Portland Fire & Rescue
Health and Wellness Manual
Table of Contents
Section 1: Introduction and Policy
2
Section 2: Medical
Physical Injury Risks
Health Risks
Cardiovascular disease
Personality type
Cancer
Nutrition and fitness level
Stress
Temperature
4
4
5
5
5
6
7
9
Section 3: Fitness
Fitness Program Design
Attitude
Adaptation Principle
Balance
Program Components
Strength and Power
Cardiovascular Training
Flexibility
Lifestyle
Exercise Basics
Frequency
Duration
Intensity
Warm up
Exercise
Cool down
Progression
14
14
14
15
15
16
17
18
19
20
20
20
20
21
23
24
24
Section 4: Rehabilitation and Prevention
Over Training
Special Need in Firefighting
Prevention
Treatment for sprains/strains
26
27
27
27
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Section 5: Nutrition
Carbohydrates
Fats
Proteins
Vitamins
Minerals
Water
Body Composition
Obesity
Weight control
Suggestions for Nutritional Health
29
31
33
34
35
35
36
37
39
41
Section 6: Behavioral Health
Positive Coping Skills
Techniques to Manage Stress
Substance abuse
Alcohol
Tobacco
Sleep
Conclusion
43
44
44
44
46
48
51
Appendices List
Personal Stress Inventory
PAR-Q
52
53
54
1
Section 1: Introduction and Policy
The basic duties of a firefighter require above average strength, endurance and agility.
Maintaining a high level of functional physical fitness is a critical necessity. The
Portland Fire & Rescue Physical Fitness Program requests a major commitment of each
and every member of the department to meet the physical demands of the profession
while reducing the risk of injury.
This program is designed for, and relates throughout to, the uniform members of PR&R.
All non-sworn members should maintain a high level of wellness and fitness in order to
have a more healthy and extended life.
This program is designed to focus on results, providing maximum support to the
individual's efforts to achieve and maintain physical fitness. The basic goals of the
program are:
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To ensure that PF&R members have the physical strength, agility, endurance and
mental alertness required for the proper performance of their duties.
To reduce the frequency and severity of injuries suffered by PF&R members.
To reduce the frequency and severity of illness.
To extend the health and longevity of active and retired members.
POLICY
All sworn members of PF&R shall maintain a high level of health and physical fitness.
PF&R recognizes that the state of being physically fit is more important than the precise
program one follows to attain fitness. Therefore, a considerable amount of individual
discretion will be allowed in selecting and managing fitness activities. Evidence of
acceptable fitness shall be determined through annual performance evaluations.
To encourage regular participation in physical fitness activities, approximately one hour
per shift for suppression members and two hours a week for 40-hour members will be
committed to physical fitness. Activities performed during this period will be regulated
by the Company Officer, or Supervisor with the approval of the Division Manager. It will
be the responsibility of the Company Officer or Supervisor to ensure that fitness activities
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2
are consistent with guidelines presented in this manual, and that they are performed in a
manner that minimizes both injuries and civilian complaints.
The major areas normally considered when measuring physical fitness levels include:
cardiovascular fitness, muscular strength/endurance, body composition and flexibility.
Physical fitness programs should include activities to improve performance in each of
these major areas. Competitive/recreational sports such as handball, racquetball,
basketball, soccer, softball, baseball, volleyball, tennis, etc. are not encouraged or
authorized as part of the on-duty physical fitness program.
Companies are encouraged to use the recreational facilities at parks and schools within
their first response area. The number of companies using the same recreational facility
will be at the discretion of the District Battalion Chief.
The Physical Fitness Program is an in-service activity. Therefore, the following
requirements will be in effect:
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Standard uniforms and protective clothing must be worn when responding to
incidents from physical fitness activities.
Clothing worn for physical fitness activities shall be in good taste and not discredit
PF&R in any way.
Jogging must be confined to a 300-foot radius of the assigned apparatus.
To protect PF&R’s "public image" - activities must project a high fitness,
non-recreational attitude.
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3
Section 2: Medical
PHYSICAL INJURY RISKS
The most prevalent injuries sustained by firefighters are musculoskeletal injuries in the
form of strains and sprains, with lower back injuries being the most prevalent. Fractures,
dislocations, shin splints, tendonitis and overall joint and muscle soreness also occur, but
less frequently. Injuries occur at the fire station, on the fire ground, on the EMS scene,
and during physical fitness activities. Though they differ in severity and how they occur,
many of these injuries have one basic underlying cause: OVEREXERTION.
Overexertion is physical exertion to a state of abnormal exhaustion. Due to the nature of
the Fire Service, we are often called upon to perform at peak levels of exertion with little
or no chance for proper warm-up. This increases our chance of injury.
There is an inverse relationship between fitness levels, and rates of injury frequency and
severity. The higher our level of fitness is, the lower our risk of injury. A proper fitness
program can help prepare us to meet the physical demands of fire fighting and increase
our overall capacity for physical exertion. There will be a thorough discussion of fitness
in a later section.
HEALTH RISKS
The following is a discussion of some of the most common health risks associated with
our occupation. Keep in mind the difference between intrinsic and extrinsic factors:
INTRINSIC factors are those over which you have little or no control, and include age,
sex and family history.
EXTRINSIC factors are those items in our lives over which we can exert some control,
i.e.: smoking, personality type, stress, obesity, fitness level, and diet.
