Strains & Sprains - During Wellness/Fitness Activities

You’re trying to get in shape, right?  You’re eating balanced meals, you’re enjoying physical activities with your families, you’re working out at the station, and you’re noticing the difference on the fireground.  Good for you!  Sometimes, though, injuries occur when you’re trying to be healthy.

Injuries by Body Parts & Severity  (2011) - click to enlarge

Wellness/Fitness programs are mandated SOP compliance areas, and even unregulated departments have Wellness/Fitness programs to keep their teams in tip top shape.  Unfortunately, you are reporting injuries to us that occur during the activities associated with Well/Fitness programs.  Most of these reported injuries are minor in nature (66%) but at least a third are serious (34%) and your team members are missing work due to these injuries.  The most common body parts injured during Wellness/Fitness activities are knees and ankles, followed by shoulders. 

Check out some examples of the injuries that have been reported to us:

 “He was jogging during physical training and felt a pop in his knee”

 “Employee was playing basketball and twisted ankle”

 “Fire fighter strained shoulder while lifting weights”

 “Individual strained back while lifting weights”

We all know it’s important to stay in shape, whether mandated by us, or not, but we DON’T want you to get hurt in the process.

Quick tips for avoiding injuries while working out:

• Employ good form.  Read books, watch videos, or get a trainer who can provide you with the proper form to use when doing different exercises.  Using improper form may make you think you lift more weight, but it’s actually causing other muscle groups to take over for the one’s you mean to work, which can lead to injury.  Using improper form can also place body parts in vulnerable places, causing injury.
• Rest between sets or activities so your body parts don’t get fatigued.  Also, if you rest between sets you can lift the same, or more, weight on your next set, causing you to have a more beneficial workout.
• Get a workout buddy to make sure you are using good form and to spot you.
• Don’t forget to stretch.
• Use lifting belts and wraps to keep yourself aware of vulnerable body areas that you need to be careful to not injure.  Don’t use them because you think they will help you lift more weight.  They won’t help you at all, so relying on these tools for that reason is a recipe for injury.   
• Listen to your body and don’t over-train.  Follow your department’s program and don’t try to be a rock star by overdoing it.  The same advice applies when playing recreational sports.  Don’t play so aggressively that you hurt yourself.
• Sleep well so your body is rested and ready to work out when the time comes.
• If you play recreational sports, stay in shape by doing safe cardio and weight training workouts.  If your body is out of shape, you’re sure to injury yourself during recreational sports.
• Vary your exercises so you don’t only strengthen the same body parts over and over again.  Train your whole body, not just the ones that make you look like a tough guy. 
• Strengthen your core!
• Stop trying to impress everyone and follow a progressive work out plan that’s right for you and your body at this moment.
• If you’re older, take it easy.  Everyone can benefit from working out, but take it easy as you get older because your body doesn’t heal the way it used to. Decrease intensity, duration, and frequency as needed.
• Seek advice from your doctor before starting a workout program.  We all hear this, but do we really do it?  Your doctor knows you in and out and can tell what activities are right for you.  A personal trainer could be helpful also.

Image courtesy of the  US Dept. of Health & Human Services - click to enlarge

Learn to exercise safely with resources from the TCFP Library:

Anyone in the state can borrow these videos for free (you only pay for return shipping).
Click the links to reserve your copy today!

• FIRE SERVICE JOINT LABOR MANAGEMENT WELLNESS-FITNESS INITIATIVE
• PRESCRIPTION FOR PERFORMANCE, PART 1 AND 2
• BACK INJURY PREVENTION
• FIREFIGHTER`S WORKOUT

Have you hurt yourself while working out?  Tell us what happened.  Could your injury have been avoided?

What precautions does your department take to try to limit injuries during Wellness/Fitness activities?

Seat Belts

Wall image courtesy of Greencandy8888 on Flickr

As you know, your emergency vehicles respond to Motor Vehicle Accidents (MVAs) regularly, but unfortunately they also get involved in them.  These can occur when en-route AND when stopped on the road while working an accident.  Many departments are reporting injuries that result from MVAs involving their fire trucks and ambulances.

You are also reporting injuries occurring simply while driving.  Apparatus commonly traverse uneven ground (especially at those wildland fires you’ve all been fighting!), causing passengers to get bumped around.  Similarly, we’re getting reports of firefighters getting injured when apparatus take sharp turns or make sudden stops.  These types of injuries are especially common in ambulances.  

