Strengthen your core to avoid injury
Learning how to brace the abdominal wall prior to lifting will give us the mechanical advantage needed to prevent injury while on the job
By Bryan Fass
I don't care who you talk to or what program you follow — there is no good way to lift in public safety. Attend any course on safe lifting or transferring of patients and more than likely you will be taught in a controlled environment with good lighting, solid footing, and plenty of help.
Your career in public safety is no different than anyone else who runs calls, rarely are patients in controlled situations where they are easy to move, and for that matter rarely is the job easy to perform. I call it the rule of threes: It's 3 a.m., the patient is three floors up, the elevator is broken of course and the 300-pound patient is stuck between the wall and the toilet.
Responders, there is no good way to extricate a patient like this with proper technique. The same holds true for confined space rescue and extrication from vehicles of all sizes, makes and whatever position they have come to rest in. On the street in a dangerous situation with an emergent patient we simply have to get the job done, and get it done fast.
There are many programs available to public safety agencies that will teach responders how to lift and move. Many are simply bodybuilding type routines that will contribute to injury more than they will prevent it, others tout fancy systems of lifting and leverage to make your job on the street easier and safer.
Having seen the injuries occur on the street as a medic and having rehabilitated them clinically, there is a better way to do it. Now, we are not talking about reinventing the wheel here, we are talking about using our bodies to their full potential, thereby drastically reducing the chance for injury while running a call.
Over the years, research into the human body, particularly the spine and core has drastically changed from isolation based exercises into a more anatomically correct and biomechanically proper approach.
In the past it was common to teach exercises that have now been proven to be less than effective and some even dangerous. A prime example of this type of exercise is the crunch. Abdominal crunching, and for that matter most machine-based abdominal exercises, have been shown to not only be less than effective, they have been shown to actually shear and damage the discs in the Lumbar spine.
To confuse the situation even further, many common ab exercises such as leg raises, scissor kicks and hanging abdominal movements have been shown to be equally ineffective and dangerous for the spine.
Having studied human physiology all medics understand that there are still primal functions in the human body that work today just as they did thousands of years ago. These same primal patterns are also the key to preventing injury.
Let's break a very complicated series of mechanical and neurological events down into something very simple. If someone is about to punch you in the stomach what is your natural reaction? You're primal reaction, which occurs very quickly and without conscious thought is to brace the abdominal wall just prior to impact.
This same pattern is at play, just prior to any traumatic event, where we or our patients brace for impact. Simply put, if our body already knows how to perform a primal pattern that can protect it from injury, shouldn't we be consciously reinforcing that pattern?
Learning how to brace the abdominal wall and stiffen the spine prior to lifting, pulling, pushing grabbing or carrying any object no matter how awkward a position we are in will give us the mechanical advantage needed to prevent injury while getting our job done. Another way to experience this primal pattern of abdominal bracing, which leads to spine stiffening, is to perform what is called abdominal raking.
As you sit tall in your chair push your fingertips into your abdominal while wall simultaneously 'raking' them back toward your thumbs. In essence imagine trying to pull your abdominal wall apart or pressing your belly button down and out against your finger tips.
Your body's natural reaction is to push out against your fingertips bracing the abdominal wall and stiffening the spine. With practice, this simple technique can be used, just prior to performing any exertional movement common to public safety, allowing us to stiffen the spine and drastically preventing injury.
I challenge each and every one of you to practice this simple technique in various positions and to then employ this technique on the street each and every time that you move, lift, pull, push, carry or exert yourself against any resistance.