Firefighter Fitness: Finding the Weak Link - Pt.2
Dec
21
Written by:
12/21/2011
Last time we talked about how asymmetries or muscular imbalances can affect your low back pain or other problem areas. This week we will discuss screening methods to help identify them.
Selecting a method to help identify these muscular imbalances may seem challenging, yet it is quite simple. The Functional Movement Screen (FMS) is an excellent tool to incorporate into any health and wellness program. It consists of seven different movement patterns that are used every day on the fire ground. It is not a diagnostic tool but rather an assessment tool that focuses on: trunk stability, neuromuscular coordination, symmetry of movement, flexibility, acceleration, deceleration, and dynamic stability. A good example would be the shoulder mobility test. Firefighters often have limited mobility in their thoracic spine. This is due in large part to the SCBA device. Because their SCBA is loaded on the posterior side the firefighter will internally rotate their shoulders and collapse their torso to prevent them from falling back. Overtime this will created stiffness in their thoracic spine. By performing the shoulder mobility test we can better identify any asymmetries or stiffness before it becomes a problem, thereby reducing the chances for further injury. The thoracic spine is an area I believe to be one of the main areas of concern in regards to preventing injuries. We are continuing to learn more and more about it. Many firefighters display some type of thoracic kyphosis and will show signs of Dr. Janda’s Upper Crossed Syndrome. Tight pectoralis major and pectoralis minor, combined with weak upper back muscles are very common in the fire service.
The most important goal of a successful health and wellness program is injury prevention. It is important to try to ensure that a previous injury will not become a current injury. Making corrections in faulty patterns by correcting tightness and/or weakness is beneficial to preventing further injuries. It is not uncommon to hear a firefighter describe a previous injury which may have been a separated shoulder, an AC sprain, or dislocation/partial dislocation earlier in their career. They may have undergone surgery or may have rehabbed it without surgery. Either way, the injury created some type of mobility and /or stability problem within that around that area. Therefore, we may have some asymmetries between the left side and right side during the hurdle step, in-line lunge, shoulder mobility, or active straight leg raise.
Here at the Sacramento City Fire department we are starting to see some trends since utilizing the FMS. One interesting trend is that of the scoring and how it relates to light duty. We will assess anyone assigned to light duty due to an injury and/or pain or discomfort. Once they complete the FMS their score is always 11 or lower. This would place them in our Level 1 program and within 4-6 weeks we will re-assess them and their score will range between 14-16 (level 2). We do not have enough data yet to determine what score would be the most optimal for a return to duty policy, but in time we hope to establish this number.
The following chart shows the overall scores of 75 screened firefighters. As you can see there seems to be some inefficiencies associated with both Rotary stability and the Active straight leg raise.
It should be noted that progress will take time to overcome these muscular imbalances. The corrective exercises provided cannot be performed once or twice and then be forgotten, but rather incorporate them into their daily workouts. Many firefighters will develop their own exercise routines, but we provide them the corrective exercises that will help reduce their chance for injury. In most cases they utilize these exercises in their warm up. As a result, there will be small increases over time and more and more firefighters stating “my shoulder feels better” or “my low back does not hurt as much”. The FMS is a great tool to incorporate into any health and wellness program. The results will not only provide you specific information on what areas to focus on for each firefighter but also as a department.
It is recommended that you seek out a fitness professional in your area who can perform the FMS. The easiest method is to go to www.functionalmovement.com and search in their database. It should not cost much (probably $50). Once you have a score, you can select the appropriate workout based on your score. Think of this as an investment in yourself rather than an expense.
Level 1 Workout: Score 0-11
Level 2 workout: Score 12-16
Level 3 workout: Score 17-21
FMS - Level 1 - Corrective Excercises
FMS - Level 1 - Foam Roller
FMS - Level 1 - Stretches
FMS - Level 2 - Corrective Excercises
FMS - Level 2 - Foam Roller
FMS - Level 2 - Stretches
FMS - Level 3 - Corrective Excercises
FMS - Level 3 - Foam Roller
FMS - Level 3 - Stretches