By Monte Egherman
Published Friday, December 28, 2012
| From the February 2013 Issue of FireRescue
Millions of people around the globe suffer from chronic back pain. For a firefighter, this can be a major issue because of the physical demands placed on our bodies by our profession. But maintaining a pain-free back is almost a full-time job. To help firefighters maintain their overall health, and to provide a total wellness program, fire departments should implement a sound healthy back program.
What You Need to Know
To maintain a pain-free, healthy back, it’s a good idea to be cognizant of human anatomy, as well as how the muscles of the back are layered and their general location. In addition, you’ll want to be aware of the spine and how it’s put together.
The back is made up of three layers of muscle: The deep layer includes the splenius capitis and the erector spinae, which includes the longissimus, spinalis and iliocostalis. The middle layer of the back includes the serratus posterior, superior and inferior; the rhomboid major and minor; and the levator scapulae muscles. Finally, the superficial back muscles include the thoracolumbar fascia, latissimus dorsi and the trapezius. All of these muscles support the spine and its movement, and are intertwined with nerves and blood vessels. My point: There’s a lot of “stuff” going on within your body, and all muscles need to be exercised if they’re going to remain strong and protect your body. As I said before, it’s almost a full-time job keeping the back healthy.
But it’s not just about hitting the gym and working your muscles. To maintain a pain-free back, you must also maintain a healthy body weight, pay attention to your nutritional needs and stay properly hydrated. Being overweight puts undue stress on the joints, making it increasingly difficult to maintain a healthy posture. In short, you follow the same guidelines to develop and maintain a healthy back that you would follow for maintaining overall fitness and health.
The Foundation for a Healthy Back
Whether it’s lifting a patient or a tool, dragging a hoseline or performing a specific exercise, maintaining a proper lifting technique is the foundation for a healthy, pain-free back. To perform proper technique, when lifting any load, bend at the knees as the object comes off the ground, keep your chest out and keep your lower back locked so that twisting isn’t an option. Keep your eyes forward to avoid any twisting motion.
Next, lift the object with the legs, using the knees-over-toes method. Maintain proper alignment at all times. This is the same form used in power lifts, which is why they’re a great exercise for firefighters. Remember: On an emergency scene, not all lifts originate from the ground.
People suffering from back pain most often do so because of a pulled or strained muscle or ligament, and with those three layers of muscle I discussed earlier, there’s plenty of opportunity for injury when not following a total back fitness program.
Important: Other, more serious forms of back pain may be caused by diseases, such as cancer; arthritis; skeletal issues, such as a curvature of the spine; spinal nerve issues; and bulging and/or ruptured disks. So if you experience back pain for more than a few days with no relief, consult your physician and get checked out. Once your doctor gives you the go-ahead, you may start working your healthy back program.
Cardio Work & PPE
Cardiovascular training is another vital element of every healthy back program. Raising the heart and respiratory rates works muscles and supplies them with oxygenated blood. Training the cardiovascular system will also lead to increased stamina in daily activities, which will result in more calories burned per workout. And when you burn more calories, you help maintain a healthy body weight, which also helps you maintain proper posture.
Cardio training can be performed in many ways. Once you develop your strength and stamina, you might try performing some cardio exercises in your PPE. This too will help firefighters maintain a healthy back. Setting up skills courses and pulling hose in our PPE keeps our bodies accustomed to the gear and the demands it places upon us. No athlete walks into a game without having trained and prepared for it, so unless you wear your gear during every shift and get moving in it, you’ll be in for a rude awakening when the tones go off. Note: Training in our gear is also important for staying acclimated to the weight it adds to our bodies. Remember, we have an “athletic season” that never ends.
Strength Training for the Back
Just like a cardiovascular training program, a solid strength program is key for a healthy back. In previous articles (www.firefighternation.com/article/firefighter-fitness-and-health/three-power-lifts; www.firefighternation.com/article/firefighter-fitness-and-health/try-power-clean), I’ve discussed sports performance lifts, such as the power clean, snatch, push-press, clean-and-jerk and front squat. These are total body training lifts that should always be incorporated into a healthy back program, but what are some other lifts we can perform to gain total back strength and stability?
The dead lift is a straightforward lift that’s easy to do and will help you build confidence in your ability to maintain proper form. To begin, the participant places their shins against the bar, uses a reverse grip and lowers their butt. Keeping their chest out and lower back locked, they lift while keeping their gaze straight ahead. Remember: When doing this lift, the shoulders should always rise before the hips.
The Romanian dead lift, or RDL, is similar to the regular deadlift, but in this case, the bar is not returned to the ground until after the first repetition. The participant slightly bends at the knees when lowering the bar, which only goes about halfway down the shins.
