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1st SFAB's physical therapist practices preventive measures to keep unit healthy

By Jon Micheal Conner | Army Public Affairs | Nov. 7, 2018

FOB LIGHTNING, Afghanistan — The Army's 1st Security Force Assistance Brigade has a Soldier who is helping his own unit members here and those of the Afghan forces by implementing physical therapy-related preventive care to keep personnel healthy and fit in a deployed environment.

Maj. Nicholas Koreerat, Headquarters and Headquarters Company, 1st SFAB, is ensuring Soldiers are taking care of any musculoskeletal issues by not letting them linger and worsen, which ultimately affects mission readiness.

Koreerat is a doctor of physical therapy, a board certified clinical specialist in orthopaedic physical therapy, and a certified strength and conditioning specialist. He is a 10-year veteran who deployed to Afghanistan in 2012/13 for seven months in the Zabul Province in southeast Afghanistan. 

FOB Lightning is headquarters to the Army's 1st Security Force Assistance Brigade, deployed to Afghanistan in support of the NATO-led Resolute Support mission. The new unit is designed to train, advise, and assist other nation's militaries in need of specialized expertise that each member brings. In Afghanistan, 1st SFAB enables the Afghans from the battalion to Corps level.

The unit's home station is Fort Benning, Georgia. 

Prior to the deployment, then-Col. Scott Jackson, 1st SFAB commander, had Koreerat and a couple of other Soldiers from U.S. Army Medical Command conduct some training about different aspects of health concerns regarding deployed Soldiers. Jackson was promoted to brigadier general in August. 

The purpose was to teach all 1st SFAB Soldiers that they can thrive in any type of operational environment by implementing the tips and advice learned during the training. 

"Everyone's different and that's what makes medicine fun," Koreerat said.

The main idea of having a physical therapist in a unit is to be pro-active in prevention versus treating Soldiers in rehabilitation. The goal is to do more prevention and performance optimization techniques rather than treatments, Koreerat said.

Whether it's jumping out of aircraft, road marches in full combat gear, training exercises, or just doing their mission, Soldiers' bodies endure a lot of wear and tear.

Koreerat said that 75 percent of why Soldiers have to curtail their deployment is because of musculoskeletal reasons. "That's absolutely a huge figure," he said.

In an effort to decrease that, the Army is attacking that by addressing performance optimization. That looks at the physical, mental, and nutritional aspects of an individual and trying to improve in those areas as needed.

More and more Soldiers are coming in for physical therapy versus just living with injuries, Koreerat said. 

"The trust factor has changed," he said. "A lot more (Soldiers) are prone to seek help. I can give the brigade surgeon assistance." 

The brigade surgeon serves as the senior adviser for the commander regarding health support services, force health protection, supervises technical training for brigade medical personnel, and develops policies, protocols, and procedures for medical and dental treatment among other duties, according to the Army's Division and Brigade Surgeon's Handbook.

Koreerat presented a document -- Memorandum For Record -- dated April 2018, titled "Physical Therapist in the Security Force Assistance Brigade." The document outlined the importance of the physical therapist 

"When treated by a physical therapist within the theater of operations, 95-98 percent of Soldiers return to duty. Prior to deployments, physical therapists improve unit readiness. Due to the small numbers of Advisors in a team embedded with the host Army, one unavailable Advisor results in a significant decrease in capabilities limiting the team's effectiveness …"

As an example, Koreerat said, instead of sending a deployed Soldier to Landstuhl Regional Medical Center, for treatment, he can work with him in the deployed area, thereby not affecting the unit personnel roster. LRMC is in Germany and is the largest U.S. military hospital outside the continental United States.

And the memo defined the physical therapist as a "mobile physician extender and proponent of performance optimization across the theater of operations to provide prevention, surveillance, early intervention, diagnosis, and aggressive treatment of injuries in preparation for and recovery from missions."

Regarding the host nation of where an SFAB is deployed, the physical therapist also has an important role with the SFAB's mission.

"With the SFAB's train, advise, assist, accompany, and enable mission, the physical therapist can uniquely provide the host nation's Army in implementation of emerging rehabilitation training programs for physical therapists to include injury prevention, treatment, and performance enhancement," the memo stated.

Consequently, part of Koreerat's duties with the 1st SFAB include working the Afghans on the other side of the base called FOB Thunder. It is where the headquarters of the Afghan National Army's 203rd Corps is located. 

Inside it is a small hospital where Koreerat trains, advises, and assists his Afghan counterpart, a physical therapist who used to be a finance officer.

"Their facilities are good," Koreerat said. "I'm impressed with their hospital."

While the 100-bed hospital is not quite up to American standards regarding technology, it does provide a lot of capability, he said. 

One thing that is similar to the U.S. Army, Koreerat said, was the most common complaint of the Afghan soldiers -- back pain.

"We have had a series of back classes" for them, Koreerat said, which resulted in reduced rehabilitation time, and helping the Afghan soldiers get back to a normal (healthier) life.

On average, Koreerat sees his Afghan counterparts -- five persons -- about once every two weeks. He said he is very impressed with them because every time he comes back, they've mastered a technique he taught them from the previous visit. 

Previous training has included back classes in general, manipulation on the lower back, hip and mid-back. It also includes conversations too.

"They're beyond eager and willing to learn," Koreerat said.