Military service demands strength, endurance, resilience, and sacrifice. But long after active duty ends, many veterans continue to carry the physical impact of their service. From repetitive overuse injuries to high impact training demands and deployment related strain, musculoskeletal pain is one of the most common and persistent health concerns among veterans and active duty service members.
Physical therapy plays a critical role in addressing these challenges. Not only as rehabilitation, but as a conservative, evidence based first line approach to restoring function, reducing pain, and preserving long term independence.
For many veterans, physical therapy is not just treatment. It is a pathway back to strength, confidence, and quality of life.
Why Musculoskeletal Injuries Are So Common in Military Populat
Research consistently shows that musculoskeletal conditions are among the leading causes of limited duty days, medical discharge, and long term disability in military personnel. Training demands such as load carriage, repetitive lifting, running, tactical movements, and prolonged standing place significant stress on the spine, shoulders, knees, and hips.
Common conditions include:
- Chronic low back pain
- Shoulder injuries and instability
- Knee pain and ligament injuries
- Tendinopathies
- Post surgical rehabilitation needs
- Balance and mobility impairments
- Degenerative joint conditions
Many veterans also delay care. They are accustomed to pushing through discomfort, minimizing symptoms, or prioritizing mission readiness over personal health. Unfortunately, untreated pain often progresses into chronic movement dysfunction, compensation patterns, and long term limitations.
Early physical therapy intervention can help interrupt that cycle.
Physical Therapy as Conservative First Line Care
In today’s healthcare environment, conservative care is increasingly recognized as the appropriate first step for many musculoskeletal conditions. Clinical guidelines from organizations such as the American College of Physicians recommend non invasive treatments including exercise therapy, education, and manual therapy before considering imaging, injections, or surgery in many cases of back and joint pain.
Physical therapists are trained to:
- Perform comprehensive movement assessments
- Identify contributing biomechanical and strength deficits
- Screen for red flags requiring medical referral
- Develop individualized exercise programs
- Provide hands on manual therapy when appropriate
- Educate patients about pain science and recovery
For veterans and military populations, this approach is especially valuable. It supports function, readiness, and long term independence without unnecessary escalation of care.
Physical therapy is not about delaying treatment. It is about choosing the right level of care at the right time.
Addressing Chronic Pain in Veterans
Chronic pain is significantly more prevalent among veterans compared to the general population. Studies suggest that up to 50 percent of veterans receiving care through the Veterans Health Administration report chronic pain.
Pain that persists beyond normal tissue healing often involves more than structural damage. It may include nervous system sensitization, fear of movement, and long standing compensation patterns.
Physical therapy addresses these factors through:
- Graded movement exposure
- Strength and mobility retraining
- Balance and proprioceptive training
- Functional task restoration
- Education that reduces fear and improves confidence
When veterans understand why they hurt and learn that movement is safe, outcomes improve. Pain intensity often decreases, function improves, and reliance on passive treatments can be reduced.
Post Surgical and Post Injury Rehabilitation
Veterans frequently undergo orthopedic surgeries such as joint replacements, ligament repairs, and spinal procedures. The quality of rehabilitation following surgery strongly influences long term outcomes.
Evidence shows that structured physical therapy after orthopedic surgery improves mobility, strength, return to activity, and overall satisfaction. Additionally, engaging in physical therapy before surgery, when appropriate, can enhance postoperative recovery by improving baseline strength and conditioning.
This is particularly important for veterans who wish to return to recreational activities, fitness, work duties, or simply maintain independence in daily life.
Balance, Fall Prevention, and Aging Veterans
As veterans age, fall risk becomes an increasing concern. Balance impairments, joint degeneration, and deconditioning can significantly impact independence.
Physical therapy plays a preventive role through:
- Balance assessment
- Gait analysis
- Strength training
- Environmental safety education
- Functional mobility training
For aging veterans, maintaining mobility is about more than comfort. It is about preserving autonomy, safety, and quality of life.
