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HPRC Fitness Arena: Total Force Fitness

Are your kids active enough?

This week, the spotlight’s on children and teenagers—and whether they’re getting the exercise they need.

Previously HPRC reported on how much physical activity healthy adults need. This week, the spotlight’s on children and teenagers—and whether they’re getting the exercise they need.

According to the Physical Activity Guidelines for Americans, children and adolescents need at least 60 minutes of physical activity every day, including:

  • Aerobic exercise for most of the 60 minutes. Most days can include either vigorous-intensity activities (such as running, swimming, and jumping rope) or moderate-intensity activities (such as walking or skateboarding), but at least three days a week it should include at least some vigorous-intensity exercise. Check out Let’s Move! for ideas on how to get active as a family.
  • Muscle-strengthening activities such as playing tug of war, exercising with resistance bands, or climbing on playground equipment. Strengthening exercises should be done at least three times a week. For safety guidelines on strength training for children and teens, check out this article from HPRC.
  • Bone-strengthening (impact) activities such running, jumping rope, basketball, tennis, and hopscotch. Impact activities strengthen bones and promote healthy growth and also should be done at least three times a week.

For more ideas on moderate- and vigorous-intensity aerobic activities, as well as muscle-strengthening and bone-strengthening physical activities, check out the table in Chapter 3: Active Children and Adolescents of the Physical Activity Guidelines. For more ideas on getting fit as a family check out Let’s Move, a comprehensive initiative by the First Lady. For military-specific resources, check out HPRC’s Family & Relationships domain.

Biofeedback for pain

HPRC Fitness Arena: Mind Tactics, Total Force Fitness
Harness the power of your mind with biofeedback and take control of pain.

Biofeedback teaches you how to control your body’s nervous system in order to reduce pain and stress and promote relaxation. Biofeedback can sometimes relieve musculoskeletal pain such as neck, back, and shoulder pain. It also may work for migraines and stress- and tension-induced headaches. For more in-depth information, read HPRC’s InfoReveal on biofeedback for pain management.

Moms-to-be: Keep the “active” in active duty

Pregnancy is a special time for most women, but it can be especially challenging for women in the military. Exercise before, during, and after pregnancy to help keep you and your baby healthy.

There are more than 200,000 women in the military today—almost 15% of active duty members. Not surprisingly then, pregnancy in the military has become a hot health topic as more and more women choose to serve. Even though most women should exercise during pregnancy, pregnant women still engage in less physical activity than their non-pregnant counterparts. Being active during pregnancy has a lot of health benefits, including maintaining a healthy weight and reducing risk of gestational diabetes and preeclampsia, stress, operative or assisted deliveries, and labor time. Remember this very important message – Don’t ignore pain or fatigue; listen to your body and consult your healthcare provider if you have concerns!

The U.S. Department of Health and Human Services (HHS) recommends that healthy pregnant women engage in moderate-intensity aerobic exercise at least 150 minutes a week, which comes out to around 20-30 minutes a day. Women who already engage in vigorous-intensity exercise can continue physical activity at this level as long as they remain healthy and check with their healthcare provider about when to adjust activity levels (and what limits they should keep in mind). A healthy fetus is not adversely affected even by vigorous exercise, but be careful that you don’t overdo it. Remember that your body is changing with pregnancy—it may take more effort to do the same exercises you did before you were pregnant, and you may not realize when you’re pushing yourself too hard. Monitor your heart rate and use tools such as the talk test to gauge intensity. The American College of Sports Medicine (ACSM) has adopted the age-based heart rate ranges for pregnant women from the Society of Obstetricians and Gynecologists of Canada.

After giving birth, you may find that the “baby weight” gained during pregnancy is stubbornly hanging around.  Excess weight carries a whole host of adverse health risks, so keep moving—even walking for 45 minutes three to four times per week at low to moderate intensity can reduce risk of chronic disease. As with any exercise program, resuming activity after giving birth should be a gradual process (after consulting with your Doctor).

Certain general precautions should be taken with exercise during pregnancy. Avoid contact sports and exercises that increase the risk of falling. Avoid exercises that require stomach-down (supine) positions, with the exception of swimming during pregnancy, which doesn’t place stress on your joints like other forms of exercise do. Regular exercise before you get pregnant can help you prepare for the physical changes that occur during pregnancy and keep you ready and resilient for your family and your military service.

If you’re pregnant, keep in mind there isn’t any consensus about exercising at altitude, so it’s even more important to know the symptoms of acute mountain sickness (AMS). Take time to acclimatize if you travel to altitudes above 2500 meters and allow two or three days before exercising moderately. Wait for complete acclimatization before engaging in heavy exercise.

First and foremost, however, if you become pregnant, consult with your healthcare provider before starting or continuing any exercise routine. Also, each service branch has its own policies regarding pre- and post-natal exercise (available via HPRC’s pregnancy resources page).

