Superficial ballistic trauma and subjective pain experienced during force-on-force training and the observed recovery pattern

Introduction: Military training involves preparing individuals for combat, yet applying the stressors ofcombat while maintaining a safe training environment is exceedingly difficult. One method to induce significant anxiety while still maintaining reasonable safety has been to utilize simulated ammunition. These rounds enable force-onforce training with reasonable stress and firing accuracy while also readily allowing participants to realize they havebeen shot. As such, these rounds have significant value when performing force-on-force training. However, although inwidespread use, there has not been a documented medical effort assessing the subjective pain experienced by individuals after being struck by one of these rounds, nor a visual record tracking recovery. The current investigation presents pilot data collected from an existing training course to provide an assessment of superficial ballistic traumainflicted by simulated ammunition. Materials and Methods: Participants completed one-on-one duels as part of theirintended course curriculum. These individuals used 9 mm pistols firing marking cartridges while wearing only prescribed protection equipment, leaving the chest, arms, and hands minimally covered by typical clothing. Participantsengaged in the duels as overseen by the instructors and without guidance or interference by the experiment team. Afteran individual completed these drills, researchers then asked questions about subjective pain experience while also documenting the recovery via photographs. Results: Results indicated that simulated ammunition only inflicted a mildamount of subjective pain, which reduced to zero even upon palpation after only a few days. Subjective pain for thechest was rated slightly higher than any other region. The visual record documented that most contusions were reducedto minor bruising, largely dissipating as quickly as the pain. Conclusions: Participants were able to safely conductforce-on-force training with simulated ammunition by following the manufacturer recommended safety standards.Participants did rate a statistically significant level of subjective pain, although this mild pain serves as a necessary factor to create the stressful environment of simulating combat conditions. It is possible that the subjective pain was ratedhigher for the chest due to the increased number of total rounds striking the chest, or the more direct impact of therounds upon this tissue. The differences in subjective pain and recovery between impact regions of the body are likelydue to the specific force-on-force drill conducted as a part of this training. Additional research will be necessary to support or dispute this latter speculation.