In-Depth Look: Athletic Trainer for the US Air Force Special Operations

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Steven Koch, MS, LAT, ATC, CKTP, is Program Manager/Head Athletic Trainer for the Versatile Injury Prevention and Embedded Reconditioning (VIPER) Clinic for the United States Air Force. He currently works with Air Force Special Operations.

Describe your work setting:

The military setting is a unique setting to say the least. As an Athletic Trainer (AT), there are many opportunities to think outside the box. Not only are there your typical acute athletic injuries including sprains and contusions, but you’ll also see chronic/overuse injuries or stress-related injuries. These injuries include stress reactions and stress fractures that will mimic other injuries ATs really won’t see in a typical athletic setting.

On the flip-side, we see muscular injuries that are also compensating for a stress injury and evolving from a stress reaction into a stress fracture. As an AT in the military, the focus is geared towards injury prevention. A lot of the injuries we see are lower extremity injuries. Most of these can be mitigated by teaching something as simple as proper running form, rucking form, stretching techniques or correcting biomechanics during exercise.

How long have you worked in this setting?

I have spent a little more than 5 years working in a military setting. I first started off doing my graduate degree at the 377th Medical Group (MDG) out at Kirtland Air Force Base in Albuquerque, New Mexico. After that, I worked in the Army for close to 3 years with Basic Combat Training and Army Sapper School.

After a brief hiatus from the military, I was brought on to work in the Navy Seal/SWCC pipeline up at Naval Station Great Lakes at the Naval Special Warfare Preparatory School. I’m now in San Antonio, Texas to work with Air Force Special Operations including Pararescuemen/Combat Rescue officers; Tactical Air Control Party, Combat Control, and Special Operations Weather Team specialists; and Special Tactics officers.

Describe your typical day:

My typical day starts around 6:00am. I go out to early morning physical training and observe the airmen completing exercises to ensure they have proper form.

After physical training is complete, I perform musculoskeletal sick call. This means if anyone is hurt or injured, I perform a complete neuromusculoskeletal evaluation and diagnose the injury. From there, I educate the airman about their injury, perform manual therapy as well as give them therapy exercises to help decrease their pain, heal them and keep them in training. Performing sick call keeps the airman in training and decreases training time lost, which increases on-time graduation rates.

Depending on the injury, I may have to keep the airman from performing or modify certain training exercises or events in order for the injury to heal a little faster. If needed, I refer the airman to our sports medicine physician if I suspect any type of evolving stress injury so they can receive further evaluation and appropriate imaging, which is usually an x-ray or stress fracture MRI.

Once musculoskeletal sick call is complete, I attend training events, whether it is an obstacle course, ruck march or other physical training event. Just in case someone gets injured, the AT is normally on site to evaluate the injury. Most of the time, the AT also performs some of the training events going on. Being side-by-side with the airmen or instructors during the training events is a good way to get to know the airmen and gain their trust.

After the day is complete, I perform one final sick call to see if any airmen need further treatment. On any given day, the airmen have the chance of going through 2 to 3 musculoskeletal sick calls. This ensures they have the opportunity to get any injuries evaluated and treated accordingly.

What do you like about your position?

First off, I work among some of the military’s most elite airmen. I never did sign the dotted line to serve the military myself, so I thought, the least I could do would be to provide them with immediate medical services. Just like any other AT, I like to see the airman fully recover from an injury and join back with their team like they were never injured.

Second, I work with an excellent team of 3 other ATs and a sports medicine physician, who together, make for a great team and provide unparalleled medical services. Unlike sports, every day is game day for these individuals, and they really don’t have any down time. When they eventually get to their team, they have to be ready with little to no notice and have to perform at 110 percent at any given time.

What do you dislike about your position?

The hardest part of my job is evaluating an injury and knowing the airman might have a stress-related injury. That injury will keep them from continuing on with their team who they have built a strong relationship with. It’s kind of like having an injured athlete watch their team from the sidelines.

What advice do you have about your practice setting for a young AT looking at this setting?

The best advice I can give to a young AT looking into the military setting is to reach out to those who already work in the military setting. Look for internship opportunities to gain hands-on experience. The military is still an up-and-coming setting for ATs. It isn’t your typical setting – there aren’t any games to prepare for, no overnight travel and no time away from your family. The military setting is challenging to break into to say the least. All branches usually require a bachelor’s degree with 5-8 years’ experience, or a master’s degree with 3-5 years’ experience. Having additional credentials is also very helpful in setting yourself above other ATs who are applying for the same position.

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