Health Recommendations For Women Entering Combat

The 1994 ban on women in combat has been lifted. Women are soon going to be entering physically demanding positions in the US army, Marines, Navy, and Air Force. Sex integration is becoming a reality. Besides the other considerations in regards to standards, what is often ignored is the health of the soldiers. This includes physical and mental well being. If women are to enter combat they should know how to avoid injury and keep their bodies at peak physical condition. There are health concerns that women face in larger numbers than their male counterparts. Musculoskeletal injuries are a huge issue for women. For all soldiers doubtless of sex, these injuries  are becoming more common sue to the fact gear and armor is heavier. A more disturbing revelation is the prevalence of sexual assault in the US military. It has become a bigger health and crime crisis over the past decades. The most ignored is the problems in regards to mental health. A soldier may survive war with no physical ailment, but mental scars are harder to detect. Even though these health issues are numerous, there are solutions.

         Women suffer more musculoskeletal injuries than their male counterparts in the US military. There are biological reason for this disparity. Men have denser bones, ligaments, and tendons. The male body contains more muscle mass. Women have a lighter bone structure and more body fat. Stress fractures cause long term health issues. Although men do get injured it causes more problems for women. Detractors use the higher injury rates  as a justification for maintaining the ban on women in combat. The average woman will struggle as an infantry soldier marching with packs that are 80 to 100 pounds on their backs. Spinal cord and connective tissue injuries have increased during the conflicts in Iraq and Afghanistan. The new gear soldiers acquire weighs more and it is clear they are being overloaded. According to a study “Musculoskeletal Injuries in Military Women” they have up to 52% higher injuries compared to 26% of males injuries in basic training. It is true men are stronger than women, but the injury rate is still high for that sample of males. One would expect it to be possibly around 5% to 16% under favorable conditions for males. This means that it may not be beyond women’s  physical capacity . The reason males had lower injury rates is because they had more strength natural  strength initially  ( no weight training )so overloading or  training in an incorrect manner   would not effect them as much. Women who have less natural strength would get injured more. It is critical that women build their strength as much as possible before entering an physically demanding military position.


Building upper body strength is a requirement for these jobs.

 These injuries can be reduced with a change in policy. The Army Science Board had concluded that soldiers were overloaded and that it hindered speed including mobility. Armor and boots must be designed to fit the female body. This can solve some of the burden in mechanical action. Women will need to train harder and longer due to physiological differences. Even with training most women will not perform to the same level of an equally trained man. Males have a larger cross section in separate muscle fibers . This explains why there are not large numbers of women in foreign armies, besides the more obvious presence of discrimination. The problem of heavy gear must be addressed to avoid drop out rates among soldiers. The UK has a similar issue with overloading. The average UK soldier carries more gear than what they would have during the war in the Falklands. UK soldiers may have it worse carrying up to 145 pounds in equipment. This is causing soldiers to fatigue faster than normal. The US soldier’s gear has different weight depending  on the specific role. Weather specific gear also causes some problems. Cold weather gear is close to 101.5 pounds, while warm weather is 88.3. Rifle platoon soldier’s load is 91 pounds.Loads must be tailored to a particular mission. Unnecessary items have to be discarded. The comfort items will have to go for the sake of bone health. Lower back pain, scoliosis, and stress fractures can ruin careers for soldiers.Seeing as women have less bone mass these can be major health issues. Scoliosis is particularly troubling due to the fact the spine with develop curvature and could require surgeries.


 If the US military does not make the needed changes disability compensation will increase. Bone spurs and arthritic conditions become permanent for some soldiers. One third of medical evacuations from Afghanistan and Iraq between 2004 and 2007 were due to spinal and connective tissue injuries. According to the study by a Johns Hopkins University researcher that is more than double the injuries from actual combat. It has been estimated that the Department of Veterans Affairs had exceeded $ 500.000,000 in disability payments for these injuries. It has been proven that even the strongest woman or man will get some form of injury when carrying a 100 pounds for just a year. Pain killers are a temporary solution, but this has a risk of an individual becoming addicted. Other methods such as acupuncture, message, and chiropractic care should be considered. Having an understanding of ergonomics and lightening the load of gear can reduce injuries . Musculoskeletal injuries are described as harm or damage to the muscle or skeletal system due to rigorous or strenuous physical activity.


