Using Suspension-Based Resistance Training as a Method of Shoulder Prehabilitation for Firefighters

by Sarah Mros, CSCS and Jay Dawes, PhD, CSCS,*D, NSCA-CPT,*D, TSAC-F,*D, FN
TSAC Report August 2019
Vol 53, Issue 3


This article discusses how suspension-based resistance training may help develop the stability and muscular endurance in the shoulder joint needed to decrease the risk of shoulder injuries as a result of the demands of firefighting.

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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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1. Bryant, C, and Green, D. ACE’s Essentials of Exercise Science for Fitness Professionals. San Diego, CA: American Council on Exercise; 2012.

2. Byrne, J, Bishop, N, Caines, A, Crane, K, Feaver, A, and Pearcey, G. Effect of using a suspension training system on muscle activation during the performance of a front plank exercise. Journal of Strength and Conditioning Research 28(11): 3049-3055, 2014.

3. Calatayud, J, Borreani, S, Colado, J, Martin, F, Rogers, M, Behm, D, and Andersen, L. Muscle activation during push-ups with different suspension training systems. Journal of Sports Science and Medicine 13(3): 502-510, 2014.

4. Campbell, R. Patterns of Firefighter Fireground Injuries. National Fire Protection Association. 2016. Accessed 2019 from and-reports/Emergency-responders/ospatterns.pdf.

5. Dawes, J. Complete Guide to TRX Suspension Training. Champaign, IL: Human Kinetics; 2017.

6. Donovan, P, and Paulos, L. Common injuries of the shoulder. Diagnosis and Treatment. Western Journal of Medicine 163(4): 351-359, 1995.

7. Felstead, A, and Ricketts, D. Biomechanics of the shoulder and elbow. Orthopaedics and Trauma 31(5): 300-305, 2017.

8. Frost, DM, Beach, TAC, Crosby, I, and McGill, SM. Firefighter injuries are not just a fireground problem. Work 52(4): 835-842, 2015.

9. Gledhill, N, and Jamnick, VK. Characterization of the physical demands of firefighting. Canadian Journal of Sport Sciences 17(3): 207-213, 1992.

10. Knight, KL, Draper, DO. Therapeutic Modalities: The Art and Science. Philadelphia: Wolters Kluwer Health/Lippincott Williams and Wilkins; 2013.

11. Le Roy, B, Selvy, M, and Slim, K. The concept of prehabilitation: What the surgeon needs to know? Journal of Visceral Surgery 153(2): 111-115, 2016.

12. Lippert, L. Clinical Kinesiology and Anatomy. Philadelphia, PA: F. A. Davis Company; 2011.

13. Melrose, D, and Dawes, J. Resistance characteristics of the TRXTM suspension training system at different angles and distances from the hanging point. Journal of Athletic Enhancement 4(1): 1-5, 2014.

14. Mok, N, Yeung, E, Cho, J, Hui, S, Liu, K, and Pang, C. Core muscle activity during suspension exercises. Journal of Science and Medicine in Sport 18(2): 189-194, 2015.

15. Murray, I, Goudie, E, Petrigliano, F, and Robinson, M. Functional anatomy and biomechanics of shoulder stability in the athlete. Clinics in Sports Medicine 32(4): 607-624, 2013.

16. Sheaff, AK, Bennett, A, Hanson, ED, Kim, Y, Hsu, J, Shim, JK, et al. Physiologic determinants of the candidate physical ability test in firefighters. Journal of Strength and Conditioning Research 24(11): 3112-3122, 2010.

17. Speed, C. Shoulder pain. British Medical Journal Clinical Evidence 9: 1107, 2006.

18. Tenforde, A, Shull, P, and Fredericson, M. Neuromuscular prehabilitation to prevent osteoarthritis after a traumatic joint injury. Physical Medicine and Rehabilitation Journal 4(5): 141-144, 2012.

19. Terry, G, and Chopp, T. Functional anatomy of the shoulder. Journal of Athletic Training 35(3): 248-255, 2000.

20. The Economic Consequences of Firefighter Injuries and Their Prevention. Final Report. 2004. Retrieved 2018 from https://

21. Valkenet, K, van de Port, IG, Dronkers, J, de Vries, W, Lindeman, E, and Backx, FJ. The effects of preoperative exercise therapy on postoperative outcome: A systematic review. Clinical Rehabilitation 25(2): 99-111, 2011.

22. Williams-Bell, F, Villar, R, Sharratt, M, and Hughson, R. Physiological demands of the firefighter candidate physical ability test. Medicine and Science in Sports and Exercise 41(3): 653-662, 2009.

23. Zlatkin, MB. In: Barry, B (Ed.), MRI of the Shoulder. (2nd ed.) Philadelphia, PA: Lippincott Williams and Wilkins; 2003.

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Sarah Mros, CSCS

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Jay Dawes is an Associate Professor of Applied Exercise Science at Oklahoma State University, and the Co-Director of the Oklahoma State University Tac ...

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