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Fort Bliss PTs about-face readiness

Various exercise equipment lines the floor in 2nd Brigade Combat Team, 1st Armored Division’s repurposed gymnasium, April 25. The gymnasium, which is centrally located within 2nd BCT’s footprint, is one of many efforts leading to a decrease in Soldiers on profiles (physical limitations) across Fort Bliss resulting in an increase in readiness. William Beaumont Army Medical Center’s Rehabilitation Services implemented new hours of operation for physical therapy clinics at primary care clinics as well as increased the education and access to care for Soldiers needing physical therapy.

Various exercise equipment lines the floor in 2nd Brigade Combat Team, 1st Armored Division’s repurposed gymnasium, April 25. The gymnasium, which is centrally located within 2nd BCT’s footprint, is one of many efforts leading to a decrease in Soldiers on profiles (physical limitations) across Fort Bliss resulting in an increase in readiness. William Beaumont Army Medical Center’s Rehabilitation Services implemented new hours of operation for physical therapy clinics at primary care clinics as well as increased the education and access to care for Soldiers needing physical therapy.

Story by Marcy Sanchez

William Beaumont Army Medical Center Public Affairs Office

In 2015, Fort Bliss had one of the heaviest volumes of Soldiers on physical training profiles, meaning Soldiers were limited to activities/ exercises they could perform. Today, readiness has increased significantly and profiles have decreased.

The physical rehabilitation program at William Beaumont Army Medical Center and other Fort Bliss units are crediting the change to improved fitness programs. An increase in access to physical therapists and educating noncommissioned officers to detect, early on, distress and discomfort within their ranks is helping improve readiness.

“A year ago Fort Bliss was one of the worst in readiness, now we’re one of the best,” said Lt. Col. Kevin Houck, chief, Rehabilitation Services, WBAMC. “When looking at (two metrics regarding percentage of Soldier population on temporary profile per 100 Soldiers and percentage of Soldiers on temporary profile for more than 90 day in a six-month period) there was a dramatic decrease, the first one (temporary profile per 100 Soldiers) decreased by 49 percent and the other (Soldiers on temporary profile for more than 90 days) by 42 percent.”

Over the past few years, Rehabilitation Services at Fort Bliss has made significant changes including opening more physical therapy clinics closer to Soldiers, extending hours of operation beyond normal duty hours and offering dedicated sick call slots to Soldiers whose units don’t have assigned physical therapists. Rehabilitation Services has also implemented dry needling, a technique which uses needles for therapy of muscle pain similar to acupuncture, into programs.

According to Houck, educating combat medics is also vital in improving readiness at Fort Bliss since combat medics are usually the first point of care for Soldiers. Through education, combat medics are better equipped to diagnose musculoskeletal pain and refer to appropriate treatment to deter further injury.

At 2nd Brigade Combat Team, 1st Armored Division, some outside of the box thinking and leadership engagement led to substantial increases in readiness.

“We’ve seen a 40 percent reduction in musculoskeletal injuries and profiles just in (2nd BCT),” said Capt. Andrew Bressler, commander, Medical Company, 2nd BCT, 1st AD. “We’re training junior (noncommissioned officers) to identify injuries earlier, so it never got to a point of injury. It builds Soldiers and empowers lower cell supervisors before ever (leading to injury).”

Less than a year ago, Bressler, a native of Oak Harbor, Washington, and his medical team made changes to 2nd BCT’s approach to physical therapy. Aside from educating NCOs on safe and evidence-based physical training programs, the brigade also repurposed unused space and equipment into a fitness center designed to support the physical therapy mission.

“Nearly 400 Soldiers come in on their own time to optimize their own performance each week,” said Bressler. “If they’re hurt we get them better, and we help Soldiers that aren’t injured optimize their performance and build strength to prevent injury.”

Before the gymnasium was erected at 2nd BCT, the brigade’s physical therapist, Capt. Roy Camacho, started the physical therapy program at 2nd BCT with resistance bands and PVC pipes to place progressive loads on injured Soldiers.

“Soldiers don’t have to drive 15 minutes to a clinic; we could mitigate and save a lot of time if we gave the Soldiers somewhere they can work on themselves at the brigade or near it,” said Camacho. “It’s equipment you’d see (at a physical therapy clinic), it’s bona fide. We wanted to make sure we were doing things the right way and make sure it was evidence-based.”

One of the major concerns was the time required for Soldiers to seek care away from their place of duty. Previously, Camacho would treat patients at the Spc. Hugo V. Mendoza Soldier Family Care Center, a primary care clinic with rehabilitation services which is located about three miles away from the unit. Although WBAMC’s physical therapy clinics are dispersed throughout Fort Bliss, some Soldiers found it difficulty with treatment programs without spending excess time away from the brigade.

To combat this obstacle, Camacho and his team migrated the brigade’s physical therapy treatments to the newly-constructed gymnasium within the brigade’s footprint.

The brigade’s physical therapy program lined up with organization PT and allowed for Soldiers to get treated, improve conditioning and optimization with an evidence-based program under the supervision of a physical therapist. By timing the program to coincide with unit PT, Soldiers with profiles were less likely to further injure themselves while still participating in conditioning to help return to full duty expeditiously.

“As soon as they get that profile, they show up for our reconditioning program. The program allows for exercise and treatment the same way they would at a physical therapy clinic,” said Camacho, a native of Guam. “The risk of them further aggravating their injury is out of the picture because it’s at the same time as their unit physical training.”

“Most evidence shows that the earlier you start therapy, you’re going to have a better outcome,” said Houck, a native of Hermitage, Pennsylvania. “(2nd BCT’s) program really hits that. Getting leadership support to have a facility where they can come to do that in their own footprint is key to that success.”

According to Camacho, providing guidance to leaders was vital in the direction of 2nd BCT’s physical therapy program. Enlightening leaders on risks and needs of Soldiers, not only in reconditioning programs but in conditioning programs as well, helped direct leaders to implement the program within their footprint.

“It’s really going to be the leadership at all levels to give some of that authority to people there on the ground level. They’re going to do what’s best for the unit and get the mission accomplished,” said Houck. “Having the dialogue and equipment to do this has really made a big difference”

“We started with about 23 feet of (resistance bands) and some PVC pipes,” said Camacho. “Some individuals may not know where to start (reconditioning programs) but the key is: just start.”

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