Page 49 - JSOM Winter 2017

Figure 2 Treatment modality frequencies. be a focus of mission logistics. This study highlights the mo-
dalities used to treat deployed personnel. Physical therapists
have long been known to be experts in the field of identifying
and treating these injuries, 5-7, 12-13 helping maintain the integ-
rity of these small-footprint commands by offering care at the
point of injury. In this study, 68% of all treatment modalities
were manual therapies not requiring extra equipment, and no
restrictions to location of treatment were necessary. Therapy
exercises and mobilization/manipulation are viable options
even during “high-speed” NSW operations in austere envi-
ronments. All other treatment options used during this study
were noninvasive techniques. We believe the use of and access
to these therapies helped keep personnel effective and able to
complete their missions. Without inclusion of the acute care
provided by a PT and their therapies, we believe the opera-
tional capacity of this unit would not have been maintained.

The unique, high-speed, small-footprint structure of NSW
Command units emphasizes the significance of each member
of the unit. Our results are similar to those of other reports
that discuss MOI and injury location in a deployed setting.
Because few reports discuss medical care at the frontline in
Special Forces commands, many comparisons cannot be com-
E-stim, electrical stimulation.
pleted. The general knowledge of the effectiveness and ex-
(approximately 80%). We showed that an incidence of two pertise of PTs, as well as studies such as ours should provide
DNBIs per day resulted in southern Afghanistan. a driving force to continue to push PTs to the front lines to
provide direct access to their care. We believe doing so will
Lumbar and sacral spine injuries were the most common inju- result in increased command readiness and decreased loss of
ries evaluated. This is consistent with prior deployment-setting personnel, allowing commands such as NSW to continue to
12
reports described by Teyhen and Rhon et al. This consistent optimally function at their high operational tempo.
7
prevalence of lumbar and sacral spine musculoskeletal injuries
is likely due to the difficulty maneuvering in an austere envi- Disclosures
ronment as well as the gear required to be carried while in a The authors have nothing to disclose.
combat zone. Modern gear carried by personnel can weight
upward of 60 lb., depending on mission objective. Quick and Author Contributions
quiet mobilization of these commands requires additional J.S. performed the background research, organized the data,
planning of mission objectives and supplies. Lower back pain and interpreted the results and is the lead author. on this manu-
should continue to be investigated, because we know that script. L.B. was the physical therapist deployed with the SEAL
approximately 20% of all DNBI medical evacuations are of team. She evaluated and treated each patient and was the indi-
7
spine etiology. We believe that having PT access in the vicinity vidual responsible for the data collection. She also completed
of where the injury occurred prevented progression of muscu- a review of the information once the manuscript was created.
loskeletal injuries and allowed patient recovery, halting pro- B.J. was the NSW Group 2 head physical therapist who helped
gression to medical evacuation consideration. arrange and review the incoming data and sought WARCOM
and SOCOM approval for publication. She also completed a
review of the information once the manuscript was created.
Although the SEAL team was pushed to the forefront of
combat, the most common injuries were the result of physi- All authors approved the final version of the manuscript.
cal training. This was unit driven and entailed organized par- References
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4
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ing Freedom (Afghanistan). Am J Trop Med Hyg. 2005;73(4):
5
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