Firefighters are regarded as our nation’s heroes–and rightfully so. These men and women are first responders, saving lives and providing support to millions of Americans, including those who may have no one else to rely on. Firefighters also occupy one of our nation’s most dangerous professions. They are required to perform in extreme environments, often moving their bodies into unnatural positions while wearing more than 70 pounds of protective gear. As a result, a staggering number of firefighters suffer from physical injuries and stress-related disorders.
A study in the New England Journal of Medicine reported that 45 percent of firefighters die because of heart disease rather than burns or smoke inhalation. Cardiac arrest among firefighters is two times higher than in the private sector.1 According to a 2013 report by the National Fire Protection Association, 65,000 firefighters were injured on the job.
More than 55 percent of those injuries were musculoskeletal, resulting in strains and sprains.2 Given the magnitude of injuries and deaths among firefighters, and the enormous cost of rehabilitation and workers’ compensation, fire departments are increasing efforts to develop and assess wellness programs that target specific firefighter issues.
As the daughter, sister, and niece of firefighters, I have seen firsthand the toll the job takes. My father, who would frequently joked that he loved his work so much he couldn’t believe he got paid to be a firefighter, was forced to retire early. Like many firefighters of his day, he lifted heavy weights as a way to prepare both body and mind for the demands of his profession but after more than 30 years of doing that was left with three bulging disks in his cervical spine that were causing searing nerve pain to radiate down both arms.
For my dad, the alternative to early retirement was spinal surgery. The success rate for this type of surgery was low with no margin for error.
The surgeons would be working close to my dad’s spinal cord, and a tiny mistake could leave him paralyzed for life. My dad reluctantly chose retirement and continues to live with both shoulder and neck pain.
The services firefighters provide are indispensable. They serve as the safety net for people who have no one else to turn to. Our wellness programs need to do everything possible to help them meet the physical and mental demands of providing these services effectively, safely, and routinely.
ALTERNATE SOLUTION
As a long-time yoga practitioner and teacher who has seen the benefits of regular mind-body practice, and to honor my dad, I have made it my mission to create the most effective, low-cost, easy-to-implement yoga program specifically targeting firefighter needs. FireFlex YogaTM, a functional-movement based yoga practice, is the result. FireFlex YogaTM integrates best practices in mind-body therapies together with the most widely used movement assessment screen.
This article describes my work with firefighters at a large metropolitan fire department using FireFlex YogaTM to enhance firefighter performance as well as improve physical and psychological well-being. The program specifically targets preventing or reducing recovery time for strains and sprains because the research shows they are largely preventable, especially through wellness programs that focus on functional fitness. Firefighters who participated in these programs demonstrated improved core strength and stability, neuromuscular coordination, symmetry of movement, flexibility, and dynamic stability.
In this article I will also present step-by-step instructions on how to perform several yoga postures that strengthen and improve mobility to shoulders, back, and hips. These postures target precise movements needed to perform key firefighting moves, as shown in chart one. I also give instructions for a relaxation exercise that can be used after running a call or before sleep. These postures can be done without any special equipment, at home or the station, and can be the beginning of an individual or stationwide wellness program.
WHY YOGA?
Yoga is becoming more mainstream because it works. A substantial body of research, including many clinical trials, clearly shows the therapeutic effects and benefits of mind-body practices. A small but growing number of studies indicate that regular yoga practice has the potential to improve firefighter performance, reduce cardiovascular disease, and regulate the balance between sympathetic and parasympathetic nervous system.
Regulating the nervous system means firefighters can manage stress, lower anxiety, sleep more easily, and dissipate the energy accumulated from trauma. Moreover, yoga practice offers firefighters skills to regulate their breathing and clarify their thinking in the midst of emergency situations. The skills learned on the mat translate fluidly to preventive and life-saving practices in dangerous conditions.
On the surface, fire stations might seem like an unlikely place to find yoga. And yet, in my experience, new recruits and veteran firefighters alike are enjoying a practice that brings balance to the highly frenetic and adrenaline-fed atmosphere of the urban fire stations where I teach. The mind-body aspect of yoga is showing promising results in reducing stress on the heart muscle and hypertension. And it’s the deep breathing exercises and relaxation techniques that firefighters are turning to in the dead of night when sleep is hard to come by.
One firefighter I’m working with is struggling with “decades of witnessing some horrendous stuff.” He recently confided in me that yoga is helping him shed some of the emotional weight he has been carrying around in his metaphoric backpack. He is also requesting that his department expand its current yoga offerings. Instead of having yoga instructors teach at individual stations, he suggests offering a daily class at a centrally located facility where all firefighters could have access to uninterrupted early morning practice before their shifts begin.
HOW DOES IT WORK?
FireFlex YogaTM combines the Functional Movement Screen (FMSTM) with mind-body practices including yoga postures, deep breathing exercises, and relaxation techniques. The FMSTM is an assessment tool widely used by organizations including the National Football League, the National Basketball Association, and Major League Baseball to help evaluate professional athlete risk for injury.
Here’s how the FireFlex YogaTM program works:
1. All participating firefighters are evaluated using the FMSTM and receive a pre-FMSTM score.
2. Based on the data from the FMSTM scores, yoga classes are developed to meet the deficiencies of the group. The most critical dysfunctional movement patterns are addressed first.
