During their day to day activities, Special Forces soldiers place considerable stresses on their bodies. The continual arduous training undertaken through force generation cycles followed by complex and demanding operational duties mean that these stresses potentially last the duration of the soldier’s service. While the risk of musculoskeletal injuries through physical stress is present, it is mitigated by a high level of personal physical fitness and meticulously monitored training. Considering this, every SF soldier, at some time in their career, may encounter a battle with injury.
If an injury does occur the process of regenerating the soldier may take many forms, from a short and relatively uncomplicated process (an ankle sprain for example) to a more lengthy, complicated and multidisciplinary process (ligament rupture for example). The ultimate aim of regenerating the soldier is a full return to functional duty. This sees the Special Forces soldier undertake their regeneration with the same resolve that served them well in their initial Special Forces selection. With the dedicated support of fellow soldiers and a highly skilled rehabilitation team, the Special Forces soldier approaches their rehabilitation with a mind set of ‘what can I do?’ rather than ‘what can’t I do?’ While this dedication and mental strength serves the soldier well, it may need to be tempered if they are to avoid outpacing their regenerating bodies.
Just as the Special Forces soldier appreciates the potential need for a high level of support to optimise their training and operations (intelligence, mobility and lethality asset support as examples) so too do they appreciate the need for support as part of their recovery from injury. Depending on the circumstances and nature of injury, this support can commence with triage provided by fellow soldiers and combat medics before progressing to injury treatment by specialist surgeons, doctors and nurses.
Finally, assisted by physiotherapists and Physical Training Instructors, the potentially slow and frustrating period of returning resilience to the injured tissues is undertaken. This final stage of regeneration will vary, depending on the soldier, their injury and their return to work needs. As such, the program will consider the soldier’s attitude, being wary of their tendencies to push too hard too quickly, and be tailored to their individual needs.
The Five Phases of Regenerating the Special Forces Soldier
1. Rest the Warrior – Following any injury, initial recovery commences with rest and recuperation. While any reduction and restriction to physical activity can frustrate the soldier, rest for the injured part is important if effective healing is to be promoted and further damage to the body avoided. This does not however mean that the injured soldier is limited to doing nothing and often other forms of lower level conditioning, that do not hinder the recovery of the injured site, can occur. On this basis the protocol of; Protecting the injured area, Optimal limb Loading, Ice, Compression, and Elevation (POLICE) are key to a speedy recovery.
2. Move the Warrior – As soon as possible the soldier must start to move again and restore functional range of movement to the injured body part. Range restoration will usually begin with accessory or passive movements of the injured part. Depending on the method employed and the severity of the injury this treatment may initially be provided by a physiotherapist or Physical Training Instructor before the warrior facilitates their own treatment. Once general range of motion is restored the soldier will start to strengthen the body part through this range and restore optimal muscle control. Concurrently, during this period of regeneration, the soldier will maintain general conditioning for the rest of their body and monitor their nutritional intake in order to limit fitness loss and prevent an increase in body weight. This integrated approach of injury treatment and general body management enhances the soldier’s potential to be job ready at the earliest possible stage in their regeneration process.
3. Remodel the Warrior – The soldier will continue to strengthen the regenerating body part, increasing the volume and intensity of their conditioning steadily and progressively. In order to limit the chance of re-injury and prepare for return to work the initial focus of the conditioning will be on establishing tissue resilience rather than fitness. Considering this, tissue strengthening and movement control become the key foci. General resistance training through more complex movement patterns will develop strength and resilience throughout range while proprioception, balance, agility and coordination training will be used to optimise movement control. Once a measure of tissue resilience and movement control have been established, the soldier’s regeneration pathway will focus on progressively returning their body to the level of fitness, both metabolic (aerobic and anaerobic) and neuromuscular (strength, power, muscle endurance), that they maintained prior to their injury.
4. Warrior Specific Training – Now physically fit again, the soldier can begin to move into the demanding and specific requirements of their occupation. The soldier will train using methods that best mimic their workplace demands, cognisant of the requirements for reinstatement to full duty status. This training may commence with shortened sessions that gradually increase in duration, intensity and complexity to meet duty requirements. Activities like general conditioning wearing body armour and helmet, weight loaded walking, and battle type physical training, in conjunction with other job specific skills training, will form the core activities undertaken during this stage of regeneration. Eager to prove that they are ready to return to training, it is during this phase of the regeneration program that the Special Forces soldier may face the challenge of patience.
5. Re-assessing the Warrior - Being pain free and having good joint mobility are not indicators that the Special Forces soldier is ready to return to the job. While these signs and symptoms are important clinical markers of recovery, they do not mean the soldier is ready to return to a complex and demanding environment, an environment which potentially caused the injury in the first instance. Considering this, the Special Forces soldier must again prove themselves, not only to their peers and superiors but, perhaps most importantly, to themselves. To achieve this final step in regenerating the body following injury, the warrior will begin to undergo a range of physical assessments. After completing a series of fitness tests, which would include the Army Basic Fitness Assessment, the soldier would be required to compete a series of job specific functional tests that not only assess their physical recovery but also their skill level and technical ability. Never wanting to be considered average, the regenerated warrior will push their bodies to achieve good results and in doing so provide assessors with a true indication of their level of recovery and suitability to return to work.
SGT M, Physical Training Instructor, 2 Commando Regiment
LT R, Human Performance Officer, Special Operations Headquarters