Consortium for Health and Military Performance and American College of Sports Medicine Consensus Paper on Extreme Conditioning Programs in Military Personnel

Abstract

A potential emerging problem associated with increasingly popularized extreme conditioning programs (ECPs) has been identified by the military and civilian communities. That is, there is an apparent disproportionate musculoskeletal injury risk from these demanding programs, particularly for novice participants, resulting in lost duty time, medical treatment, and extensive rehabilitation. This is a significant and costly concern for the military with regard to effectively maintaining operational readiness of the Force. While there are certain recognized positive aspects of ECPs that address a perceived and/or actual unfulfilled conditioning need for many individuals and military units, these programs have limitations and should be considered carefully. Moreover, certain distinctive characteristics of ECPs appear to violate recognized accepted standards for safely and appropriately developing muscular fitness and are not uniformly aligned with established and accepted training doctrine. Accordingly, practical solutions to improve ECP prescription and implementation and reduce injury risk are of paramount importance.

Clinical management of immunosuppression in sportsmen-women: recommendations for sports medicine physicians and physiotherapists

“…Finally, in order to optimize treatment, it is critical that all members of the health-care team treating the athlete have good communication with one another concerning the progression and responses of the athlete if symptoms develop and persist [2,4,10].…”

Kinetic and Kinematic Changes during a 30-Repetition Bout of the Barbell Clean

“…Training programs characterized by the use of compound resistance exercises combined with high-volumes, moderate to high loads and short rest periods have become popular in both military and civilian populations [1,2]. Such programs are commonly referred to as extreme conditioning programs [1] and exercise professionals have predicted that participation in these activities will continue to increase in the near future [3].…”

“…Such programs are commonly referred to as extreme conditioning programs [1] and exercise professionals have predicted that participation in these activities will continue to increase in the near future [3]. However, a number of researchers have raised concerns regarding the safety of combing technically demanding ballistic resistance exercises with high-repetitions over short time periods [1,2]. In particular, it has been asserted that for ballistic exercises such as the barbell clean, fatigue accrued from performing high-repetitions can readily prompt unsafe movement execution and lead to acute injury [1].…”

“…However, a number of researchers have raised concerns regarding the safety of combing technically demanding ballistic resistance exercises with high-repetitions over short time periods [1,2]. In particular, it has been asserted that for ballistic exercises such as the barbell clean, fatigue accrued from performing high-repetitions can readily prompt unsafe movement execution and lead to acute injury [1]. There is however, limited data investigating potential biomechanical changes when performing technically demanding resistance exercises for high-repetitions, especially under the instruction to complete the set of repetitions as fast as possible as is frequently the objective set in many popular extreme conditioning programs [1,4].…”

“…Therefore, it was the purpose of this study to incorporate both discrete and continuous analysis methods to compare the technique of a complex resistance training movement performed under a traditional framework of minimal fatigue with a protocol that featured a high number of repetitions and generated substantial fatigue. The barbell clean was selected for this study as it represents a class of exercise most often cited as unsuited for such training programs and despite these recommendations is still commonly used in increasingly popular extreme conditioning programs [1,8]. It was hypothesized that fatigue would significantly alter lifting technique and also interrupt coordination between segments.…”