The job task of an EMS provider is 100% physical, yet all our training and education focuses on the clinical and operational aspects of the job; little-to-no time is spent on you.
To do this job and to survive this job, you must have the basic physical ability to safely lift, push, pull, carry and move patients and gear. Even as technology has improved solutions for transporting patients, we still have to get the patient on and off the transportation tool. On top of that, there’s the issue of finding our patients in the most awkward of positions. Even a professional mover doesn’t have to lift objects out of the positions we do. Because of these awkward lift positions, lifting heavy loads from the floor and repetitive postures that constantly fatigue our bodies, fitness truly is a necessity.
The issue we see in EMS is that the deck is stacked against us. First, there’s no formal self-care education, such as teaching responders how to eat healthy on the street, or how to stay fit while on duty or managing the stress and fatigue common to a career in public safety. Because EMS is a physical job, it only makes sense responders have the education and tools necessary to stay fit on duty. But we need to take it one step further—we need to separate fact and fiction. There’s a lot of misinformation out there when it comes to exercise.
I want to provide you with five exercises that can be done on duty and in uniform. These exercises have to meet the following scientific criteria to be both safe and accurate:
- They’re job specific and target the primary muscle groups that can reduce your chance of injury;
- They’re biomechanically accurate and have a high-reward, lowrisk ratio;
- They’re easy to do;
- Anyone of any fitness level can benefit from them; and
- They can be done with little-to-no equipment.1
With any exercise routine, a warmup is paramount. The science says using a foam roller for five minutes before exercise will improve flexibility and mobility while increasing tissue temperature.2 Conveniently, this tool will also drastically reduce your chance of getting hurt on the job and make you feel better.
Ideally any responder can do these five exercises 2–3 times per week with a day of rest between sessions. If you’re just getting back into shape, rest 30 seconds between sets. If you’re more advanced, do each exercise back-to-back with no rest for three total rounds. Start by completing 8–15 repetitions per set. As you get stronger, do more reps or add some external resistance. As with any exercise, movement matters, so move well and move often.
1 STEP UP
This is a great exercise that can help you perform on-the-job responsibilities as well as everyday tasks. The trick is to not choose a step that’s too high: never choose one higher than your knee, as this will force you to step up using your back. Instead, we want to focus on the glutes/hips.
Action: Slowly step up without locking the knee by pushing on the step, not the floor. Try to use the glute to finish the move. Balance at the top for a second and then slowly lower back down to the floor. Don’t look down. Keep the heel down at all times.
2 REAR FOOT ELEVATED SPLIT SQUAT
This exercise builds both strength and flexibility, with some balance thrown in. Find an object from knee to mid-thigh height to rest your boot on. Keep your head up and back flat (neutral spine).
Action: Slowly lower the back knee toward the floor. When a good stretch is felt in the elevated leg, push up with the front leg. Don’t lock the knee at the top. Keep your chest and head up at all times.
Holding an exercise band secured in a doorway (these can be purchased at any sporting goods store), step back and go into a “hip hinge”—knees slightly bent, butt slightly out, head up and chest up. This is the same posture you want when laterally transferring a patient, by the way!
Action: Maintaining your hip hinge, pull the band back to the sides of your body. Rows are a no-touch exercise, so no touching your body, no shrugging and no leaning back. Imagine squeezing a $100 bill between your shoulder blades on each repetition. The goal is to make the back muscles contract, so the squeeze is the key.
4 FARMER’S WALK & GEAR CARRY
This exercise is highly job specific and is actually a fantastic hip, oblique and lower back exercise. Plus, it strengthens the rotator cuff. These exercises are walking planks, so they’re actually better than floor-based planks.
Action, two-arm carry: Grab some weight: gear bags, dumb bells or—my favorite—kettle bells. With a good squat, pick up the weight, keep the chest high and head up. Slowly walk up and down the bay, focusing on a slow pace (this forces the hips to fire more as you walk) with the shoulders pulled back. Take 3–4 laps, depending on the amount of weight in your hands.
Action, one-arm carry: Grab your weight using a good squat. The movement is the same as above, but the free arm is key here: Place that hand on the back of your neck with the elbow pulled back. If you can see your elbow out of your peripheral vision as you do the slow walk, your posture has gotten sloppy. Switch arms at each end of the bay.
5 PUSH-UP REACH
Assume a push-up/plank position on the back of the truck to start, but move to the floor as you get stronger. Keep your spine in neutral, chin tucked, knees locked and pretend to be squeezing a $100 bill between your cheeks/glutes. This is a great arm, abdominal and core exercise all in one.
Action: Slowly lower down until your chest is close to the step, then push back up keeping your body neutral. Before you finish the full push-up, take one hand and reach under your body to tap the opposite hip. Don’t let your body rotate. Put your hand back on the step and do another rep, switching to the opposite hand.
As with any exercise program, consistency is important. Forming healthy habits will help you to succeed in this job. When I began my EMS career I didn’t fit in, at all—as my partner downed burgers, I ate meal replacement bars. As my partner smoked at the back of the truck, I did these exercises and a good bit of stretching. But, my partners got hurt a lot and I didn’t. Your fitness will save your life one day, and every day.
1. LaTourrette T, Loughran DS, Seabury SA. Occupational safety and health for public safety employees: Assessing the evidence and the implications for public policy. RAND Corporation: Santa Monica, Calif, 2008.
2. MacDonald GZ, Penney MD, Mullaley ME, et al. An acute bout of self-myofascial release increases range of motion without a subsequent decrease in muscle activation or force. J Strength Cond Res. 2013;27(3):812–821.