5 Keys to Injury Avoidance

A great way to prevent injury is to incorporate flexibility training into your daily drills and workout programs. Increased flexibility can improve aerobic fitness training, muscular strength and endurance, and job-specific movements. Flexibility training can decrease soreness and stiffness, improve mobility on and off the fireground, and also be a great form of relaxation, which can positively impact not only physical fitness but also mental fitness. This, in turn, can positively affect performance through increased mental toughness and stress relief. And keep in mind that a proper warm-up before training and workouts can dramatically reduce the number and severity of injuries incurred while training. 

A note about warm-ups: Traditional workouts routinely include static stretching before activity. Static stretching means holding a target muscle in a stretched state without movement for a period of time, usually around 15–30 seconds. A couple of the most recognizable static stretches are the sitting toe reach and the standing quadriceps stretch in which you pull your ankle behind your leg. 

Over the years, research has discovered that this stretching method can be effective, but not before a workout or training. I’m not saying that static stretching has no benefit. It feels good to stretch and, if done correctly, you can gain flexibility. For example, if you lack the flexibility in the hips and ankles to properly perform a squat correctly, then a daily stretching routine after a workout or proper warm-up would help you gain flexibility in these areas. But the key is to perform this stretching after a workout or a proper warm-up.

You’re probably wondering, if not a static stretch, then what should we do? A dynamic warm-up has been shown to not only increase performance, but also decrease injuries. A dynamic warm-up is essentially a series of low-intensity activities that target the muscles and joints involved in the given activity or exercise. Instead of holding these stretches, dynamic warm-ups require movements that gradually increase joint mobility, raise the body’s temperature, and increase heart rate and blood flow to the muscles and tendons. In addition, the dynamic warm-up increases the mind-muscle connection, contributing to better coordination and reflex time.

Some great dynamic movements are lunges with a twist, pulling your knees to your chest, arm circles and bodyweight squats. A proper warm-up should take between 10 and 15 minutes, which is one major reason why people often skip it and dive right into their exercise or activity. Keep in mind that starting a workout or training with “cold” muscles can lead to injury, so don’t skip this vital step.

2. Be proactive

“Prehab” is a common practice in the athletic training world. Prehab is a proactive approach to avoiding pain and injury and includes any and all exercises, practices and routines that prevent one from getting injured and needing rehabilitation. 

A great way to prehab is to perform corrective exercises that help build strength and stability around your most vulnerable areas, while improving mobility, balance and joint function to decrease the potential for injuries. In other words, don’t wait until you’re injured to do rehab exercises. Try to incorporate movements that will strengthen the more commonly injured joints—knees, shoulders and back. After all, why wait until you injure your knee to do balancing exercises? Perform exercises that will strengthen your knees and the surrounding muscles.

Effective firefighter workout programs will creatively integrate rehab, or prehab, exercises. The key is to continually perform them even if when not injured. The exercises used to rehab after injury can also be used to prevent further damage. 

3. Work your core

Back problems are among the most expensive of musculoskeletal disorders and one of the most common work-related ailments affecting adults in the United States. As might be expected, firefighters are at increased risk of back injury compared to other professions due to the rigorous physical requirements of the occupation. The International Association of Fire Fighters’ annual Death and Injury Survey reveals that sprains and strains routinely account for approximately 50 percent of all line-of-duty injuries, and back injuries account for approximately 50 percent of all line-of-duty injury retirements each year. These back sprains result in significant lost time and medical expense. 

With this in mind, a great way to prevent injury, especially to the back, is to incorporate core exercises that strengthen through all planes of motion. A preventive core routine for firefighters should include planks and, more importantly, side planks and other exercises that improve stamina of the lower back and glute muscles. 

4. Practice like you play

When was the last time you incorporated crawls or carries in your workouts and training? To prevent injuries, you need to incorporate motions that we regularly do in the field. If you break down the motions of the fireground, you will find that there are some common movements. Stepping, crawling, carrying, pulling, pushing, slamming, twisting and dragging are all common activities that firefighters do throughout a shift. These same activities should also be performed off the fireground in workouts and trainings. For example, if you carry heavy stuff on the fireground, work on your grip strength and core strength by carrying heavy stuff in your workouts. Professional athletes routinely simulate “game situations” and constantly work on their skills to improve performance and reduce injury. Department training divisions should incorporate this same philosophy and try to make training sessions simulate realistic fireground and rescue scenarios. 

5. Focus on good posture

Good posture does not immediately come to mind when we think of ways to avoid injuries. However, correct alignment of the neck and shoulders goes a long way in preventing overuse injuries of the shoulders, as well as acute and chronic neck pain. Maintaining correct alignment is difficult because life activities—driving, computer usage, wearing a helmet and wearing heavy gear—tend to pull us forward at the head and shoulders. 

With the shoulders in proper position, less stress is placed on the rotator cuff and biceps tendon, therefore reducing the incidence of shoulder injury. Good posture includes a relaxed neck with shoulder blades down and back. This position gives maximum stability to the shoulder joint and lets the muscles of the rotator cuff function optimally. Practice maintaining the shoulder blades in this position while you do activities on the fireground and/or gym.

To decrease stress and injury at the neck, in addition to reducing the chance of shoulder injury, the head must be held in the proper position. The back of the neck should be elongated with the chin tucked. When the head is held in a forward position, muscles are constantly contracting to keep the head upright against the force of gravity. This position is especially damaging when wearing a helmet. When the head is in line with the shoulders, gravity is neutralized, taking the stress off of the cervical muscles. Make a conscious effort to keep your neck and shoulders in good alignment, and take note of the posture of others around you, because that will often serve as a good reminder to maintain proper alignment.

In sum

In the fire service, we are taught to minimize the risks. This also should be the mentality when it comes to injury prevention. Although there’s no guarantee that we’ll have an injury-free career, there are things we can and should do to give ourselves the best possible chance of achieving that.

Make time to stretch, take a proactive approach to your fitness, work your core, practice like you play, and sit up straight with good posture. You owe it to your crew, family and community to stay healthy, and incorporating these simple tasks can help you stay healthy and serve your department. After all, it’s hard to serve from the sidelines. 

Resources

Bay Sports. “Good Posture Avoids Sports Injuries.” baysport.com/blog/good-posture-avoids-sports-injuries. 

Gummelt, D. “The Impact of Flexibility Training on Performance.” American Council on Exercise. August 2015. tinyurl.com/ACE-flex.

IAFF. “Back Injuries and the Fire Fighter.” iaff.org/hs/Resi/BackPain.asp.

Moore-Merrell, L., Zhou, A, et al. “Contributing Factors to Firefighter Line-of-Duty Injury in Metropolitan Departments in the United States.” 2008. tinyurl.com/LODI-IAFF. 

Sell, K. “Firefighter Perceived Fitness: Implications for Injury Risk and Training Program Development.” National Strength and Conditioning Association. May 2015. tinyurl.com/NSCA-Injury-Prevention.