.
* Unable to tolerate impact.
* Able to use non-impact ETMs.
* Able to use STMs.
* Able to perform modified Recovery Drill and PMCS.
Table 12-1. Category 1 severe reconditioning schedule template
Week A
Monday Tuesday Wednesday Thursday Friday
Stability Drill Stability Drill Stability Drill Stability Drill Stability Drill
ETM STM ETM STM ETM
Rehabilitation Rehabilitation Rehabilitation Rehabilitation Rehabilitation
RD Mod PMCS RD Mod PMCS RD Mod
Week B
Monday Tuesday Wednesday Thursday Friday
PD Mod PD Mod PD Mod PD Mod PD Mod
Trunk STM Pool Walk ETM legs STM arms ETM arms
Rehabilitation Rehabilitation Pool Rehabilitation Rehabilitation Rehabilitation
PMCS RD Mod PMCS RD Mod PMCS
Rehabilitation exercises are specified by a medical provider.
ETM endurance training machine PMCS preventive maintenance checks and services
Mod modified RD recovery drill
PD preparation drill STM strength training machine |
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Category 2: Moderate Lower Body Profile Restrictions
12-33. Soldiers entering Category 2 for lower body injuries must meet Category 2 entry criteria (see
table 12-2). Lower body injuries in Category 2 include moderate low back pain or mild to moderate foot,
ankle, knee, or hip pain. See table 12-3 for moderate lower body reconditioning. If the injury does not
interfere with use of the uninjured limb, that limb should be trained as close to standard as possible. The
Soldier can tolerate some impact and so is able to—
* Use ETMs such as an elliptical machine or stair master.
* Walk or run in a pool.
* Use STM circuits.
* Perform modified Preparation Drill.
* Perform modified Conditioning Drill 1, Running Drills, and Suspension Drills.
* Perform modified Strength Training Circuit and light Free Weight Training.
* Walk or run in the shallow end or aqua-jog in the deep end of the pool.
* Perform modified Recovery Drill and PMCS.
Table 12-2. Category 2 entry criteria
Exercise Dose
Partial Squats without worsening condition 5 repetitions at slow cadence
Hand-Release Push-Ups without worsening condition 10 repetitions at slow cadence
Rower or Leg Tuck and twist without worsening condition 10 repetitions at slow cadence
Straight-Arm Hang from climbing bar without worsening condition 15 seconds
Walk without worsening condition without limping 30 minutes
Table 12-3. Category 2 moderate lower body reconditioning schedule template
Week A
Monday Tuesday Wednesday Thursday Friday
PD Mod PD Mod PD Mod PD Mod PD Mod
STM arms CD1 Mod, SD1 Pool Run FW, STM Mod ETM legs
Rehabilitation Rehabilitation Rehabilitation pool Rehabilitation Rehabilitation
RD Mod PMCS RD Mod RD Mod PMCS
Week B
Monday Tuesday Wednesday Thursday Friday
PD Mod PD Mod PD Mod PD Mod PD Mod
Trunk STM Pool Walk, RUD Lower ETM Upper STM, MB1 ETM legs
Rehabilitation Rehabilitation pool Rehabilitation Rehabilitation Rehabilitation
RD Mod RD Mod RD Mod PMCS RD Mod
Rehabilitation exercises are specified by a medical provider.
CD1 conditioning drill 1 PMCS preventive maintenance checks and services
ETM endurance training machine RD recovery drill
FW free weight training RUD running drill
MB1 medicine ball drill 1 SD1 suspension drill 1
Mod modified STM strength training machine
PD preparation drill |
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Category 2: Moderate Upper Body Profile Restrictions
12-34. Soldiers must meet Category 2 entry criteria (see table 12-2) for moderate upper body profile
restrictions. The injury involves the hand, wrist, elbow, shoulder, upper back, or neck. If the injury does not
interfere with use of the uninjured limb, Soldiers should train that limb as close to standard as possible (see
table 12-4). For the injured limb, Soldiers can tolerate some impact without aggravating the injury and can—
* Use a recumbent bike or elliptical machine while holding supports.
* Perform lower body STM circuits.
* Perform modified Preparation Drill.
* Perform modified Conditioning Drill 1, Running Drills, Recovery Drill, and PMCS.
* Perform modified Strength Training Circuit and light Free Weight Training.
* Walk or run in the shallow end of the pool or aqua-jog in the deep end.
