Imagine working in a coal mine: Dark, narrow, and cave-like. This is the image most would have. But David Nelson, Doctor of Physical Therapy student at the Hazard Campus, had the opportunity to go into a mine and see for himself, and he describes it differently.

“The mine was like a giant, dark, low-roof super store with anything but an even surface to walk on,” Nelson said. “We relied on our balance and the light source of our helmets to walk on coal the size of softballs and to navigate the tunnels, commonly known as seams.”

Nelson’s trip into the coal mine was made possible by Harlan-based PT Pros, as part of his clinical education. Tim Yost, Co-Director of PT Pros in Harlan, and a Physical Therapy alumnus, aims to provide PT students with varied hands-on experiences, including some outside the typical clinic setting. Nelson, along with PT Pros employee and Physical Therapist, Melodye Ramsey, UK CHS DPT class of 2013, went underground last fall.

The pair received safety training, along with gear, which included coveralls, hard hats, steel-toed boots, mining lights, and self-contained self-rescue devices (portable oxygen source). Along with their guide, they were transported on a “man-trip”, or underground personnel carrier, about a mile into the mine.

Ramsey, whose husband is a mining engineer, had wanted to go into the mines to experience his working environment. The common image of the coal miner with rudimentary tools has been replaced by coal miners, operating various forms of heavy machinery to maximize output, Ramsey said.

“I had envisioned it to be like going into a narrow cave,” Ramsey said. “However, in this type of coal mining system, room and pillar, the entries were very wide and were connected by cross-cuts every several feet, which made it seem like a little underground city. It’s amazing the system they use to ventilate the mine, the markings in the mine that direct you to the section they are working at, escape routes, and entrance and exit routes. I was surprised at the amount of electricity they had in the mine to run and operate their heavy equipment.”

Despite the fact that complicated machinery is now utilized, the work environment still presents unique challenges and risks for mining engineers. 

“Our patients who work in mines are involved with very heavy machinery in variable ceiling heights, ranging from 20 inches to 17 feet,” Yost said. “Even though coal mining safety has significantly improved, they are also dealing with other factors, such as loud noises, risk of rock falls, wet environments with electrical equipment nearby, and coal dust that can affect breathing. This results in the worker having to be in challenging positions at times, which makes it difficult to perform correct body mechanics. Providing them with flexibility, strengthening, and functional ideas, in an effort to help their safety, posture, and symptoms is very important.”

It is critical that Physical Therapists understand the work environment that contributed to a patient’s physical condition, particularly if the patient will return to work in that environment. Dealing with a serious injury is a more complicated matter, but understanding the work environment is still key.

Jeff Branson understands both the everyday demands of the coal mining environment and the lasting effects of an injury. He was an underground coal miner for 12 years, working as a Roof Bolter, before he was seriously injured in a large rock fall several years ago. Branson now works part-time at Harlan County High School as a coach and substitute teacher.

“The rock fall did significant damage to my pelvis, hips, knees, right shoulder, and left femur,” Branson said. “The damage was extensive, and I wasn’t sure if I would walk well again. I have been a client at PT Pros for about 15 years due to these injuries. Tim has treated two hip replacements, pelvis fracture, right shoulder injury, back pain, left femur ORIF [Open Reduction and Internal Fixation], and knee pain from the original injury. PT Pros helped me return to being active. Although I couldn’t go back into underground coal mining, they helped me get physically fit to return to school, become a teacher, and have better quality of life. I now work out regularly and have been able to be very involved with my family on a more physical level than I could have been otherwise.”

PT student, David Nelson said he has already been able to apply what he learned in the coal mines to helping his patients.

“The week after my visit to the mines, I was able to adjust aspects of my treatment with a patient who had sustained an ankle fracture and challenge him with simulated mining tasks and environment,” Nelson said. “I appreciate the experience and will have ample opportunities to challenge my patients, based on their individual functional tasks specific to their environments.”

Yost and Ramsey agreed that an experience such as this benefits not only PT students, but practicing Physical Therapists in areas with a high population of coal mining staff. The ultimate result: better treatment for patients.

“As a son of a former coal miner and being from this area, coal mining is such a vital part of our community,” Yost said. “This type of opportunity is critical for our profession as a whole, for students, new grads, or seasoned PTs. It is vital for Physical Therapists to visit industrial facilities in their community, whether the industry is coal mining, automobile plants such as Toyota, furniture factories, or other facilities. This allows the clinician to communicate more effectively with the patient, rehab nurse, and physician, while also having a more specific understanding of what the patient’s job entails. This allows a clinician to develop a more specific rehab program for that patient to help them return to work safely.”