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Cardiovascular Disease
We most commonly see these factors as the agents causing heart attacks, hypertension,
and strokes. The incidence of arteriosclerosis and other cardiovascular problems is rising
at an alarming rate among the American population. Cardiovascular disease represents
the largest category of on the job deaths among firefighters. Firefighters are at an
increased risk of heart disease because of several factors, both intrinsic and extrinsic,
including:
 Stress: going 0 to 60 in a matter of seconds
 Fire environment: carbon monoxide, organic solvents, heavy metals and other
chemicals can have significant adverse affects on the heart…WEAR YOUR
SCBA!
 Job hours: living a third of life at work
 Firefighter lifestyle: large meal portions, heavy meals, recliners and lack of sleep
Some of the uncontrollable factors for heart disease include: sex, males over 45, females
over 55, family history, post-menopausal females and race. Controllable factors include:
smoking, hypertension, high LDL levels and low HDL levels, diabetes, obesity, inactivity
and uncontrolled stress and anger.
Personality
Personality also has an affect on the risk of health problems, including cardiovascular
disease. Research has shown that individuals with type “A” personalities are easily
recognized as aggressive and competitive. These characteristics can also be used to
describe a great number of firefighters. It is not the intent to infer that these
characteristics are undesirable or should be avoided. It is known, however, that
controlling and directing type "A" behavior at the appropriate times (such as during
fires), will benefit your health. If you allow type "A" behavior to direct your entire
lifestyle, you can increase the risk of heart disease due to increased emotional stress.
Cancer
Research available to us at the present time on the relationship between the incidence of
cancer and the occupation of fire fighting has produced some startling data:
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The cancer rate for fire fighters rose from 18% in 1950, to 38% in 1988.
Since 1950, the average age of death from cancer for firefighters has dropped
from 49 to 44.
A comparison of the cancer incidence rate between firefighters and the general
population produced the following table*:
Type of Cancer
Throat
Mouth
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Percentage Rate Above Normal
200+
200+
5
Lung
Brain
Prostrate
Pancreatic
Rectal
120-190
129
117
140-176
143
*Table result of mortality and incidence studies in L.A., Toronto, Seattle and Boston; National Institute for
Occupational Safety and Health; National Cancer Institute; Foundation for Fire Safety; National Bureau
of Health Statistics.
The medical community is not in complete agreement regarding the validity of this
research and its subsequent data. The one area that researchers appear to have agreed
upon, however, is the increased risk of exposure to carcinogens by firefighters in the
performance of their duties. Carcinogens are present in almost every object we come into
contact with on a daily basis, whether it is hidden asbestos in insulation, wallboard or
floor tile, or the products that contain plastics. For the most part these items are benign in
their natural usable state, but when introduced to fire and heat they can produce the
"killing" smoke. This "plastic" smoke is known to contain 53 toxic compounds, 43 of
which are known or suspected to be carcinogenic.
To complicate matters, not all by-products of plastic smoke are understood or even
known. The accumulative affects of multiple exposures to low levels of carcinogens, or
the simultaneous exposure to multiple carcinogens, is also unknown.
It will be up to each of us to acknowledge that certain risk factors exist that influence, or
possibly could influence, our chance of developing cancer. This field of study is dynamic
in that new research yields new concepts on how to win the battle against cancer.
Nutrition and Fitness Level
Exercise, nutrition and body composition are common extrinsic risk factors can be
discussed together because of their significant interaction with each other. The individual
who is at high risk for heart disease generally does not participate in an exercise program,
or may be involved in some type of activity, but it usually is not of sufficient intensity,
duration, or frequency to reap the benefits of increased cardiovascular fitness. The same
individual will consume foods high in cholesterol and fats. Consequently, as the saying
goes, "you are what you eat." This individual has a high percentage of body fat and runs
a higher risk of heart disease. This added risk requires the heart to supply blood to an
enormous amount of useless body fat by pumping through fat-filled vessels. In addition,
for every extra pound of fat, your heart has to pump blood through 1 extra mile of
vasculature, which greatly increases the workload on your heart.
These three factors feed on each other in a downward spiraling manner. First, the
individual's physical activity decreases with no corresponding decrease in caloric intake.
It is hypothesized that as fitness levels decrease so does the desire to eat healthy foods,
which may account for the type of food consumed. Second, the combination of
decreased exercise and increased caloric intake results in an increase in the percentage of
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body fat. The fat is not confined to the superficial layers of the skin. It is deposited on
the interior of the body’s vessels as well. Finally, this process decreases the ability of the
body to participate in physical activity, thus completing the cycle. The individual now
performs less activity, eats more, and deposits more fat. It is therefore necessary to break
this cycle by becoming involved in a regular fitness program and adopting a low
cholesterol, low fat diet. In this way the cycle can be reversed with the final result of a
better quality of life. Both fitness and nutrition will be discussed in greater detail in later
chapters.