Table 12-4. Category 2 moderate upper body reconditioning schedule template
Week A
Monday Tuesday Wednesday Thursday Friday
PD Mod PD Mod PD Mod PD Mod PD Mod
CD1 Mod STC Pool Run / RUD FW ETM legs
STM legs SD1 Mod Rehabilitation Pool STM Mod Rehabilitation
Rehabilitation Rehabilitation RD Mod Rehabilitation RD Mod
PMCS RD Mod RD Mod
Week B
Monday Tuesday Wednesday Thursday Friday
PD Mod PD Mod PD Mod PD Mod PD Mod
CD1 Mod Pool Run / RUD ETM legs Upper STM ETM legs
Trunk STM Rehabilitation Rehabilitation SD1 Mod Rehabilitation
Pool
Rehabilitation PMCS Rehabilitation PMCS
RD Mod RD Mod RD Mod
Rehabilitation exercises specified by a medical provider
CD1 conditioning drill 1 RD recovery drill
ETM endurance training machine RUD running drill
FW free weight training SD1 suspension drill 1
Mod modified STC strength training circuit
PD preparation drill STM strength training machine
PMCS preventive maintenance checks and services
Category 3: Minimum Profile Restrictions
12-35. Soldiers must meet Category 3 entry criteria (table 12-5 and table 12-6) for minimum profile
restrictions. The injury involves upper or lower body pain that is resolving. The Soldier is able to participate
in all drills and exercises on the unit physical training schedule, modifying the number of repetitions.
Table 12-5. Category 3 entry criteria
Exercise Dose
Preparation Drill 5 to 10 repetitions
Stability Drills Standard
Conditioning Drills 1 and 2 5 to 10 repetitions
Climbing Drill 1 5 repetitions with spotters
Military Movement Drill 1 Standard
30:60s or 60:120s 5 to 10 repetitions
Strength Training Circuit 1 circuit |
7-22 | 143 | Special Conditioning
Table 12-6. Category 3 minimum profile restrictions
Week A
Monday Tuesday Wednesday Thursday Friday
PD, HSD PD, 4C PD, HSD PD, SSD PD, HSD
MMD1 & MMD2 CD1, CD2 RUD, ETM CL1, STC / FW MMD1 & MMD2
30:60s (5 reps) Rehabilitation RD RD 30:60s (6 reps)
RD PMCS Rehabilitation
Week B
Monday Tuesday Wednesday Thursday Friday
PD PD PD, HSD PD, SSD PD, 4C
ACFT practice Aqua-jog 30:60s (7 reps) MB1, ST1 Release Run (30’)
PMCS Rehabilitation Pool RD PMCS RD
PMCS
Rehabilitation exercises specified by a medical provider.
30:60 30 second sprint: 60 second walk MMD military movement drill
4C four for the core Mod modified
ACFT Army Combat Fitness Test PD preparation drill
CD1 conditioning drill 1 PMCS preventive maintenance checks and services
CD2 conditioning drill 2 RD recovery drill
CL1 climbing drill 1 rep repetition
ETM endurance training machine RUD running drill
FW free weight training SSD shoulder stability drill
HSD hip stability drill ST1 suspension training drill 1
MB1 medicine ball drill 1 STC strength training circuit
12-36. Soldiers will depart Category 3 and the unit’s Reconditioning Program after completing the exit
criteria in table 12-7 or when instructed to return to full training by an H2F or unit medical provider.
Table 12-7. Category 3 exit criteria
Exercise Dose
Preparation Drill (PD) without worsening condition 5 repetitions at standard cadence
Military Movement Drill 1 (MMD1) without 1 repetition
worsening condition
Conditioning Drills 1 and 2 (CD1 & CD2) without 5 repetitions at standard cadence
worsening condition
Climbing Drill 1 (CL1) without worsening condition 1 repetition at standard cadence
Release Run (RR) without worsening condition 30 minutes at slowest unit ability
group run (AGR) pace
Equipment and Facilities
12-37. Units ensure adequate space and equipment are provided for the reconditioning program to
accommodate STMs and ETMs. In the absence of H2F equipment sets and expertise, Soldiers best execute
the reconditioning program at the brigade or installation fitness facilities. Lower extremity injuries may
hinder a Soldiers ability to appropriately perform strength- and endurance-related activities. Units need to
provide an adequate number of ETMs that offer alternative activities so as to not aggravate or continue to
injure Soldiers while promoting conditioning and recovery. Sample ETMs include cycle ergometers,
steppers, elliptical machines, rowing machines, rope climbers, and treadmills. Treadmills are full weight
bearing machines and are most appropriate for Soldiers cleared by medical personnel to begin a walk-to-run
progression. Specialized treadmills that reduce weight-bearing have the potential to further speed recovery
and, because of their harness systems, have the advantage over conventional treadmills of eliminating the
risk of falling while walking or running.