A Patient Centered, Respectful Approach to Care
Veterans deserve care that recognizes both the physical and psychological aspects of service related health challenges. A patient centered physical therapy approach includes:
- Listening to service history and injury background
- Setting functional goals that align with personal values
- Communicating clearly and respectfully
- Encouraging collaboration in the plan of care
For many veterans, trust is essential. Physical therapy should feel supportive, structured, and empowering.
When Should a Veteran Seek Physical Therapy?
Veterans should consider seeking physical therapy when:
- Pain persists longer than two to three weeks
- Symptoms return repeatedly despite rest
- Movement becomes limited or uncomfortable
- Daily tasks feel more difficult than they should
- Balance feels unsteady
- Recovery after surgery feels stalled
Earlier intervention often leads to better outcomes. Waiting until pain becomes severe or disabling can prolong recovery.
The Bigger Picture: Value Based Care for Those Who Served
Healthcare systems are increasingly shifting toward value based care models that prioritize effective, conservative interventions. Physical therapy aligns strongly with this model by:
- Reducing unnecessary imaging
- Limiting reliance on invasive procedures when not indicated
- Supporting functional independence
- Improving patient satisfaction
- Reducing long term healthcare costs
For veterans and military populations, this approach supports sustainable recovery rather than short term symptom suppression.
Honoring Service Through Quality Care
Supporting veterans is not just about recognition. It is about delivering evidence based, personalized care that helps them live fully and independently long after their service ends.
Physical therapy offers:
- Movement restoration
- Pain reduction
- Functional strength
- Balance improvement
- Confidence rebuilding
For those who have served, conservative and thoughtful rehabilitation is one meaningful way we can continue to support their mission.
If you are a veteran experiencing persistent pain, stiffness, or mobility limitations, consider speaking with your healthcare provider about whether physical therapy is appropriate for you.
Movement matters. Strength matters. Independence matters.
References
- Biden Administration. (2022). National Strategy for Preventing Veteran Suicide 2022–2028. U.S. Department of Veterans Affairs.
Highlights the importance of multidisciplinary care, including nonpharmacologic pain management approaches for veterans. - VA Office of Research and Development. (2021). Chronic Pain and Veterans. U.S. Department of Veterans Affairs.
Reports that chronic pain prevalence remains significantly higher in veteran populations compared to civilians and emphasizes non opioid, movement based care. - Tick H, et al. (2018). Evidence Based Nonpharmacologic Strategies for Comprehensive Pain Care. The Journal of Pain, 19(9).
Recommends physical therapy, exercise, and multidisciplinary rehabilitation as first line treatments for chronic pain. - Foster NE, et al. (2018). Prevention and Treatment of Low Back Pain: Evidence, Challenges, and Promising Directions. The Lancet.
Supports exercise therapy, education, and early conservative management before imaging or invasive procedures. - Horn ME, et al. (2021). Association of Physical Therapy With Long Term Opioid Use Among Opioid Naïve Patients With Musculoskeletal Pain. JAMA Network Open.
Demonstrates that early physical therapy is associated with reduced risk of long term opioid use. - George SZ, et al. (2020). Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2020 Clinical Practice Guideline. Journal of Orthopaedic & Sports Physical Therapy.
Recommends exercise therapy, manual therapy, and patient education as core treatment strategies. - Wainner RS, et al. (2020). Clinical Practice Guidelines for Physical Therapy Management of Musculoskeletal Conditions. Journal of Orthopaedic & Sports Physical Therapy.
Reinforces physical therapy as first line management for common orthopedic conditions. - Deyle GD, et al. (2020). Physical Therapy versus Glucocorticoid Injection for Knee Osteoarthritis. New England Journal of Medicine.
Demonstrates superior long term outcomes with physical therapy compared to injection alone. - Department of Defense and Department of Veterans Affairs. (2022). VA/DoD Clinical Practice Guideline for the Diagnosis and Treatment of Low Back Pain.
Emphasizes noninvasive, movement based interventions as initial treatment. - Ambrose AF, et al. (2018 updated consensus reaffirmed 2021). Falls and Fractures: A systematic approach to fall prevention. Clinics in Geriatric Medicine.
Supports structured balance and strength training in aging populations, highly relevant for older veterans.