The bent-over barbell row is done by once again maintaining strict lifting posture and bending at the waist until the back is parallel to the ground. The lifter extends their arms all the way down so the bar is away from the body. The lifter then raises the bar to just below the chest before returning the bar to the start position. This exercise may be done with dumbbells as well.
Lifts Using Weight-Training Machines
The high-pull row and the low-pull row are two very popular lifts that are beneficial for building the latissimus dorsi, one of the largest muscles in the body. A high pull is any pulling exercise that starts above the shoulders while the low pull starts from below the shoulders. The machines used are typically free-wight machines that work off a counter-balance point in the middle, so that you pull from one end while the load is at the other end. Note: There are cable versions of this type of equipment, and the typical lat machine comes with various attachments for both high- and low-pull exercises for the back.
The front latissimus pull-down is a popular exercise that’s easy to do and a good alternative exercise if you have problems with pull-ups. I suggest building up to your body weight and then training so you can perform 10 pull-ups at minimum.
It’s paramount to maintain flexibility when developing a healthy back. When you’re called to action in the middle of the night, or any other time for that matter, there’s no time to warm up your muscles, so the only way to stay ready is to stay flexible as a way of life.
The best time to stretch and work on flexibility is after the body is warmed up, perhaps after you’ve finished a cardio session or hose-pulling. This is because when the body’s temperature is elevated, there’s less chance of muscle tearing and damage. I’ve preached to countless firefighters about proper flexibility, and every one of them has told me that as soon as they started doing stretches for their back, their pain went away after a few days.
Try a few of my favorite back stretches. They are simple but effective:
Two knees to the chest: While lying on your back, bring your knees to your chest and squeeze them in by wrapping your arms around them. Hold this position for 30 seconds, rest a minute and then repeat.
Single knee to chest: This stretch is performed much the same way as with two knees, but this time, leave one leg stretched straight out or with a very slight bend in the knee. Hold the position for 30 seconds, then switch legs.
Knee-over twist: In the seated position, place one leg over the other. Then bring the elbow from the opposite side of your body and place it across the leg, so that your body twists a bit. Hold this position for 30 seconds, then repeat on the other side.
Lying double-knee twist: While lying supine on the ground, bring the knees up so they’re bent, but keep your feet flat on the ground. Place your arms out to each side so that they are away from your body. Twist at the hips so that both knees go toward one direction and hold for 30 seconds. Repeat on opposite leg.
Leg over reach-through: While lying on your back, bring your knees up but keep your feet flat on the ground. Lift up one leg, cross it over the other. Then reach through the middle with one arm and clasp your hands around the uncrossed leg and pull. Hold this position for 30 seconds and release. Then repeat on the opposite side.
Yoga has been around for thousands of years and has many varieties. The physical postures found in yoga were developed to stretch and strengthen the body in preparation for meditation. The roots of probably every stretch we perform stem from the third limb of yoga known as the Asana, which means “seat” or “posture.” (Note: For those of you who think yoga looks too easy, or that it’s kid’s stuff, I challenge you to take a class. You’ll discover that it’s not as easy as it looks. Don’t think for one second it’s relaxing, because that’s not part of any yoga class I ever took!)
There are thousands of poses, but I’ve included five here that greatly benefit the back. Important: If you haven’t tried yoga before, don’t do anything that hurts. Choose easier poses to start with.
The Navasana or “boat pose”: Form a V with the legs and torso, and keep your arms parallel to ground while holding at the knees. This position helps maintain a strong core, which maintains a healthy back.
The Salabhasana or “locust pose”: Lie face-down on the ground with your arms back and palms up. Lift your chest, arms and legs off the ground while keeping your head up and eyes facing forward. This pose is a total back strengthener.
The Setu Bandha Sarvangasana or “bridge pose”: Lie on your back with your knees bent and feet hip-width apart. Lift your hips off the ground while pressing your feet into the floor. Place one hand in the middle of your back for support. This pose helps maintain a flexible back.
The Urdhva Mukha Svanasana or “upward-facing dog pose”: Lie face-down with your hands facing forward and positioned at about the level of the lower ribs. Keep your feet together and laid out straight. Lift your body off the floor by pressing your hands into the ground and raising your shoulders while looking up. This stretch helps maintain a strong lower back.
The Caturanga Dandasana or “four-rod pose”: For this pose, you basically stay in the starting position of a standard push-up. Be sure to keep your head up and eyes forward. This is a good core strengthener.
A Final Word
As you can see, maintaining a healthy back takes a lot of work, as there are many activities that contribute to developing one. Every area of total body wellness is touched on when maintaining a healthy back: cardiovascular exercises, nutrition, strength training, flexibility, etc. And because of the physical demands of our job, it’s imperative that we take the utmost care of our bodies and our backs. I strongly encourage everyone to implement back health and wellness activities into their daily workout. With so many of us suffering from back issues, it’s a necessity, not an option.
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