title: Operational Physical Performance and Fitness in Military Women: Physiological, Musculoskeletal Injury, and Optimized Physical Training Considerations for Successfully Integrating Women Into Combat-Centric Military Occupations.
abstract: This article summarizes presentations from a 2014 United States Department of Defense (DoD) Health Affairs Women in Combat symposium addressing physiological, musculoskeletal injury, and optimized physical training considerations from the operational physical performance section. The symposium was held to provide a state-of-the-science meeting on the U.S. DoD's rescinding of the ground combat exclusion policy opening up combat-centric occupations to women. Physiological, metabolic, body composition, bone density, cardiorespiratory fitness, and thermoregulation differences between men and women were briefly reviewed. Injury epidemiological data are presented within military training and operational environments demonstrating women to be at a higher risk for musculoskeletal injuries than men. Physical training considerations for improved muscle strength and power, occupational task performance, load carriage were also reviewed. Particular focus of this article was given to translating physiological and epidemiological findings from the literature on these topics toward actionable guidance and policy recommendations for military leaders responsible for military physical training doctrine: (1) inclusion of resistance training with special emphasis on strength and power development (i.e., activation of high-threshold motor units and recruitment of type II high-force muscle fibers), upper-body strength development, and heavy load carriage, (2) moving away from "field expediency" as the major criteria for determining military physical training policy and training implementation, (3) improvement of load carriage ability with emphasis placed on specific load carriage task performance, combined with both resistance and endurance training, and (4) providing greater equipment resources, coaching assets, and increased training time dedicated to physical readiness training.
authors.affiliation: U.S. Army Public Health Command, US Army Institute of Public Health, 5158 Blackhawk Road, Aberdeen Proving Ground, Aberdeen, MD 21010.
authors.forename: Bradley C
authors.initials: BC
authors.lastname: Nindl
authors.affiliation: U.S. Army Public Health Command, US Army Institute of Public Health, 5158 Blackhawk Road, Aberdeen Proving Ground, Aberdeen, MD 21010.
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Jones
authors.affiliation: Consortium for Health and Military Performance, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Van Arsdale
authors.affiliation: Department of Warfighter Performance, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106.
authors.forename: Karen
authors.initials: K
authors.lastname: Kelly
authors.affiliation: Department of Human Sciences, College of Education and Health Ecology, The Ohio State University, 127 Arps Hall, 1945 North High Street, Columbus, OH 43210.
authors.forename: William J
authors.initials: WJ
authors.lastname: Kraemer
mesh_terms: D003226:Congresses as Topic; D005260:Female; D006801:Humans; D008889:Military Personnel / Q000193:education*; D009141:Musculoskeletal System / Q000293:injuries*; D060051:Occupational Injuries / Q000209:etiology / Q000517:prevention & control*; D010806:Physical Education and Training / Q000379:methods*; D010809:Physical Fitness; D055070:Resistance Training; D014481:United States; D059030:United States Department of Defense; D014930:Women