Recently, someone critiqued one of my articles and told me that my exercise training programs resembled strength and conditioning programs that various athletes use, and that I shouldn’t aim to train EMS providers like they were athletes. My response to this kind of statement is that we are all athletes to some degree, and that athletes should train in a balanced fashion to prevent overuse or imbalance injuries. Additionally, their training should be comprehensive, including training that targets musculoskeletal strength, musculoskeletal endurance, cardiorespiratory endurance and overall flexibility. Considering this, it’s a great idea for EMS providers to train like athletes.
I recently taught a swiftwater rescue certification course for the firefighters in Butte, Mont. It was a fantastic group of guys in general, and one of the other instructors, Paul, was very impressed with one firefighter in particular.
“That guy Kahl Clark is really impressive; he’s just physically more capable on the water than I thought he would be,” he said. Kahl, who also works as an EMT for A-1 ambulance in Butte, didn’t have any previous river rescue experience, so Paul wasn’t expecting him to be so efficient and effective during the rescue scenarios.
Clark is a mixed martial arts champion from Butte, and we work together on his strength and conditioning, specifically to prevent injury and to enhance performance for mixed martial arts competition. This training, however, has had a positive effect on his abilities as an EMT and rescue professional.
Mixed martial arts, also known as MMA, combines the techniques of culturally accepted grappling and striking sports, such as boxing, wrestling, karate, judo and jiu-jitsu. Although your average EMS provider doesn’t have to train specifically to compete in the MMA arena, there are a number of good reasons why EMS providers could benefit from MMA-style training.
Benefits of MMA-type Training
First, EMS providers, like Americans in general, should be more mindful of what to eat. It’s easy, very easy, for us to make meal choices based on convenience, i.e., it’s easier to order a pizza than to plan and create a healthy meal. Fighters are always mindful of their body weight and whether or not they are making a nutritional choice. Although some fighters and grappling athletes have been known to take drastic and unhealthy measures to reduce weight, the ones I work with (like Kahl) are on a regular training regimen along with a healthy eating plan that maintains their weight within an acceptable range.
A second reason to train like a fighter is for stress management. Our profession is a stressful one and, although traditional stress management techniques can help us deal with the daily stressors of our job, exercise is an important general approach to stress management. More specifically, training like a fighter can offer an unparalleled physical release unique to combat sports. Managing anxiety and pressure are daily expectations for EMS providers, and it would be unprofessional to react emotionally during a call.
Athletes, on the other hand, are expected to train with enthusiasm. To “leave it on the mat,” or the ring or the cage, is encouraged. Most combat athletes leave their training sessions physically exhausted, but mentally calm, relaxed and recharged.
Third, grappling training may be useful in terms of scene safety. An unfortunate part of our profession is that sometimes the very people we’re trying to help may try to hurt us. Additionally, understanding how to position our bodies to escape from an attack or to protect ourselves from strikes may be useful when a patient displays excessive violence.
I’m not suggesting we execute several good elbow strikes, and then follow up with a swift double-leg takedown slam to every patient who pinches, gropes, slaps or attempts to bite us. Most of us have had to deal with the actions of patients who are under the influence of dementia/psychosis, drugs or alcohol, and a professional and calm approach often does the job. However, I do suggest defending yourself if the assault is violent and intended to cause bodily harm, and the training of an MMA athlete may allow you to use grappling to control the attacker in a way that would prevent them from harming you without having to strike at them—possibly harming them.
A fourth reason to train like a fighter is related to the old adage, “Train for the worst, hope for the best.” Mixed martial arts bouts can be won in several ways. First, a bout can be won by submission or “tap out.” A tap out is achieved when one athlete applies a technique that is inescapable and may cause injury; the opponent then has the option to submit, or tap out, to signal defeat. The tap out allows this sport to be practiced without injury. Once an athlete taps out, the bout is over and he/she is able to compete in the next match, in theory, without any ill effects. Although many bouts end early due to submission or knockout, fighters must train as if the bout will continue through regulation time and into an overtime period. They must train for the worst-case scenario.
EMS providers are usually the most physically challenged by the call they didn’t expect—the worst case scenario. For example, think about an injured hunter who can only be reached by hiking with your equipment through rough terrain; then add snow or rain to the mix and it becomes even more hazardous. Sometimes one fighter isn’t as well conditioned as another, and it becomes obvious during the bout. Many bouts are won based on conditioning or lack thereof. EMS providers don’t have an option; we MUST be prepared for the worst-case scenario. Lives depend on it.
The final reason to train like a fighter is that it’s fun. You don’t have to be a fighter to enjoy the variety that MMA training can add to an existing fitness schedule. Some very basic tools of training that are probably more associated with boxers and grapplers, but that may be effective in fitness programs, include the following:
• Heavy bag
• Speed bag/double end bag
• Ground and pound dummy
• Jump rope
• A mat for body-weight exercises
• Medicine ball
The combinations of exercises that can be formed from just these tools is limited only by the imagination. A couple of sample programs for you to begin with include the following, and you can follow this link to watch the workouts:
Repeat as many times as necessary. Two cycles of this workout make a 36-minute workout.
• Heavy bag 1 x 3 minute round
• Jump rope 1 x 3 minute round
• Speed bag/double end bag 1 x 3 minute round
• Jog 1 x 3 minute round
• Ground and pound 1 x 3 minute round
• Jump rope 1 x 3 minute round
• Repeat as necessary
One cycle through this workout is about 32 minutes.
• Shadow striking, 1 x 3 minute round
• Wall sit for 1 minute
• Lunge walk 1 minute
• Heavy bag 3 x 3 minute rounds
• Between rounds 1 and 2: abdominal curls
• Between rounds 2 and 3: bridging
• Speed bag 3 x 3 minute rounds
• Between rounds 1 and 2: pull-ups
• Between rounds 2 and 3: push-ups
• Jump rope 3 x 3 minute consecutive rounds (no rest between rounds)
These are just a couple of sample programs used for conditioning, but there are literally hundreds of modifications you could make to fit your needs as an EMS professional. Progress at a comfortable pace for your needs; some options from lower to higher intensity include:
• Resting between rounds;
• Continuing your exercise between rounds; and
• Adding strength and endurance exercises between rounds.
When training in boxing, it’s important to wrap your hands/wrist to prevent injury. A basic handwrapping procedure is illustrated here. Handwraps can be bought at any sports store. Additionally, a round timer, like the one found here is helpful in keeping time of the rounds. If you’d like to break up the monotony of your exercise regimen and equip yourself for any potential situation, then consider adding some boxing/training for variety, fun and overall fitness.