Catalytic Engagement - Taking care of tactical athletes

Shared courtesy of Beyond Auburn magazine

In 2008, JoEllen Sefton received a phone call from U.S. Army Major Todd Burkhardt at Fort Benning that went a little bit like this:

“Dr. Sefton, the commander of our training unit, tells me we have way too many injuries, and we need to fix it. Can you help?”

Sefton’s response was immediate, methodical and effective. A leading expert in athletic training and injury prevention at Auburn University’s School of Kinesiology, Sefton developed what would become the Warrior Athletic Training Program, embedding graduate student athletic trainers within the units at Fort Benning and implementing evidence-based interventions to reduce musculoskeletal injuries and improve physical readiness in training units.

The success of that program ignited Sefton’s research and changed the trajectory of health for tactical athletes. Recently named the recipient of the 2024 Award for Excellence in Faculty Outreach, Sefton has spent the past two decades spearheading research and outreach to improve performance while reducing injury for military, police, firefighters and first responders.

“All the work that we do here is to solve a problem and to help people,” Sefton said. “Our scope is tactical athletes and how to keep them safe and healthy. If it’s not going to make a difference in somebody’s life, then we don’t spend our time on it.”

Athletic training lays foundation for helping warriors

When Sefton received that call in 2008, she was running the athletic training master’s program in Auburn’s College of Education. As a Navy spouse, she knew a little about the military, but not a lot about the Army.

“The first thing I did was travel to Fort Benning to view how they trained their soldiers,” she said. “I could immediately see things that needed to change, and we started talking about how I could help his battalion.”

Many trainees come to the Army without the level of physical fitness required for the job. Sefton realized that no one had ever recorded data on the military training programs or the population of trainees, in terms of their health and physicality. She began a first-of-its-kind research program on military tactical athletes, employing Auburn graduate students to develop protocols on measuring the trainees’ health, fitness and other factors.

“We took what we learned about working with sports teams and adapted that to the specific needs of the trainees,” Sefton said. “The research showed that in one week, the trainees get the physical activity that most people would get in a full month. We designed a program that helped ease the transition to training, especially in the first three weeks, as the trainees are getting used to the rigorous training and being in that environment.”

Sefton and her graduate student research team tracked injuries and demonstrated what it cost the Army in terms of personnel time loss and medical expenses. They discovered the majority of the injuries were overuse injuries, especially stress fractures that could not heal quickly because of the accelerated training.

They developed interventions, including educating trainees on how to run, building athletic training rooms and provisioning them with the right equipment and teaching drill sergeants about stretching, flexibility and warming up. They also examined nutrition and other health factors to improve trainee performance. And, perhaps most importantly, they trained the soldiers to understand why they should not hide injuries.

“Reporting injuries was a huge culture change,” Sefton said. “It took a lot of education to teach them that, if they report it and get help from an athletic trainer right away, they will be back into training in a day or two. If they hide it until it gets really bad, they can be out for months. It was an enormous change to go from the ‘We don’t want to make ‘em weak’ mindset to one of achieving training goals while reducing injuries.”

Over the course of eight years, the Warrior Athletic Training program grew from one battalion and three embedded athletic trainers assisting with soldier injury assessment and recovery to 33 athletic trainers serving all five training brigades at Fort Benning. In that time, the program served more than 860,000 soldiers in training and cadre, treated more than 510,000 new injuries, saved 1,692,872 soldier training hours by reducing lost training time due to injury and saved the Army more than $30 million in medical costs.

In addition, the program fully funded 85 graduate students as they earned their master’s degrees at Auburn in the School of Kinesiology.

“JoEllen Sefton’s passion and concern for the tactical athlete is the driving force for her efforts to improve performance while reducing injury and improving health and wellness of our military,” said Ronald L. Burgess Jr., retired Lt. Gen., U.S. Army. “Dr. Sefton’s hard work continues to have a positive and lasting impact on our military, tactical athletes, Auburn students and the Auburn community and reflects Auburn University’s commitment to both community outreach and to serving our military.”

Warrior Research Center

In 2010, Sefton expanded her work with the Warrior Athletic Training program to found the Warrior Research Center (WRC) in the College of Education. With a mission to maximize soldier readiness through improved health and performance, the WRC enables tactical athletes to safely complete the occupational demands of their jobs.