12-38. Pool activities such as swimming or deep-water running eliminates most weight-bearing stress. All
Soldiers recovering from surgery or have wounds that are still healing require a physician’s clearance before |
7-22 | 144 | Chapter 12
entering the swimming pool. Swimming laps, aqua-jogging, and aquatic exercises enable Soldiers to maintain
or improve cardiorespiratory fitness without putting undue stress on joints and bones. Limitations to one leg
or one arm are minimal deficits in a pool environment. Kick board workouts or upper body workouts allow
for strenuous activity with minimal risk of re-injury to an affected limb. With enough staffing, units can
implement specialized aquatics programs to work on water aerobics or deep-water running programs for non-
swimmers. Effective leaders plan activities that keep everyone active during group pool sessions. Even if a
regular pool program is not practical, leaders can schedule an occasional trip to the pool to break up the
routine and provide cross training.
12-39. Units that must rely on installation or shared facilities should make arrangements to ensure that space
and STMs or ETMs are available during the time dedicated to the reconditioning program. This may require
policies that restrict the use of these facilities to only reconditioning programs. Leaders might need to
schedule reconditioning outside typical physical training times such as after 0800 or before 1600 to best have
dedicated access to gym space and equipment.
PREGNANCY AND POSTPARTUM PHYSICAL TRAINING
12-40. Soldiers are expected to meet strenuous physical fitness standards when they return to their jobs after
their postpartum phases have ended. A P3T program aims to help pregnant and postpartum Soldiers maintain
fitness throughout their pregnancies and to help them meet the physical requirements of their units’ METLs,
as well as the standards of the ABCP and ACFT.
12-41. In the H2F System, pregnant Soldiers perform the majority of their special programs in the same
environments and at the same times as their units under the supervision of medical providers or exercise
leaders certified in P3T. When the unit trains as a whole, it maintains cohesion, reinforces performance, and
sustains unit readiness and retention. Sometimes multiple units consolidate P3T education classes for Soldiers
to establish support networks and to promote peer reinforcement on topics about pregnancy, labor and
delivery, newborn babies, and parenting issues. Instructors can use classrooms in the SPRC to teach these
sessions while the rest of the unit performs other H2F training in the building.
12-42. Soldiers diagnosed as pregnant or who are recovering after their pregnancies perform physical
activities directed in their pregnancy profiles up to 45 days after the end of their pregnancies. They do not
have to meet the physical training goals or test standards of the unit during this time. During maternity or
convalescent leave, leaders encourage Soldiers to follow at-home exercise programs. Soldiers can also attend
P3T while still on maternity or convalescent leave. If postpartum Soldiers pass practice ACFTs, and receive
clearances from their healthcare providers, they may return to unit physical training before the one-year
requirement to pass the ACFT. They must submit a DA Form 4856 (Developmental Counseling Form) to
complete disenrollment from P3T.
Note. In the event that a Soldier’s pregnancy ends before normal delivery, consult with the
Soldier’s healthcare provider regarding participation in the postpartum phase of P3T.
PRECAUTIONS FOR PREGNANT SOLDIERS
Commanders and H2F performance team personnel must ensure that Soldiers
follow these safety precautions:
Soldiers must have written approval from a healthcare provider that clears them
to exercise during pregnancy. The DA Form 3349 (specified for pregnancy) will
indicate if they are allowed to exercise at their own pace.
Soldiers are encouraged to continue to run or jog through the 2nd trimester at
their own pace.
Soldiers are encouraged to participate at the highest level they are comfortable
and at their own pace. |
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PRECAUTIONS FOR PREGNANT SOLDIERS (CONTINUED)
Soldiers must bring water to exercise sessions and are encouraged to drink water
as needed.
Soldiers are excused to use the restroom as needed.
Soldiers are encouraged to consume a small amount of calories before the
exercise session.
Soldiers are allowed to modify exercises to reduce physical discomfort (such as
nausea, fatigue, or pain).
Soldiers are to be led in strength and endurance exercises at a slow pace, which
may be slower than the standard slow cadence of 50 counts per minute.
Pregnant Soldiers will not exercise to exhaustion, breathlessness, or fatigue. If
Soldiers exhibit these signs, leaders coach them to decrease the intensity or to
stop vaginal bleeding, abdominal pain, regular painful contractions, and amniotic
fluid leakage.
Pregnant Soldiers should be led in slow, deep breathing during all phases of
exercise to prevent them from hyperventilating.
Soldiers more than 20 weeks pregnant do not perform exercises lying on their
backs.
Soldiers more than 20 weeks pregnant must use a splinting technique to support
their abdomens during all abdominal exercises.
