Secret Sauce: Part 1

Firefighters have a uniquely challenging job. They have to move powerfully and efficiently with little time or space to warm-up, move unbalanced, heavy loads even from awkward positions, and perform strenuous, repetitive motions over years of service. This leads to orthopedic injuries, such as shoulder impingement syndrome or chronic back pain. Orthopedic injuries such as these were the leading cause of worker’s compensation claims for a Fire Department in Southern California.

My business partner, Trevor St. John, and I were brought in to consult with the fire department and work directly with 110 firefighters. Our brief: could we lower the number of orthopedic injuries suffered? To address this query, we developed a unique program for firefighters called Preparation for Chaos (PFC).

After a year of using PFC, the fire department reported an 80% decrease in the number of days lost due to injury and a 65% decrease in workmen’s compensation claims.

I’d like to let you in on the secret sauce.

The Methods and Madness
Firefighters have a wide range of duties. We studied the types of actions, movements and demands that were placed on their bodies. This ranged from paramedic calls, to structure fires, exercises at the drill tower, to working out at the stations, we studied and experienced it. PFC was delivered live once per quarter, with specific exercises given in between. During the first session, each firefighter gave a health history and received a mobility assessment.  When we observed nonuniform motion from left to right, coupled with unequal strength 1, we facilitated an acute increase in strength (by using isometric contractions or massaging the origins and insertions of muscles) called Post Activation Potentiation (PAP)2. Uniform motion was often restored, as well. The unusual massage, easy isometrics, and immediate changes in strength and motion made a lasting impression, in our estimation.

After the assessment and PAP, we spent the majority of our time educating the firefighters about how to use exercise to prepare, maintain, and protect their muscles and joints. In group and one on one sessions, we taught the firefighters how to manipulate the variables of exercise most relevant to the demands of the job and the needs of the individual. As a result, not only did they execute the exercise we designed for them, they were able to create safe, effective, and strategic exercises for themselves.  In the remaining quarterly visits, we spent 100% of our time engaged in hands-on instruction to reinforce, enhance, and refine what we coined the firefighter exercise variables.

The Secret Sauce
At the time, Trevor and I thought the PAP that we facilitated in the first session was the secret to our success. After all, observing immediate and demonstrative increases in strength and motion can be impressive. We assumed the increase in uniform strength and motion were permanent changes. Furthermore, we thought that isometrically contracting muscles or massaging their origins and insertions were the only ways to facilitated PAP. We now know that PAP is an acute, temporary neuromuscular response, it does not last indefinitely, and massaging the muscle does not facilitate PAP3. So, our idea that the initial PAP sessions were the key to PFC’s  success is not supported logically or empirically.

The Real Secret to the Sauce
There are 4 clues that shape our current understanding of why this program was successful.

1. The firefighter’s comments about what they liked about PFC centered around our process, not the wow factor of PAP. They liked that we observed all aspects of what they do and asked questions about their concerns regarding the unique physical demands of the job. In turn, the results of our observation and investigation informed which exercise variables we chose to feature in PFC.

Take away:

Get to know your client. Observe how they move, ask questions about their concerns and challenges. Make sure to find out what progress feels and looks like to them. All of this information will inform the design of each repetition of each exercise.

2. The fire department reported that 95% of the firefighters approved of the program and participated regularly.

Takeaway:

Creating a compelling, client-centric reason for participation is critical. This is accomplished by listening to what the client wants, determining what they need, and accounting for their abilities. Lay out your plan and deliver an experience that generates trust in the program that you’ve designed.

3. PAP is a naturally occurring phenomenon that can be facilitated with a variety of muscle contractions (not exclusively isometric). PAP requires no more expert intervention than blood does to clot.

Takeaway:

If you use a progressive strategy to prepare a body for an exercise, PAP will likely occur along the way. It’s natural and normal. The goal of some workouts may necessitate fatiguing muscles beyond their ability to potentiate. Also, natural, normal, and not indicative of injury.

4. Regular bouts of appropriately intense exercise and appropriate recovery facilitate lasting structural and recruitment adaptations in the neuromuscular continuum45678

Takeaway:

If your client wants something to shift and stay that way, design exercises (path, amount, rate of motion, intensity, volume, load, etc.) that stimulate change or maintenance in specific elements of the Neuromuscular system. Recovery is a critical component, as well.

If you would like examples of how to work these principles into your exercise design, please reach out. I’d love to hear from you.