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Total Force Fitness - Overview

Total Force Fitness model

Figure 1. The eight domains of the Total Force Fitness model are based on a variety of sources
including current practices on medical fitness, psychological resilience, physical fitness and
injury screening, and integrative health care approaches. There are specific factors that are
considered in measuring overall fitness highlighted in the interior of each domain.

Keeping fit means more than just physical fitness - it requires a comprehensive approach that focuses on the mind, body and spirit working together. Stress and associated symptoms, such as headaches or anxiety, can reduce the ability to maintain appropriate weight, fitness, and nutrition. They increase the likelihood of developing chronic pain or impairing your body’s normal functions. As a warrior, familiarity with stress management skills and maintaining a healthy lifestyle before, during and after deployment can reduce depression, prevent a progression to post-traumatic stress disorder (PTSD), and it may well reduce the chances of diminished work performance, obesity, and injury.1

Under the direction of Admiral Mike Mullen, Chairman of the Joint Chiefs of Staff, experts from the operational, scientific and educational communities came together to integrate the components of health and fitness under the title “Total Force Fitness for the 21st Century.” The concept of Total Force Fitness encompasses eight domains:


  • Psychological
  • Behavioral
  • Spiritual
  • Social


  • Physical
  • Medical and Dental
  • Nutritional
  • Environmental

Total Force Fitness involves seamlessly integrating fitness of the mind, body and spirit. Achieving total fitness is a state in which you, your family and your unit/organization can sustain optimal well-being and performance even, under difficult conditions.

Physical Fitness: Training Year-Round Boosts Resilience

Military physical fitness involves your ability to physically handle all aspects of a mission, while at the same time remaining healthy and uninjured to meet the criteria for retention and continued military service. Year-round exercise can help you build and maintain your psychological health and resilience, and some studies have shown that it may improve your mood and attitude.2 The latest military fitness guidance emphasizes the need to focus on "mission and job task-oriented fitness."1 This involves having a well-rounded approach to your fitness routine that reflects the various types of conditions that you might experience. Physical fitness assessments can provide important tools to measure whether your fitness efforts effectively complement mission duties.

Psychological Fitness: Keeping Your Mind Fit

Coping with the stressors and realities of deployment takes a fit mind, not just a fit body. Psychological fitness is about strengthening your performance and resilience. It involves the way you:1

  • Think and process information
  • Feel about yourself, others and your environment
  • Act in response to your thoughts and feelings

Understanding what makes up psychological fitness and how to develop a healthier mental state can improve your readiness to confront the challenges of life – both in the military and in civilian life. Learning stress management tips to build coping skills is important part of strengthening your psychological health.

Behavioral Fitness: Coping Skills Build Resilience

Being behaviorally fit means controlling your actions to the benefit of your health. There are three primary components of this domain, including:2

  • Substance misuse prevention (e.g., alcohol in moderation)
  • Risk mitigation (e.g., wearing seat belt, helmet use)
  • Hygiene promotion (e.g., getting enough sleep, hand washing)

Rather than engaging in behaviors that may lead you down an unhealthy path, you can navigate through tough times by managing stress and building resilience in positive ways, including through exercise or spiritual activities. Healthy coping skills, like pursuing hobbies and other creative activities, can also lower your risk of substance misuse, sleep loss, relationship difficulties and more - all problems that can affect your well-being and your career.

Spiritual Fitness

For many, spirituality may be a relationship with God and certain religious practices. For others, it plays out in non-religious ways, such as through a focus on family or nature. However you express it, spirituality can promote healthy connections with others, healthy lifestyle choices and the strength to endure hard times.2 Spirituality can:2

  • Help cope with multiple deployments, combat stress or injury
  • Encourage a supportive environment and foster unit cohesion
  • Help cope with “moral injuries,” which can occur from either participating in or witnessing certain acts that may conflict with deeply held moral beliefs and expectations

As service members and members of civilian communities, spirituality can play a key role in a warrior’s well-being. Research has linked spirituality to increased optimism, less anxiety and depression, fewer suicides and greater marital stability.1

