Trending Topics

3 exercises to help paramedics, EMTs avoid back injury

These techniques can and should be done on duty, and will help you manage those aches and pains before they become an injury

Updated April 20, 2016

Your lower back has been aching for a few weeks now. Sure, some days are better than others, but overall it’s been downright cranky.

Last shift, you and your partner were picking up a frail old patient off the floor, and instead of taking an extra second to grab the flexible stretcher or the Reeves you just decided to “get it done.” While awkwardly lifting this patient, you felt a pop in your back and the pain was immediate.

Back injuries consistently rank as the leading cause of disability, lost work and early retirement in the country — especially in EMS. The good news is there are a lot of great new products hitting the market that make lifting and moving patients much easier.

Prevention is key

That flexible stretcher or MegaMover is not just for bariatric; use them with all patient contacts to provide better lifting height, distributed load and reduced friction during lateral transfers.

The same holds true for what we consider the post injury responders. You had an injury, it’s “mostly” better but let’s be honest — your back still lets you know that it’s there. One wrong lift and that familiar pain will be back.

Prevention is obviously the key to having a healthy back. Studies and data clearly show that stretching daily, consistent exercise, good nutrition and hydration will all help to prevent on-the-job injury.

Let’s take it a step further. Current best practices from the sports, therapy and public safety clearly show that using tissue mobilization tools like foam rollers, massage balls and massage sticks all have a clear benefit to helping your tissue be more mobile.

These techniques are all uniform and station friendly so they can and should be done on duty. Plus you will feel better, and you can manage those aches and pains before they become an injury.

So what are the three exercises you need to be doing to protect your back?

1. Bird dog

Contralateral extension focuses on the poster chain muscles. But what it really does is begin to stabilize the fine-motor spine while simultaneously engaging the muscles in the core and hips. Do two sets of 15 to 30 repetitions every other day.

Start on your hands and knees and imagine you have a broom stick on your back. Extend your opposite arm and leg until fully extended. Slowly draw imaginary boxes in the air for 15 to 30 reps each side. Keep your body still and in broom stick posture as your arm and leg do the work.


2. Bowlers squat

Named such because it looks like a bowler releasing the ball. In the beginning go slow and focus on your form. As you get better speed it up, but technique is key. This is a gluteal integration technique; its purpose is to strengthen your hips and legs so when you lift, these muscles fire properly and provide a spine sparing effect. Do three sets of 10 to 15 repetitions.


3. Kettle bell swing

Having the ability to hinge the hips when performing a physical task like lifting, or reaching over a bed to transfer a patient, is very important. This is why you were taught to lift with your legs and not your back, but as we have seen in the field almost every one of you still initiates and finishes your lift with your back. We need an exercise that trains your body to hinge the hips rapidly while maintaining a safe neutral spine angle (flat back/broom stick posture).

So yes, you need a kettle bell for this but it does not need to be heavy. Proper technique is of the utmost importance at all times. This is not an arm exercise; it’s a leg and core exercise.

Use your hips to explode the kettle bell from under your body, thinking of your arms as simply an attachment for the kettle bell. Think broom stick on the back at all times. Do three sets of 15 repetitions.


Warm up and active stretching

As with all exercise always warm up first. Foam roll, actively stretch and then do a few light reps of the exercise before you jump into your sets. These three movements are my go-to exercises because they are effective, quick and can be done in uniform.

One word of caution: there is a learning curve with the kettle bell swing. If you have a trainers or coaches who can critique you please use them, and if not, a mirror will give you great feedback on technique as well.

None of these exercises are complicated or flashy but they are job specific, and will help you to keep your back strong and mobile.

Bryan Fass, ATC, LAT, CSCS, EMT-P (ret.), dedicated over a decade to changing the culture of EMS from one of pain, injury and disease, to one of ergonomic excellence and provider wellness. He leveraged his 15-year career in sports medicine, athletic training, spine rehabilitation, strength and conditioning and as a paramedic to become an expert on prehospital patient handling/equipment handling and fire-EMS fitness. His company, Fit Responder, works nationally with departments to reduce injuries and improve fitness for first responders.

Bryan passed away in September, 2019, leaving a legacy of contributions to EMS health and fitness, safety and readiness.

Rescuers in Chaffee County were sent to rescue an ill-prepared hiker trapped by a snowstorm
Guilderland Emergency Medical Services will have improved crew, patient safety with a power stretcher, power load system
The three patients were flown from the scene in Kissimmee to a hospital in Orlando
Part 1 — The San Diego Fire-Rescue captain shares the emotional story of how a seemingly “routine call” quickly escalated to a near-fatal stabbing