The Case for Professional Oversight in Military Physical Training

By Seung Ho Choi

The Army’s Holistic Health and Fitness (H2F) program is a comprehensive initiative designed to optimize soldier readiness through an integrated approach that includes physical training, mental resilience, sleep quality, nutritional support, and spiritual well-being. Intended as a shift away from traditional physical training, H2F represents a broader cultural transition toward long-term health and performance.

Since implementation, H2F has delivered promising outcomes—reducing suicide rates by 37%, lowering musculoskeletal injuries by 52%, and improving scores on the Army Combat Fitness Test (ACFT) and rifle marksmanship (Rempfer, 2023). On paper, it appears to be a groundbreaking success. Yet in everyday execution—particularly during morning PT sessions in units and ROTC programs—these benefits are often diminished by inconsistent application, outdated routines, and lack of professional oversight.

From firsthand experience in the Korean military and through ROTC involvement in the U.S., it’s clear that many cadets approach PT passively, completing exercises out of obligation rather than understanding. This mindset often stems from the wide variability in fitness levels within units, where many individuals are underprepared for the physical demands placed on them.

Despite H2F’s intent, most PT sessions continue to be led by non-specialists—senior enlisted leaders or cadre without formal training in exercise science, periodization, or injury prevention. As Nelson and Russell (2024) caution, “Hubris in superiors can lead to overconfidence and subject Soldiers to unnecessary harm.” This dynamic frequently results in poorly structured programs that fail to drive meaningful progress and instead elevate injury risk.

Indeed, military injury rates remain alarmingly high. Murphy et al. (2023) found that injuries during military PT can reach 19.52 per 1,000 training days, particularly during high-load tasks like rucking and timed runs. Crucially, many of these injuries stem not from mission stress, but from flawed training design, insufficient movement instruction, and inadequate progression.

Comparable injury trends are also seen in other tactical professions. Wildland firefighters report that 45.8% of injuries occur during physical training, while law enforcement recruits experience 368.63 injuries per 1,000 annually—again, with PT being the most common cause (Maupin et al., 2022; González-Cáliz & López-García, 2023). These patterns suggest a shared issue: high physical demands paired with insufficiently guided training.

The military can address this by adopting evidence-based, periodized training models—the kind used in tactical and athletic populations—which emphasize gradual load progression, movement quality, and adaptation to individual readiness. When soldiers understand the purpose of each exercise and follow structured progressions, training becomes more effective, engagement improves, and injury risk decreases.

Beyond performance and safety, there is a strong financial case for professional oversight. The U.S. Army Public Health Center (2022) estimates that musculoskeletal injuries cost the Army $2.7 billion annually—with 87% of those costs due to lost or restricted duty time. In 2017 alone, lower extremity fractures cost $116 million, with $92 million tied to productivity loss (Hauret et al., 2021).

To address this, the H2F initiative has begun placing strength and conditioning coaches at the brigade level. Yet implementation remains inconsistent. Many commanders lack clarity on how to integrate these resources into daily training, leading to underutilization (Army Connect, 2024). A recent restructuring increased the number of strength coaches from 7 to 11 per brigade while removing athletic trainers altogether—an attempt to consolidate expertise (Army Times, 2025). Still, many leaders cling to outdated routines like long-distance runs and calisthenics, undermining the adoption of modern, science-backed approaches (Army University Press, 2024). Without committed leadership and structural support, the potential of H2F will remain unrealized.

Meaningful change requires not just staffing, but empowering professionals to design individualized programs based on readiness. For those unable to meet minimum standards, this means supplemental training beyond standard PT. More broadly, it means shifting from passive compliance to active, informed participation—where soldiers train with purpose and understand the “why” behind their work.

This is especially critical in ruck marching, where loads of 45–75 pounds are common. Without proper programming, repetitive loading can cause significant strain to the knees, back, and core. Knapik et al. (2004) note that ruck-related injuries are especially prevalent among untrained individuals—further emphasizing the need for professionally managed, progressive training.

Although H2F reports strong metrics, real-world execution is hindered by tradition, insufficient leadership education, and spotty integration of professional staff. By investing in trained professionals, adopting periodized programming, and educating soldiers on training purpose and technique, the military can meaningfully reduce injuries, boost performance, and save billions in preventable costs. In a time when physical readiness is directly tied to mission success, professionalizing PT is no longer optional—it is essential.

---

Citations

Rempfer, K. (2023). Army units see 37% suicide drop with H2F program. Army Times.
https://www.armytimes.com/news/your-army/2023/04/26/early-data-shows-37-suicide-decrease-in-units-with-holistic-health/

Nelson, R., & Russell, R. (2024). The Seven Deadly Sins of Leadership. NCO Journal, Army University Press.
https://www.armyupress.army.mil/Journals/NCO-Journal/Archives/2024/May/The-Seven-Deadly-Sins-of-Leadership/

Murphy, M. C., Stannard, J., Sutton, V. R., Owen, P. J., Park, B., Chivers, P. T., & Hart, N. H. (2023). Epidemiology of musculoskeletal injury in military recruits: A systematic review and meta-analysis. BMC Sports Science, Medicine and Rehabilitation, 15, 144.
https://pubmed.ncbi.nlm.nih.gov/37898757/

Maupin, D. J., Canetti, E. F. D., Schram, B., Lockie, R. G., Dawes, J. J., Dulla, J. M., & Orr, R. M. (2022). Profiling the injuries of law enforcement recruits during academy training: A retrospective cohort study. BMC Sports Science, Medicine and Rehabilitation, 14(1), 136. https://doi.org/10.1186/s13102-022-00533-y

González-Cáliz, C., & López-García, J. R. (2023). Occupational injuries of Spanish wildland firefighters: A descriptive analysis. International Journal of Environmental Research and Public Health, 20(5), 1234. 10.3390/healthcare12161615

U.S. Army Public Health Center. (2022). Estimating the costs of injury among Army soldiers.
https://ph.health.mil/PHC%20Resource%20Library/cphe-ip-estimating-costs-of-injury-among-army-soldiers-2022.pdf

Hauret, K. G., Jones, B. H., et al. (2021). Medical costs and productivity losses of lower extremity fractures in U.S. Army soldiers. Military Medicine, 186(9–10), e881–e888.
https://pubmed.ncbi.nlm.nih.gov/34379379/

Army Connect. (2024). Unraveling the Challenges of Army H2F Training. https://armyconnect.me/unraveling-the-challenges-of-army-h2f-training

Army Times. (2025, April 22). Army to replace athletic trainers with strength coaches on H2F teams. https://www.armytimes.com/news/your-army/2025/04/22/army-to-replace-athletic-trainers-with-strength-coaches-on-h2f-teams

Army University Press. (2024). Versatile and Resilient Through H2F. https://www.armyupress.army.mil/Journals/NCO-Journal/Archives/2024/August/Versatile-Resilient-Through-H2F

Knapik, J. J., Harman, E., Steelman, R., & Graham, B. S. (2004). A review of the literature on load carriage in military operations. Military Medicine, 169(1), 1–13.
https://doi.org/10.7205/MILMED.169.1.1