Bottom Line Up Front (BLUF): Lets face it, in general we aren’t great at monitoring and scientifically progressing training for our soldiers. Now admittedly we face a far more complex situation than is found in most sporting environments. Our athletes don’t have a ‘season’, they don’t have a game day and in general they have to maintain a good degree of readiness at all times, rather than peaking as required. This makes a controlled, monitored and progressive training environment hard to maintain. However it is not unachievable, and this article will explore some relatively simple and evidenced based tools to improve this, and to leave behind the days of ad hoc training.
I cannot express how excited I have been to see both the interest and debate that has resulted from recent ‘Conditioning’ articles published on the Cove here and here and here. These articles have explored the physical requirements of a modern soldier; a science based methodology of getting them to and maintaining them at peak condition; and (hopefully) justification for the death of ‘Long Slow Distance’ runs in our organisation. If you haven’t read them yet, get amongst it.
A topic that is starting to be teased out for consideration through both the content and debate garnered from these articles, is how the proposed models will protect the force from injury and how we can monitor and determine if these programs achieve the effect of a fitter fighting force with fewer injuries. Ultimately it comes down to one key concept in the strength and conditioning space: ‘Load’ management.
Load in this context is defined as a combination of the forces exerted on the body from the outside world (i.e. weights and reps, distances run) known as external training load (ETL) and the athletes individual response to a training session or program (i.e. perceived exertion, biological markers of stress) known as internal training load (ITL).
Load = ETL + ITL
When we get the balance of ‘Load’ right, everything is roses. When we get it wrong performance is compromised, or worse, soldiers break. Does this mean we have to train smarter not harder? NO! In the long run getting load management right enables us to train far harder than we currently do, breaking plateaus and providing appropriate stimulus for adaptation. The key consideration of load management is not how hard we work, but rather the speed at which we progress training. So how do we capture data on ETL and ITL?
The training methodologies recommended in the blogs discussed in the intro give you a good understanding of the design of a consistent periodised training program. These are the measures we can use to understand the ETL by simply capturing the data of the methods of inducing training effect (think rep max for primary lifts, interval distances, weights of packs and distances carried.) Our need for consistent ETL data is further evidence to support moving away from ad hoc physical training (PT) programs and sessions. With forward planning and strict implementation we can KNOW rather than GUESS what external loads are being put on soldiers over time.
The ITL is the bit that many struggle to understand how to capture. Those in the ‘treat soldiers like elite athletes’ camp, often point towards the technology based tools used in a highly staffed, highly funded sports environment. These can include measuring things such as heart rate variability, blood cortisol concentrations, and a barrage of long winded wellbeing questionnaires (as just a sample of what’s out there). I disagree with this approach in the Army environment for a couple of reasons, one pragmatic and the other a bit more philosophical.
Pragmatically we don’t have the resources, time or people to be running and overseeing the multitude of data sets that come from all this guff. Furthermore the literature would suggest that the cost benefit ratio of these high tech approaches doesn’t see dividends anyway, as subjective measures are equally as effective as objective measures for understanding ITL. Philosophically, I disagree with this approach because it is taking control away from members. The more we technify (I realise this isn’t a real word) this process, the more difficult it is for soldiers to understand its importance and take ownership of their own physical well-being. This has the effect of creating a technological dependency or crutch and reduces the soldiers self-efficacy (this is a real word) which is a critical component of resilience.
Capturing ITL really isn’t that tricky: Rate of Perceived Exertion (RPE) scales and a basic wellbeing questionnaire will give us all the info we need for this piece of the ‘Load’ puzzle. So by sticking to the KISS principle for ETL and ITL data capture we have all the info we need to document load effects on solders: but how do we turn the data into meaningful information to drive practice? My recommendation is through monitoring of Acute to Chronic Workload Ratios.
Some quick definitions:
Acute Workload = load over a short period (traditionally between 1 session to 1 week) – sometimes referred to as fatigue
Chronic Workload = the rolling average of load over the most recent 3 to 6 weeks – sometimes referred to as fitness
Acute: Chronic Workload Ratio = the measure of fatigue vs fitness (and voila an understanding of the impacts of load).
Ultimately the aim of the Acute: Chronic Workload Ratio is to ensure that we are keeping soldiers in the training sweet spot of getting fitter, and that our predictions of training benefit via periodisation (ETL) are well matched with the individual soldiers capacity to handle that training (ITL). From the literature (British Journal of Sports Medicine) we can garner that if our Acute:Chronic Workload Ratio sits somewhere between 0.8-1.3 then we are golden. If however we spike loading or don’t load enough and our Acute:Chronic Workload Ratio is <0.8 or >1.3 we are no longer getting bang for buck from our PT and are exponentially increasing the risk of injury.
The beauty of this method is that its evidence based, but very low drag from a data management perspective. Soldiers keep a record of their session RPE’s. At the end of the week the weekly average is loaded to a centralised excel spreadsheet or basic data management program (held at whatever level of command is desired) as the acute workload. The spreadsheet/ data management tool does the work to formulate the rolling average required for the chronic workload. It then presents the data by member in a way that is easy to check that:
- individuals are in the sweet spot, and
- more broadly the unit is in the sweet spot and therefore the programming is on the money to achieve the desired effect.
Unit Combat Fitness Leaders (CFLs) can monitor and champion this approach as key unit enablers, and feed potential signs of programme errors back to the Brigaded Physical Training Instructors (PTIs) for adjustment.
Reiterating what’s been discussed. It has been suggested that the way we deliver PT in Army needs to change. To understand the effect of our training on both fitness and injury risk we need to first understand how to measure load (Load = ETL + ITL). Once we have this locked in we then need a system to interpret how load is effecting performance (Acute:Chronic Workload Ratio). From this understanding we can intervene in our processes to ensure that we’re breaking less people and optimising physical performance for effect. To achieve all of the above, we need to adhere as much as possible to the mantra of KISS (avoid going too techno) – or it will fail to gain adoption across our force and the era of ad hoc PT will continue.
My next blog on this topic will work through some real time examples of how the Acute: Chronic Workload Ratio can be used in the Army context (and how to get to the required ‘Load’ number) – particularly with the re-integration of injured personnel into the unit PT environment. But I encourage the interested reader to explore the references in this blog in more detail and pick apart my theories. Lets keep the debate going on how we can optimise physical capacity of our most important asset – our people.
About the Author:
Nick Alexander is a military physiotherapist with post graduate qualifications in complex rehabilitation and pain management. He is passionate about putting himself out of a job by educating soldiers and commanders on more effective ways to reduce injury risk and achieve optimal rehab outcomes if injury does occur.