Justifying a fitness and wellness program

Getting your department to make health a priority

By Bryan Fass

Mention fitness and job-specific testing to an EMT and I promise you that the reaction will be swift and severe. Shock, outrage, defiance, and fear are all emotions that come to mind when you mention the possibility of testing a medic's physical ability. Unless you are a fire-medic and are held to the standards of a firefighter, you probably have not been physically tested. Sure, there may have been a pre-hire physical and job-specific test that was administered upon a conditional job offer. But if you are like most medics, you have not been tested since, and sadly the majority of injury occurs after we have been in the field for a few years.

If you have worked in EMS/public safety long enough, you have seen countless co-workers, partners, and peers quit or retire from injury. EMS does not afford us a fall back option; you are either in the field or you are not. As the call volume keeps increasing — which will in turn increase your chance of injury — and the patients get heavier and heavier, your chances of physically surviving this job steadily decrease. Instead of fighting mandatory fitness and wellness, we should be embracing it as a way to stay fit and injury-free, feel good, and look good.

Trying to get such a process started can be quite a daunting task, particularly when HR and management have differing views and opinions on the legality and logistics of testing and maintaining fitness. Oddly enough, many in HR and administration seem to have lost sight of the purpose of a program that results in fewer health care dollars spent, less injury, and more happy and productive employees. As 'field responders,' we can look forward to better equipment, newer units, and more perks as our agencies don't need to spend as much money on workers' compensation claims, overtime for injured employees, and constantly training new employees in conjunction with high employee turnover.

A look at the data on workplace wellness and testing programs clearly shows that departments and organizations that have a program have healthier and fit employees. We can see on average five fewer sick days used per year and up to a 16 percent increase in work capacity, which equates to a reduced chance of injury. Their employees have fewer sick days and less injury time, which means that vacation time is used for vacation and not for an injury, thus ensuring a happier field staff. If a simple worksite wellness program is that effective, then imagine what a targeted and structured program can do!

"When an entire urban fire department was instructed on a bracing or spine stiffening technique — and this technique was reinforced throughout the year — this department saw a 42 percent reduction in injury. Responders, I am not a mathematician, but that is HUGE" (Core strength: A new model for injury prediction and prevention Journal of Occupational Medicine and Toxicology 2007).

Now that we understand the positive aspects of a structured and consistent program, justifying the need is much easier. Starting a program is not as difficult as some departments might think. A few things need to fall into place and once they are enacted, they simply need to be maintained. First, we need to understand the differences among three different types of tests.

Physical Fitness Testing vs. Job-Specific Testing
Physical fitness testing — which this author vastly prefers — has some distinct advantages, including being able to predict who can and cannot do the job. It also shows if the candidate is 'trainable' and directly links to an established fitness and injury prevention program.

Job-specific testing falls under numerous ADA acts and requires a significant amount of validation data. I am not saying that this is impossible to do, but without a national standard for EMS and varied standards for law enforcement and fire, some grey areas are bound to occur. The other issue is that once a standard is validated, it is very hard to change it. With physical fitness testing, however, we are able to adapt the tests to the job as science changes.

My preferred testing method is Functional Movement Analysis (FMA).

What it is: Series of normal movements done in a specific fashion to screen for abnormal movements patterns.

What it does: Gives us a grade for injury potential and provides us with a checklist of corrective exercise strategies, which link back to an established fitness and injury prevention program.

What it shows us: Normal, abnormal, compensation, and cheat movement patterns, which have been proven to lead to injury.
Additionally, functional movement analysis is quick, inexpensive to perform, easy to reproduce on a large scale, and existing staff can be trained to perform the analysis. FMA can also be used when an employee returns from an injury or a prolonged absence along with tracking progress over a career.

Please be aware that all programs are not created equal. A fire- or police-based program does not always encompass the needs of EMS and vice versa. Many commercially available programs are simply repackaged from other professions. Any program your department decides to pursue should include some form of yearly fitness testing/functional movement analysis and be directly linked to an established fitness program. Beware of bodybuilding or tactical fitness programs disguised as public safety fitness. I am personally getting frustrated of rehabilitating friends that have gotten hurt from many of the exercises these programs recommend. Consistency is the key; test yearly and establish a fitness standard and you and your agency will reap the rewards on numerous levels.

About the author

Bryan Fass, ATC, LAT, CSCS, EMT-P (ret.), has 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 has 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. Contact Bryan at bryan.fass@ems1.com

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