Along with the relentless mental pounding you receive day after day there s another casualty that is not so much overlooked as it is taken for granted. I m talking about your body and the relentless pounding it takes on a daily basis. Bending over, twisting, kneeling, lifting, pushing, pulling, and sitting on your rump a day in the life of EMS almost equates to that of an obstacle course designed specifically for the public s amusement. The point is each call is unique in its own way in terms of how and what precarious positions your body will adjust to in order to maneuver yourself, the patient and/or the equipment.
If the elevator is broken, and your 350 lb. unconscious patient who's on the third floor at the end of the hallway in the apartment with the busted air-conditioner, is wedged between the toilet and the bathtub, there is a good chance you'll discover your physical limits quickly. Oh, guess what? You re only an hour into your shift. There is no rule that says; Only one physically demanding run per day. You can go home. Theoretically, you could have a dozen just like this one in a single shift. On the other hand, I ve found that a slow day with fewer calls may have its own physical drawbacks and not for the reasons you may think.
According to Patrick Mummy, president of San Diego s Symmetry Clinic and former NCAA Division 1 baseball player turned pain specialist, more than 80% of working American s will suffer a minimum of one episode of disabling back pain in their lives. He contributes this to a lifetime of poor posture and sitting on your rump. Over time, your pelvis naturally tilts forward as your rear draws inward. The pelvis and abdomen push outward while your hip flexors get tighter and your low back flattens out. The result is a slump-like position that you may not even realize you have which is affectionately known as the suck and tuck .
In EMS, you can't escape the fact that we sit a lot. We do it sometimes for hours at a time and then we go home to do it some more. When the day is through and it s time for bed, guess what, we do it for about eight more hours only to get up the next day and wash, rinse, repeat. Couple this with the occasional difficult patient lift or awkward stretcher maneuvering and you will eventually find that the abuse taken by your back and lower body is enough to make your muscles scream You know what? I m giving up on you today!
I m as guilty as anyone of poor posture especially with down time between runs while sitting in the ambulance. That s why I decided to take the bull by the horns before I become another statistic. It doesn t make sense to preach about posture when EMS barely allows for downtime comfort. Sitting in that truck can make for a very long shift so go ahead and get comfortable. By utilizing a very important tool for body mechanics such as occasional stretching techniques, it will help to alleviate some of the short-term pain, maybe even long term potential as well. It may also save you from having to purchase Ibuprofen by the pallet.
I ve collected some back and body stretching techniques from various sources that I felt would be essential for improving flexibility and mobility for everyday life relevant to the EMS line of work. You can do some of these on the job, even on a call. Others should be done at home and after work on a daily basis for maximum effectiveness. Try looking at it as a diet for your soft tissues. You simultaneously stretch pivotal muscles, ligaments and tendons that you use and abuse every day plus you are working to improve circulation to vital areas of the body thus reducing the risk of forming blood clots.
1. Counter Stretch (approx five seconds immediately following a lift)
How to do it: If you are bending forward, grab your hips and stretch your back backwards for a few seconds. Do this after EVERY lift. Occasionally it is not a bad idea to stretch your neck and back in the opposite direction of the way you lift, sit, bend and especially twist. Why you need to do it: You bend over hundreds of times each day. Repetition will eventually get the better of you if you don t counter-stretch
2. Overhead Extension (30 seconds)
How to do it: Clasp your hands together and raise them above your head with your arms locked. Stretch like your reaching for the ceiling. Why you need to do it: This process lengthens and decompresses your spine. You will stand taller and relieve pressure on your disks.
3. Cervical Stretch (30 seconds in each direction)
How to do it: Slowly and carefully bend your neck in a forward, backward and side-to-side motion. While doing this, be sure that you are stretching the muscles while being careful NOT to hyper-extend or hyper-flex. You want to stretch the area just enough to feel adequate resistance and hold that position for at least 5 seconds in each direction. If you have a history of cervical injury, consult with a physician before attempting this. Why you need to do it: Since your neck is a literal extension of your back, it is equally as important to maintain flexibility in that area. Stretching the neck will improve your range of motion and decrease muscle tension surrounding your cervical spine.
1. The Cat Stretch (10-12 repetitions; Hold position for five seconds).
How to do it: This one looks ridiculous and may scare the cat away for a while but it s one of the best lower back stretches that I have tried. Start by placing your hands and knees on the ground. Arch your back up to the ceiling with your head facing down wile tucking your hips in. Your spine should curve like a rainbow. Then slowly return to a neutral position and reverse the maneuver. Arch your back while looking up at the ceiling. Push your pelvis up as if you are trying to touch your butt to the back of your head (extra points if you can do that). If you re doing it properly, you should feel it in your low back and abdomen. Why you need to do it: Stretching this area will actually increase muscle around the low back and help to strengthen the core around your spine. It will also benefit by helping to prevent future strains or injuries. If you ignore all other suggestions, do not ignore this one.
2. Inverted Wall Stretch (two minutes)
How to do it: Find your favorite wall. Lay on your back with your feet straight up in the air and your tailbone up against the wall. Keep your legs about hip-width apart and your feet flat as if you were trying to balance a tray on your shoes. Why you need to do it: You will feel this in your glutes, hamstrings and lower back. It stretches your suck and tuck as discussed earlier and will not only help with low back issues but it will help your balance as you walk and run.
3. Knee To Chest (30 seconds)
How to do it: Lay flat on your back. Bend your knees and clasp your hands around the top of your shins. Gently pull your knees toward your chest until you feel a stretch in your lower back. Why you need to do it: Specifically targeted for key low back muscles, this stretch will help to increase strength, blood flow, flexibility and balance while simultaneously reducing stress and pain to that area as well.
Over the course of time, the demands of each patient encounter can lead up to serious physical consequences if long standing habits of poor maneuvering and lifting are not countered by stretching and exercise of the relevant muscle tissues. Just like fast food, it may not get the best of you right away but give it time.
Physical stamina isn t a request it s a requirement of EMS and you must be ready for the unusual and unlikely at all times. No two emergencies are exactly the same and for this reason you must have your game face on and your body in check for potential abuse.
Having said that, I feel it is just another reason to love this business. On a beautiful sunny day, how many people get to say that they get to go to work and play outside. To you it may not feel like playing but surely it stands in contrast to a windowless office cubicle. And while surgeons rely on their hands, pilots rely on their eyes and politicians rely on their mouths. In EMS, your back is the most precious commodity you have so take care of it because if it fails you one day, you may actually end up in that cubicle after all.
- Wallack, RM: The Men s Journal Back Program, Part 1: Realign your back. Men s Journal . 9:72 2006.
- McKinley Health Center University of Illinois at Urbana Campaign Back and Neck Care Guide ; Section 2; http://www.mckinley.uiuc.edu.
- Peter Ullrich Jr. MD Spine-Health.com Exercise and back pain. September 8, 1999. updated October 27, 2006. http://www.spine-health.com.