P2 ~ Reducing Firefighter Injuries and LODDs

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Most people think of fitness as getting a good workout in every day, but there is much more to it. The problem is that many people don’t know what to do or when to do it in terms of working out. As a result, a couple of crew members go to the free weights, and each tries to outpress the other, or another member goes and runs on the treadmill for an hour. Are these truly effective steps to take to improve our fitness levels?

The first step in fitness should be to determine your functional mobility and stability. Several movement screening programs are on the market; each varies slightly. I am a Functional Movement Screen™ (FMS) Level 1 certified member and am sold on the benefits of performing a basic movement screen on all individuals to determine their baseline mobility/stability. Why do you need to care about basic mobility? Because it is the foundation for every movement pattern we perform. A person with a decreased movement range or an impaired movement pattern is at higher risk for an injury.1

It all goes back to that “preventable injury” issue above. Younger firefighters may dispute this, saying they feel they are limber as can be and don’t have any issues. However, the generational changes that we are seeing populationwide are predominantly the result of our modern busy lives in which we spend more time sitting (e.g., driving, behind a desk, on the sofa at home) than earlier generations who spent much more time on their feet.

A screening usually will silence that person’s objections and even help him to identify some core issues he can and will want to work on. With a simple FMS, a screener can identify dysfunctional movement patterns or asymmetries and assign a corrective exercise regime to eliminate those dysfunctions. The screen is quickly performed, and the corrective exercises can be worked into a morning routine or a regular physical fitness session with minimal extra equipment or time. The screen also identifies exercises that the subject shouldn’t be performing until he clears the dysfunctional pattern. That really is the key in the prevention portion. Several studies conducted with the fire service demonstrate the efficacy of using the FMS for fire recruits2 as well as with the whole population of the Tucson (AZ) Fire Department personnel, who represent various ages and abilities.3

Once we address an individual’s ability to move without dysfunction, we need to provide some direction for building individual abilities. I am not a fan of cardio, specifically just getting on the treadmill for an hour and calling that a tough workout because you are sweaty. Several recent studies have cited the damaging effects of excessive cardio-type workouts.4 However, you should include cardio in your everyday life by walking more whenever possible. I like to hike frequently during the summer in full wildland gear because of the all-risk requirements of our job.

I prefer cross-training workouts, although not specifically CrossFit. CrossFit does have a place in the fire service. Many people claim that CrossFit injures people and shouldn’t be allowed on duty because the risk it poses to employees outweighs the benefits it provides. However, it is how the individual uses or abuses the CrossFit mentality that makes it beneficial or harmful. Yes, mentality, because Crossfit is a very competitive workout regime that pits each person against the timer.

The key to CrossFit is proper instruction and coaching. Unless you have that, you should not be pushing untrained individuals through a lot of the workouts (especially the ones that involve Olympic weightlifting skills) because the novice or untrained individual tends to sacrifice form for repetitions, which is how injuries often occur. I like the muscle confusion that cross-training provides, because if you are doing the same routine over and over, you will get bored and start skipping workouts. I don’t like standard aerobic cardio, but I really like anaerobic sprinting intervals. All you have to do is compare a typical marathon runner to a sprinter. Which body type do you want?

Along with fitness goes hydration. Our department over the past several years has seen a rise in rhabdomyolysis (rhabdo). Rhabdomyolysis is a serious syndrome caused by a direct or indirect muscle injury, the result of the breakdown of muscle fibers and release of their contents into the bloodstream. This can lead to complications such as kidney (renal) failure. Rhabdo seemed to hit our portion of the fire service out of nowhere, although the phenomenon was known in sports medicine for some time. A more consistent causal factor has been dehydration in the firefighters prior to their workouts, exertional periods on incidents, or insufficient rehydration after the event. We cannot overstress hydration in our occupation. As shown in a study by the Orange County (CA) Fire Authority, most firefighters are actually dehydrated prior to engaging in physical activity and thus are stressing their bodies, specifically their heart, even more on top of the high demands of the job.5

An essential part of fitness is knowing when not to work out. Many people will drag themselves, hangover and all, out of bed to get to the gym to feel productive for the day. We’ve all heard it from our buddy, “It was tough, but I did manage to get a good workout in, even though I was dragging my feet!” The problem with this mindset is that it is counterproductive if your body is in a deficient state.6 If you haven’t addressed the items above, nutrition and sleep, then you might as well take a rest day and let your body recover. The cumulative stress you will put it through when it isn’t ready will be completely counterproductive to any gain you think you are making.

Most people think they need to get a good burn every day to make progress. But if you are addressing your nutrition and sleep effectively, your body will make significant progress with only working out three times a week. This rest time allows full recovery and rebuilding for your body and allows for those optimal gains everyone wants to see from their efforts. Most coaches would agree that a good starting point to your fitness goals is to perform some type of physical assessment test. Once you score your results, you can move forward with deciding what your fitness goals are. A nice regime is to establish short- and long-term training goals (e.g., fitness goals for one, three, or six months), and then formulate a training plan along those guidelines based on your program. If you have addressed your functional movement patterns and are free of dysfunctional patterns or asymmetries, move forward with your targeted fitness goals.


The top three priorities for all individuals should be nutrition, sleep, and fitness, in that order. Addressing these greatly diminishes your risk of injury, cardiac disease, and all other health issues. Everyone wants to be the exception to the rule and not one of the many statistics that reinforce that our chosen occupation is one of the deadliest industrywide. If more people started focusing on these three priorities, we can see a statistical decline in injuries and LODDs over the long term.


1. Cook, G. (2010). Movement. Santa Cruz: On Target Publications.

2. Contreras, M. (2006). “How to Create and Sustain a Comprehensive Injury Prevention Program.” Orange County Fire Authority Firefighter Academy.

3. Peate WF, et al. (2007). “Core Strength: A New Model for Injury Prediction and Prevention.” Journal of Occupational Medicine and Toxicology, 2:3.

4. Skoluda, ND. (2011). “Elevated Hair Cortisol Concentrations in Endurance Athletes.” Psychoneuroendocrinology, 2012 May;37(5):611-7. doi: 10.1016/j.psyneuen.2011.09.001. Epub 2011 Sep 25.

5. Espinoza N. (2008). “Can We Stand the Heat?” Journal of Emergency Medical Services, 94-105.

6. Gleeson, M. (2007). “Immune Function in Sport and Exercise.” Journal of Applied Physiology, 103, 693-699.

MIKE WATERS is a captain with the CAL FIRE/Butte County (CA) Fire Department and is the CAL FIRE Butte unit safety officer.

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