Weight bearing activities (running and jogging) for pregnant Soldiers are limited
to 45-minutes to prevent decreased blood flow to the heart and uterus.
Pregnant Soldiers are not to perform activities that put them at risk of falling or
being hit in the abdomen.
If a Soldier less than 20 weeks pregnant falls during an exercise, she should rest
for 10 minutes on her side and notify her health care provider for further
instruction. If symptoms of injury exist (such as cramping, bleeding, or swelling),
the Soldier should go to the emergency room. If the Soldier is more than 20
weeks pregnant, then she needs to seek immediate care at the medical treatment
facility.
Pregnant Soldiers with the following symptoms are to be referred to health care
provider immediately: swelling of face and hands; severe headaches; persistent
dizziness; chest pain; palpitations; difficulty walking due to pain, vaginal bleeding
or discharge; fever; or contractions that increase in intensity, frequency, or
duration.
Soldiers follow trained exercise leaders who can assist them in modifying
exercises to fit their pregnancy or postpartum conditions. Training is not be led
by other pregnant Soldiers.
Safe and beneficial exercises during pregnancy include walking, stationary
cycling, aerobic exercises, dancing, resistance exercises, stretching exercises,
hydrotherapy, and water aerobics.
The exercise session must always have at least two exercise leaders in
attendance who will correct exercise performance to prevent injury.
After 20 weeks gestation, Soldiers need modified or substituted physical training
activities to accommodate physiological changes and to promote safe
performance.
Leaders use RPE to monitor exercise intensity during pregnancy. Moderate-
intensity RPE of 5 to 7 is acceptable, or using the “talk test.” As long as a Soldier
can talk while exercising, she likely is not overexerting herself. |
7-22 | 146 | Chapter 12
PRECAUTIONS FOR POSTPARTUM SOLDIERS
Commanders and H2F performance personnel must—
Administer a needs analysis or standardized postpartum questionnaire that
includes questions about cesarean-section, other delivery complications, or
profile limitations that will influence exercise performance.
Offer guidance as to the appropriate modifications required by their individual
condition or limitations.
Recondition postpartum Soldiers who have had cesarean sections more slowly
and modify exercises to reduce jumping, twisting, and pulling on the abdomen.
Ask postpartum Soldiers if they have a separation midline between vertical
abdominal muscles and give guidance as to the appropriate abdominal exercises
based on their condition. A Soldier with a separation of more than two fingers in
width must manually splint her abdomen during abdominal exercises.
Encourage Soldiers to not move or change direction quickly and to exercise at a
slow pace for the first 10 weeks after delivery.
Watch for Soldiers with pelvic pain, low back or sciatic nerve pain, difficulty
walking, limping, incontinence during exercise, or with deep abdominal pain.
They may need to further modify exercise performance and check with their
providers for exercise restrictions.
Encourage frequent hydration (preferably with water). Dehydration remains a
concern after pregnancy, especially for breastfeeding mothers.
Give postpartum Soldiers the chance to practice ACFT events and measure their
body composition as part of their needs analysis and program development.
Progress postpartum Soldiers to unit conditioning program and use
reconditioning programs to do so.
Watch for symptoms of depression that may occur between 3 and 4 months
postpartum. Encourage Soldiers who exhibit symptoms to seek professional
assistance, and alert the Soldier’s chain of command about a potential concern.
PREGNANCY AND POSTPARTUM PHYSICAL TRAINING
EXERCISE SESSIONS
12-43. It is safe for Soldiers to continue or start most types of exercise during a normal, uncomplicated
pregnancy. Soldiers who were very active before pregnancy or are experienced runners, for example, may be
cleared by medical providers to keep doing the same workouts well into their pregnancies. Physical activity
does not increase risk of miscarriage, low birth weight, or premature delivery. The benefits of exercise during
pregnancy include the following:
* Decreased risk of pregnancy-related medical complications.
* Reduced back pain.
* Healthy weight gain during pregnancy and healthy weight loss afterwards.
* Improved maintenance of overall physical readiness and health.
12-44. The changes in the body during and after pregnancy drives the frequency, intensity, duration, and
types of drills and exercises performed. See table 12-8. Each physical training session should integrate
multiple exercise components. During pregnancy, Soldiers deliberately limit intensity. They limit their
physical fitness components to muscular strength, muscular endurance, flexibility, and aerobic endurance.
