Utility of Embedding a Physical Therapist in a United States National Park: A Pilot Program

The US military has reported that embedding physical therapists (PTs) with forward-deployed personnel reduces the impact of nonsevere musculoskeletal (MSK) injuries. This paper describes a pilot program that embedded a PT with outdoor professionals working in Grand Teton National Park (GTNP). The PT spent 3 summer seasons providing onsite care in multiple locations within GTNP. Individuals who received care included search and rescue personnel, trail crew, wildlife biologists, wildland firefighters, and law enforcement officers. The PT performed 111 consultations for a wide range of MSK disorders. The lower extremity was the most frequently treated region (38.7%; n=43). Sixty-seven percent of consultations (n=74) were for symptoms that had a gradual onset with no specific injury. Fifty-six percent of consultations (n=62) were for symptoms of 3 months or more duration. Physical therapy treatments emphasized self-management and included exercise prescriptions, manual therapy, taping, and pain control using transcutaneous electrical nerve stimulation. Based on the preliminary findings from this pilot program, embedding PTs has the potential to increase access to care for nonsevere MSK injuries that occur in outdoor professionals employed in US National Parks. Further study is needed to assess the cost/benefit as well as the short- and long-term impacts of embedding PTs.