There is a difference between these types of injuries. Fractures are when the bone has been broken. Dislocation refers to the disruption of a joint from where it is suppose to be. Sprains refer to the tearing of the ligaments. Strains are when muscles are stretched  or torn. Repetitive motion can increase the possibility of individuals acquiring these injuries. The solution would be to have women train in gear to simulate what daily activities will be like. Their bodies must adjust to rigorous activity. Lowering gear loads will be a big help. A change will not only make healthier soldiers, but reduce medical expenses.

          Conditioning and physical strength are essential to the health of military women. Strength makes it possible to perform particular tasks in military occupational specialties. Although men would have more physical strength, women may also have some useful physical advantages. Women have more body fat, but may be better at burning it as energy early on during periods of physical activity. This means their physical endurance could be higher. Men’s higher amount of muscle and free circulating testosterone means they are using more energy. Men would fatigue earlier than women. It has been speculated that it is because women recruit muscle groups in a more efficient manner according to the Journal of Applied Physiology. The gap in physical strength and speed has raised concerns, but it can be narrowed. Men can on average have 26 pounds more skeletal  muscle than women. Smaller hearts , lungs, and  a wider pelvis means women have slower run speeds.The automatic assumption is that biology limits them. This is not true because weight training can not only build muscle, but increase bone mass. Stronger bones and muscles means carrying tank shells or performing casualty drags will not be an issue.

Pauline Nordin (10)

Diet is also critical. Soldiers need to be fed healthy meals low in sugar and saturated fat. There are some cases in which soldiers may gain weight from a poor eating habits. Weight management programs will have to be put in place to prevent this. Obesity is a growing problem for American society and it is caused by certain life style choices. Most Americans would need some type of weight management program if they wanted to join the US military. Women also need to have a healthy diet, because the way metabolize food differs . Estrogen stores more fat and it is harder for women to lose weight. Extra body fat only acts as dead weight when carrying loads. Type II muscle fiber is has more explosive power than body fat. Women must meet the same standards as men. The US military has changed standards over the years, but this is to reflect the environment of battlefield tasks . Sit-ups, push-ups, and two mile runs may be emphasized less as compared to casualty drags or  loading 25 mm shells for guns on Bradley vehicle. Regular exercises   should not be phased out. These prevent injuries and diseases. The assumption that women cannot do this has been proven false, when the three pull-ups requirement controversy was challenged. When women stopped doing the flexed arm hang, only then was there improvement. If women were never shown how to do this correctly, it would be ludicrous to assume they could get it right the first attempt.

  Major General Mike Murray and Staff Sergeant Terry Kemp   who tested a group of women volunteers at Fort Stewart in 2014 noted that women acquired physical skills with just a month of training.  This experiment found that women utilized their core and legs more in tasks requiring strength. This small army study helps with designing a fitness program for women. Upper body exercises need to be emphasized. Doing more push-ups and pull-ups can reverse some disparity between the upper and lower body. There is a specific method for building upper arm strength for a woman. Bicep curls are effective. When beginning a training regimen always consult your doctor. When doing this start with the lowest weight and over a period of time add more.Only add more when you can easily do the current weight level over a series of weeks. Tricep kickbacks are also recommended . Bench dips can also add to upper arm strength. These are only a few of some practical solutions.

Some women are going to be stronger than others. The most athletic ones will find doing physical tasks easier. Even at that level they will still have to push themselves to their full athletic performance level. Chareece Moore for example has a military career, but her devotion to physical fitness lets allows her to perform better. Many still believe women are not capable of lifting heavy objects or grown men from a battlefield. Cahreece would have no problem doing this if there was a need for it. The NPC bodybuilder projects and demonstrates  immense strength. There is the concern that women would struggle with moving the injured in combat gear.


If the combat gear is reduced in weight as the military promised, this can be solved too. If women self-pace managing loads they can successfully remove a fellow comrade. Besides moving people or objects physical strength is pivotal to ones safety. If ammunition runs out or weapons are lost hand to hand combat is needed. Just being strong does not make a person a great fighter; skill is the most important component. Then there is a physiological element of remaining calm in stressful situations.The average woman has less upper body strength and is slower in running speed, which means building strength and emphasizing fighting skills is critical. Women attempting to fight a man with just her bare hands would leave them at a disadvantage. Knowing self-defense techniques and martial arts can reverse some, but not all of the disparity. Hand grip strength is vast among the sexes. This is quite significant for a person in a fight considering fists are that primary part of the body used. A study of women Judo martial artists and handballers examined hand grip strength with athletic males and non-athletic males in the European Journal of Applied Physiology in 2006 . It showed that 90 percent of women scored lower than 95 percent of men. The athletic women score 75 % worse than men on the same task. The result of this may be that men have lager hands, therefore being able to exert more force. The athletic women were still stronger than non-athletic women meaning training can build some strength.

maxresdefault (7)
Women can reach at least an average male’s level of strength through training, but rarely perform at top levels of athletically trained males. Here Amber Betchel  arm wrestles a man with no training. If she did not have any she would not be able to beat him.

