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EMS clinicians experience about 16,900 job-related injuries annually, with leading diagnoses involving sprains and strains affecting the foot, leg, upper trunk neck or shoulder. More than half of those clinicians reporting injuries were males younger than 35 years of age.
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Given the current male-to-female ratio among EMS clinicians and the physically demanding nature of EMS work, these injuries and demographic breakdown aren’t surprising, according to Jordan Bowen, doctor of physical therapy; and Kate Heyman, doctor of occupational therapy at the R Adams Cowley Shock Trauma Center on the campus of the University of Maryland Medical Center in Baltimore.
Some reported sprains and strains are linked to falls or other events leading to injuries, including violence, harmful exposures, transportation incidents and contact with objects or equipment; while many are linked to exertion.
These types of injuries are consistent with the day-to-day realities of EMS work.
Matt Ryan, doctor of physical therapy at Progressive Physical Therapy and Rehabilitation Center in Cumberland, Maryland, added “the younger age of injured clinicians is likely due to less experience (i.e., thinking they can lift heavier things or do certain job-related actions without asking for assistance).”
Newer clinicians may be less inclined (or undertrained) to focus on proper body mechanics when working with patients, which can lead to overuse injuries, sprains and strains. Ryan offers the following two mantras:
- Work smarter, not harder
- Never be afraid to ask a colleague for assistance
Ryan also emphasizes that proper EMS training should involve biomechanics to prevent work related injuries.
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“We are all invincible until we aren’t, Ryan said. “Ask experienced EMS clinicians for advice and assistance. If you are lifting loads that are too heavy without help, it is only a matter of time before you strain your neck, back or shoulders.”
Preventing work related injuries
Bowen and Heyman offered the following agency-level recommendations to reduce the physical strain on providers:
- Implement proper training in lifting techniques and body mechanics
- Incorporate preventative strengthening programs
- Ensure effective training on equipment use
- Utilize assistive devices, such as lift sheets and transfer boards
According to Ryan, maintaining an adequate level of physical fitness is also vital to prevent injuries.
“No one is expected to be a marathon runner, however repetitive lifting/carrying/pushing/pulling can (put) strain on the trunk, spine and extremities,” Ryan said. “Find a workout routine works with your schedule.”
Ryan recommends the following 3-5 days per week:
- Walking
- Cycling
- Swimming
- Light resistance training with higher repetitions and lower weights
Bowen and Heyman also recommend the following to aid in preventing injuries:
- Maintaining a healthy diet
- Following healthcare provider recommendations
- Proper body mechanics
- Maintaining proper self-care
- Utilizing appropriate lifting devices, such as mechanical lifts to limit strain on EMS professionals
- Environmental assessments, de-escalation of agitated patents
- Identifying and mitigating burn out
- Taking/utilizing vacation days to prevent over-fatigue and injury due to over-stress/strain from job-related tasks
“Maintaining a healthy lifestyle with appropriate diet, staying hydrated and not smoking,” all help maintain wellness, Ryan noted. “Mental fatigue may also be a side effect of long hours and injuries, so finding something that relaxes you is important when you are not working.”
Many EMS clinicians may even benefit from an evaluation by a physical therapist even if they don’t have an injury, to see if there are imbalances that may predispose them to future work-related injuries, Ryan advised. “Prevention is great medicine.”
After an injury occurs
After a clinician is injured, the timeline to recovery can vary significantly, according to Bowen, depending on the severity, intensity and location of the injury.
“Work with your doctor to get in with a physical therapist as soon as you can after an injury,” Ryan said. “Physical therapists are movement specialist who can address muscle imbalances that lead to overuse injuries and work-related injuries.”
“Each injury recovery is unique to the patient, but general mild sprains/strains should be on track in 4-6 weeks,” Ryan added. “If we think it is more of a moderate injury with more significant pain and functional limitations, perhaps 8-12 weeks.”
While strains and sprains may resolve within a few weeks, more severe injuries can take several months to heal and, in some cases, may require surgical interventions, Heyman said. Ryan added that a skilled physical therapist will perform a thorough evaluation to address your impairments to achieve your goals to return to work and other life activities that may be affected by your injury.
“Work hardening or conditioning programs — often provided by outpatient physical or occupational therapists — are designed to help individuals safely regain the strength and stamina needed to meet the physical demands of EMS work,” Bowen said.
“The plan with any work-related injury is for a patient to recover to 100% before returning to work to minimize the risk of reinjury if they try to go back to soon,” Ryan explained.