Stress
The stress we face every day, and perhaps more importantly how well we tolerate that
stress, has significant effect on our risk for heart disease. Stress, from a healthcare
perspective, involves both the physical and psychological forces that are experienced by
individuals. It is generally agreed that a certain amount of stress is necessary for the
growth and well being of an individual. However, when stress levels exceed a person's
capacity to effectively deal with it the individual will begin to decompensate. If an outlet
cannot be found, the stress becomes detrimental to the individual and is seen as an
underlying cause for a large percentage of physical injuries and illnesses, including heart
disease, high blood pressure, immune system disorders, migraine headaches, insomnia
and sexual dysfunction. It has been estimated that approximately 40 to 80% of' all
physical injuries and illnesses have an underlying cause or relationship with stress.
Stress, regardless of its origin, elicits three phases of response in the individual:
THE FIRST STAGE is the alarm reaction and involves the fight or flight response. The
individual must make a crucial decision of whether to stay and fight the stressor, or to
turn and take flight. The body’s sympathetic nervous system initiates physiological
changes including increased heart rate, increased blood pressure, increased blood flow to
skeletal muscles, increased blood sugar levels, pupil dilation and increased mental
activity. The individual takes advantage of this state to either fight or flee from the stress.
THE SECOND STAGE, or the stage of resistance, is that period of time when your body
attempts to compensate for the stress being placed upon it by adapting certain changes in
bodily function. This can be seen as increased heart rate, increased blood pressure and
increased blood sugar levels. This adaptation of the body to stress is thought to be
limited, in as far as the length of time it can be sustained. If the stress level continues to
elevate, eventually the body will lose its ability to keep up and adapt to the stress.
THE THIRD STAGE is exhaustion. If the stress is still present at this stage, the body is
now unable to protect itself and begins to suffer ill effects as seen in the breakdown of
bodily systems (diseases) and eventually death. This phase is the body’s way of
attempting to force the individual into a period in which to recover and prepare to meet
the next stress.
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Stress and the subsequent fight or flight responses of the body are essential to our very
existence. It is possible for us to use this concept to improve our capabilities to tolerate
future stress by introducing specific types of stresses in a controlled environment, i.e., the
activities in a total fitness program.
How can stress be considered such an integral part of the injury and disease process if it
is vital to our existence? With regard to physical injuries such as sprains and strains, the
stress simply exceeds the individual’s ability to handle it effectively. This is most
commonly seen in individuals who have a low capacity to handle physical stress because
of their low fitness levels. Also, in situations where the stress is not introduced in a
controlled setting, many factors which influence an individual's ability to handle stress
more effectively are missing. This includes such factors as allowing time for proper
warm-up and following recommended techniques. Chronic stress can often cause muscle
aches and pains (such as lower back pain) because of the tightness and subsequent fatigue
that develops in the muscles as a result of keeping the body in a constant state of
readiness.
The emotional component of stress is probably the most significant factor contributing to
the disease process. It has been hypothesized that the same three stages of stress that were
found beneficial in preparing and protecting the body could also be responsible for its
role in the disease process. In our case, the emotional stress might be from the
anticipation of the next call, from the helplessness we often feel in carrying out our
duties, or simply from dealing with human suffering and death.
Emotional stress is often not a tangible force. In other words, when dealing with physical
stress there is a physical task associated with it such as pulling a hose or fighting fire.
There exists the opportunity to recognize the stress and then do something physical to
effectively reduce the stress. However, this is often not the case with emotional stress. It
seems logical to try to recognize what causes emotional stress on our own, but this may
be a difficult task. It might be more appropriate to look at some of the subtle signs that
exhibit themselves as certain behavioral characteristics. Emotional stress might surface
as irritability, difficulty sleeping, anxiety, reduced productivity and/or a variety of abnormal behavioral patterns.
It is sometimes difficult to recognize what things in our lives are causing our emotional
stress. Emotional stress is different for everyone because it is based on perception.
Therefore, anything that is even imagined as a threat to an individual's welfare becomes a
stress. Also, because there is usually no direct physical outlet for emotional stress, an
individual may not know how to cope with it.
Another hazard seldom thought to be associated with stress is noise. Sirens, air horns,
power saws, extrication equipment, air chisels, and generators may produce potentially
harmful sound pressures. The most obvious adverse effect from noise is hearing loss.
There may also be cardiovascular effects from exposure to high noise levels. Noise
levels have been shown to result in fatigue and adverse cardiovascular function. It is
suspected that the stress created by a noisy work environment can result in higher heart
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rates at work where high noise levels are present. If you feel high stress levels from
noise, ear protection is advised.
*See appendix for Personal Stress Inventory Quick Drill
Temperature
It is extremely important for firefighters to understand the physiological effects of heat
and how it affects the ability to perform work. The normal internal temperature of the
body is related to the body’s poor efficiency for converting energy into actual physical
work. It is estimated that only 25% of the body's energy stores actually produce work,
while the other 75% of the energy is converted to heat in the process. When a person is
at rest, the normal metabolic demands generate heat at approximately 98.6 degrees F. If a
person performs some physical activity, the metabolic energy need increases, resulting in
a higher metabolic rate and raising internal temperature.
The protected body can tolerate extremes in temperatures ranging from 122 degrees to
212 degrees F. However, the body cannot tolerate a change in its own internal core
temperature of more than 7 degrees F without suffering some type of damage. This
explains, in part, why we feel poorly when we are running only a slight temperature
above the normal of 98.6 degrees F.
Your body is well prepared to regulate your temperature within its set limits. When the
body's temperature rises above or falls below the normal range, a sequence of events
occurs which helps to generate or dissipate heat. The exact process of how this works is
still questionable, but we know that radiation, conduction and convection all play a part
in the process of body heat regulation.
