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BACKGROUND CONTEXT: Special Forces training is even more demanding than that of elite athletes. The training includes grueling physical activity and periods of sleep deprivation. The soldiers routinely carry heavy loads up to 40% of their body weight on their backs while running and marching for distances up to 90 km. PURPOSE: Our purpose was to find out if Special Forces recruits are able to complete the preparatory Navy Seals training program without sustaining magnetic resonance imaging (MRI) signs of overuse or irreversible injury to their backs. STUDY DESIGN/SETTING: Prospective cohort study. We performed MRI scans before and after 14 weeks of Navy Seals preparatory training course. PATIENT SAMPLE: Ten soldiers underwent MRI of their lumbar sacral spines and right knees before and after the completion of Navy Seals preparatory training. OUTCOME MEASURES: Physiologic measures …