Exercises promote the fullest safe range of motion, balance, coordination, and healthy body composition. |
7-22 | 147 | Special Conditioning
Table 12-8. P3T drills, exercises and schedule template
Strength and Mobility Drills and Exercises
Pregnancy Upper Body Lower Body Core Flexibility
Kegel SSD Hip Stability Drill 4C PMCS
Standing Trunk Chest Press Front Leaning CD1 Mod RD Mod
Curve Rest Mod
Biceps Curls Trunk Extension PD Mod
Pelvic Clock Seated Row Hamstring Curls Trunk Flexion
Deep Sumo Squat Shrug Leg Press Front Leaning Rest
CRP Bent Over Row Squat Bender Mod
Lat Pull Down Forward Lunge Sit-ups Mod
Deep Sumo Squat Reverse Sit-ups
Oblique Sit-up
Endurance Activities
No Impact Lower Light Impact Lower Moderate Intensity Upper Body
Body Body Lower Body
Rowing Machine MMD1 / RUD Stair Climber Upper Body Cycle
Aqua-jogging Treadmill walking Water Aerobics Rope Climb Machine
Elliptical Foot March Release Run
Stationary Cycling
Pregnancy Daily Schedule Template
Monday Tuesday Wednesday Thursday Friday
Preparation PD Mod PD Mod PD Mod PD Mod PD Mod
SSD Mod HSD 4C HSD SSD
Activities STMs upper RUD, MMD1 Pregnancy Ex’s CD1 Mod STMs lower
Pregnancy Ex’s ETM, Walk FW RR / ETM / FM Pregnancy Ex’s
Recovery PMCS PMCS PMCS PMCS PMCS
RD Mod RD Mod RD Mod RD Mod RD Mod
Postpartum Weekly Schedule Template
Week 1* Week 2 Week 3 Week 4 Week 5
Preparation CRP** x 2 mins CRP x 3 mins CRP x 3 mins CRP x 3 mins CRP x 3 mins
Kegel (5 reps) Kegel (10 reps) Kegel (3x5 Kegel (4x5 Kegel (3x10)
reps) reps) PD Mod
Activities Walk (5-10 Walk (5-15 Walk (5-20 Walk (5-30 Walk (5-40
mins) mins) mins) mins) mins)
Pregnancy Ex’s ETM
Recovery Mindfulness RD Mod RD Mod PMCS RD
CRP x 10’ RD
*First week after the end of the pregnancy **Constructive Rest Position
4C four for the core Mod modified
CD1 conditioning drill 1 PD preparation drill
CRP constructive rest position PMCS preventive maintenance checks and services
ETM endurance training machine RD recovery drill
Ex exercise reps repetitions
FM foot march RR release run
FW free weight training RUD running drill
HSD hip stability drill SSD shoulder stability drill
min minute STM strength training machine
MMD1 military movement drill 1 |
7-22 | 148 | Chapter 12
12-45. P3T sessions include three typical elements: preparation, activities, and recovery. A preparation
activity called centering—purposeful concentration on the base of support and changing center of mass—
and relaxation are unique P3T activities leaders deliberately program into the Soldier’s schedule. Preparation
and strength training should occur before endurance training. To avoid light-headedness when getting up
from the ground, standing exercises should precede sitting and floor exercises. For the same reason, pregnant
Soldiers do not return to the position of attention between floor exercises. They use that time to recover in
place. Recovery at the end of the session safely returns the Soldier to the pre-exercise state. In pregnant
Soldiers, a heart rate below 100 bpm indicates that they have returned to a pre-exercise level of exertion.
PREPARATION
12-46. P3T preparation aims to get the Soldier’s mind and body ready for exercise. It consists of centering,
core compressions, and modified Preparation Drill. It should last approximately 15 minutes. Centering
focuses on mental preparation, deep abdominal breathing, and physical balance. Soldiers can perform it
sitting or standing. When a profile restricts Preparation Drill exercises, Soldiers can perform other general
warm up movements including walking, marching or jogging in place, dynamic stretching, or easy aerobic
dance steps. Soldiers focus also on core compressions on the transversus abdominis (muscle layer on sides
of the abdomen). They pull the belly button in and toward the spine, hold for a few seconds, and repeat for a
minute.
ACTIVITIES
12-47. Pregnant Soldiers should plan to exercise three to five times per week for 60 to 90 minutes at each
session. Microcycles of one week and mesocycles of two to four weeks allow sequential training and fit
neatly into the three trimesters of pregnancy and the postpartum period. Leaders can modify periodized
training cycles to accommodate the changes occurring in the pregnant Soldier’s fitness and fatigue levels,
directives from medical providers, and the Soldier’s motivation to train.
12-48. Otherwise-healthy, postpartum Soldiers resume core strengthening exercises shortly after giving
birth. They may need modifications to core and hip strengthening exercises at first, but as they progress,
standard movements become safe. Before resuming sit-up type exercises, Soldiers should be checked by their
medical provider for rectus diastasis, a midline separation between the vertical muscles of the abdomen.