HEAT REGULATION
The center for temperature regulation is located in the hypothalamus region of the brain.
When the hypothalamus notices a rise in temperature, its first reaction is to return the
body to resting or normal temperature levels. It accomplishes this initially by shifts in
blood flow; the blood picks up metabolic heat from deep in the core of the body and
transports it to the blood vessels that lay close to the surface of the skin. Those blood
vessels are dilated to allow for more "hot" blood to come in contact with the cooler
external environment. Dilation of the blood vessels also effectively slows down the rate
of blood flow. All of this allows for longer exposure and more time to dissipate heat.
If the rise in body temperature is significant, simply altering blood flow will not maintain
body temperature within normal ranges. In this case, the body has a particular
conduction mechanism available to it in the form of perspiration. This cooling
mechanism, also initiated by the Hypothalamus, involves stimulation of sweat glands in
the skin to produce perspiration. Sweat is primarily composed of water and minerals,
principally sodium and calcium. The production of sweat in itself does not cool the body,
but the evaporation of the sweat induces a tremendous amount of heat loss. The
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efficiency of this heat transfer process is one of the key factors in keeping body
temperatures within the safe operating range.
Since the cooling effect is not achieved until the water actually evaporates, clothing will
alter the process. Cottons and other natural fabrics tend to wick the water away from the
skin and push it to the outside where it can evaporate. Most synthetics restrict the
passage of the water so they feel hotter. We want the sweat to be wicked off the skin,
squeeze out to the surface and to evaporate away. A thermal liner that is highly
absorbent, such as the lining in a turn out coat, will accumulate water (and weight), and a
waterproof liner will keep it from ever getting outside – we create our own miserable
environment inside the coat. The newest protective clothing is designed to counteract
these problems, particularly with Gore-Tex vapor barriers that allow the internal pressure
to squeeze the water to the outside of the coat.
The outside environment also plays a big part in heat regulation of the body. The
temperature difference between the body and its surroundings is the driving force of this
heat transfer. Heat energy always transfers from a warmer mass to a colder mass and
tries to maintain equality. The transfer of heat increases the temperature of the cold mass
and cools the warm mass until they reach the same temperature. So on a hot summer
day, the direct rays of the sun warm the body by radiation, sometimes to the point of
burning. When clothes are worn, the heat is radiated to the clothing and then conducted
to the body. Loose clothing feels cooler because there is less direct contact with the
body, and therefore the transfer of heat is less efficient. Heavy clothing can absorb more
radiating heat energy than light clothing, so it has more capacity to heat up the body and
can keep transferring stored heat even after we are out of the direct sunlight. On the other
hand, when we walk outside on a cold night, our bodies will radiate heat away and we
become colder. The body can expend massive amounts of heat trying to heat-up its
surroundings to a comfortable temperature.
The outside environment can also influence body temperature through direct contact.
The best examples are a hot bathtub or an icy cold dip in a mountain lake. When the bath
water is greater than 98.6 degrees F, heat is transferred to the body by conduction until
the water cools off and equilibrium is achieved. Of course, the equilibrium is short lived
as the water keeps on cooling (by radiating heat to the atmosphere) and we soon find
ourselves in cold water with the warmer body transferring heat back to the water. Cold
water in a large amount, such as a lake, can cool a body very quickly since the mass of
the water can absorb tremendous amounts of heat. Body temperature can be lowered in
this manner by several degrees in a matter of minutes. Drowning in very cold water is
often the result of paralysis induced by this rapid cooling.
HEAT AND FIREFIGHTING
In the performance of your duties as a firefighter, you test your body's ability to maintain
a normal body temperature to the maximum. Protective clothing provides protection
from the heat of a fire. However, this same protective equipment effectively blocks all of
the body's capability to dissipate the rising body heat.
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There are four factors that can reduce the negative effects heat can have on your body:
1. INCREASED FITNESS LEVELS allow your body to be more tolerant of
stresses placed upon it, regardless of their origin. In this instance, higher levels of
fitness will insure that your body is working at peak efficiency, which means it
will require less effort to perform the same work. This will produce less body heat
and better dissipation of the heat produced. Ultimately, your tolerance to the
negative effects of heat will be greater.
2. ACCLIMATIZATION is simply allowing your body to become accustomed to
an adverse environment by exposing it in a controlled setting over a period of
time. The body has the opportunity to make any adjustments necessary to better
compensate for the adverse condition. To become better acclimatized to heat,
something as simple as wearing your turnout gear each shift and performing some
light exercises for a period of 10-15 minutes would suffice. The improvement in
heat tolerance is associated with increased sweat production, lowered skin and
body temperature and a reduced heart rate.
3. PROPER FLUID AND MINERAL INTAKE are essential in deterring the
onset of heat-related injuries. The amount of water lost during fire fighting is
estimated to be one to two liters per hour, or 10% of total plasma volume. It is
essential to maintain adequate amounts of water and sodium chloride in the body.
The best approach is to make a conscious effort to drink water at periodic
intervals regardless of thirst. The objective is to stay ahead of the game; once the
symptoms of dehydration and heat disorders appear, you will be playing a losing
catch-up game. Once you become dehydrated on the scene of an incident, it may
be impossible to effectively re-hydrate while continuing with the increased
workload.
