Leatherhead Thursday: Physical fitness in the fire service

By Shane Wells

of the Leatherhead Instructors

Many departments across the United States require that new recruits pass a physical fitness or abilities test of some kind prior to their appointment to the position. So why aren’t more departments requiring their firefighters to keep up some type of physical fitness performance level? One reason might be a rejection from the local union. They may fear losing their job if unable to meet the fitness requirements. Many cities have or are implementing work place wellness programs that are voluntary. These programs are sometimes encouraged by workers compensation for lower rates. My question is why aren’t more firefighters proactive in starting physical fitness programs in their own departments? Core training is gaining in popularity among firefighters.

The National Occupational Research Agenda has identified traumatic injury and intervention effectiveness as two of its priority research areas. Injuries are the leading cause of mortality and loss of potential years of life for working individuals. This study focused on a unique method of injury prediction and prevention in high risk workers using a functional movement screen and core strength intervention. Many workers must deal with physically demanding tasks that involve awkward positions and less than optimal ergonomics. Firefighting is a particular hazardous profession with exposure to a host of chemical, biological, and physical hazards including musculoskeletal trauma. Firefighters perform physically demanding tasks such as forcible entry and rescues that are injury prone because of maneuvers that compromise trunk stability and ergonomically hazardous conditions. Because of the nature of firefighting, these physical conditions are often difficult to control. There are over one million firefighters in the United States and the injury rates of firefighters are among the highest in all occupations. In 2006 U.S. firefighters sustained 88,500 injuries while on duty. Forty four percent of all U.S. firefighters have suffered from sprains and strains while on duty. It is important for firefighters to be fit because they work in physically unpredictable settings, and must maintain a high level of fitness for at least 20 years before they are eligible for retirement. Various strategies have been evaluated to decrease the occurrence and the severity of the firefighter’s injuries. These methods have focused on exercise, training, ergonomic coaching and flexibility improvements. A physical fitness intervention for firefighters was shown to effective in reducing injuries, but the scope of the study was limited to back disorders. A firefighter flexibility training program did not find improvement in injury incidence, though lost time, severity and costs improved. Workplace injuries are multi-factorial, especially in occupations where work events are unpredictable and task completion places rigorous demands on the body. Furthermore, many ergonomic interventions have limited applicability in certain firefighter tasks. For example, a firefighter who must crawl under wreckage and control his or her body to rapidly rescue a trapped individual has severe ergonomic challenges that are difficult to address with standard ergonomic suggestions such as “lift with your legs not with your back.” Although many firefighter exercise programs have focused on upper and lower body strength, they have paid less attention to core stability and strength and the other dimensions of movement that might decrease the chance of injury in the above scenario. Core stability is the ability of the lumbopelvic hip complex to prevent buckling and to return to equilibrium after perturbation. Although static elements (bone and soft tissue) contribute to some degree, core stability is predominately maintained by the dynamic function of muscular elements. There is clear relationship between trunk muscle activity and lower extremity movement. Current research suggests that decreased core strength may contribute to injuries of the back and extremities, that training may decrease musculoskeletal damage, and that core stability can be tested using functional movement methods. The study goes on to talk about how a group of 433 firefighters were ran through a battery of seven tests over a four week period in 2004. After that they were enrolled in a training program designed by multi-disciplinary team. Participants were all taught techniques to strengthen core muscles and to decrease mechanical load on the affected parts of their musculoskeletal system during these ergonomically challenging job tasks.

For one year following the training, information on the type and number of injury cases, cost of treatment, and the lost day’s due to injury were gathered by the organization’s worker’s comp department. Comparing the number of injuries pre and post-intervention of these 433 firefighters, lost time injuries were reduced by 62%, whereas total injuries were reduced by 44% compared to a historical control group. In my area there are several Cross Fit gyms that have continued to gain in popularity. Cross Fit is a core building focused workout program.

Reference: Peate, W. F., Bates, G., Lunda, K., Francis, S., & Bellamy, K. (2007). Core strength: a new model for injury prediction and prevention. J Occup Med Toxicol, 2(3), 1-9.