FIREFIGHTER HEALTH & WELLNESS PROGRAM · Working with San Jose Fire Fighters over the past year, ... Barry Carlos Darron Jarrod Mike Alfred Bill Brett Dave Mike ... SHOULDER MOBILITY

FLEXFIREFIGHTER HEALTH & WELLNESS PROGRAM

FLEXFire�ghting is one of the most important and most dangerous occupations in the nation. Fire �ghters perform many physically demanding tasks, such as forcible entry and rescues, that put them at high risk for injuries because these maneuvers are ergonomically hazardous and require a high degree of trunk stability. As a result, musculoskeletal disorders (MSDs) are the most common work-related injuries among �re �ghters.

According to a 2013 report by the National Fire Protection Association, 65,000 �re �ghters were injured on the job. The majority of injuries (55.3%) received during �reground operations were strains, sprains and muscular pain. The magnitude of injuries among �re �ghters, in addition to the total estimated cost for all �re�ghter injuries, at $4.6 billion in 2012, warrant e�orts to develop �tness programs designed to reduce MSDs and enhance physical and mental wellness for �re�ghters.

Working with San Jose Fire Fighters over the past year, I developed a functional-movement-based yoga program called FLEX. FLEX combines the Functional Movement Screen (FMSTM), with yoga postures, to strengthen proper functional movement and correct ingrained patters of ine�cient movement, resulting in fewer strains and sprains. FLEX also incorporates deep breathing exercises and relaxation techniques to reduced perceived stress by �re�ghters. Overall FLEX enables �re �ghters to meet the physical and mental demands of �re �ghting e�ectively, safely and routinely.

Why Fire Fighters Need FLEX

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Results of San Jose Fire Department FLEX ProgramUsing the FMS for pre- and post-screening, and targeted yoga practice, I conducted two pilot studies with two groups of �re �ghters at a large metropolitan �re district. Eleven participants were given the FMS, and yoga postures were selected to target areas in which a majority of �re �ghters showed de�ciencies: shoulder rotation and �exion, hip extension, abduction, adduction and �exion, and abdominal strength. Deep breathing exercises were added to promote relaxation and reduce stress.

ResultsParticipating �re�ghters at the San Jose Fire Department (SJFD) reported signi�cant improved �exibility in shoulders and hips; less back pain; stronger core; weight loss; improved relaxation and decreased anxiety.

• Group 1 completed 10, 75-minute FLEX classes with a 75% improvement in FMS scores. • Group 2 completed 14, 75-minute FLEX classes with an 80% improvement in FMS scores.

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The FLEX Program for San Jose Fire Department 2

What is FLEX?FLEX is a functional-movement-based yoga program designed to improve �re �ghters’ overall health and �tness. Through a focus on proper movement, FLEX reduces injuries related to strain and sprain and speeds recovery time for injured �re �ghters.

The FLEX program is designed to be a low-cost and highly e�ective whole body program. Classes take place on-site and can be easily modi�ed to accommodate individual and department needs. FLEX was designed to be a stand-alone program, and it can also augment existing wellness programs. The FLEX program includes �ve components:1. The Functional Movement Screen (FMS™)2. Yoga classes, training and postures3. Deep breathing exercises4. Relaxation techniques5. Tracking wellness data

What is the Functional Movement Screen? Gray Cook, a practicing physical therapist, developed the FMS to assess athletes for mobility, motor control and/or stability issues. The following organizations are currently using the screen to help assess professional athletes’ risk for injury: NFL, PGA, NBA, NCAA, and MLB. Fire �ghters are tactical athletes and the FMS can be used as an evaluation tool to assess �re �ghters’ movement patterns. The FMS uses 7 fundamental exercises that require a balance of mobility and stability, which are crucial to a �re �ghters’ ability to perform safely and e�ectively.

Heart disease causes 45% of the deaths that occur among U.S. �re �ghters while they are on duty". ~ The New England Journal of Medicine (2007)

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How does FLEX works? The seven exercises that comprise the FMS also simulate what �re �ghters must be able to do in an emergency situation, such as crawling, squatting, lifting, carrying, lunging, stepping over obstacles and contorting the body into unnatural shapes.

FLEX uses FMS data as a baseline to develop targeted yoga practice that increases �exibility, mobili-ty and stability, allowing �re �ghters to perform their job in a way that is safe and e�ective.

