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MILITARY PHYSIOTHERAPISTS PART 3/3: THE PTO ENVIRONMENT

A.L. Ager

 

“What’s the difference between a military physiotherapist and a civilian physiotherapist?”  As a former military physiotherapist, I used to get this question often.

This is the final post in a three part series that illustrates what I found to be unique about being a Physiotherapy Officer (PTO). This post is about the environmental differences that PTOs experience.

 

The attire: The dress of choice for a military physiotherapist is the uniform. Whether it is sky blue (the air force), black and white (the navy), or the classic green camouflage (the army), all military physiotherapists begin their day in some form of combat boot.

The physiotherapy uniform represents another profession to which military physiotherapists also belong: the profession of arms. A PTO has the responsibility of being both a health care provider and a soldier.

One of the interesting aspects of the military is that if you know the trade (i.e. job) of the individual and you can see their rank displayed on their chest, you generally know what that person is qualified to do. It’s almost like wearing your work credentials on your uniform; the same concept applies with a military physiotherapist.

Your environment: Imagine yourself in a world where every patient has to be fully healed, yesterday. A soldier’s career depends on their ability to be medically and physical fit.  If you are unable to be “fit for duty”, there is an eventual possibility that you will not have a career to come back to.

The Canadian Armed Forces (CAF) requires physically fit soldiers. Despite having excellent world class medical care, the bottom line remains that the health of a soldier remains their best asset.

Another challenge of being a military physiotherapist is not the injuries per say, but working within an environment that is not always conducive to promoting healing. Did I mention the physical training? What about the lack of sleep? A nomadic lifestyle, carrying heavy rucksacks? High stress? Pressure to perform? The military is a constantly running machine and its personnel cannot afford to stop doing their jobs.

Your patient: While they can vary, patients are usually young, fit, and predominantly male. They run, march, climb, lift, and jump on a daily basis.

A military physiotherapist could work in a variety of settings, including:

  • In a clinical setting on a base (the majority of our time!)
  • Traveling in Canada or internationally with a military sport’s team
  • On field exercises, sleeping in a tent in all kinds of weather
  • Tasked on humanitarian mission (such as a hospital ship)
  • On deployments (the most recent in Afghanistan)
  • On a navy base (Halifax for example), treating a ship’s crew
  • With an army brigade (such as in Edmonton)
  • With an air force squadron (with mostly aircrew members such as in Bagotville)

Each base, clinic, or detachment presents its own unique challenges and demographic diversity.  However, all of them require a PTO to adapt to a fast-paced position, maintain a high level of fitness. There is no room for injury. When treating soldiers, time is most definitely of the essence.

 

Injury profile: This is an even more difficult area to address because it is vastly different for every element (air, sea and land) and even between military trades. A foot soldier (infantry) won’t share the same injury profile as a helicopter pilot, for example.

They won’t have the same rehabilitative concerns, either. An ankle sprain won’t be as important to a helicopter pilot as to an infanteer.

As a PTO, you get to know the trades, daily tasks, and the potential rehabilitative obstacles which lie ahead of each.  Generally speaking, the injury profile of a soldier resembles that of a professional athlete. You see typical wear-and-tear, overuse and traumatic injuries, and also the dreaded postural impairments.

 

Bring in the reinforcements: This may come as a surprise, but the military heavily relies on support from civilian physiotherapists. The majority of physiotherapists who are currently employed on military bases are civilian!

Civilian physiotherapists may be public servants or on temporary contracts. I am proud to say that civilian physiotherapists are the backbone of the rehabilitation services for the Canadian Armed Forces (CAF). Without their dedication and reliability, the PTOs would not be afforded the flexibility to follow the need for uniformed rehabilitation efforts around the world.

The uniformed physiotherapist was born from the very real need for primary care rehabilitation services in adverse conditions, including operational deployments. Civilian physiotherapists who remain on bases provide continuity of care; PTOs can train or go on deployments.

 

Sick parade: This has to be my favorite topic. A sick parade is essentially a military medical walk-in clinic with a triage system. It’s designed to methodically assign the presenting patient to the appropriate health care provider. If a soldier comes in complaining of back pain, they will be sent directly to the physiotherapist, who will then determine if the pain is truly MSK in nature. The physiotherapist will determine if the patient requires advice, a few exercises, further physiotherapy investigation, or if they need to see the doctor for imaging or medication.

Sick parade is not only a great example of multidisciplinary cooperation, but it is also a very direct and efficient service for the patient. It is an absolutely brilliant system that (in my opinion) should be implemented in all hospitals, military or otherwise across Canada. Stay tuned for a future post via CPA on this!

 

What it’s all about

Being a military physiotherapist was about more than just wearing the uniform and being a moving part in a worthy organization. The military environment is one of the most challenging and rewarding I can think of.

My experience as a PTO not only allowed me to grow as a mature physiotherapist, but also an adaptable professional who welcomes a good challenge.  The military has given me the critical thinking ability I need to be efficient and effective within my chosen profession.

Without sounding cliché, my 10 years with the military has left a profound imprint on me, and has helped to shape who I am, professionally and personally.  It was a pleasure to serve alongside fellow PTOs and learn from the multitudes of experience provided by my civilian and military colleagues.

Out of respect for Remembrance Day around the corner, please take the time to think about the men and women (past, present, and future) who wear the uniform, and who believe in and serve a cause more important than themselves. 

 

Lest we forget / On se souvient.

I welcome your questions or comments about my post. If you want to know more about the unique challenges of this environment, please feel free to comment below with your thoughts.

Learn more about military physiotherapists in Canada here.

 

Have you read part one and two?

Military Physiotherapists Part 1/3: The road to becoming a PTO

Military Physiotherapists Part 2/3: “Keeping soldiers fit for duty”