4. THE RECOGNITION OF THE EARLY SIGNS and symptoms of heat
disorders should allow you to start early treatment and stop the progression of
events leading to the most serious heat disorder - heat stroke and the possibly of
death. Exhaustion occurs much sooner during heavy physical work in heated
atmospheres because the blood, in addition to carrying oxygen to the working
muscles, has to carry heat from the core. This leads to a reduction in dexterity
and coordination. The ability to remain alert and to make quick decisions is also
diminished. Simple motivation is in no way an effective means to counteract the
detrimental effect of excessive heat.
Early warning signs of impending heat disorders include:
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a chilled feeling
goose bumps on chest and upper arms
throbbing pressure in the head
unsteadiness
nausea
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fatigue
If these early signs and symptoms are not recognized, it then becomes only a short matter
of time before we see either heat cramps or heat exhaustion.
Heat cramps are characterized by severe cramping of the skeletal muscles, primarily
those muscles being used in the activity being pursued. Heat cramps are the result of the
depletion of body fluids and minerals that accompany the sweating process. Heat cramps
are the least serious of the heat disorders, but extremely painful.
Heat exhaustion, which is characterized by extreme tiredness, breathlessness, dizziness,
increased heart rate and a body temperature of 101 - 104 degrees F, may or may not be
preceded by heat cramps and sweating may or may not be present. The individual may
also suffer a varying level of consciousness due to an inability to continue compensating
for the increased temperature. The extent to which an individual suffers or exhibits signs
and symptoms tends to be inherent to that individual.
Heat stroke is characterized by a body temperature of 105' F - 106' F, total confusion or
unconsciousness, cessation of sweating, increased heart rate, low blood pressure and
ultimately death. In heat stroke, the body's temperature regulating systems have been
completely overwhelmed and have ceased to function, resulting in a dramatic increase in
internal core temperature. Unless active cooling methods are pursued immediately,
severe injury or death will quickly occur.
In summary, as you become more aware of the early signs and symptoms your body
gives about it's temperature, you will be better able to take proper preventive measures to
avoid heat disorders. When taking a break, allow the body's cooling mechanism to
function. Open or remove your turnout coat, and remove your helmet and hood – sixty
percent or more of the body's heat will escape through the head and chest area. Maintain
adequate fluid volumes. Listen to what your body is trying to tell you, and when it's time
to stop and cool down, listen and follow that advice. If you don't listen to your body
early, you won't have a chance to listen later.
HEAT AND STRESS QUESTION AND ANSWER
1. Why is a fit firefighter going to survive heat stress better than a fat firefighter?
A fit firefighter has less body fat and doesn’t have to carry around non-functional
weight. They require less energy to do the same job. Body fat also compromises
the body’s ability to lose heat.
2. Does a conditioned firefighter need more or less fluids? Why?
The conditioned firefighter needs more fluids because they are able to store and
burn more energy in a shorter amount of time. That means that your body releases
more heat- requiring more cooling.
3. Does it really matter if you lose body water when you are dehydrated? Why or
why not?
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Of course, for every 2 lbs of body water lost, your heart rate elevates about 8
beats per minute. This same 2 lbs of body water causes a decline in cardiac output
and a rise in core body temp of .3 degrees Celsius when exposed to heat.
4. What are the mental effects of heat stress?
Decreased mental agility, ability to make decisions and hand-eye coordination,
higher error rate, narrowed attention span with a neglect of secondary tasks and a
diminished response to unusual events.
5. What are the main differences between heat cramps, heat exhaustion and heat
stroke?
Heat Cramps: Painful muscle spasms affecting muscles worked the hardest,
profuse sweating accompanied by loss of body salt and a normal body
temperature. Accumulation of lactic acid may play a role.
Heat Exhaustion: Most common form of heat stress. Temperature slightly
elevated, drop in blood pressure, sweating, fatigue, headache, nausea, vomiting,
decreased coordination, staggering, and tachycardia.
Heat Stroke: High body temperature (above 106 degrees), altered consciousness
and lack of sweating.
6. What factors predispose someone to heat stroke?
Older age, hot humid weather, exercise and exertion, dehydration, obesity, heavy
clothing, infection and fever, cardiovascular disease, poor acclimatization,
hyperthyroidism and certain drugs (alcohol, amphetamines, diuretics, beta
blockers and anticholinergics).
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Section 3: Fitness
FITNESS PROGRAM DESIGN
The Fire Service, by its very nature, includes the risks of injury and disease. Exposure to
hazardous situations, the necessity to perform at the peak of your physical capabilities,
and the ever present stress all contribute to the likelihood that you may sustain an injury.
The old adage "an ounce of prevention is worth a pound of cure" is of great significance
in our line of work. It is the Fire Bureau's belief, substantiated by much research, that the
most beneficial and effective means to prevent injury is to follow standard safety
procedures and increase fitness levels through a comprehensive fitness program.
Research has shown the need for high levels of aerobic fitness, muscular endurance and
muscular strength to perform safely and effectively in the fire service.
In the development of our total Fitness Program, we came across a statement which we
felt should be the foundation for our program: "Pursuit of Excellence." As individuals,
we do not begin life with equal innate capacities for mental or physical achievement.
Consequently, we cannot pursue excellence in physical fitness on an absolute scale.
