The Increase Readiness guide can be downloaded and print copies ordered from the Army Public Health Center Health Information Products e-catalog. 
Leaders can increase readiness by talking about the connection of sleep, activity, and nutrition to prevent musculoskeletal injuries.
Musculoskeletal (MSK) injury is the leading cause of medical non-readiness in the Army.1 Research has shown the following:
- 56% of Soldiers in 2017 were diagnosed with a new injury.2
- The average number of limited duty days per injury was thirty seven.1
- In 2017, MSK injuries and related conditions resulted in 2 million medical encounters and roughly 10 million limited duty days.2
- Soldiers who do not meet the AR 600-95 weight for height standards are at an increased risk for MSK injury.6
Leaders actions can make a difference
As a Leader, you can help Soldiers decrease their injury risk by promoting healthy sleep, activity and nutrition habits. Advocating for doing all of these three healthy habits will help to optimizing Soldier readiness. Here are some ways to promote readiness, by helping Soldiers with the greatest injury risk, and refering them to Army resources.
Sleep makes a difference!
Adopting healthy sleep habits can reduce Soldiers' risk of injury. Soldiers that averaged less than 4 hours of sleep at night had the highest percentages of injuries. Soldiers averaging between 5 to 7 hours of sleep were at the next level of risk of injuries. Sleep of 7-9 hours of sleep had the lowest risk of injuries.3
What can leaders do?
Leaders at all levels need to discuss sleep in training and mission planning and try to minimize duties and shifts longer than 12 hours. Leaders can consider holding physical training in the afternoon to promote sleep schedules. Here are discussion points to help educate Soldiers on healthy sleep practices.
- Set a bedtime that allows for 7-9 hours of sleep
- Turn off lights and remove electronics before bed
- Stop caffeine use at least 6 hours before bed
- Encourage Soldiers with significant concerns about their sleep to make an appointment with their primary care provider or a behavioral health provider.
Run times can screen for potential injury risk
Research found the most aerobically fit Army Soldiers experience lower risk of injury. This data can help leaders to decrease Soldiers' risk of injury.
What can leaders do?
- Limit long-distance running and increase interval training to prevent over-training among your Soldiers.
- Refer the following Soldiers to an Army Wellness Center for personalized plan:
- Male Soldiers with 2-mile run times greater than 15:00 minutes
- Females Soldiers with 2-mile run times greater than 18:00 minutes
- Soldiers concerned about their Army Combat Fitness Test (ACFT) performance
- Soldiers interested in changing their sleep, exercise, and nutritional habits
What about body weight?
Soldiers with higher body composition are at greater risk of injuries.4
What can leaders do?
- Refer Soldiers to a Registered Dietitian for Soldiers who express interest in weight loss and weight management for a personalized plan. Refer Soldiers that do not meet AR 600-9 standards.
- Refer Solders to the Army Wellness Center for metabolic testing to determine calories needs.
- Model and talk about eating 8 fruits and vegetables each day.
- Model and talk about choosing complex carbohydrates, lean protein and a balanced diet.
- Model and talk about hydrating right. Aim for drinking at least 8-10 glasses of water each day.
- Encourage junior leaders to communicate about healthy nutrition behaviors with their Soldiers.
For additional resources to meet your soldiers' needs, please see the local Community Resource Guide and https://www.army.mil/article/245165/new_army_leader_guide_offers_strategies_for_reducing_soldier_injuries for available programs and resources.
References
1. Canham-Chervak, M., Rappole, C., Grier, T., and Jones, B.H. 2018. Injury Mechanisms, Activities, and Limited Work Days in the U.S. Army Infantry Units. The Army Medical Department Journal July-December 2018: 6-13.
3. Grier, T., Dinkeloo E., Reynolds M., and Jones B.H. Sleep Duration and Musculoskeletal Injury Incidence in Physically Active Men and Women: A Study of U.S. Army Special Operation Forces Soldiers. Sleep Health. The Journal of the National Sleep Foundation.
4. Jones, Bruce H, Keith G Hauret, Shamola K Dye, Veronique D Hauschild, Stephen P Rossi, Melissa D Richardson, Karl E Friedl. 2017. Impact of Physical Fitness and Body Composition on Injury Risk in Young Adults: A Study of Army Trainees." Journal of Science and Medicine in Sport, 20: S17-S22.
5. Department of the Army. 2019. Regulations 600-9, Army Body Composition Program.
6. Grier, T., Canham-Chervak, M., Bushman, T.T., Anderson, M.K., North, W.J., & Jones, B.H. 2017. Evaluating Injury Risk and Gender Performance on Health-and Skill-Related Fitness Assessments. Journal of Strength and Conditioning Research 31, 4: 971-980.