 Women in combat will most likely be fighting other men. Knowing judo, karate, or taekwondo may help women who are smaller be able to fend off an enemy when disarmed. While strength is important to the job, mental strength has to be built up with it. Any recruit could pass the training, but may not be psychologically prepared for possible dangers. This could cause a person to be paralyzed with fear when a situation is critical. That feeling has to be controlled so that self-defense moves can be executed. Also, there needs to be a level of confidence in the performance. Just because women are smaller does not mean they are not able to inflict physical harm. There are instances in which people who were underweight or smaller could be just as good fighters. Audie Murphy at 5 7′ and 130 pounds when he enlisted in the Marines. He was rejected, but at the end of World War II he ended up with many medals for his combat service. His lower weight did not stop his combat capability.


Christy Resendes  weighs up to 142 pounds ( 170 in the off season). As you can see it is mostly muscle and it can be assumed that she would be stronger than Audie Murphy. The diffrence is he would not be banned from combat, because he is male. Christy if she wanted to joined would be banned even if she could perform the same tasks.

Soldiers come in all different sizes. There is the common image of the large hulking male soldier that has been seen in fictional depictions and popular entertainment. Physical strength does win wars.Technology, tactics, and a lucid understanding of the enemy determines ultimate success.  If physical strength was a major factor then the United States would have won Vietnam. The average US soldier weighed more and was taller than the average Viet cong  fighter. Yet they were victorious by using guerrilla  warfare against America’s conventional strategy. It is forgotten that women fought in the Viet cong  and their sex did not hinder their objectives. They had less training and less resources compared the US soldier. What was demonstrated was a high level of mental strength. This requires a soldier to accept harsh conditions, be resilient, and continue no matter what the circumstance. The Vietnamese communist believed in their cause and were willing to sacrifice themselves for it.  The National Liberation Front wanted to see Vietnam united and free from foreign rule and influence. This type of mental strength must be developed as much as the physical.

Female Viet Cong Warrior c.1973

army gal
The assumption is that the US Army woman would automatically be the better fighter. This is not the case, because the NLF fighter may be more willing to fight to the death. A scenario in which these two fight it is clear to see the advantages. The US Amy woman has more strength, but it would only be useful if she were disarmed. The NLF fighter has more mental toughness living in a hostile environment.

Being in peak physical condition helps with certain tasks. However, there is a growing issue in regards to mental health.

         The US military has ignored the growing problem of declining mental health of soldiers and veterans. Health problems such as post-traumatic stress disorder and severe brain injuries are reaching astronomical levels.  A study conducted by the military in 2014 found shocking results. Soldiers have higher rates of mental illness than do civilians.Another part of the study claimed about 14% of soldiers had contemplated suicide . Other mental disorders such as depression, intermittent explosive disorder, and addiction were common. Dependence on alcohol and other drugs became prevalent. The soldiers that decided to commit suicide would not do it overseas, but instead did it when they returned home. This has been the unseen trouble with a military career. It leaves mental scars from carnage and brutality. This has been seen though out history. During World War I soldiers suffered from “shell shock.” It was a term for soldiers who were having mental turmoil from the violence they witnessed. The United States after World War II had to invest in mental health programs to get former soldiers to adjust to civilian life. The troops that went to  fight  in the Vietnam War received very little assistance. Even worse they were blamed for what corrupt leaders in both the Democratic and Republican Party did to Vietnam. Many of the Vietnam veterans suffered from mental health issues, drug addiction, or had to deal with homelessness. The mistakes of the past should not be repeated. Outreach programs must be developed to prevent serious social consequences of a health epidemic. Troops should be given reasonable tours of duty, so they can have enough rest and be rejuvenated  when they return. Younger soldiers could be at risk more so, because it may be their first time away from home. Family and friends are a support structure that a recruit must keep in contact with. Older soldiers now how to deal with the loneliness and long periods away from loved ones. For anyone entering the US military, you must understand the difficulties and challenges. Most experiences will not be pleasant ones. Women  veterans are likely to suffer from more metal health issues. This is related to military sexual trauma, which includes rape, sexual harassment, and sexual assault. Women are becoming a growing section of the homeless veteran population. The solution to this is not only having outreach programs, but encourage soldiers to get help. People with mental illness may not seek help, due to the societal stigma surrounding it.There is no shame in seeking help. The US military teaches soldiers to be tough regardless of the situation.Even the strongest people need emotional support. women-marines-570x342