Everyone should, however, strive for the highest level of fitness within the limitations of
his or her own physical potential. THAT IS THE TRUE GOAL OF THIS PROGRAM!
*See appendix for the PAR-Q: Physical Activity Readiness Questionnaire
ATTITUDE
Maintaining a positive, enthusiastic attitude about your fitness program is essential.
Exercise should be something you look forward to and enjoy. If this is not the case, it is
time to reevaluate your program. The reasons why people exercise are diverse, such as to
lose weight, gain weight, prevent injuries, etc., but regardless of motivation, remember to
keep it fun! If you enjoy it, you are more likely to carry it over into your off-duty hours
and continue being active well into your retirement years.
ADAPTATION PRINCIPLE
The principle of specific training, otherwise known as the Adaptation Principle, states
that the amounts and types of physical demands you place upon yourself determine how
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your body will respond and ultimately determine the changes you will see in fitness
levels. For example, if you pursue an aggressive cardiovascular program through
jogging, expect to see increases in your cardiovascular system, but not in areas of
strength or power. The Adaptation Principle also goes one step further in saying that the
majority of improvement you experience will be confined to the actual activity
performed. That is to say, if your fitness program is centered on jogging,
expect to see the majority of your success in jogging but not biking, even though biking
is also a cardiovascular activity. Keeping this concept in mind, the importance of a
well-rounded fitness program becomes clear.
BALANCE
A total fitness program should provide activities that exercise all muscles of the body
equally. This is important because all movements of the body are a result of a check and
balance system. In other words, in order for you to accomplish a basic movement, such
as rising from a chair, a series of coordinated muscular contractions, relaxation and
stabilization occur. It is essential that “mirror” muscle groups in the body are in balance,
otherwise undue strain can be placed on a particular group and potentially result in an
injury. This is similar to a coordinated attack on the fire ground; if one phase of the
operation does not accomplish its assigned function, the entire attack is put into jeopardy.
PROGRAM COMPONENTS
A comprehensive fitness program should include activities which help increase fitness
levels in a variety of areas. Whenever the design of a fitness program is considered, it is
essential that four components always exist:




Strength or power component
Cardiovascular component
Flexibility component
Lifestyle approach
It is impossible to truly say a program is designed for total fitness unless each and every
one of these components exists.
The only difference between individual fitness programs should be the individual
component that is emphasized in the program. For example, although long distance
runners require emphasis on cardiovascular fitness, they need to incorporate some of the
other three components in their program to be successful. The same holds true for the
power-lifter that places emphasis on the strength/power component. To achieve total
fitness, the other remaining factors will need to be incorporated. The benefits and basic
principles on how to train and achieve maximum results from each component will be
discussed in detail.
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Strength and Power
Similarly, strength and power are often used in the same context, but actually are quite
different. Strength is defined as the maximum ability to apply or to resist a force. This
can be seen as the ability to lift a maximal weight one time. Power is the ability an
individual has to utilize strength in relation to time. If two individuals with equal
strength lift an identical weight, and the first individual takes less time to complete the
strength movement, the first individual is said to have more power.
The most common method for increasing levels of strength or power is through a
progressive resistance program involving a variety of different equipment. These range
from free weights to Nautilus, Universal and Cybex machines. Because all fire stations
contain free weights, this manual will focus on this equipment. Most other types of
resistance machines will employ the same strategies, but if you have access to other types
of equipment, be sure to consult instruction on their proper use.
Remember, these guidelines are for the average individual. If you are already a power
lifter or body builder, this program may not be of sufficient intensity to meet your needs.
It can, however, serve as a good reminder of the foundation on which you build your
individual program.
A basic strength program should follow the following guidelines:
 Incorporate basic exercises that work the major muscle groups. You should work
in the order of largest to smallest muscle groups.
 Each major muscle group should be worked no more than three times a week and
not on consecutive days.
 Between each exercise or set, allow ample recovery time: at least two minutes or
until you catch your breath.
 Every exercise should be performed in a strict, slow and deliberate manner if
maximal gains are to be achieved without injury. A good rule of thumb is to take
two seconds to lift and four seconds to lower.
 Perform all exercises through full range of motion to maintain flexibility and
prevent muscle soreness.
 While in the lifting, or positive, phase, remember to breathe in. While in the
lowering, or negative, phase, remember to breathe out. This is important in aiding
blood return to the heart. If you hold your breath while exercising, you create
such a tremendous pressure in your chest cavity that blood flow back to the heart
is hampered. This can result in decreased blood flow not only to the heart, but to
the brain and working skeletal muscles.
 The optimal number of sets and repetitions varies slightly depending on which
data you read. Basically, three sets of 6-10 repetitions per body part is considered
acceptable. One set is defined as the number of repetitions done consecutively,
without resting. For example, if you were doing a bench press and had completed
ten repetitions with a particular weight that would be considered one set.
 The process of choosing weight amounts for each exercise should proceed as
follows: first, a determination should be made as to what weight you could use to
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16

perform no more than ten repetitions with a maximum effort. Once this has been
determined, the amount of weight used during the first two sets represents a
percentage of that initial maximum weight. For example, if you are able to bench
press 100 lbs. for a maximum of ten repetitions, the weight you would use for
your first set would be 50% of 100 lbs, or 50 lbs. The weight you would use for
your second set would be 75% of 100 lbs, or 75 lbs. The third set would then
require you to use the full 100 lbs.