Twelve weeks after the pregnancy has ended, postpartum Soldiers should be able to run three times per week.
Postpartum Soldiers with leadership qualities should also be considered by commanders for leadership roles
in the P3T program.
RECOVERY
12-49. Relaxation and stress management are recovery activities that maintain a pregnant Soldier’s health
throughout her pregnancy and prepare her to conserve energy during labor and delivery. A quiet, comfortable,
and dimly lit environment with calming music can assist with mental imagery, deep breathing practice,
muscle relaxation, and mindfulness practice.
PREGNANCY AND POSTPARTUM PHYSICAL TRAINING
EXERCISES
12-50. Soldiers maintain physical fitness with P3T exercises. Each exercise may be selected for Soldiers
by their providers and coached in the P3T program by H2F performance specialists. Table 12-9 lists P3T
exercises (see ATP 7-22.02 for illustrations). Soldiers adjust the dose and range of movement based on their
specific needs, level of conditioning, and trimester. |
7-22 | 149 | Special Conditioning
Table 12-9. Pregnancy and postpartum physical training exercises
Name Description
Kegel This exercise strengthens the muscles of the floor of the pelvis. These muscles, support
the contents of the pelvis and surround the birth canal. The Kegel requires expert medical
instruction for beginners. Like any muscles, the muscles of the pelvic floor can be
strengthened over time to reduce the chance of long-term dysfunction, pain, and
incontinence particularly associated with pregnancy. Three sets of 10–15 repetitions of
Kegel exercises should be performed as part of a daily routine.
Pelvic Clock This exercise strengthens and improves the control and coordination of muscles in the
lumbar spine and pelvic region. Often used in the treatment of low back pain, the Pelvic
Clock exercise safely unloads the spine and maintains mobility in the joints of the lumbo-
pelvic region. Attention should be paid to limiting how long a pregnant Soldier remains on
her back when performing this exercise, especially in the second and third trimesters.
Deep Sumo This squat is similar to other squatting exercises. This version safely prepares Soldiers for
Squat delivery of their babies. It challenges balance and hip mobility and prepares for a return to
similar movements with free weights in the postpartum and reconditioning periods after
pregnancy.
Standing To avoid prolonged supine positions, Soldiers can use the Standing Trunk Curve exercise
Trunk Curve to safely engage muscles in the front of the abdomen and pelvis. It can be practiced
through the third trimester and in the postpartum period by Soldiers who have no rectus
diastasis or no diastasis greater than two fingers wide. The exercise can be performed in
a seated position to make it easier, or on hands and knees to make it harder.
Sit-ups Modified Sit-ups, Reverse Sit-ups, and Oblique Sit-ups safely challenge the pregnant and
(Modified) postpartum Soldier’s abdominal muscles. The Modified Sit-Up and Oblique Sit-Up
exercises can be practiced during the first trimester and in the postpartum period by
Soldiers who have no rectus diastasis (midline separation of the vertical muscles of the
abdomen) or no diastasis greater than two fingers wider than two fingers. Reverse Sit-
Ups with the splinting technique are to be performed after 20 weeks of pregnancy, and by
any Soldier with a diastasis of more than two fingers wide.
Front To prepare for training and testing events, Soldiers can adapt the Front Leaning rest
Leaning Rest position by moving to a six-point position or by resting on their forearms with elbows bent.
(Modified) These static positions allow for weight-bearing through the upper body and keep the
pregnant Soldier’s abdomen safely off the ground.
Constructive In the Constructive Rest Position the postpartum Soldier lays on her back with hands
Rest Position resting on her abdomen to facilitate relaxation and focused breathing.
(CRP)
PREGNANCY AND POSTPARTUM PHYSICAL TRAINING
EDUCATION SESSIONS
12-51. Weekly education sessions are taught during P3T during pregnancy and monthly during post-partum
Soldiers to improve Soldier preparedness for pregnancy and parenthood. Core curriculum sessions are
mandatory and may be repeated twice during the year. See table 12-10 on page 12-16. |
7-22 | 150 | Chapter 12
Table 12-10. P3T core curriculum sessions
Course Description
Prenatal
Pregnancy and Program overview of P3T implementation, enrollment process, attendance
postpartum physical requirements, uniform policy, benefits, exercise intensity, safety procedures,
training (P3T) orientation special exercises, exercise session components, and education classes.
and special exercises
Nutrition While Pregnant Benefits of healthy nutrition for pregnant and breastfeeding women.