It has to be known that it is necessary to seek mental health assistance. Therapists must employed in higher numbers to address mental health issues. Simply discharging soldiers will not solve the problem. Traumatic brain injuries are also on the rise. Soldiers should have mandatory screenings to make sure they have not sustained concussions. This could have a link to increase in mental illness, but so far it is only speculative. The symptoms of mild traumatic brain injury include headache, dizziness, blurred vision, inability to concentrate or retain memory, fatigue, lethargy, erratic sleep patterns, constant mood swings, and a bad taste in the mouth. A severe traumatic brain injury has symptoms much more intense. These include vomiting, nausea, headaches, convulsions or seizures, confusion, loss of coordination, slurred speech, and   anisocoria. These injuries are related to harm inflicted by improvised explosive devices. The symptoms may appear soon or later depending on the level of harm inflicted. Developing methods to detect IEDs can prevent these injuries and deaths. The US military must treat mental health as important as physical health.

          Another major issue that needs to be addressed is rape. This is a criminal and health problem that plagues the US military. Women are afraid to report these cases for fear of being attacked again or having their careers terminated. This must stop for the sake of the soldiers that serve and the image of the institution. The US is already guilty of war crimes in numerous conflicts and there should not be an expansion of criminal activity. Even though there are more men in military and they also face sexual assault, women are dis proportionally victims. Unwanted sexual touching or bullying has become a common practice. The result of these attacks include mental and physical damage to the victim. The problem is that attacks are dealt with through a chain of command. Commanding officers either do not care or fear their careers will be in jeopardy. This must change, because commanders clearly do not see rape as a problem. Former Secretary of Defense Leon Penetta  formed a special victims unit and a 24 hour hotline for service members, but that has not been effective. A crime unit for sexual assault should be established in the military police and be reported there, instead of depending on commanding officers. From that process the offenders can be court-martialed  and then be tried in a civilian court as well to ensure enough punishment is given. This will require much structural change and work with advocacy groups. Women cannot wait for bureaucracy to make changes. A proactive method is for women recruits to learn self-defense before entering the service. Not only will you have to fight another army, you may have to fight people in your unit.


There should be no fear in retaliating against an attack from a colleague.  Learning new fighting skills and using them in a hostile environment is critical. The 2013 annual report revealed that 26,000 service members experienced sexual assault. Women composed 12,100 compared to 13,900 of men. Less than half of these attacks involved alcoholic beverages. This is not just a “female problem.” Anyone entering the US military could become a victim to a criminal in their ranks. The increasing numbers could be the result of people reporting sexual misconduct and violence. This should not be a shock, seeing as rape has been an unwritten policy of the US military. Everywhere the United States has invaded there have been cases in which US service members have directed sexual violence against the population. This culture of rape needs to be dismantled through law enforcement and severe punishment.

Southern Partnership Station 2014
Never be afraid to strike at someone who is attacking you.

These types of rapes are probably acquaintance rapes. This means the assailants are someone the victim knows. There is a common myth that criminals like these appear in dark alleys waiting for victims. That is not the case. Women are not “asking” to be attacked. What a woman wears or does will not deter a violent individual. That prevalent sexist fabrication has been used to make excuses for brutish behavior. Attitudes and policies must be revised to ensure a crime free environment. The prevalence of rape may explain why one and five women experience some form of mental illness after serving in the US military.

         It should be noted that certain concerns about the menstrual cycle and pregnancy are unfounded. There is a common myth that is held that the menstrual cycle will negatively effect women’s physical  performance. The claim that women lose half of their strength has no biological or physiological basis. Women may have feelings of being tired during different phases of the cycle, but it does not mean they become weak. When examining women weightlifters it explains that there are some changes. During the luteal phase and the follicular phase knee injuries increase. The solution would be to move training regimes for legs later in the week. The luteal phase causes an increase in appetite. The metabolic  rate increases to about 11%. PMS also occurs during this phase and could accompany lack of energy and endurance. The consumption of magnesium can assist with this problem and it is found in foods with high fiber. The body uses glycogen has an energy source. The body will spare the glycogen during the luteal. This is important due to the fact that using glycogen stores it can help burn fat faster. The luteal phase causes a woman’s body temperature to increase, pain tolerance lowers, and some studies have shown that their is a level of higher cardio vascular strain. During the follicular phase pain tolerance goes back up. This does not mean women cannot do strenuous tasks; it means they will experience more pain. This does not paralyze a woman. Soldiers are used to discomfort, so this is only minor. Women’s muscles will not weaken from the menstrual   cycle.