3. At the conclusion of the classes, all participating firefighters receive a post-FMSTM score.
4. Follow-up suggestions and routines are given so firefighters can continue their progress.
FMSTM WITH YOGA POSTURES
The FMSTM is so valuable for fire departments because it mirrors key movement patterns firefighters use to perform their work. The seven exercises that comprise the screen simulate movements done in emergency situations, including crawling, squatting, lifting, carrying, lunging, stepping over obstacles, and contorting one’s body into unnatural shapes.
By using the FMSTM as a baseline, I can target the appropriate postures that will increase flexibility, mobility, and stability and help firefighters to perform their job safely. And the FMSTM comparisons give fire departments a way to screen, develop targeted classes, and evaluate results.
Here are the seven exercises that comprise the FMSTM matched with firefighting tasks.
1. Hurdle step: stepping over an obstacle during a fire or rescue or getting into the truck.
2. In-line lunge: taking one long step forward and lunging downward while using a fire hose or an ax to open a door during a fire or rescue.
3. Shoulder mobility: lifting and placing on the back a self-contained breathing apparatus.
4. Stability push-ups (press-ups): using core strength while reaching through or around an obstruction during a fire or rescue.
5. Deep squat: squatting to avoid an overhead hazard during a fire or rescue.
6. Rotary stability: staying low to the floor while entering a burning building.
7. Active straight leg raise: maintaining torso and pelvic stability while in awkward positions during a fire or rescue.
Chart one demonstrates the relationship between the FMSTM, firefighter tasks, and the specific yoga postures that are used in FireFlex YogaTM programs. I want to stress that although most of us will not do these postures perfectly or look like a yoga teacher, we can still get the benefits.
STEP-BY-STEP YOGA POSTURES
Yoga posture for shoulder mobility: Why is shoulder mobility important for performance? The shoulder is the most mobile joint in the human body and is crucial for firefighting. The shoulder needs to be strong enough to allow firefighters to lift, push, pull, twist, and move with or against force in multiple directions in emergency situations. Shoulders are one of the most commonly injured joints in the fire service because mobility of the shoulder joint is compromised.
The following yoga posture is designed to lengthen and stretch the upper back and help lubricate the shoulder joint by gently working the shoulder into full flexion.
Yoga posture for trunk stability: Why is trunk stability important for performance? The body’s core is the foundation for all movement, balance, stability, and flexibility. Strong and stable core muscles are critical for firefighters to maintain a full and safe range of motion when maneuvering through awkward positions during a fire rescue operation.
Try the following core-strengthening posture to address the external abs or “six pack” muscles, the deep abdominal muscles, and the muscles that stabilize sideward movements.
Yoga exercise for pelvis stability: Why is pelvic stability important for performance? Pelvic stability is critical to maintaining a neutral spine, especially when the spine is being loaded through heavy lifting. Creating a stable foundation through pelvic stability will help distribute force throughout the spine in the most optimal and efficient way.
Caution: If you’ve been diagnosed with disk disease or have other injuries, consult a health professional before attempting these poses.
It is very important with any pose that you don’t force it and that you stop if you feel pain. One of the benefits of practicing yoga is learning to discern between intensity and pain. Many of the yoga postures may feel intense but should not feel painful.
One of the best ways to avoid injury both on and off the mat is to be mindful of your breath. Mindful breathing increases sensitivity to the body’s feedback mechanisms. If you pay attention, gradually you will begin to identify the feeling of intensity that accompanies a new movement or exercise regime and avoid the feeling of pain that may lead to an injury.
Yoga exercise for relaxation: Not only can yoga help strengthen key muscles firefighters use on the fireground, it can also help firefighters address excess energy and stress after a call.
A NEW MODEL FOR PHYSICAL FITNESS
When I approached the fire department a little more than a year and half ago, I could not have predicted that yoga would be so well received. Until that time, I only knew the fire service through the eyes of my father. My dad understood the importance of keeping his body healthy to perform on the job but for him, keeping the body healthy meant hitting a punching bag and pounding weight. He would not have considered doing yoga as a practice to maintain strength, reduce stress, and increase his overall vitality. I was pleasantly surprised to discover that today’s firefighters are eager for a chance to find out what this yoga craze is all about.
The important question currently being asked by fire departments is: “What exercise and wellness routines can address specific firefighter needs–maintaining optimal physical fitness while reducing the alarming number of injuries and stress related deaths?” What is beginning to emerge in the fire service is the recognition that yoga is a solution that is both affordable and easy to implement and that yoga delivers benefits to address the physical and psychological stressors of firefighting.
I am passionate about bringing yoga to firefighters because I have experienced how yoga practice is changing firefighter lives.
ENDNOTES
1. Kales, S. N., Soteriades, E. S., Christophi, C. A., and Christiani, D. C., “Emergency duties and deaths from heart disease among firefighters in the United States,” New England Journal of Medicine, 2007, 356(12), 1207-1215.
2. Karter Jr., Michael J. and Joseph L. Molish, “Firefighter injuries in the United States,” National Fire Protection Association, November 2014, www.nfpa.org/research/reports-and-statistics/the-fire-service/fatalities-and-injuries/firefighter-injuries-in-the-united-states.