Identifies key nutrients, amount of calories needed to support healthy weight
gain, foods and beverages to avoid, ways to maintain a healthy diet with
dietary restrictions, tips for safe food preparation, and resources for
nutrition.
Fetal Development Development of the baby according to the month of pregnancy:
Major internal and external organ systems and their functional
characteristics.
Things your baby does.
Cognitive development and things baby responds to.
Readiness for birth and risk if born prematurely.
Tips for coping with the changes of pregnancy.
Dental Health During Dental treatment during pregnancy, how pregnancy impacts fetal tooth
Pregnancy development, how pregnancy alters oral health, and ways to improve oral
hygiene during pregnancy.
Physical Changes During The anatomical and physiological changes that occur during pregnancy.
Pregnancy Impacts of these changes on postural dynamics, movement, muscles, and
potential for injury. The means to combat these effects.
Exercise and Pregnancy Scientific evidence of the beneficial effects of exercise on pregnancy,
benefits expecting mothers may attain by meeting recommended guidelines,
negates perceived risks that may hinder engaging in physical activity during
pregnancy, and benefits of exercise that a baby may attain with regular
maternal exercise.
Sleep in Pregnancy Sleep recommendations and how pregnancy changes sleep. Tips for
improving sleep.
Breastfeeding Advantages of breastfeeding, preparations for breastfeeding, nursing
positions, breast care, breastfeeding challenges, and weaning. Government
and military breastfeeding policies, information on breast pumping, and
government and nongovernment online resources for nursing moms.
What to Expect in Labor Information about each phase of labor and delivery. Prepares parents to be
and Delivery a part of the decision-making process and gain confidence at birth.
HIV and Sexually Discussion regarding sex during pregnancy and after delivery. Describes
Transmitted Diseases sexually transmitted diseases symptoms and treatments.
Reproductive Hazardous Defines reproductive and developmental hazards and explains most
Exposures important facts about toxicology. Lists common chemical, drug, and physical
hazards and legal sources of information provided to help with decision
making.
Postpartum
Pregnancy Prevention Myths and facts on reproductive health, birth control, available contraceptive
and Contraception options. Recommendations for how to make the right personal choice.
Psychological and Explanations of psychological issues of postpartum blues, postpartum
Interpersonal Issues depression, and postpartum psychosis. The benefits of exercise during
postpartum. How complicated pregnancies impact psychological functioning.
Nutritional Readiness Details on how to eat nutritiously during postpartum for the health of mother
and baby, especially for breastfeeding mothers. Successful and safe
strategies for weight and body fat loss. |
7-22 | 151 | Special Conditioning
Table 12-10. P3T core curriculum sessions (continued)
Course Description
Postpartum
Sleep Sleep recommendation for all ages and tips for good sleep during
postpartum.
Parenting Issues
Parenting Child rearing principles and expectations in the first four years; coping skills
for discipline, sibling issues, and rivalry.
Stress Management Broad overview of stress definition, sources of stress, common reactions,
coping mechanisms, and stress reduction tips.
Military Issues
Social Services for Military The following programs are explained:
Women Infants and Children (known as WIC).
New parent support program.
Social work services.
TRICARE and Defense Enrollment Eligibility Reporting System (known
as DEERS).
Family Advocacy Program (known as FAP).
Community resources
Army Community Service (known as ACS).
Child and Youth Services (known as CYS) care.
Military housing issues.
Career Options 8 Explains pregnancy policy, separation due to pregnancy, reassignments,
Including Separation from basic allowance for subsistence and basic allowance for housing, family
Service care plan, and costs associated with an infant.
Infant Issues
Infant Dental Care Explanation of oral conditions of infancy, development of teeth, prevention
and causes of early childhood cavities, and the first dental visit.
Pet Safety Benefits and risks of pet ownership, goals for pets, preparing for bringing
baby home, preventing dog bites, and feline tips.
Infant Immunizations Overview of infant and childhood immunizations and the importance of
having children vaccinated.
Safety Recommendations for safety of an infant in the car, at home, in the
bathroom, kitchen, with toys, sleeping, and fire prevention. First aid tips,
household hazards, and poison control are also discussed.
Social Services
Child Development Basic aspects of care and wellness for a baby to include: newborn
characteristics, care and feeding of the newborn, behavioral cues, signs of
illness, and sudden infant death syndrome (known as SIDS). |
7-22 | 153 | PART FOUR
Deliver
This part of the doctrine provides practical examples for leaders and H2F performance
experts to coach Soldiers about the H2F programs.
