FLEX
Firefighting is one of the most important and most dangerous occupations in the nation.
Fire fighters 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 fire fighters.
According to a 2013 report by the National Fire Protection Association, 65,000 fire fighters were
injured on the job. The majority of injuries (55.3%) received during fireground operations were
strains, sprains and muscular pain. The magnitude of injuries among fire fighters, in addition
to the total estimated cost for all firefighter injuries, at $4.6 billion in 2012, warrant efforts to
develop fitness programs designed to reduce MSDs and enhance physical and mental wellness
for firefighters.
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 inefficient movement, resulting in fewer strains and sprains. FLEX also incorporates deep
breathing exercises and relaxation techniques to reduced perceived stress by firefighters. Overall
FLEX enables fire fighters to meet the physical and mental demands of fire fighting effectively,
safely and routinely.
Why Fire Fighters Need FLEX
Results of San Jose Fire Department FLEX Program
Using the FMS for pre- and post-screening, and targeted yoga practice, I conducted two pilot studies with two groups of fire fighters at a large metropolitan fire district. Eleven participants were given the FMS, and yoga postures were selected to target areas in which a majority of fire fighters showed deficiencies: shoulder rotation and flexion, hip extension, abduction, adduction and flexion, and abdominal strength. Deep breathing exercises were added to promote relaxation and reduce stress.
Results
Participating firefighters at the San Jose Fire Department (SJFD) reported significant improved flexibility 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. SJFP Pilot #1 SJFP Pilot #2 Pre-FMS 0 5 10 15 20 9 9 9 13 13 16 14 14 13 11 9 11 12 16 13 16 13 13 15 14 Post-FMS
Barry Carlos Darron Jarrod Mike Alfred Bill Brett Dave Mike
Participating Fire Fighters
FMS S cor es 0 5 10 15 20
What is FLEX?
FLEX is a functional-movement-based yoga program designed to improve fire fighters’ overall health and fitness. Through a focus on proper movement, FLEX reduces injuries related to strain and sprain and speeds recovery time for injured fire fighters.
The FLEX program is designed to be a low-cost and highly effective whole body program. Classes take place on-site and can be easily modified 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 five components: 1. The Functional Movement Screen (FMS™) 2. Yoga classes, training and postures 3. Deep breathing exercises
4. Relaxation techniques 5. 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 fighters are tactical athletes and the FMS can be used as an evaluation tool to assess fire fighters’ movement patterns. The FMS uses 7 fundamental exercises that require a balance of mobility and stability, which are crucial to a fire fighters’ ability to perform safely and effectively.
Heart disease causes 45% of the deaths that occur among
U.S. fire fighters while they are on duty".
~ The New England Journal of Medicine (2007)
How does FLEX works?
The seven exercises that comprise the FMS also simulate what fire fighters 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 flexibility, mobili-ty and stabilimobili-ty, allowing fire fighters to perform their job in a way that is safe and effective.
Benefits of Using the FMS
Using the FMS as a pre- and post-evaluation tool provides fire departments with the data needed to assess a wellness program’s efficacy. In addition to the positive results shown in my work with fire fighters at SJFD, recent research at Orange County Fire Department shows the benefits 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 fighters 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 find 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
H U R D L E S T E P
FIREFIGHTING TASK FLEX EXERCISES
FMS ASSESSMENT
Ability to step over an obstacle during a fire 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.
S H O U L D E R M O B I L I T Y
FIREFIGHTING TASK FLEX EXERCISES
FMS 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 fire or rescue, or to cut a roll up door or security
D E E P S Q U A T
FIREFIGHTING TASK FLEX EXERCISES
FMS 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 floor while entering a burning building, or operate a chainsaw on a roof.
A C T I V E S T R A I G H T L E G
FIREFIGHTING TASK FLEX EXERCISES
FMS ASSESSMENT
Ability to maintain torso and pelvic stability during awkward positions at a fire 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
"The biggest benefit I am getting from yoga is with my flexibility.
I can feel an improvement with my recovery and prevention of
injury due to a stronger core.”
~SJFD
Fire fighters who participated in FLEX classes demonstrated improved core strength and stability, neuromuscular coordination, symmetry of movement, flexibility and dynamic stability.
FLEX Program Delivery
The efficacy of the FLEX program can be measured, and is based on pre- and post-FMS scores, with classes targeted to the precise areas identified on the screen.
Specifically:
1. All participating firefighters receive a pre-FMS score.
2. Based on the data from the pre-FMS scores, yoga classes are developed to meet the deficiencies of the group. The most critical dysfunctional movement patterns are addressed first.
3. At the conclusion of the classes, all participating fire fighters receive a post-FMS score.
Suggested Schedule
• The program begins with FLEX classes for fire fighters 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 firehouse.
• 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 off-duty fire fighter or fire fighter on modified 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.
Outcomes
The FLEX program can be designed to facilitate the following outcomes:
• Reduce the number of first-time injuries and re-occurring injuries, specifically targeting strains and sprains.
• Reduce the length of time fire fighters are on modified duty.
• Increase mobility and flexibility, targeting back, shoulders, hips, and knees. • Strengthen core.
• Decrease stress and anxiety and increase relaxation. • Improve relationships and morale.
• Promote physical fitness.
• Augment current wellness programs.
Bio
Shannon 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 certified Functional Movement Trainer and holds a Master of Arts degree in Leadership and Psychology.
References
1. Karter, M.J. & Molis, J. L. Firefighter injuries in the Unites States. National Fire Protection Association, October 2013.
2. TriData Corporation. The economic consequences of firefighter injuries and their Prevention. March 2005.
3. Contreas, M.A. The performance and financial benefits of using the functional movement screen in the fire service. Orange County Fire Authority, September 2012. Retrieved
at http://www.firehouse.com/article/10760330/safety-fitness-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.
