Doctoral Residency Bio

Doctoral Residency Bio

Tactical Response Force Residency,

USAF Global Strike Command Minot

I chose the 91st Tactical Response Force (TRF), Minot Air Force Base, in the United States Air Force Global Strike Command for my residency.  Being a certified / licensed athletic trainer at Minot Air Force Base offers a unique perspective in what is considered one of the highest catastrophic risk factors for all of the Security Forces in the nuclear enterprise. The residency serves as a new and emerging area in athletic training because it offers a tactical perspective into the care, treatment, and prevention of protective service members most clinicians would not have access to.  The goal is to help the Air Force advocate for better healthcare.

Minot is home to the smallest Tactical Response Force (TRF) of 3 in the United States Air Force; therefore managing commanders do not have the luxury of available replacement staff should a member become injured. Because of this, there is a tremendous pressure to ensure the prevention of injury. A central concern with this demographic is that previous attempts at outpatient physical therapy have limited capability to reach tactical response return to elite level tactical goals. Treatment and time factors limit traditional physical therapists that are outsourced to provide basic contract healthcare.  Because the base medical center is already taxed with providing care for injury and illness, there is very limited feasible capability left to also begin the task of preventing these same injuries.

Another important problem which hinders TRF post-injury status, is caused by a lack of civilian to military translational research knowledge. Off base professionals are usually not privileged to the minimum physical demands unique to most high-risk TRF military duties. The Doctor of Athletic Training Clinical Residency with the University of Idaho, Moscow agree with Human System Integration models of the Air Force which help to sustain, optimize, and exceed the life cycle capabilities of humans within a weapons system.

The TRF program was a pilot force modeled after Special Operational Forces and currently falls under the USAF Global Strike Command.  Their intent was to create a security response force with advanced physical capabilities and training began out of a Department of Defense need to demonstrate increased first responder capabilities for nuclear resources. This was a tremendous challenge.

TRF’s mission is to enhance security operations and to reinforce uncompromised security despite extreme weather or vast areas of land.  The TRF at Minot are composed of small teams of specialized Security Forces with a unique ability to travel via (land but more notably) air utilizing UH-1N helicopters cruising on average 110mph (max 150mph) often in extreme winter climates.  They also provide a potential to transport medical evac, distinguished visitors, or improve the daily mission to some 150 different missile launch facility sites in record time.  There are currently only 3 TRF Squadrons in the world (Minot, ND, Great Falls, MT, and Cheyenne, WY).

Numerous complications with wearing heavy gear create: LB instability, rotator cuff strain, frequent knee and ankle instability. My advanced clinical athletic training residency serves to help determine current return to duty physical criteria. For the past year, I have established catastrophic injury models to communicate to various stakeholders with a vested interest in the physical capabilities of the Tactical Response Force, Minot.

The Security Forces population experiences far greater injuries than most other AF occupations due to sheer numbers but mainly due to what is required of them day in and day out.  The TRF are a subset of Security Forces with more expectations levied upon them.  For example: TRF may wear government issued gear weighing 40-114lbs sometimes in excess of 12 hours, they are subject to immediate deployment into specified roles as sniper teams, 20-50+ ft rappel teams (to reach nuclear missiles underground), as well as several other “high-risk” tasks.  For example, the role of a designated “breacher” (a member of the TRF that is expected to gain entry into anything they come across using an assortment of tools such as saws, cutting torches, and explosives) may carry 100+lbs on a single person and always sustain an expected 85% advanced level fitness test score. The example of breacher is one of multiple specialized occupations unique to TRF active duty members.

The advantage of a Fall 2011 residency with TRF as compared to Security Forces squadrons is that the Security Forces Group Commander has allowed clearance as a licensed healthcare professional to create new research to meet the Human Performance Optimization needs for this select cohort group. There is also a potential to partner with other areas of Security Forces to do comparison studies.  For example, Convoy SF sit daily in vehicles for up to 10-12 hrs with 50lbs+ of gear, then participate in physical drills.  There is a great opportunity to also collaborate with the Medical Clinic Commander (MD), Physical Therapist (DPT), and Exercise Physiologist on base (EPC). This joint healthcare effort is intended to create a patient-centered approach toward Department of Defense sustainment.

In the next 6 months, even more risk for injury is anticipated, as TRF are projected to participate in more robust exercises around the clock. The TRF manning will increase eventually but until then, their physical exertion will increase while maintaining their original numbers.  A 1,667-foot elevation, winds sometimes reaching 60 knots, and ice create constant issues for land vehicles, helicopters and of course, the TRF.

Because of the Doctor of Athletic Training (DAT) program has begun this residency with the University of Idaho, Moscow it leads the research community in what would be the first in the nation to report any official TRF prevention mentored effort by a certified and licensed athletic trainer focused to specialize in improving the Air Force Global Strike Command Human Integration System. By creating this year’s residency, the future 2012 DAT students may have increased opportunities to complete future residencies. Due to the unique clinical residency research component, the role of placing a certified and licensed athletic trainer in the Air Force Base setting may have greater potential to be welcomed and appreciated by such an underrepresented set of tactical athletes.

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