Check out some examples of firefighters getting hurt in ambulances:

“Transporting a patient and riding in the back of the ambulance, which was struck by a vehicle, sustained pain and soreness in back and abdomen.”

“Transporting a patient from a medical emergency to the hospital, a private truck collided with the rescue unit, injuring employee’s back.”

“Employee was in the patient compartment of a moving ambulance when the ambulance had to brake hard to avoid a pedestrian.  Employee was thrown to the front of the ambulance injuring his elbow on a metal corner on the inside of the ambulance.”

Ambulance safety- Optimal patient care with optimal provider safety
As Fire Chief Magazine tells us, better driver-training, and even high-tech solutions like inertial sensors, can help reduce MVAs caused by drivers, but today we’re focusing on Seat belts – for all passengers, in the front and the back of apparatus.  Wearing seat belts while riding to and from incidents will help minimize injuries, and save lives.  Think seat belts will inhibit your patient care?  Think again.  You’re talented enough to get a patient stable quickly at the scene and then put your seat belt on.  Moreover, newer ambulances have 5-point harnesses and “mobile restraints” allowing more movement for patient care.

Of course, we do see injuries even to those wearing seat belts - but they are minor:

An apparatus was involved in an MVA and the occupants only had minor bruises because they were wearing their seatbelts. 

An engine was parked on the freeway, blocking the road during an MVA, when another private vehicle ran into the engine.  A fire fighter was still seat belted in the engine and was just tossed around but did not sustain any major injuries. 

The injured firefighter was responding to a reported grass fire in a department Tanker. The firefighter over-corrected after running off the side of the road and rolled the tanker.  The injuries were minor as the fire fighter was seat belted in. 

It’s important to remember that when not performing life-saving care, in an ambulance or other apparatus, you should be wearing a seatbelt.  Period.  

Has your department signed the seat belt pledge and started changing its culture surrounding seat belts?

Does your department have written seat belt SOPs?  Does your team follow these?

Do any of your newer apparatus have the referenced 5-point harnesses?  Are they any good?

Guest Post: Do It Smarter

Today’s guest post is brought to you by Don Wilson – Compliance Deputy Division Director, TCFP

Having discussed the topic of safe lifting with veteran firefighters, one of the main messages that is always touched upon are these simple words of wisdom – “Do it smarter.” 

(Yes, the old guys do know some things that may be passed on…besides war stories)

This message is especially important when it comes to safe lifting.  Too many of the older firefighters have that “grandfather” walk.  You have witnessed this and may have even practiced it.  You know…the slow, methodical, bent back when getting up from a sitting position.  The stance that takes a few steps to get straightened out.  This is not due to poor posture, but instead comes from years of being the “man” and not asking for assistance when lifting objects - especially when lifting patients from awkward positions or when retrieving heavy objects from inconveniently high compartment spaces on apparatus. 

Forget this practice and Do It Smarter.

Hurting your back and having to deal with later nagging pain is not worth it.  Please take the time to evaluate the situation and then use the proper lifting techniques necessary to get the job done.

Image courtesy of the NIH's website

If the task requires additional help, seek it out. 

For example, that 30 ton PPV fan (Figuratively speaking, of course, but with a sore back it does seem this heavy) stored behind the pump panel (because that is the only available space), typically requires more than one person to remove from its storage spot… so get more than one person to do it!  It does no one on the scene any good if it is not utilized in a timely manner because you are injured in the process of moving the behemoth.  Not only do others have to take care of you, but other important and possibly life-saving operations are not being performed.  If you are injured this way, you are typically off for a few shifts (and will likely have re-occurring episodes in the future).  While this does contribute to the overtime pool for others, it does nothing for you and your future well-being. 

Once again, from a guy with experience….Do It Smarter.

Strains & Sprains - Safe Lifting

As we discussed last week, strains & sprains are the most common types of injuries being reported to us.  Most reported strain & sprain injuries are due, in large part, to lifting and moving patients and fire equipment.  Luckily, the bulk of those injuries (67%) are minor and the individuals are not missing work.  But the other 33% are serious injuries, causing firefighters to miss work.  Missed work, due to injuries, costs everyone a great deal, so avoiding these are best for the whole department.   The majority of the serious injuries are to the back, followed closely by knee, shoulder and ankle injuries.  

