Post-Injury Training to Essential Job Demands for Firefighters

by Dr Michael Waller, PhD, CSCS, NSCA-CPT, FNSCA, Dustin Dunnick, PhD, CSCS, Andrew Shim, EdD, CSCS,*D, Tim Piper, EdD, CSCS,*D, and Robert Townsend, MS, CSCS,*D
TSAC Report April 2022
Vol 63, Issue 7

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This article explores a return to duty program for the tactical facilitator to implement with injured firefighters.

Introduction

Tactical athletes are often exposed to injuries and may be exposed to serious, even life-threatening, injuries due to the nature of their professional tasks and demands. There has been a decrease in total firefighter injuries over a 10-year period from 2006 (83,400 injuries) to 2016 (62,085 injuries) with the majority of the 2016 injuries (24,325 injuries) occurring while “at fire ground” (5). The “fire ground” indicates an operations area where a fire is present and emergency personnel are on-site to combat the fire and treat individuals. Approximately 56.3% of the injuries in 2016 were categorized as a strain, sprain, or muscular pain, suggesting the importance of a robust strength and conditioning program to reduce severity or occurrence of injury (5).

McDonough et al. demonstrated improved health behaviors (e.g., increased maximal oxygen consumption, decreased resting blood pressure) and physical performance in firefighters during an eight-week occupational-specific health education program (8). The ability to improve overall health is one aspect that should be addressed initially, followed by progressing to fitness, and finally occupational performance (Figure 1). The fitness variables specific to the firefighter that should be assessed and increased are abdominal strength, lower-body power, upper-body muscular endurance, and resting heart rate (2,4,9). Once these fitness variables are improved to a “functional level,” a progression to the development of the firefighter may proceed. Scofield and Kardouni provided a progression to follow for developing occupational performance of a tactical athlete that utilizes traditional concepts of periodization, starting with a general preparation phase emphasizing work capacity and fitness that progresses towards job task specific training (Table 1) (12). However, with the occurrence of injuries, progressive approaches to return a firefighter to full duty is needed, following release from medical care of a physician and physical therapist. There are a number of musculoskeletal injuries that a firefighter may experience, and this article will focus on an upper-extremity injury based on a case study about ruptured triceps brachii. The concepts and layout of the program for return to duty (RTD) from an upper-extremity injury can be applied to other injuries with modifications to the specific area and type of injury. Prior to a full unrestricted release to work, a firefighter will have to demonstrate the ability to successfully perform upper extremity tasks that will stress the previously injured area. Although specific to the job requirements of firefighters, other tactical athletes may benefit from the program if an upper-extremity injury occurred. This program will provide information for a tactical facilitator to assist in returning an injured firefighter to duty.

This article originally appeared in TSAC Report, the NSCA’s quarterly, online-only publication geared toward the training of tactical athletes, operators, and facilitators. It provides research-based articles, performance drills, and conditioning techniques for operational, tactical athletes. The TSAC Report is only available for NSCA Members. Read more articles from TSAC Report 

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References

1. Abel, MG, Sell, K, and Dennison, K. Design and implementation of fitness programs for firefighters. Strength and Conditioning Journal 33(4): 31–42, 2011.

2. Bjerke, W. Health and fitness programs for firefighters. Strength and Conditioning Journal 33(2): 55–57, 2011.

3. Campbell, R, Evarts, B, and Molis, JL. United States firefighter injury report 2018. National Fire Protection Association Research, 2019.

4. Gnacinski, SL, Meyer, BB, Cornell, DJ, Mims, J, Zalewski, KR, and Ebersole, KT. Tactical athletes: An integrated approach to understanding and enhancing the health and performance of firefighters-in-training. International Journal of Exercise Science 8(4): 341-357, 2015.

5. Haynes, HJG, and Molis, JL. United States firefighter injuries – 2016. National Fire Protection Association Journal, 2017.

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8. McDonough, SL, Phillips, JS, and Twilbeck, TJ. Determining best practices to reduce occupational health risks in firefighters. Journal of Strength and Conditioning Research 29(7): 2041–2044, 2015.

9. Michaelides, MA, Parpa, KM, Henry, LJ, Thompson, GB, and Brown, BS. Assessment of physical fitness aspects and their relationship to firefighters’ job abilities. Journal of Strength and Conditioning Research 25(4): 956–965, 2011.

10. Pawlak, R, Clasey, JL, Palmer, T, Symons, TB, and Abel, MG. The effect of a novel tactical training program on physical fitness and occupational performance in firefighters. Journal of Strength and Conditioning Research 29(3): 578–588, 2015.

11. Peterson, MD, Dodd, DJ, Alvar, BA, Rhea, MR, and Favre, M. Undulation training for development of hierarchical fitness and improved firefighter job performance. Journal of Strength and Conditioning Research 22(5): 1683–1695, 2008.

12. Scofield, DE, and Kardouni, JR. The tactical athlete: A product of 21st century strength and conditioning. Strength and Conditioning Journal 37(4): 2-7, 2015.

13. Sheppard, C. Injury risk reduction programs for firefighters – A case example. TSAC Report 45: 30-39, 2017.

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15. United States Department of Labor, Bureau of Labor Statistics. Occupational outlook handbook. Retrieved 2021 from https://www. bls.gov/ooh/protective-service/firefighters.htm#tab-2.

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Dr Michael Waller, PhD, CSCS, NSCA-CPT, FNSCA

Arkansas Tech University, Russellville, AR, United States

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Michael Waller is currently an Associate Professor in the Department of Health and Physical Education at Arkansas Tech University. Waller earned his ...

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Dustin D. Dunnick, PhD, CSCS

Educator, Arkansas Tech University, Russellville, AR, United States

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Dustin Dunnick is an assistant professor at Arkansas Tech University. His research interest involves tactical strength and conditioning, pulmonary f ...

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Andrew L. Shim, EdD, CSCS,*D

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Andrew Shim has been teaching Exercise Science courses in Higher Education for more than 20 years. He has a B.S. degree in Kinesiology from Cal Poly P ...

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Tim Piper, EdD, CSCS,*D

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Tim Piper is an Assistant Professor at Western Illinois University. He has over 25 years of experience in teaching, coaching, and competing in a wid ...

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Robert J. Townsend, MS, CSCS,*D

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Robert Townsend is currently a Clinical Consultant for Bardavon Health Innovations, LLC. As a clinician, he has been involved in treating injured wo ...

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