Physical Therapy as a Force Multiplier: Population Health Perspectives to Address Short-Term Readiness and Long-Term Health of Military Service Members

Abstract

Neuromusculoskeletal (NMSK) injuries are ubiquitous in the United States Armed Forces and pose a substantial threat to operational readiness. Many service members who sustain an NMSK injury progress to develop chronic conditions that may result in substantial decrease in function and physical activity across a lifetime. Both social and psychological factors may drive care-seeking and treatment compliance in service members following NMSK injury, contribute to the chronification of injury, which likely result in long-term cardiovascular consequences that contribute to morbidity and mortality. The decision to seek care following NMSK injury is ultimately related to the knowledge, beliefs, attitudes, and values of individual service members that are influenced by the military culture in which they serve. In this clinical perspective, the authors provided a theoretical framework on how psychosocial determinants of care-seeking may contribute to chronification of NMSK conditions and how this may influence long-term cardiovascular health. Cultural shifts and changes in health care delivery in the military may help to mitigate barriers to care and promote care-seeking with the clinician being viewed as a “force multiplier” or optimizer of readiness. Because there are substantial gaps still remaining in the evidence, the authors hope that this perspective will facilitate future research related to this topic.