Injuries by Body Parts, Serious vs. Minor (2011) - click to enlarge

  

Backs, shoulders, and knees are being injured while lifting patients.  Here are some examples of these types of injuries that have been reported to us:

“Lifting stretcher with patient into ambulance, strained lower back.”

“Back strain off-loading patient onto hospital bed.”

“Lifting a patient and strained left knee.”

“Assisting moving a patient from bed to stretcher.  He had pain in shoulder.”

Here are some other examples of the lifting injuries that have been reported to us:

“Fire fighter was loading gear on the truck and twisted knee.”

“Fire Fighter was loading rehab supplies, lifted a case of water and injured shoulder.”

“Fire fighter was assisting with the loading of 5” hose.  As he grabbed the hose and hoisted it above his shoulder and took a few steps, he felt pain in the middle of his back.”

“Fire fighter strained back while pulling hose line for fire attack.”

“During structure fire while pulling ceiling with pike pole, fire fighter felt pain in shoulder.”

“Fire fighter injured upper back lifting exhaust fan from ground.”

Lifting injuries occur when you lift something larger than what your body can handle.  Avoiding such lifting is nearly impossible in your line of work.  Finding ways to lift heavy objects safely is paramount.  While your departments can create back safety programs, the responsibility of protecting your back lands squarely…well, on your back.

Most of these injuries can be avoided by practicing safe lifting techniques, such as: 

• Lift with your legs, keeping your back straight 
• Maintain strong leg and arm muscles to assist with this. 
• Pivot, don’t twist. 
• Maintain strong ab and lower back muscles so they don’t get hurt if you end up using them. 
• Lift on stable and level ground. 
• Move smoothly, avoiding jerky movements. 
• Think before you lift – develop a lift strategy.
  

Finally, lifting injuries can be acute and temporarily painful, and they can also be chronic and lead to long-term problems later in life.  You may not feel injured, but if you are consistently lifting heavy objects improperly, your body might feel it later.  It’s time to get your team trained on proper lifting techniques!

TCFP Library videos to help you prevent injuries while lifting:

• BACK INJURY PREVENTION
• PATIENT HANDLING
• PROPER LIFTING TECHNIQUES - KEEPING YOUR WORKPLACE SAFE
• STEPS FOR SAFE LIFTING AND CARRYING

Additional online resources:

• Proper lifting techniques (Mayo Clinic)
• Patient lifting and moving (Video)
• Back Exercises(Patient Education Institute)
• Back Pain - How to Prevent(Patient Education Institute)

How often do you see these types of injuries at your departments?

Be honest, do you practice safe lifting techniques?

Strains & Sprains

Strains & Sprains by activity and body part (2011) - click to enlarge

Strains and Sprains are the most frequently reported injuries in our FIDO system in 2011.  As you can see, the majority of injuries are taking place during Rescue-Non-Fire calls, Fire Suppression, Station Duties and Wellness/Fitness activities.   Rescue-Non-Fire calls are the leading culprit in firefighter strains & sprains.

Of the Rescue-Non-Fire injuries we see back & neck injuries occur most frequently during EMS-type calls.  These are followed by leg injuries.  The good news is that most of the strains & sprains we see are minor and fire fighters are not missing work.

Legs, knees & ankles are the most commonly injured body parts during Fire Suppression, followed by arm, wrist & shoulder injuries and back & neck injuries.  For instance, we are seeing lots of trips over hoses and missteps out of trucks or on uneven ground, all leading to twisted ankles and knees.   

Station Duties, such as checking apparatus, moving apparatus, checking hydrants, or maintaining the station (mowing, cleaning bays, house-keeping, etc.) lead to strains & sprains also.  Like in your own home, there are hazards everywhere and accidents happen!  

Finally, we see many strains & sprains occurring during Wellness/Fitness activities.  Most often these end up being leg, knee & ankle injuries.  

Stay tuned in September as we examine more closely the causes of the strains & sprains that have been reported, and give you tips on how to stay healthy and avoid these types of injuries.  

What types of strains & sprains are common in your department?   

Why do you think these are so common? 

Feel free to share ideas and anecdotes here and we’ll address them in our future posts.