Col. Brandon Isaacs, DO, serves with the Idaho Air National Guard as the 124th Medical Group Commander.
Field OMT

Military medicine: Keeping pilots in flying form

OMT has helped countless members of our military swiftly return to duty without medication or extensive recuperation time.

Col. Brandon Isaacs, DO

His call sign was “Lurch.” He was a lieutenant colonel from Indiana, deployed overseas in 2016 to augment our U.S. Air Force 190th fighter squadron. A dedicated, veteran pilot who didn’t like to complain, Lurch would be in excruciating pain after every sortie, or aircraft mission, over the combat zone in his A-10.

Spending six to seven hours harnessed into position and looking out of the side window, his neck would lock up so that he couldn’t even turn his head. Eventually, Lurch felt he couldn’t fly at peak performance and was possibly compromising the mission. Reluctantly, he came to ask to be taken off the next sortie.

Flight medicine clinic in Qatar.

This kind of case could result in a one to two-week period of rest and relaxation with pain medication and rehabilitation. In other words, downtime out of the cockpit. However, after just four to five minutes of osteopathic manipulative treatment (OMT), Lurch showed dramatic improvement and was ready for his next sortie.

OMT has helped countless members of our military swiftly return to duty without medication or extensive recuperation time. While on deployment in 2016, when I treated Lurch, I provided OMT to 10 to 12 airmen each day. We never missed a single sortie because of somatic complaints while I was there. There are many other DOs operating in austere environments who have similar success with minor interventions.

An expeditionary medical support (EMEDS) tent in Qatar.

But at this time, OMT is not widely available across the military to help keep more personnel in fighting form. One challenge we face in the military is that these interventions occur in silos, where a DO is co-deployed. Once that person is transferred, the treatment options go with them.

Yet when OMT is available, soldiers from other platoons, squadrons or flights will migrate to that provider. During one previous deployment we set up an “International Back Pain Clinic” and it rapidly became the most utilized clinic on the base. Military members from other countries even sought treatment.

To make manipulation more widely available, the Association of Military Osteopathic Physicians and Surgeons recommends that a field manual and training program be developed to teach medical personnel basic manipulation techniques based on OMT.

In just a matter of days, medical professionals could learn the rudiments of simple manipulation interventions–such as muscle energy, myofascial manipulation and strain/counterstrain—and carry those skills wherever they might be stationed. This training would increase access, decrease downtime and ultimately improve military medicine and performance in the battle arena.

4 comments

  1. I’m a third-year medical resident specializing in Osteopathic Manipulative Medicine / Neuromusculoskeletal Medicine, (OMM/NMM). This is one of 18 primary board certifications recognized by the American Osteopathic Association (AOA) and one of which there is no equivalent specialty within the American Board of Medical Specialties (ABMS). Prior to applying for residency I spoke to military recruiters regarding options for physicians in my specialty with an interest in serving military personnel. I was told that at this time the military does not recognize physicians certified by the AOA in NMM/OMM as it currently follows the ABMS. I have read many articles recounting how OMT has aided our servicemen in staying fit for duty and I wonder if there is any work underway to change the military’s recognition of AOA certified physicians, especially in light of the single accreditation merger currently underway. For an organization that has benefited so greatly from OMT I am surprised that I have not yet heard about efforts to recognize AOA boarded NMM/OMM specialists.

  2. There should be NO DOUBT within the osteopathic community that OMT works – that it works for our military men and women who serve this country should be a given – that should BE “given” to those with pain and known problems as well as to those who do not [yet] manifest signs of those problems to keep them all at their best level of function so they can DO their jobs at every level of service!
    As an FP/OMT doc who served those who serve in the military as a U.S. Army Medicine Civilian Corps medical officer at Joint Base Lewis/McChord and did OMT for active duty and their families, I can attest vehemently that OMT made a difference for the soldiers and the families I cared for and it will make a difference for YOUR patients too – if it’s incorporated into their care plan!
    It was tough to incorporate OMT into the care plan when time was not allotted for the procedure it is. But I did my utmost to make sure it was used daily and it made a difference! Eventually for other reasons, administration felt it was in their best interests to put all active duty in the hands of those who were either active duty or veterans which I am not. It was amazing to see that many of the soldiers whom I was treating with OMT “requested” they be allowed to continue care with me because it was making a difference for them – and THAT’s the most important point of EVERY patient’s care – positive outcome with great satisfaction! HOW INNOVATIVE A REALITY IS THAT!?
    Though OMT is NOT a new Innovative Idea – bringing it back into the daily treatment plan for our patients could be considered “innovative” and “novel” because it just isn’t being done in the family practice paradigm anymore! AT Still would be aghast! He spent years of his life and career studying the structure and function of humankind and then created a new branch of medicine – Osteopathy. The Osteopathic profession and the populations we serve owe him a huge debt of gratitude – just as we owe a huge debt of gratitude to those who serve this country within the different branches of the military.
    One of the best ways we, as Osteopathic physicians, can “pay” them back is to be innovative in our own practices by instituting the use of OMT not just for physical pain and associated problems but for all of the conditions its use can benefit! We need to give our military men, women and families ALL that Osteopathic Medicine has to offer and start using the Osteopathic Practices and Principles we were taught – especially the one that uses our hands to DO OMT!
    Don’t let the forces of traditional medicine relegate our osteopathic practices to the back burner of old school osteopathy and tell us to use those Osteopathically-trained hands only for the wielding of that almighty pen and [prescription] pad! Because soldiers use their hands and training differently (unless they are also trained as DOs!) and wield a different kind of “pen”, they deserve more. Thank God I had the opportunity to serve as an FP/OMT doc for the 3.5 years I did to give back – by using OMT to TREAT backs… and necks, and shoulders, and heads, and knees, and… !
    OMT should be a part of every patient’s care and especially EVERY pain management protocol. And its use should NOT be limited to only 6-12 visits a YEAR – after a PA (if it is even granted). As we continue to fight THAT insurance battle, we have to remember that pain should not “just” be treated with NSAIDs, muscle relaxants and OPIOIDS! Too many of our military and veterans became or are becoming victims of the inappropriate use, abuse and misuse of medications that may stem from inappropriate treatment protocols and excessive prescribing practices. And some of those have fallen through the cracks of our Veterans Administration, medical care and our society in general – yes, they deserve so much better!
    OMT works – ask those who have benefited – they will tell you the difference OMT makes – the Difference a DO who DOes OMT makes! Hopefully, someday soon, their stories, i.e., histories, will no longer be relegated to the back burner of today’s evidence-based world of medicine as mere anecdotes.
    The story written by Col. Brandon Isaacs, DO needs to be seen for what it is – the inspiring story of a life changed because of the impact of the use of OMT in military medical care protocol – the positive outcome of a treatment modality that keeps military personnel able to perform in all aspects of their lives and careers!
    With continued understanding of the foundational basis of the anecdote and what it connotes, we will all come to see the truth in the statement that the HISTORY (e.g., the “anecdote”) is 95% of the diagnosis 95% of the time… and to reiterate… that OMT should be the FIRST 95% of the treatment!
    IT’S TIME! As an Osteopathic Physician who DOes OMT, I charge my fellow osteopathic colleagues to open up their black doctor’s bag of osteopathic tricks, pull out the modality OMT – and start using it with a renewed sense of purpose!
    Let’s keep our military members and their families in the best shape to serve our country so they will be able to stand strong physically now and after their service time is up!

  3. Let us promote such an advice medically.
    The patients do need our help all over the world…
    Osteopathy deserves the best appreciation !

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