You should change up some sort of your program every 6 to 8 weeks so that your
body and mind don’t get bored. Ways to vary your program include: increasing
or decreasing training frequency, changing the exercises or order of exercises,
increasing or decreasing reps or sets, changing the type of training you do (circuit,
super slow, etc).
Remember, these guidelines are very basic, but useful as a program from which you can
build a solid foundation. It is not the only method one can follow to gain strength; the
effectiveness of isometric, eccentric and circuit training has also been proven. It is the
hope of this manual to simply cover the basics and to make you aware that other avenues
exist for you in the strength portion of your total fitness program. Once you progress in
your strength training, further study will reveal other possible training programs.
Cardiovascular Training
Cardiovascular fitness relates to the efficiency with which your body can deliver energy
and oxygen and transport the waste products of muscular activity away from the active
muscles. Physical activity that requires only short periods of intense effort (such as that
found in the strength program) is called anaerobic activity because such exercises do not
require oxygen to perform. The energy in these types of activities is provided by local
stores within the muscles. For aerobic activities, however, the intensity is at a low
enough level that the individual can keep up a sustained effort of over one minute and up
to hours. The local energy stores are not sufficient to meet the needs of the muscles at
these levels. Exercise or work tasks that are sustained continuously for over one minute
require the presence of oxygen for the working muscles to metabolize fuel for muscular
contractions. The more strenuous the task is, the greater the oxygen requirement. The
greater the ability of our cardiovascular system to deliver and utilize oxygen, the more
work we will be able to sustain, and the greater our level of cardiovascular or aerobic
fitness
Although an individual’s upper limit of cardiovascular fitness appears to be largely
inherent, improvements of 25% or more from a consistent training program are common.
While MaxVO2 tends to reach a peak around age 25 and decreases approximately 10%
per decade, this decrease is markedly less for individuals who maintain their
cardiovascular fitness programs, and it is not uncommon for an active 50-year old to have
a superior fitness level as compared to a sedentary 25-year old.
Firefighters need a high level of aerobic, or cardiovascular, fitness for several reasons.
Numerous studies have demonstrated the necessity of maintaining a high level of aerobic
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17
capacity for fire service duties. Measurements of HR response taken during normal fire
fighting tasks have been shown to be at or near, maximal levels. In addition, oxygen
consumption rates associated with the performance of live fire, rescue and suppression
tasks fall within the range of 60-80% of max.
There are several schools of thought on how to train for cardiorespiratory fitness. All
cardiorespiratory activities have certain things in common, such as increasing the fitness
level of the heart, decreasing body fat and decreasing cholesterol level, making these
activities an excellent way to combat heart disease. In fact, the importance of
cardiorespiratory fitness, not only to today's athlete but also to the average individual, is
recognized without question by the medical community. Each program has its own
individual merits, and it appears that an individual could benefit best by incorporating
several aspects of each program into one. In this way, variety is introduced into the
training program, keeping boredom down to a minimum.
CONTINUOUS TRAINING
This type of training, as the name suggests, involves performing some activity (for
example, biking, swimming, jogging, or aerobics) done over a specific period of time
(usually 20-30 minutes minimum) without resting. Because of the necessity of the time
factor, the intensity levels in these types of activities are generally low to moderate. For a
training effect to occur, the individual must reach and maintain a heart rate which is 60%
of his or her maximum heart rate for 10 - 15 minutes. This type of program should be
performed three to five days a week.
INTERVAL TRAINING
Interval training is a relatively new concept and involves periods of high intensity work
with rest periods interspersed within the program. The amount of time spent in the
exercise phase and the rest phase should be approximately the same. The resting phase is
dependent on how long it takes the individual to recover to a predetermined heart rate
(usually 120/min.), at which time exercise can start again.
CIRCUIT TRAINING
Circuit training combines jogging with various physical tasks. A course can be laid out
anywhere without the need of specialized equipment and would be limited only by the
imagination of its designer. The area the course will cover is variable, but it is usually
determined by the location where training is held. At regular intervals along the course
stations are arranged where a particular task will be performed for a pre-determined
number of repetitions. The activities should be arranged in such a manner that no muscle
group is worked in consecutive stations.
Flexibility
The next component of a fitness program is an emphasis on the importance of
maintaining flexibility. Flexibility can be most simply defined as the range of possible
movement in a joint, but more correctly should include the ease at which a joint can
move as well. The amount of flexibility inherent in any one joint is set by the design of
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18
the individual’s skeletal system, muscle, connective tissue and the overlying skin. The
importance of flexibility is seen in the prevention of muscular strain and rupture.
You can make the best of your own intrinsic flexibility by maintaining proper technique
during warm-up and cool-down periods. To effectively increase flexibility, stretch the
muscles to a point just before it's painful and hold the stretch for ten seconds. It is not
considered acceptable practice to bounce, use a jerking motion, or hyperextend while
stretching because it actually has an adverse effect on flexibility. The muscles of the
body have automatic stretch reflexes which monitor excessive stretch. As a protective
mechanism against excessive or rapid stretching they cause contraction of the muscle to
prevent the potentially dangerous motion from occurring. Therefore, bouncing or
hyperextension of a muscle group will activate the stretch reflex and actually cause
muscle contraction, not relaxation.