Healing through scuba

HPRC Fitness Arena: Environment, Total Force Fitness
Scuba diving is being used to help wounded warriors get back in the swim of things and on with life.

Physical and mental rehab for wounded warriors can come in the form of an undersea adventure. A 2011 study at Johns Hopkins University looked at the effects of a four-day scuba certification class on a group of veterans with spinal injuries. The benefits noted included improved muscle movements, reduction of post-traumatic stress disorder symptoms, and improved sensitivity/sensation for those with certain spinal cord injuries.

Being in the water offers a zero-gravity environment that enables Warfighters to develop the confidence and ability to do activities they may not feel comfortable doing on land. There are organizations that provide scuba lessons and outings for wounded veterans and their families free of charge, such as Adaptive Heroes, Soldiers Undertaking Disabled Scuba (SUDS), and Divers4Heroes, to name a few. Check for programs in your area and explore the great unknown!

Acupuncture for pain

HPRC Fitness Arena: Mind Tactics, Total Force Fitness
Acupuncture is more commonly being used in the military as a method for pain treatment and management in conjunction with traditional practices.

Acupuncture is an ancient form of Chinese medicine. Thin needles are inserted into the skin at points of the body that are thought to regulate the body's flow of energy (also known as qi or chi). It often is used for common health concerns such as headaches and migraines, carpal tunnel syndrome, and back, joint, and chronic pain. For more in-depth information, read HPRC’s InfoReveal on acupuncture for pain management.

Exercise for the rest of us!

Just because you’re not an active-duty Warfighter doesn’t mean you don’t need exercise. Use these guidelines to make sure you’re getting enough.

Getting enough exercise is important to everyone’s mental and physical health in order to achieve optimal performance. Active-duty Warfighters usually get enough exercise in the course of their mission, but for the rest of us in the sphere of the military—family members, desk warriors, and the like—it can take more effort, so sometimes it’s helpful to review.

The Physical Activity Guidelines for Americans recommend that:

Aerobic exercise: For health benefits, adults should do at least 2.5 hours (or 150 minutes) a week of moderate-intensity exercise, or 75 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity exercise.

  • For the greatest health benefits, adults should do aerobic exercise of moderate intensity for five hours, or 300 minutes, weekly, or 2.5 hours or 150 minutes of vigorous-intensity aerobic exercise, or an equivalent combination of both.
  • Do aerobic activity for at least 10 minutes at a time, preferably spread throughout the week.
  • Don’t know how to gauge your exercise intensity? Check out ACSM’s video on aerobic intensity or the description from the Centers for Disease Control and Prevention (CDC). Examples of moderate-intensity activities include walking at three miles an hour, water aerobics, biking less than 10 mph, and gardening; vigorous-intensity activities include jogging or running, swimming laps, singles tennis, biking more than 10 mph, jumping rope, and hiking. Another method for determining exercise intensity is to keep track of your heart rate; use this explanation from CDC for how to determine your target heart rate for various activity levels.
  • A general guideline for time spent exercising is that two minutes of moderate-intensity activity is equal to one minute of vigorous-intensity activity.
  • For exercise ideas, check out ACSM’s video on types of aerobic exercise and/or HPRC’s Performance Strategies on Rebuilding Cardiovascular Fitness.

Strength training: Do muscle-strengthening exercises (resistance of moderate or high intensity) that involve all major muscle groups at least twice a week.

Finally, remember to stretch after your workouts. For some basic ideas on stretching, check out ACSM’s pictorial sheet, their video on stretching basics, or HPRC’s Performance Strategies to “Improve your flexibility.”

FDA Warns Consumers about DMAA

FDA urges consumers to check all dietary supplement product labels to ensure they do not contain the illegal stimulant DMAA.

The Food and Drug Administration (FDA) has issued a Consumer Update warning of the potential dangers of DMAA, which was announced illegal on 12 April 2013. DMAA is also referred to as dimethylamylamine and other names. This dietary supplement product ingredient has been used in many weight-loss, bodybuilding, and performance-enhancement products. FDA received numerous reports of illnesses and death from the use of products containing DMAA; commonly reported reactions include heart and nervous system problems as well as psychiatric disorders. DMAA has been the focus of conflicting information regarding whether or not it is a natural extract from geranium. FDA has now found “the information insufficient to defend the use of DMAA as an ingredient in dietary supplements.” Online, FDA also stated, "Dietary supplements containing DMAA are illegal and FDA is doing everything within its authority to remove these products from the market."

For more information, read the FDA Q&A on DMAA here.

“MATs”—The future of injury prevention in the military?

The Army hopes to minimize injuries and optimize performance by investing early in the health of its soldiers with Musculoskeletal Action Teams (MATs).

