Operations, Patient Care, Trauma

The Soft American

Issue 5 and Volume 34.

In a very real and immediate sense, our growing softness, our increasing lack of physical fitness, is a menace to our security.” You’d think this quote was from a recent political speech, but it was actually a statement made by John F. Kennedy in “The Soft American,” an article in a 1960 issue of„Sports Illustrated. Kennedy was alarmed with the poor performance of most American children on basic physical fitness tests. Many of us in EMS were one of the kids he was referring to. How would we perform today?

Only during the past couple decades has mainstream America been convinced of the necessity to improve musculoskeletal fitness through resistance training. In the 1970s, jogging (or aerobics) was considered the best form of exercise. The average coach or trainer would often dissuade the young athlete from lifting weights for fear of them developing high blood pressure and becoming “muscle bound” and inflexible. Years of research, however, have dispelled these myths.„

The truth is that musculoskeletal fitness is just as important as cardiorespiratory fitness, and examples abound in the EMS field. Think about your last physically demanding call; you probably had to move a patient through tight quarters or move an obese patient who, even with four to six rescuers, was difficult to carry through narrow doorways, down the stairs and out to the gurney. In both of these situations, the cardiorespiratory system and the musculoskeletal system are working together in a synergistic fashion to provide the needed energy.„

In a future article, I’ll provide you with „several safe and effective programs for improving musculoskeletal fitness. But first, let’ find out if you’re a “soft American.”

Muscular Endurance„

If you’re not the gym type, you can perform several tests at home. These tests focus more on your muscular endurance as opposed to strength, but muscular strength and muscular endurance are directly related. For example, someone who scores high on a muscular endurance test, such as the pull-up or push-up test will likely score high on a muscular strength test as well.„

Four practical muscular endurance assessments are the pull-up, push-up, sit-up and partial curl-up tests.„

Pull-up test: On any fixed horizontal pull-up bar, take an overhand grip (palms facing away from the body), pull your chin above the bar in a smooth motion, and return to the starting position, without letting your feet touch the floor. Do as many repetitions as you can.

If you can’t complete one pull-up (many people can’t), consider the flexed-arm hang test. With the assistance of two spotters, raise your chin above the bar, and time how long you can hold this position. Time stops when you_re no longer able to keep your chin from touching the bar or when your chin falls below the level of the bar.„

Norms for these tests are usually limited to children, but we have used them successfully to track the fitness changes of public safety personnel, focusing on an individual’s progress over time.

Push-up test: Count the number of push-ups you can do in one set. Position your hands directly under your shoulders with your body straight. The toes are the pivot point for males, and the knees are the pivot point for females. Gently touch your chin to the ground with each repetition, and count your repetitions until you can no longer continue or maintain good form. Compare your final score by plugging it in at„ www.exrx.net/Calculators/PushUps.html.

Sit-up test: Many of you reading this have done the one-minute timed sit-up test as part of a fitness assessment because it_s often included in firefighter assessments. The one-minute timed sit-up test assesses how many sit-ups can be done in one minute. Bend your knees and, with your feet secured, cross your arms and put a hand on each of your shoulders. Touch your elbows to your knees at the top of the sit-up, and return to the starting position so your shoulder blades touch the floor. Evaluate your final score by plugging it into the online calculator at„www.exrx.net/Calculators/SitUps.html.

Partial curl-up test: If you haven’t exercised regularly in more than six months or are at risk for lower-back pain, you should do this one instead of the sit-up test. Plus, the American College of Sports Medicine recommends the partial curl-up test to assess abdominal muscular endurance. Lying with bent knees and hands on the thighs, exhale as you contract your abdominal muscles and flatten your lower back into the floor, while reaching your hands to the knee caps. Inhale during the return movement and continue this pattern of exhaling slowly while you touch the knee caps and inhaling slowly while you return.„

Perform as many repetitions as you can without pausing. Stop if you can reach 75 repetitions. (This is an excellent score and harder than it sounds!) Technically, you’re supposed to use a metronome set at 40 beats/minute to time the upward and„downward movements. (If you have a child who plays an instrument, have them keep„the beat to get them involved.) If you don’t have a metronome, coordinate your movements with slow, controlled breathing. It’s important to minimize jerky, ballistic movements when doing the partial curl-up. For those up to 50 years old, if you can perform about 30 curl-ups, you’re rated as average, about 50 curl-ups is rated as above average, and 75 is well above average.

Make sure you have clearance from a physician, and warm up prior to the test.„An effective warm-up might include 10Ï15 minutes of stationary cycling, general aerobics and a couple of light sets of the exercise you’re being tested on.„

On the Move

Despite how you performed, it’s never too late to start exercising. In Kennedy’s words, “We can fully restore the physical soundness of our nation only if every American is willing to assume responsibility for his own fitness and the fitness of his children.”JEMS


  1. Brzycki M: A Practical Approach to Strength Training. Masters Press: Indianapolis, 1995.„„„