Load Management for First Responders
By Jason Mitchler, O2X Injury Prevention Specialist (PT, DPT, OCS, CSCS, FMS)
In the First responders/Tactical community, every day is a potential game day. And by the nature of their job, these individuals are required to wear some external load as part of their daily uniform. Whether it’s a basic utility belt, body armor, or a SCBA (self contained breathing apparatus), these pieces of equipment add weight to the first responder. This equipment can average 20-75 pounds and adds stress to the body’s musculoskeletal system. This stress, if not managed properly, can cause injuries and lost duty days. It could also shorten a first responder’s career and lead to chronic injuries. Below are six management tips to help you and your body manage these loads effectively.
- Load fit: This could be a complete article by itself, but I will make some generalized comments regarding how to wear your gear. How you wear your equipment can have a huge effect on the stress it places on the musculoskeletal structure. Use the correct size gear. Wear it correctly. Pay attention to hot spots or stress points early before they create problems. Observe how more experienced first responders wear their equipment
- Strength: I’m talking general overall body strength. Get strong. Stay strong. Wearing 40 lbs of gear all day feels a lot different to someone who can squat 315 pounds for reps versus a person who is only squatting 185 pounds. Overall strength helps you to minimize dysfunctional movements and decrease the stress on your musculoskeletal system. Resistance training, done correctly, such as squats and overhead presses, grooves neural movement patterns that allow you to stay in bio-mechanically correct positions under load that limits harmful stress on joints and muscles and reduces the chance of injury.
- Aerobic capacity: First responders are called upon to perform their job duties at a moment’s notice.
Depending on the situation, they may be required to perform these duties under load for many hours at a time with little rest. This requires a solid endurance base. A trained aerobic system is more efficient in utilizing carbohydrates, fat, and protein for energy for longer periods with less fatigue. Fatigue leads to poor movement patterns, which makes an individual susceptible to injury. An aerobically trained individual is also able to recover faster with shorter breaks.
- Thoracic spine: The thoracic spine is a resilient region and is not often an area of pain. However, tightness in the thoracic spine creates stress and potential for injury above and below. This tightness usually develops from poor sitting or standing posture, and wearing equipment exaggerates these positions. Lack of extension (ability to straighten) the thoracic spine creates stress on the neck, shoulders, and low back. Lack of rotation in the spine creates stress on the low back with walking. Exercises to improve thoracic mobility are vital and will reduce the effects of prolonged postures and equipment wear. Perform thoracic mobility exercises daily.
- Hip strength: As the thoracic spine reduces stress on regions above and below, so do the hips. When moving through the stance phase, strong hips prevent excessive motion in the pelvis, which reduces stress on the hips and low back. If the hip musculature is not stabilizing the thigh throughout gait, as in walking or running, this can create abnormal load on the knee and hip joints, leading to pain in those areas. Perform hip strengthening as part of an overall strength program.
- Ankle range of motion: In walking or running, as you put weight on your foot, your ankle moves into dorsiflexion (top of your foot moving towards your head). Restrictions in this motion are common because we are spending many hours (especially sleeping) with our foot moving away from us. If this motion is limited, structures on the bottom of your foot (plantar fascia), achilles, and calf can all be overloaded. Also, this restriction can lead to you rolling your foot in or out which makes you susceptible to an ankle sprain or other injury. Perform ankle mobility exercises daily.
The tactical community regularly carries an external load as part of their duty day. By wearing the load correctly, staying fit through endurance and resistance training, as well as regular mobility exercises, the first responder can reduce the stress on their body and decrease the chance of an injury and lost duty days.