Medical and Dental Fitness

The medical and dental fitness domain involves multiple evaluation tools to determine whether warriors are medically fit for mission duties and deployment. Military medical fitness specifically establishes you are:1

  • Free of contagious diseases that would likely endanger the health of other personnel
  • Free of medical conditions or physical defects that would require excessive lost duty time for treatments or hospitalization or would likely result in separation from service for medical unfitness
  • Free of medical conditions or physical defects that would require excessive lost duty time for treatments or hospitalization or would likely result in separation from service for Medically capable of satisfactorily completing any and all required training
  • Free of medical conditions or physical defects that would require excessive lost duty time for treatments or hospitalization or would likely result in separation from service for Medically capable of performing duties without aggravation of existing physical defects or medical conditions

Determining your medical fitness involves evaluation tools, including DNA, immunizations, periodic health assessments, hearing and vision assessments, dental health, and a behavioral health assessment.1 Sleep is also an important aspect of medical fitness, as it provides improved judgment, reduced obesity, inflammation, and cardiovascular disease, improved resilience, and more rapid recovery from behavioral health problems, injury and illness.2

Environmental Fitness

Warriors that are environmentally fit are able to perform their duties well in any environment, such as in high altitudes or contaminated areas, and withstand multiple stressors associated with some military missions. Combating the stresses associated with challenging environments involves the following two sets of tools:2

  • Biomedical (i.e., nutrition, hydration)
  • Mission-related (i.e., the equipment and clothing available to service members)

Adapting to challenging environments involves acclimating to the particular conditions (e.g., cold temperatures, high altitudes, etc.), building up your tolerance while exposed to certain environmental stresses and cross-tolerance, when you adapt to environment stresses prior to any exposure.2 Leaders should ensure that appropriate risk assessments are conducted prior to entering and extreme climate. Additionally, routine risk assessments for all conditions should include an environmental component. Prior to deploying to a different environment, proper equipment for that climate should be issued and leaders should monitor for appropriate utilization. While deployed to difficult environments, you can often take steps to assist in adapting, such as use of proper vision and hearing protection, DoD insect repellent system and water purification techniques.1

Nutritional Fitness

Nutritional fitness includes providing and consuming all types of foods in quantities, quality, and proportions sufficient to preserve mission performance and to protect against disease or injury.

Healthy foods are fuel for the body. This fuel is important to your physical and mental performance, and helps maintain emotional control during field operations. Beyond performance, nutrition also plays an important role in protecting overall health throughout a lifetime. A diet rich in whole grains, lean protein, fruits, vegetables and low-fat dairy products helps lower the risk of certain diseases such as diabetes.

Nutritional needs are not universally the same. Daily fluid and food requirements depend on body mass, physical activity and the environment in which the work is performed.1 While military nutrition efforts have traditionally focused on making sure warriors are eating enough, the concern today is about eating too much.1 Consuming more calories than you need leads to excess weight. Being overweight can impact the success of missions, as well as raise your risk for heart disease, certain cancers, diabetes and more.

Social Fitness

Social fitness involves building and maintaining healthy relationships with others.1 It also plays a role in supporting optimal performance and resilience. Social fitness is multi-dimensional and includes not only friends and family, but also recreation, religion and hobbies, as well as bosses and peers. Social activity can help you relieve stress, build connections with others, and ease the strain of missing family and friends.

Unit cohesion is an important component within social fitness. When you and your fellow unit members exhibit healthy social connections and behaviors, the unit thrives. The stronger your unit is socially, the more resilient it is. Having a clear understanding of service values, the mission and its meaning is key in supporting healthy social networks.

Additional Resources


1MAJ Tonja C. Roy and others. "Total Force Fitness for the 21st Century – A New Paradigm," [PDF 17.54MB] Military Medicine: Supplement to Military Medicine - Volume 175. Published August 2010.
2Total Fitness for the 21st Century: Conference Report [PDF 550KB], Institute for Alternative Futures, Uniformed Services University of the Health Sciences. Published December 30, 2009.

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