Air Force physical therapists contribute to historic Artemis II mission efforts

The Air Force Medical Service has a long history supporting manned spaceflight including NASA’s early Mercury, Gemini and Apollo missions. Recently, two Air Force physical therapists supported NASA’s Artemis II astronauts through pre-flight conditioning and rehabilitation following their historic 10-day mission around the moon.

At NASA’s Johnson Space Center in Houston, Texas, Lt. Col. Danielle Anderson and Lt. Col. Adrian Marrero lead musculoskeletal medicine and rehabilitation within the Space Medicine Operations’ Astronaut Strength Conditioning and Rehabilitation group. They provided physical therapy to Artemis II crew members who participated in the first human mission to the lunar vicinity in over 50 years. Marrero overlapped with Anderson for nine months at NASA to ensure continuity in musculoskeletal practice before Anderson moves to Barksdale Air Force Base, Louisiana, where she will serve as the 2nd Healthcare Operations Squadron commander.

Anderson and Marrero discussed Artemis II mission support, musculoskeletal medicine and what they’re looking forward to after their current assignment.

How did the ASCR team support the Artemis II astronauts in preparation for their mission around the moon?

Anderson and Marrero: ASCR consists of strength and conditioning specialists, athletic trainers, and physical therapists. The group supports the full continuum of human performance care across all mission phases. This includes preflight physical fitness and exercise hardware training, injury management and rehabilitation, injury mitigation, real-time exercise and care team support in flight, and postflight reconditioning, physical therapy services, and injury prevention during ground-based lunar surface analog research studies.

What does directly supporting human space exploration mean to you personally and within your specialty?

Anderson: Directly supporting human space exploration has been an incredible experience. As a physical therapist, we bring a unique perspective on musculoskeletal health, injury mitigation and human performance optimization, helping identify risks early, tailoring countermeasures and ensuring crews can tolerate the complex and evolving operational loads of deep space missions.

Personally, this experience has been a true honor. Being part of this work has deepened my sense of purpose, knowing that my skills contribute directly to enabling humans to push farther into space than ever before. It’s meaningful to support the people who make exploration possible and to help prepare them for the challenges ahead.

Lt. Col. Marrero will undoubtedly continue elevating this mission through his leadership, dedication and deep commitment to the well-being and performance of our crews. His expertise and vision will strengthen our efforts and ensure this critical work continues to advance in support of future exploration.

Marrero: I am incredibly honored to support human space exploration at Johnson Space Center. I am also deeply grateful for the nine months I had to overlap with Lt. Col. Anderson; her guidance throughout this transition has been invaluable. The foundation Lt. Col. Anderson built over the past five years in establishing the MSK program within the ASCR group is remarkable, and I am sincerely appreciative of those efforts.

As I step into this role, I hope to build upon that tremendous work by integrating my background in sports and Special Warfare human performance optimization. On a personal level, I am humbled to contribute to such an extraordinary mission - advancing space exploration and expanding human reach.

Lt. Col. Anderson, you were honored with the Silver Snoopy Award in 2024 for providing a range of clinical care to astronauts. What has evolved in terms of your role with NASA and the evidence-based practices utilized by the ASCR group?

Anderson: Since receiving the Silver Snoopy Award, my role has expanded to include publishing a new roadmap for human performance and injury prevention for Artemis and Exploration class missions. This work establishes a foundation for how we approach human performance optimization through an interdisciplinary, collaborative lens for future mission sets.

What have you taken away from your years of experience working with NASA astronauts as you return to supporting mission readiness?

Anderson: My years working with NASA astronauts have reinforced two major takeaways as I return to supporting mission readiness. Operationally, the experience has deepened my appreciation for how critical proactive, evidence-based human performance strategies are to sustaining crews through demanding mission profiles. From a leadership perspective, I’ve seen firsthand that teamwork, humility and a consistently positive attitude are what truly move missions forward. When teams show up with those qualities, we’re able to tackle incredibly complex challenges and accomplish remarkable mission sets together.