Chapter 13
Holistic Health and Fitness Coaching
H2F coaching is the act of teaching Soldiers the techniques, tips, and procedures for
improving and maintaining high levels of readiness. The information in this chapter
delivers practical health advice for the domains: physical readiness, nutritional
readiness, mental readiness, spiritual readiness, and sleep readiness. This chapter offers
ways for Soldiers to reflect on their holistic health and address what they need to do to
improve their readiness. This chapter provides the tactical information for whole
Soldier health and fitness, from the skin in and from the neck up.
BUILDING SOLDIER H2F READINESS
Attention, perception, and expectation
What Soldiers pay attention to and perceive—and what they expect to happen—has a
profound impact on their overall health.
13-1. The things that Soldiers focus on tend to drive the trajectories of their lives. The more Soldiers learn
to pay attention to their health and fitness, the more dramatic and positive their improvements in readiness
will be. Soldiers are capable of creating new pathways in their brains that will change their ways of reacting,
deciding, and behaving.
13-2. In organizations where positive lifestyle choices are valued and encouraged, those member more often
make the right choices. When Soldiers learn to focus on positive events, they more likely overcome the
negative, which all of us tend to find first. In successful teams, supervisors give three times as much positive
feedback as negative feedback.
13-3. Soldiers have their own unique perspective formed by personal experiences, histories, and education.
Changing perspectives requires deliberate hard work on the part of Soldiers, their leaders, and the
performance readiness experts in the H2F System. Focusing on specific health behaviors can impact a
Soldier’s perspective. This section of the doctrine directs holistic health coaching, teaching, and mentoring. |
7-22 | 154 | Chapter 13
HOLISTIC HEALTH
13-4. While certain behaviors make a huge impact on holistic health, Soldiers will have challenges in
different areas. The specific health behaviors associated with optimal health are—
* Eat vegetables and fruit.
* Exercise.
* Avoid tobacco use.
* Avoid excessive alcohol consumption.
* Sleep.
* Take medication only prescribed by your provider.
13-5. The domains of readiness in this doctrine cover these behaviors and much more. Soldiers have many
choices and large potential to achieve optimal health and fitness. Figure 13-1 lists these areas.
Figure 13-1. Circle of health
13-6. To help Soldiers take stock of where they stand on the circle of health, the personal health inventory
(PHI) has been developed. A completed PHI gives the Soldier and H2F performance team a full picture of
what really matters in the Soldiers’ lives, what they intend to use health for, what brings them joy and
happiness, and what their vision is of their best possible health and fitness. Table 13-1 gives the overview of
the PHI. The PHI can be taken at a time to be determined. |
7-22 | 155 | Holistic Health and Fitness Coaching
Table 13-1. Personal health inventory components
Component Examples
What really matters? Identified values, mission, aspirations, and purpose
What is going right Assets
already?
Goals SMART (specific, measurable, attainable, relevant, time-specific)
Mindful awareness Focus on what is important
Self-care Food and drink; recharge; personal development; family, friends and
colleagues; power of mind, spirit and soul; and working the body
Professional care Prevention, illnesses, referrals, screening, complementary approaches
Community Resources, team members
Next steps Follow-up, support
13-7. Mindfulness is paying attention, on purpose and without judgment, to the present moment. Mindful
awareness or mindfulness is a key component of cultivating presence—paying attention or being aware of
the moment—and it is essential for H2F. Unless Soldiers pay attention or take notice, they cannot change or
grow. Learning to focus on one thing for a period often contradicts normal behavior. When the mind is too
full of thoughts, it cannot focus in the present moment. The objective is to be mindful.
13-8. Everyone has the capacity to be mindful. It is a natural capacity to pay attention with curiosity and
openness. Simple examples include enjoying a cup of tea or coffee, watching the sunset, savoring a favorite
food, or noticing the details of driving home from work. Soldiers use some techniques, like meditation, to
foster mindful awareness, but mindful awareness is really about an overall approach that goes wherever the
Soldier goes. Mindfulness involves tuning in with personal thoughts and practicing awareness of
relationships with these thoughts.
13-9. Practicing mindfulness and other forms of meditation has many health benefits. Changes in brain
activity appear after a few weeks of mindfulness practice. Other physiological changes are associated with
increased relaxation, improved focus, reduced inflammation, lower stress hormones, and enhanced immune
system function. For healthy Soldiers, changes can include reduced stress, anxiety, depression, anger and
distress; improved quality of life, higher emotional intelligence, creativity and concentration; and increased
empathy, spirituality, and self-compassion.
13-10. For those Soldiers with health issues, mindfulness can ease chronic pain, decrease high blood
pressure, and calm stress hormones and inflammatory processes. It can help with smoking cessation,
decreasing binge eating and substance abuse, and reducing sleep difficulties. |
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