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Physical Therapy Afloat: Operation Mobility

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MARCOA Media
Story by PO3 Erika Kugler on 09/13/2019
Story by Mass Communication Specialist 2nd Class Erika L. Kugler
ATLANTIC OCEAN There I was, month four of the deployment, sprinting on a treadmill, listening to my 80's hair metal playlist, when it happened. The ship shifted, or I landed wrong maybe both but I knew in that moment, my sciatic nerve was beyond angry.
An injury I had picked up in A' school, which got worse or better depending how diligent I paid attention to sitting, lifting heavy weight, and now, running, had me making a desperate plea to Hospital Corpsman 2nd Class Matthew Brown.
A Milwaukee-native, and the only physical therapist (PT) technician aboard the aircraft carrier USS John C. Stennis (CVN 74), Brown was quick to confirm that I had irritated my sciatic nerve.
Over the next couple months, his patience with my impatience and gentle scolding to do the exercises he prescribed, slowly began to get me back to "better".
Who knew?
As it turns out, I am not the only one with lower back problems in the Navy.
Lt. Harris Maxfield, from Springfield, Vermont, the ship's new physical therapist, and Brown agree, lower back pain is one of the biggest problems they see in patients, followed by knee and shoulder pain.
"In a young, athletic, manual labor intensive population, these injuries are what we usually see," said Maxfield. "Probably more so on a ship because of some of the awkward positions sailors have to perform their work in, and the repetitiveness of it all."
According to the Bureau of Labor Statistics, civilian PTs and their physical therapist assistants (PTA), equivalent to our PT technicians, "typically work in private offices and clinics, hospitals, patients' homes, and nursing homes", but with the environment we work and live in, it's important to have them close by.
"On a ship, it is a much more dynamic environment," Brown explained. "There are a lot of things that can go wrong on the flight deck, a lot of ladderwells that are very steep If someone twists their ankle, or they sprain their wrist, or hurt their shoulder, they're out of commission. Having us there to get them back to being fully functional gets them back to their job and back to the mission."
Maxfield, having achieved a doctorate in physical therapy from Baylor University through the U.S Army-Baylor DPT Program Scholarship; and Brown completing initial corpsman training and follow-on Physical Therapy Technician training at the Naval Medical Training Center (NMTC) in San Antonio Texas, a condensed six-month intensive clinic, the equivalent of a two-year Physical Therapy Assistant (PTA) associates degree for civilians, work as a well-trained team.
While the majority of training is similar to that of their civilian counterparts, there are subtle differences that require the two to have more knowledge and responsibilities than their civilian counterparts.
"Military PT technicians have a higher level of autonomy than PTAs," said Maxfield. "While the PTAs in the civilian sector can only follow a plan of care [provided by a physical therapist], PT technicians might be expected to do their own initial screening and then discussing it with the provider. They are trained as corpsmen first, after all. As for physical therapists, we have to do a lot more radiology and pharmacology training that a civilian PT wouldn't have to, because we need to have the ability to order and read imaging (MRI, X-ray, CT) and prescribe medication."
With this extra knowledge and training, Maxfield and Brown are able to provide a large number of services, ranging from therapeutic heat to dry needling therapy. Though, there are some limitations to overcome.
"Our biggest limitation is how much equipment we can hold," said Maxfield. "Compared to Balboa, where the physical therapy clinics are probably half the size of the flight deck, our current 14-by-18 ft space requires us to be more creative in our treatments ."
As we've seen, just because there is equipment to be used, doesn't mean it is easily accessible at the times Sailors would be able to use it.
"When I first got here, I envisioned bringing patients to the gyms for treatments,'" said Maxfield. "But if we go look at the gym when most of our patients can use it, it's packed. That's why we have to come up with things patients are able to do, where they are able to do them."
Because of this, Brown says they have to use their training and maybe break away from tradition.
"You really have to think outside the box," said Brown. "I've told patients, okay, you don't have dumb bells to walk around with, use a hammer,' or something with bulk to itI wouldn't consider some of the therapies we do traditional, because we have to work with what we have."
With the two seeing 8-10 patients each a day, they are able to help upwards of 500 Sailors in a month; which is an accomplishment when you consider that they are still Sailors.
"We have to find the time," said Brown. "We try and keep our schedules static, which makes it easier to adjust things if something pops up. Keeping a regular schedule helps, but, it's definitely a challenge. We still have to do maintenance and get qualifications, same as anyone else."
Because they see patients after they are already injured, Maxfield says they are looking to take a more proactive approach, which they hope will help Sailors before they sustain injuries.
"As a profession, we are shifting toward preventative medicine, especially in the military," said Maxfield. "We hope to be able to implement injury prevention programs and classes for the ship in the near future. It is extremely beneficial to prevent and catch more injuries early on rather than Sailors needing to see us for rehabilitation after the fact. Our main focus is to keep Team Stennis healthy and moving and able to complete the mission"
Despite the intense training, obstacles they face with not only the sheer number of people but the environment they work in, and creating new programs from scratch, Brown says he really enjoys his job and the satisfaction he gets from helping Sailors recover.
"I worked at Walter Reed for about three years," said Brown. "They have the Military Advanced Training Center there for amputees. A lot of wounded warriors come in, missing limbs and we have to rehabilitate on that scaleThese are active duty member that have been overseas, have been deployed and got injuredit can be intense but it can be extremely gratifying to get them back to where they are now."
The John C. Stennis is underway in support of Commander, Naval Air Force Atlantic conducting routine operations.
For more news on John C. Stennis, visit www.stennis.navy.mil or follow along on Facebook at www.facebook.com/stennis74.

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