Physical strength is not lost during the menstrual cycle.
Women will have to deal with some physical discomfort that men do not have to.

  Pregnancy has to be discussed. There are regulations for women soldiers serving to ensure health in regards to fertility.  It is unreasonable to ask women to fight if they are pregnant.First a woman must let her commanding officer know she is pregnant. This will result in a counseling session discussing rescheduled work duties. If the pregnancy has no complications, women can continue to work. Women must seek medical care at a military facility. If a military facility is out of reach a civilian hospital can be used. Physical training will have to be modified. Pregnant soldiers can be exempted from training or chose to do modified training. This should be done only when a physician or doctor  is consulted. Women are exempt from taking the physical fitness test 180 days after pregnancy. Abortion policy is dated. It is only allowed at a military medical facility in cases of rape, incest, or if the mother’s life is in danger. If there is to be true gender equality in the US military, women should have the right to choose. Reproductive rights are critical to women being equal in society. The state has to right to control a woman’s body, especially the soldiers fighting for it. This could become another major health issue in the US military. The policy should be changed to prevent any further crisis. Having knowledge of the biological functions of a woman’s body can help develop specific training programs to counter arising injuries or health problems.

           These recommendations can make gender integration of the US military more effective. There could be potential failures or road blocks if they are not implemented. Mental and physical health issues will cause major financial issues for the Department of Veterans Affairs. As the US declines as an economic power, returning veterans will have very little benefits. They could face homelessness, unemployment, or be forced to resort to crime to support themselves. A revision in foreign policy can place the US in a better position. The United States was never meant to be an imperial power and should seek to avoid war. Nation building and interventions around the globe has caused serious destabilization. It also has put an unnecessary burden on the US military. While the foreign policy shift cannot happen overnight, improving the health of soldiers can.

 This would best be described as the integrative approach. That means mental and physical health maintenance will be part of the training. There also has to be an adjustment in mind set. Women need to have a paradigm shift when entering a combat position. They will have to learn to love physical activity and strength. There are women who reject strength training for fear of gaining muscle or looking “bulky.”This occupation will require some muscle. It is a necessity, when marching under load. Women struggle with this because they did not train themselves for it.   Women will also have to learn to have confidence in tasks that require physical skill. This will not be simple, because it requires deprogramming gender norm expectations. People assume woman means weak, but as it was seen with the Army Ranger School graduates it can be done. Commanders should have high expectations of their recruits regardless of sex. Having low expectations will only produce failure. This must be prevented when the first group of women trying out for front line infantry enter  this summer.  When examining problems with biology and physiology health issues among women in combat can be solved.

Further Reading

Scarborough, Rowan. “Army Colonel: Physical Strength Not the End-all, Be-all of Combat Service SIGN.” Washington Times. N.p., 12 Aug. 2013. Web. 4 Apr. 2016.

Giannangeli, Marco. “British Soldiers Suffer Injuries from Too-heavy Weights.” Express. N.p., 25 July 2010. Web. 4 Apr. 2016. <;.

Chidress, Sarah. “FRONTLINE.” PBS. PBS, 10 May 2013. Web. 23 Apr. 2016. <;.

Byrant, Jordan. “Heavy Loads Could Burden Women’s Infantry Role.” N.p., 10 Apr. 2013. Web. 23 Apr. 2016. <;.

Ghose, Tia. “Women in Combat: Physical Differences May Mean Uphill Battle.” Live Science. N.p., 7 Dec. 2015. Web. 21 Apr. 2016. <;.

Bernton, Hal. “Weight of War: Gear That Protects Troops Also Injures Them.” The Seattle Times. N.p., 12 Feb. 2011. Web. 23 Apr. 2016. <;.

Hoffman, Micheal. “Study Evaluates Soldier Load Weights.” N.p., 6 Aug. 2012. Web. 4 Apr. 2016. <;.

Ehrlich, Robert. “Soldier’s Load and Combat Readiness.” Global Security. N.p., 6 Mar. 2009. Web. 21 Apr. 2016. <;.

Health Recommendations For Women Entering Combat

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