Health & Wellness: Train the Pain Away

Jan. 1, 2018
Brandon Green shares exercises to help prevent or alleviate knee, shoulder and lower back pain.

As firefighters, it’s in our DNA to train. We learn the ins and outs of apparatus, practice live burns, and work for a high level of situational awareness until it’s second nature. We are problem-solving tactical athletes who always work hard to improve our “unconscious competence” where we can do what we need to do without thinking twice about it. Firefighters train so well that our bodies and minds react accordingly without hesitation. 

Stop the cycle

It’s no secret that pain, strains and injuries commonly accompany training. This job can be hard on our body, both physically and mentally. But there are so many people counting on us—our families, communities, colleagues—that we often just deal with these effects to get the job done. 

The easy answer to get past the chronic pain and injuries is to work out more, right? Not entirely. There’s a difference between just working out and training. Whereas working out might just give you a larger chest or biceps, training focuses on exercises that would give you improved upper-body strength to assist in job-related motions. Training prepares you to be dynamic on the fireground, and to be the best you possible. Training for this lifestyle needs to be ongoing, but it’s never too late to start.

You can probably recall a time when you’ve felt “busted up” after a long shift or a long call. How long did it last? Did it prevent you from working or impede normal activities? Are the aches and pain part of your everyday life? It doesn’t have to be that way. There is a stigma in the fire industry—as is the case in most physically-demanding industries—that you deal with the pain for fear that you might look weak by taking care of yourself. But you know what? Your body is the only one you get, and you need to take care of it now or you’ll be hindered long after your career in the fire service is over. With this in mind, we need to stop the cycle of enduring pain and injuries, and then working out to try to fix them. We must focus on job-specific training instead. 

Alleviate the pain

One consistent factor in all of this is where on the body those injuries tend to occur: knees, shoulders and lower back. Lower back injuries in particular plague the fire service. According to the NFPA, the number of fireground injuries per 1,000 fires remains unchanged in the last 30 years, and lower back injuries are a major part of that list. But it is not just on the fireground. Anytime you are lifting, pulling, dragging, moving, stepping down or any number of other dynamic movements, you run a risk of a strain or pain in your back.

The best training for this involves movements that support the spine, specifically your lumbar and thoracic areas. Some examples of spine-supportive movements:

  • Hyper-extensions: This movement involves supporting your hips with a bench or ball and leaning forward, creating a bend at your hips and reversing the motion to return to the top.
  • Hex lifts: This is a lift from the ground using a hex bar with weights on both sides. Similar to lifting a patient or equipment up from the ground, the movement involves driving out while keeping your chest up and spine supported and pushing your hips forward. 
  • Sandbag rotational lunges (or reverse lunges): This movement (described in greater detail later in the article) involves using a sandbag to engage your shoulders and back while stepping into a lunge (or reverse lunge).

Our posture, not how big our muscles are, dictates how strong we are due to leverage. That is not to say that strength and maximal effort training are not useful in the fire service or in keeping us healthy—quite the contrary, as they are extremely effective in both realms. It’s important to know that this type of training runs a much higher risk of injury and needs specific programming with meticulous focus on form to be effective. Functional or foundational training is the base, then start to grow your training platform and know your body to take it to the next level, maximal effort.  

Gear adds weight to our bodies and restricts our range of motion, so spinal support is vital to safe movement while under load. Many of the lower back injuries we see in the fire service happen while we are in movement—so we should train that way to train our muscles for realistic conditions. Teach your body to support your spine and engage your core to reduce your risk of injury and increase your output. 

A great exercise is the bird dog, which engages the core and supports your back at the same time. For bird dogs, start on your hands and knees, with your hands directly under your shoulders and your knees directly under your hips.  Think about your back being so straight you could balance a glass on it.  Then lift your left hand and right leg up in the air until they are fully extended out in front of you and behind you. Try your best to keep your back from moving and your hips from turning. This will engage your core. If this is a new exercise for you, start by doing it every other day, 60 seconds on, then 60 seconds off for five sets. For those already training for heavy lifts or strength training, add it in before your training.   

Sandbag rotational lunges are another way to support your body in movement and rotation, become stronger in the field, and decrease your risk of injury. Start by holding a sandbag in front of you and pulling the handles apart, thereby engaging your shoulders and back. Then step into a reverse lunge while slowing swinging the bag over your front leg to the side of your body. Then mirror your movement back to the front and repeat to the other side. It's important to keep your legs close to a 90-degree angle, and always keep your knees behind your toes. To progress the movement, swing the bag to the height of your midsection or to chest height. Regress or progress the movement based on your individual capabilities. This movement can complement any current training program, but again, if this is new to you, start every other day 60 seconds on, then 60 seconds off for five sets.

These type of movements can be a great complement to an existing training plan. A sample program might include side lunges and hip thrusts for mobility, sandbag dead bugs and planks for stability, sandbag rotational lunges and sandbag clean and press for movements, primary search (bear crawl) drills to enhance dynamic movements, and the pigeon stretch and child’s pose for restorative impact. 

Evolve your training

Firefighters must learn to move the way our bodies were designed to move, to support the areas that get a lot of work, and to be free to evolve what we have learned into your own training. It is important to have a support system in this: Work with others in your department, connect with your doctor, find a local fitness facility with proper credentials, and attend workshops and conferences to assist you. The ultimate goal is a healthier you, stronger you, safer you—and if you take anything from this, I hope it is that this is all about being you, and then being a better you!

References

NFPA Research. United States Firefighter Injuries – 2015. Hylton, J.G. Haynes and Joseph L. Molis.

Sidebar: Athlete Approach

Firefighters are athletes, plain and simple. Any collegiate or professional athletic program has services for strength and conditioning, massage, chiropractic, injury rehab, physical therapy and nutrition. After all of the required training and treatments, you start practice or head to the game. The sports industry invests time, money and effort into their athletes because they know it affects performance and reduces the risk of injury. Why don’t firefighters believe in taking care of ourselves in the same way? We always have to be ready to perform at an elite level, both physically and mentally, and always be prepared for anything. Being in a constant state of readiness is a lot of weight to carry (both figuratively and literally), so it’s up to you to ensure that your body can bear the load. 

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