PART 1 OF 2: Tactical athletes are individuals in service professions who have significant physical fitness and performance requirements associated with their work. Tactical athletes include individuals in military service, law enforcement, and first responders such as firefighters and emergency medical technicians. Military service workers can be enrolled in active duty, in the reserves, or in the National Guard, or be veterans. Read Part Two about massage research and best practices for the military, their families, as well as other tactical athletes here.

Because of the high levels of physical activity, the lifestyles of tactical athletes include high levels of physical stress and poor diets, depending on the job and time available to eat and sleep. Lack of sleep is like a badge of honor in many military units. Sailors are especially prone to poor sleep habits with long shifts and frequently varying shift times. Staying awake for up to 72 hours is common on Navy ships. Service members will also have spent extended times traveling, with regular moves and short/long term changes of duty station. All of these variables increase life stress, decrease wellness, and create physical effects in the body.

Enduring FreedomTo achieve mission success, tactical athletes face stressful, rigorous, and demanding challenges, often under life-threatening conditions, while carrying heavy gear and equipment (Sefton & Burkhardt, 2016). Because these tasks are physically challenging, they are at high risk for musculoskeletal injuries, stress, fatigue, pain, and muscle soreness.

Helmets and night vision goggles place stress on muscles of the head, neck, and spinal column. Standard army or flight helmets with vision goggles weigh between 4 and 6 pounds.  Individuals with extended daily exposure to heavy head gear are at increased risk for neck pain, muscle fatigue, and headaches. Moreover, when head gear weight is combined with vibration and shock movements in vehicles and aircrafts, it increases the risk for cervical spine injuries. The average load for soldiers and marines in Iraq and Afghanistan is between 60-120 pounds. Years of running on hard surfaces, expended periods wearing heavy boots, and being in confined spaces, falls from military vehicles, or accidents and exposure to improvised explosive devices (IED) can also cause pain and cause or contribute to injury.

There is a military and first responder culture of “train through pain,” and members may feel outcast if they sit out training or a mission. Physical training (PT) often becomes a primary method of stress relief, and they can become addicted to training and refuse to miss PT, even when in pain. Since physical activity is a lifestyle, as service members grow older they want to prove they have not lost their edge. Leaders want to set a good example for their units and will often push themselves past safe limits. Tactical athletes, especially those with physically challenging jobs, are often unwilling or unable to allow injuries to heal. They will often push themselves through pain rather than abandon the mission or leave their comrades to complete tasks without them. This leads to long-term, nagging injuries that go months or years without treatment.

00000006-702x332Not surprisingly, sports and training injuries are the #1 non-combat related reason for lost duty time or removal from deployment in military service members. Injuries to neck, shoulders, feet, ankles, knees and lower back are common. Lower back pain and knee pain are two of the most common complaints for tactical athletes. Careful consideration of the client’s specific job combined with comprehensive health assessment will direct treatment goals. For example, firefighters often must carry heavy hoses across one shoulder, which may cause pain across the neck and shoulders, but present very differently on one side of the firefighter’s body than the other.

Alternatively, some tactical athletes have desk jobs, but are still required to pass regular physical fitness assessments. These individuals are likely to have problems associated with desk bound professions and problems associated with sudden increases in physical activity to prepare for fitness tests, which may lead to overuse injuries.

Another common issue in this population is hearing loss resulting from regular exposure to noising vehicles and equipment as well as weapon fire and blasts. In fact, eighty percent of service members have hearing loss in one or both ears.

Thanks to JoEllen Sefton for her contributions to this article.

Read Part Two about massage research and best practices for the military, their families, as well as other tactical athletes here.


Picture Credits:


Articles and Journals Referenced:

  • Sefton, J.M., & Burkhardt, T.A. (2016). Introduction to the tactical athlete special issue. J Athl Train, 51(11), 845-845

View More: Susan Salvo is a massage therapist who works with massage therapists and students to promote best practices. Susan knows that education and research are the most effective ways to advance the profession. She teaches, is actively involved in research, and has written two widely used textbooks: Massage Therapy: Principles and Practice and Mosby’s Pathology for Massage Therapists. Susan has been honored with numerous awards and frequently presents at conferences and conventions across the country. Susan has a doctorate in education from Lamar University. You can contact Susan at