Hold the line: Fitness differences in firefighters from a health and wellness program who self-report injuries

Introduction: Firefighting requires the performance of many physically demanding tasks which can place the firefighter at risk of injury. Firefighters will often continue to work despite being injured. Depending on the number of injuries and their location, performance of certain physical tasks could be affected. The aim of this study was to determine differences in fitness test performance relative to injury location and number of injuries between uninjured structural firefighters, and firefighters who self-report injuries.
Method: Archival data from 270 structural firefighters (258 males, 12 females) who participated in a health and wellness program was investigated. Firefighters self-reported any current injuries (primary and secondary) by location (upper-body [UBI], lower-body [LBI], back [BI]). Body composition and fitness test data included: body mass index (BMI); body fat percentage (BF%); fat and lean body mass; waist:hip ratio; combined grip strength; predicted one-repetition maximum (1RM) leg press; 90-s abdominal crunches; cadence push-ups; flexibility (trunk flexion and extension; left and right rotation; left and right lateral flexion; shoulder flexion); and estimated maximal aerobic capacity (V̇O2max). Firefighters were split into 5 groups: uninjured (UNINJ), UBI, LBI, BI, and firefighters who self-reported multiple (>1) injuries (MULT). A univariate analysis of variance (pResults: Of the 270 firefighters, 62 self-reported a current injury (UBI: 11; LBI: 19; BI: 12; MULT: 20). The MULT group was significantly older, heavier, and had a higher BMI and BF% than the UNINJ group (p≤0.007). The LBI, BI, and MULT groups had a significantly lower absolute and relative estimated 1RM leg press compared to the UNINJ group (p≤0.026); the BI and MULT had a lower estimated V̇O2max (p≤0.007). The BI group completed significantly fewer crunches than the UNINJ group (p=0.004). The BI group had poorer trunk extension than the LBI, MULT, and UNINJ groups (p≤0.011), and poorer left lateral flexion compared to the MULT and UNINJ groups (p≤0.039).
Discussion: Firefighter injuries can lead to poorer performance in fitness tests. Firefighters with multiple injuries were heavier, had greater BF%, and poorer lower-body strength and aerobic fitness. Back injuries could affect abdominal endurance, and trunk range of motion. Fitness test performance could indicate limitations in job tasks that require these fitness qualities (i.e., poorer lower body-strength could compromise lifting, dragging, and load carriage tasks).
Impact: Regardless of self-reported injury status, all firefighters in this study were still working. Strength and conditioning practitioners should recognize firefighters may have existing injuries that require exercise modifications to maintain fitness characteristics that could affect job performance. For example, injuries could affect a firefighters’ ability to maintain certain fitness components (e.g., lower-body and back injuries could limit the ability to train aerobic fitness, leading to poorer body composition and V̇O2max). Low-impact exercise modalities (e.g., pool work) may need to be adopted for these firefighters. Older firefighters may need a greater focus on reconditioning, injury prevention, and fitness maintenance, as the career demands may lead to a greater number of injuries.
Conflict of interest statement: The authors have no conflicts of interest to declare