US Army Physical Therapist Roles and Contributions in Operations Enduring Freedom and Iraqi Freedom

Area of Science:

• Military medicine
• Physical therapy
• Musculoskeletal health

Background:

• Musculoskeletal injuries are a primary cause of healthcare use, evacuation, and disability in the US Army.
• US Army physical therapists (PTs) have functioned as physician extenders for nonsurgical neuromusculoskeletal injuries since the Vietnam conflict.
• The scope and evidence base for Army PT are continuously advancing.

Purpose of the Study:

• To discuss the evolving roles and care levels of US Army PTs.
• To review the evidence supporting Army physical therapy contributions.
• To identify key lessons learned from Operations Enduring Freedom and Iraqi Freedom.

Main Methods:

• Review of PT roles across care levels (1-5) and assignments (special operations, brigade combat teams) since 2001.
• Analysis of evidence supporting PT interventions in military settings.
• Synthesis of lessons learned from recent military operations.

Main Results:

• US Army PTs have provided comprehensive care from Level 1 to 5, including specialized units.
• Evidence indicates PTs in referral and direct access roles offer safe, effective care, improving readiness and decreasing evacuations.
• Key lessons include adopting a Soldier sports medicine forward care model, implementing injury risk assessment and performance screenings, and supporting PT structure, training, and research.

Conclusions:

• US Army physical therapy is integral to maintaining Soldier readiness and health.
• A proactive, evidence-based approach to physical therapy optimizes musculoskeletal injury management and operational effectiveness.
• Continued investment in PT training, research, and integrated care models is crucial for Soldier well-being.