In Part 1, I described three patients hospitalized after a 15-minute workout early in training—each experienced severe hip flexor soreness before presenting to the hospital. One patient had a CK level exceeding 100,000.

The problem was more than just the intensity of the workout. The bigger issue was how high-intensity interval training (HIIT) fit within the broader training cycle. These recruits were subjected to HIIT early on, at a time when they were sleep-deprived and had little opportunity for recovery. The exercises targeted the hip flexors—a small muscle group less commonly trained outside military settings. On top of that, no rest was built in after the session, which amplified the risk of injury.

What made matters worse was the “incentive training” that followed in the next few days. Candidates who made mistakes during the day were given extra physical activity as a form of education, increasing their overall exercise workload. There’s a time and place for incentive training but stacking it right after an intense HIIT workout—especially early in the training cycle—was playing with fire.

As I explained in Part 2, our medical team had serious concerns about the safety of these candidates, and we communicated these concerns to the Navy commander in charge of training. Despite the combined expertise of the medical staff, the commander dismissed our warnings, blaming what he suggested was an out-of-shape generation of recruits. He refused to see the bigger picture—that the training system itself was setting them up for failure. For our medical team, this was more than frustrating. We could recommend changes but have no power to implement changes. We could see the risks building, but without leadership support, nothing would change.