Firefighters & Back Injuries: The New Study
Study involving San Diego firefighters examines back muscle strength, endurance & flexibility
By Joe Verna, Colin Stowell, Richard Parker, Antonio Duran & John Mayer
For information about exercises to help support back strength, check out “Back for More: Exercises that can help prevent low back pain or injury,” by Jeff and Martha Ellis, in the November issue of FireRescue magazine.
The National Institute of Standards and Technology (NIST) reported that approximately 81,000 firefighters in the United States were injured during 2002 at a cost of $3–8 billion(1). Most injuries to firefighters occur on the fireground, and many of these injuries are musculoskeletal-related. The musculoskeletal system’s primary functions include supporting the body, allowing motion and protecting vital organs. Sprains and strains, including those of the low back and abdominal regions, account for most of the musculoskeletal injuries in firefighters(2). And back injuries represent the vast majority of these injuries(3). Further, low back injury is the most common injury related to early retirement from the fire service(4).
The high rate of low back injuries can be attributed to the high-risk activities that firefighters are expected to perform, such as operating charged hoselines, climbing ladders, breaking windows, ventilating structures, performing overhaul and lifting objects greater than 40 lbs.(4). These tasks are often accomplished while the body’s posture is ergonomically unsound or on unstable ground.
The Impact of Obesity on Back and Core Muscular Endurance in Firefighters
John M. Mayer,1 James L. Nuzzo,1 Ren Chen,1 William S. Quillen,1 Joe L. Verna,2 Rebecca Miro,1 and Simon Dagenais3
The purpose of this study was to assess the relationships between obesity and measures of back and core muscular endurance in firefighters. Methods. A cross-sectional study was conducted in career firefighters without low back pain. Obesity measures included body mass index (BMI) and body fat percentage assessed with air displacement plethysmography. Muscular endurance was assessed with the Modified Biering Sorensen (back) and Plank (core) tests. Relationships were explored using t-tests and regression analyses. Results. Of the 83 participants enrolled, 24 (29%) were obese (BMI ≥ 30). Back and core muscular endurance was 27% lower for obese participants. Significant negative correlations were observed for BMI and body fat percentage with back and core endurance (r = −0.42 to −0.52). Stepwise regression models including one obesity measure (BMI, body fat percentage, and fat mass/fat-free mass), along with age and self-reported physical exercise, accounted for 17–19% of the variance in back muscular endurance and 29–37% of the variance in core muscular endurance. Conclusions. Obesity is associated with reduced back and core muscular endurance in firefighters, which may increase the risk of musculoskeletal injuries. Obesity should be considered along with back and core muscular endurance when designing exercise programs for back pain prevention in firefighters.
Impact of a Supervised Worksite Exercise Program on Back and Core Muscular Endurance in Firefighters.
Mayer JM, Quillen WS, Verna JL, Chen R, Lunseth P, Dagenais S.
Purpose . Low back pain is a leading cause of disability in firefighters and is related to poor muscular endurance. This study examined the impact of supervised worksite exercise on back and core muscular endurance in firefighters. Design . A cluster randomized controlled trial was used for this study Setting . The study occurred in fire stations of a municipal fire department (Tampa, Florida). Subjects . Subjects were 96 full-duty career firefighters who were randomly assigned by fire station to exercise (n = 54) or control (n = 42) groups. Intervention . Exercise group participants completed a supervised exercise targeting the back and core muscles while on duty, two times per week for 24 weeks, in addition to their usual fitness regimen. Control group participants continued their usual fitness regimen. Measures . Back and core muscular endurance was assessed with the Biering-Sorensen test and plank test, respectively. Analysis . Changes in back and core muscular endurance from baseline to 24 weeks were compared between groups using analysis of covariance and linear mixed effects models. Results . After 24 weeks, the exercise group had 12% greater (p = .021) back muscular endurance and 21% greater (p = .0006) core muscular endurance than did the control group. The exercise intervention did not disrupt operations or job performance. Conclusion . A supervised worksite exercise program was safe and effective in improving back and core muscular endurance in firefighters, which could protect against future low back pain.