Bene�ts of Using the FMSUsing the FMS as a pre- and post-evaluation tool provides �re departments with the data needed to assess a wellness program’s e�cacy. In addition to the positive results shown in my work with �re �ghters at SJFD, recent research at Orange County Fire Department shows the bene�ts of using the FMS. In the study, new recruits with low FMS scores of 14 or less had a 3 times greater risk of sustain-ing injuries than recruits with scores of 15 or higher. Fire �ghters with scores of 14 and under accounted for 85% of injuries in a 2 to 3 year period. A 4 –minute video on the Functional Movement Screen is available at www.you-tube.com/watch?v=ndn_poPHrtw&app=desktop

“When it's been a busy day at the Fire House and I'm in bed for the night (hopefully), I �nd myself thinking savasana. My shoulders relax, my neck is less tense, and my whole body "relaxes". Through remembering how we end each Yoga session, HELPS me truly relax and go to sleep.”~SJFD

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H U R D L E S T E P

FIREFIGHTING TASK FLEX EXERCISESFMS ASSESSMENT

Ability to step over an obstacle during a �re or rescue, climb a ladder, or to step into the rig.

I N - L I N E L U N G E

Ability to take one long step forward while extending a charged hoseline.

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S H O U L D E R M O B I L I T Y

FIREFIGHTING TASK FLEX EXERCISESFMS ASSESSMENT

Ability to lift and place a self-contained breathing apparatus respirator (SCBR) on one’s back or to swing an axe.

T R U N K S T A B I L I T Y

Core strength ability to reach through or around an obstruction during a �re or rescue, or to cut a roll up door or security bars with a circular saw. 6

D E E P S Q U A T

FIREFIGHTING TASK FLEX EXERCISESFMS ASSESSMENT

Ability to squat to avoid an overhead hazard, lift a patient, or pick up equipment.

R O T A R Y S T A B I L I T Y

Ability to stay low to the �oor while entering a burning building, or operate a chainsaw on a roof. 7

A C T I V E S T R A I G H T L E G

FIREFIGHTING TASK FLEX EXERCISESFMS ASSESSMENT

Ability to maintain torso and pelvic stability during awkward positions at a �re or rescue operation.

D E E P B R E A T H I N G , F O C U S & R E L A X A T I O N

Concentration, along with integrated function movement is key to navigating critical situation. 8

"The biggest bene�t I am getting from yoga is with my �exibility. I can feel an improvement with my recovery and prevention of injury due to a stronger core.” ~SJFD

Fire �ghters who participated in FLEX classes demonstrated improved core strength and stability, neuromuscular coordination, symmetry of movement, �exibility and dynamic stability. FLEX Program DeliveryThe e�cacy of the FLEX program can be measured, and is based on pre- and post-FMS scores, with classes targeted to the precise areas identi�ed on the screen.

Speci�cally:1. All participating �re�ghters receive a pre-FMS score.2. Based on the data from the pre-FMS scores, yoga classes are developed to meet the de�ciencies of the group. The most critical dysfunctional movement patterns are addressed �rst.3. At the conclusion of the classes, all participating �re �ghters receive a post-FMS score.

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Suggested Schedule • The program begins with FLEX classes for �re �ghters on a particular shift or at a central training facility.• FLEX classes may be held in the Apparatus Bay, training facility or any open space within the �rehouse.• Pre FMS will be given at least one week before the program begins.• Post FMS will be given within one week of the program ending.• FLEX classes are 75-minutes long.• FLEX classes may be made available to any o�-duty �re �ghter or �re �ghter on modi�ed duty who would like to participate.• Following each class a wellness questionnaire is administered to track changes in: stress, anxiety, sleep, diet, pain, relationships and emotional balance.

OutcomesThe FLEX program can be designed to facilitate the following outcomes:• Reduce the number of �rst-time injuries and re-occurring injuries, speci�cally targeting strains and sprains.• Reduce the length of time �re �ghters are on modi�ed duty.• Increase mobility and �exibility, targeting back, shoulders, hips, and knees.• Strengthen core.• Decrease stress and anxiety and increase relaxation.• Improve relationships and morale.• Promote physical �tness.• Augment current wellness programs.

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BioShannon McQuaide is an experienced yoga therapist and Registered Yoga Instructor with Yoga Alliance. Shannon is the founder of Shannon McQuaide Yoga and the FLEX program. The FLEX program was developed through her work with the San Jose Fire Department, where Shannon continues to lead FLEX classes. Shannon also teaches weekly yoga classes in her hometown of Scotts Valley California, as well as co-leads a yoga program for tennis players at a local country club. Shannon has 10 years of experience leading profes-sional development training programs. She is a certi�ed Functional Movement Trainer and holds a Master of Arts degree in Leadership and Psychology.

References1. Karter, M.J. & Molis, J. L. Fire�ghter injuries in the Unites States. National Fire Protection Association, October 2013. 2. TriData Corporation. The economic consequences of �re�ghter injuries and their Prevention. March 2005. 3. Contreas, M.A. The performance and �nancial bene�ts of using the functional movement screen in the �re service. Orange County Fire Authority, September 2012. Retrieved at http://www.�rehouse.com/article/10760330/safety-�tness-avoiding-strain-and-sprains.4. Peate, W. F., et al. Core strength: A new model for injury prediction and prevention. Journal of Occupational Medicine and Toxicology, 2.3 (2007): 1-9.

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