Injury prevention is the key to optimizing soldier-athlete performance, which is why Fort Benning deployed Musculoskeletal Action Teams (MATs) to their 194th Armored Brigade and their 198th Infantry Brigade as part of a two-year pilot study. The MATs consist of physical therapists, physical therapy technicians, athletic trainers, and strength-conditioning coaches. MATs have three main principles: injury prevention, precision PRT, and human performance optimization. The MATs offer basic trainees injury screenings, early treatment of minor injuries, and instruction on proper training technique. Trainees are also given guidance on correct footwear, management skills, and strategies to prevent common exercise mistakes that may lead to injury, as well as briefings on subjects like nutrition and preventative exercises.

The aim of this study is to educate soldier athletes. By learning to manage your own health and fitness, you’re more prepared to complete your mission safely. The goal: You and your fellow soldier athletes should have less need for medical treatment facilities because you’ll be equipped with your own preventative strategies, which you can use throughout your career. This study is also being conducted at Fort Ill, OK, Fort Lee, VA, and Fort Leonard, MO. The study will wrap up in April 2013, at which time the researchers will evaluate the results.

New Provider Resilience app

HPRC Fitness Arena: Mind Tactics, Total Force Fitness
A new app has just been released to help care for the healthcare providers who care for Warfighters by giving them tools to recognize their own stress and fatigue.

The National Center for Telehealth and Technology just released an app called “Provider Resilience,” which aims to help healthcare providers by giving them tools to assess their own burnout, compassion fatigue, and secondary traumatic stress—conditions common among caregivers. The app also provides inspirational stories, comics to remind users to take breaks, and inspirational videos from Warfighters sharing stories of how they were helped. Providers can even track their own information over time—for example, the app tracks the user’s last day off and recommends taking at least one day of leave every 60 days (and color coordinates the responses over time accordingly). And as long as the user secures the phone, no one else can access the results.

For more apps from “T2,” check out their featured projects page. For more information about enhancing your own resilience, check out HPRC’s Mind Tactics.

Energy drinks and adolescents – a risky combination

Energy drinks and adolescents can be a dangerous combination, especially because of the amounts of caffeine and other stimulants that may be in these products. Educating youth about potential risks is very important.

Energy drinks have been in the news lately, mostly due to media reporting on a group (doctors, researchers, scientists, and politicians) writing to the Food and Drug Administration (FDA) to express concern over the use of these drinks by adolescents. Much of the concern has to do with the amounts of caffeine in these drinks, among other issues. Energy drinks also may contain large amounts of other stimulants, including guarana, yohimbe, yerba mate, kola nut, methylsynephrine, Citrus aurantium (Bitter Orange), and Ma Huang (ephedra). Although listing the total amount of caffeine on the label would help, consumers should be aware that there are often other stimulants in energy drinks.

The American Academy of Pediatrics has written several articles over the last year about the potential risks associated with the adolescent population using energy drinks. One very recent article outlines the harmful effects of energy drinks on adolescents, including increased heart rate, high blood pressure, anxiety, digestive problems, sleep disturbances, and dehydration. The withdrawal effects after habitually consuming energy drinks is also an issue, as it can lead to headaches and attention problems. Also, the ingestion of energy drinks by adolescents who take prescription drugs for Attention Deficit Hyperactivity Disorder (ADHD) or who have eating disorders or diabetes is another topic of concern.

The amount of caffeine contained in energy drinks is not regulated, as the FDA does not regulate caffeine in foods or beverages, except that the maximum concentration for caffeine in cola beverages is 71 mg per 12 oz. The amount of caffeine in energy drinks ranges from 50 to more than 500 mg per can or bottle. The American Academy of Pediatrics recommends that children and teens drink no more than 100 mg of caffeine per day. To put that in perspective, an eight-ounce cup of coffee typically contains about 100 mg of caffeine (or more), and the most popular caffeine-containing sodas contain around 30 to 55 mg in a 12 oz. can. Not knowing how much caffeine and other stimulants are contained in energy drinks is a potential health threat.

Furthermore, the caffeine and other stimulants contained in the energy drinks, when combined with alcohol, can mask the symptoms of alcohol intoxication, potentially leading to risky behavior. The American Academy of Pediatrics advises parents and doctors to talk to children about the dangers of mixing alcohol and energy drinks, and the Centers for Disease Control and Prevention has a fact sheet on the potential risks.

Parents, educators, and healthcare professionals need to focus on educating adolescents about potential problems associated with consuming these high-stimulant products. Companies are heavily marketing their products by featuring athletic superstars, which causes children and adolescents to confuse energy drinks with sports drinks. Generally speaking, adolescents don’t need energy drinks, and they should be made aware of the potential dangers. It’s definitely a case of “buyer beware.”

Visit HPRC’s Operation Supplement Safety (OPSS) to access resources on the informed use of dietary supplements.

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