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An EMS injury prevention training program to get strong

These EMS-specific workouts will help you meet your training goals, minimize the risk of on-the-job injury and have you feeling good

Strength and flexibility training, not working out, and a clean diet kept me injury free for almost 10 years as a paramedic. Workouts are the day-to-day activities to accomplish our training goals. Training has set goals and a plan.

But before we begin to train complete this drill to determine your resistance to change. On a piece of paper write your answers to the questions in the change equation. It only takes a few minutes but will open your eyes to how to truly succeed and create a lasting behavior change.

The change equation: D x V x F > R
Each equation variable has questions to answer.

D = Dissatisfaction with your current situation.
What is your dissatisfaction with your health and wellness?

V = Vision of your future state, positive possibilities.
What do you want the future to be?

F = First steps in the direction of positive change.
What are the first steps to take?

The product of multiplying D by V by R must be greater than the resistance to accomplishing training goals:

R = Resistance to change.
Where and from whom will resistance points occur or come from?

Second, rebrand why you are training in the first place. Fitness is not a goal, wellness is not a goal. They are concepts. Call it what it is and be honest about why you are training. Look in a mirror and say out loud:

  • “I no longer want to be overweight.”
  • “I don’t want to be in pain anymore.”
  • “I just want to feel good and look good.”
  • “I don’t want to get hurt at work.”

The power of positive affirmations is huge and with an understanding of your resistance points you are now ready to train.

Stay healthy and feel good
Not getting hurt on the job and feeling good at work and after work are fantastic places to begin. Check out my columns on foam rolling, pre-shift stretching and foundational exercises as you get started. I strongly suggest spending a few weeks on the foundational movements before jumping into this training program.

EMS injury prevention training program
This training program is based on a day-on and day-off schedule. I strongly recommend some cardio — walk, run, cycle, swim — after each day-on workout and that you stretch every day.

Day 1 workout

1. Kettle bell sumo: A fantastic primer and warm up for the sumo dead lift. Focus on keeping your shoulders tucked down and back. Complete 4 sets of 12-15 repetitions.


2. Sumo dead lift: This is one of the best job-specific EMS exercises. Go heavy here with awesome form. With your shoulders pulled down and back it’s all about getting your hips forward so your legs do the lift and not your back. Complete 5 sets of 5 reps with a very challenging weight.


3. Row: Also a highly job-specific exercise due to the trunk angle and need to keep your hips hinged and spine neutral. Focus on squeezing your shoulder blades with no shrugging. Complete 4 sets of 10-12 reps.


4. Kneeling row: This is great core, hip and back exercise. Kneel tall for 3 sets of 15 reps.


Day 2

This is a rest day with stretching.

Day 3 workout

1. Kettle bell squat: While it may not seem job specific, this exercise done with a kettle bell or a dumb bell will work the legs, hips, core, obliques, shoulders and more. A lot of patient lifts and transfers use these muscles in concert. Complete 4 sets of 12-15 reps with an eye-opening resistance.


2. Step up: We do a lot of stepping in EMS — into the truck, stairs to reach patients. Complete 5 sets of 10 reps. Use your legs to avoid scooping with your back during the exercise.


3. Turkish get up: Hands down the best full body primal mobility-stability-endurance-strength movement ever. Complete 3 sets of 3 reps with a weight you can control. This is my go-to exercise when I need to get mobile or do some postural reset.


4. Decline pushup: Put your feet on a bench or the truck bumper and have at it. Let’s do 4 sets to failure, which means do as many as you can in each set. This is actually a core exercise so keep your glutes tight, body straight and chin tucked.


Day 4

This is a rest day with stretching.

Follow this day-on and day-off cycle 30 days and let me know how you are feeling and the progress you are making toward your training goals.

One last thing before you get started; what is your shift schedule? When is the best time to train — before, during or after or only on days off? The science is 100 percent clear here. It is best to train cardio and mobility on duty or pre-shift. Save the high intensity for the off days or after your shift. Exercise should never cause injury and training heavy or intensely before or on duty will drastically increase your risk of injury.

Find out more about these exercises and more at and remember your fitness will save your life one day and every day.

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.