“The inspiration for the WRC came from a need I saw to bring together the resources of Auburn University to address the needs of our tactical personnel, families and veterans,” Sefton said. “We built off the success of the Warrior Athletic Training Program and continued to use a sports medicine model and extensive data collection to determine trends to develop protocols for injury prevention. Our research programs evolved to answer questions and improve care and training of service members.”

For the military, those research programs have included:

• Evaluating vehicles and equipment for their impact on soldiers’ musculoskeletal systems, including UH-60 Blackhawk helicopter pilot seats, M1A1 Abrams tanks, Bradley Fighting Vehicles and Stryker infantry fighting vehicles;
• Developing whole-body vibration protocols for musculoskeletal treatment and prevention;
• Technology evaluation: Real-time core body time monitoring via smartwatch with machine learning for command level situational awareness;
• Prosthetics: Prosthetic device and service satisfaction, quality of life and functional performance in lower-limb prosthesis clients.

“The work of the WRC has changed how the Army trains and cares for soldiers,” Burgess said. “The Warrior Athletic Training Model, a WRC program, has been expanded to Army and Air Force training locations nationwide. The work of the WRC has saved the military millions of dollars and hundreds of thousands of lost training hours.”

The WRC also has expanded its work to help first responders in and around Auburn.

“We started working with Auburn firefighters about eight years ago, specifically on heat issues, and we’ve had a great relationship with them,” Sefton said. “We have an environmental chamber on campus where we can exercise people in heat and study its cognitive and physical effects.”

In addition, the Auburn Police Department tapped Sefton and the WRC when it became aware its officers had high rates of cardiovascular disease. The request for help resulted in wellness screenings, a series of workshops on fitness and an embedded graduate student who helps in the police and firefighter gym on Ross Street, answering their questions and helping them achieve their fitness goals.

“Our goal: get someone back to their job and keep them alive,” Sefton said.

To date, the WRC has generated more than $13 million in funding for its research, all dedicated to generating solutions for military tactical athletes and first responders.

“The WRC has become the go-to place for Auburn researchers, industry, small businesses and government organizations to find the resources needed to solve problems,” Sefton said. “The development of the WRC has required all of my professional skills as an educator, researcher, outreach academic, networker, director and, at times, a politician to bring together the resources, funding and end users to drive the WRC forward to meeting our mission. I’m proud that the work of the WRC is built on a foundation of solid, peer-reviewed, evidence-based science.”

What's next? BOLT

In 2024, Sefton and the WRC were tapped by the Air Force to develop BOLT, a comprehensive performance initiative for military service members attending Air University at Maxwell Air Force Base in Montgomery, Alabama. Armed with a $500,000 grant, Sefton and her team of faculty members, postdoctoral researchers and graduate and undergraduate students are creating a method to improve service members’ quality of life and professional performance.

The first phase started in July when Sefton and her team screened the health and wellness of 500 military service members currently teaching and studying at Air University’s Air Command and Staff College, a school that prepares students for higher-level positions in military or government, including those in air, space and cyberspace operations.

“We found real differences in fitness between the men and women,” Sefton said. “Each excels in different areas. Our experts are there to provide specific interventions and help them work on that. In April 2025, before they leave the program, we’ll screen them again to see if they have improved.”

With their wide-ranging expertise, the team from kinesiology can build programs for every individual that include personalized fitness plans, nutrition advice, cognitive performance improvement and stress reduction techniques. They will be on base several days a week so service members can easily access guidance.

Sefton and her BOLT team are also launching wellness programs in mindfulness, sleep and other factors that speak to the Air Force’s four pillars of Comprehensive Airman Fitness: physical, social, spiritual and mental.

“We’re trying to get them to look at a holistic kind of health package and then we’ll evaluate: did the participants come see us? Did those that did come see us get better?” Sefton said. “This is really a beta year, but our hope is that we’ll be able to demonstrate these interventions are necessary and effective and that we’ll be able to scale up the program to other Air Force schools.”

As her work continues to evolve and expand, Sefton tells her students and others who are looking to help address issues in their community that flexibility in thinking is tantamount.

“Anyone working in the field of kinesiology needs to have an acute ability to communicate and collaborate with people who think differently than you do. That flexibility is key to solving problems,” Sefton said. “When you see how your work impacts people’s health and their ability to do their jobs, it’s very rewarding.”