It is also important to note that stretching will not only increase flexibility, but also help
relieve muscle soreness. To achieve this, place the muscle in stretching position at
periodic intervals two to three times a day, hold the position for approximately two
minutes, then follow with a one minute rest period. Also, during the actual activity move
the joints and muscles involved through the full range of motion in a slow, deliberate
manner whenever possible. Muscle strain and joint sprains are the most common injuries
that occur to fire fighters. However, as many as 80% of these injuries can be avoided
with proper joint strength and flexibility. Since we normally do not have time to warmup before an emergency, we should strive to be in better condition than the professional
athlete.
Lifestyle
Any fitness program must become a part of your lifestyle if it is to be successful. A
fitness program is sometimes approached as only a short-term commitment, usually to
prepare for in upcoming physical. The true purpose and the goal you should strive for is
to improve your quality of life. Physical activity can be and should be fun!! Intensity,
duration and frequency are important concepts, but the most important characteristic of
your program should be the level of enjoyment you receive from your participation.
Obviously, enjoyment will increase the likelihood of continuing the activity for an
extended period of time, let alone a lifetime.
The concepts presented in this manual are to help you make informed decisions on how
you want your fitness program to develop and the type of activities you want to pursue.
Recreational activities can range from vigorous running workouts to casual walks in the
evening. The amount of success you enjoy from your fitness program is dependent on
the effort you put forth. This manual will be considered a success if we can at least
motivate you to push away from the TV and refrigerator and go outside for a walk. It is
hoped that through a well-planned fitness program you can add LIFE to your years and,
likely, years to your life.
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EXERCISE BASICS
It is important to note that participation alone does not guarantee increases in fitness
levels. Regardless of the type of program used, the effectiveness of a person’s
cardiovascular training program and level of fitness achieved will be determined by:
1)
2)
3)
4)
5)
frequency of exercise
duration of exercise per session
intensity of effort
progression
maintenance
The challenge in developing a high performance program is to determine the appropriate
level of each variable that will provide a safe, motivating, time-efficient program that will
allow a firefighter to meet his/her specific fitness goals.
Frequency
Much research has been, and is being, done on this subject. To achieve and maintain a
higher level of cardiovascular fitness, 3-5 sessions per week are generally required.
When followed consistently and with adequate intensity, most individuals will be able to
maintain an adequate level of fitness with this routine. Any additional workouts will
bring about some training effect, but not in the same proportion of effort versus results as
the initial minimum effort.
Duration
The training component of the cardiovascular exercise session should aim to keep the
heart rate in the training zone for at least 20-minutes. This will allow for proper
cardiovascular training, with an added benefit of increasing the amount of body fat that is
mobilized and burned off. Initially in the workout, carbohydrates are the main supply of
energy because of their availability and ease of use. As the activity progresses, the body
uses up the available carbohydrates and begins to mobilize and use stores of body fat in
place of the depleted carbohydrate reserves. However, if there are time restrictions or
interruptions there is still some benefit to shorter sessions of two or more ten-minute
sessions. It is always much better to do something than nothing. Many well-trained
individuals are able to routinely train in excess of one hour every day. While this high
volume training can produce impressive results, adequate recovery for safe job
performance and injury prevention should not be compromised, nor should the other
components of fitness (i.e., strength, flexibility) be neglected.
Intensity
Monitoring your heart rate during exercise can help gauge the intensity of a workout and
the effectiveness of a program. In general, well-conditioned individuals will have a
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lower heart rate at rest and at equal levels of exercise. However, there is a considerable
variation in heart rate response to exercise among individuals with similar fitness levels.
Exercise intensity is commonly expressed as a percentage of maximum heart rate. It is
generally recommended that exercise be sustained in a range of 60-85% of maximum
heart rate. For example, first determine your maximum heart rate by the formula: 220 –
(age in years) = predicted maximum heart rate. Then take 60% of the figure obtained
above. This gives you the training minimum heart rate you want to achieve during
exercise. Repeat the same calculation for 80% and you have your target range.
Exercising below 60% of maximum heart rate does have some value in burning calories
and maintaining moderate fitness, but exercising exclusively at this level is inadequate
for developing and maintaining the high levels of cardiovascular fitness needed by
firefighters. Keep in mind that the target heart rate zone is for individuals without any
health problems. In addition, individuals taking heart rate-altering medications like beta
blockers should ask their physician to recommend an intensity level.
Another indication that you have achieved the proper levels of intensity (and duration) is
sweat. If the temperature of the environment in which you are exercising is within
normal range, your body will respond to the appropriate levels of intensity and duration
by sweating. It is also important to note that as the fitness level of the individual
increases, so will the intensity required to further increase the fitness level. For example,
an initial jogging program may require an individual to jog at a 12 minute per mile pace
to achieve the minimum training heart rate. As the individual's fitness level increases, he
or she may have to jog at an eight-minute mile pace to achieve the same training heart
rate.
A simpler method to gauge exercise intensity involves the "talk test". If you are able to
talk effortlessly and complete whole sentences, then the effort is too light for an effective
cardiovascular workout. If talking is difficult and you are gasping for air, then the
intensity may be too high. At the proper intensity, you should be able to talk in short
bursts and your breathing should be deep, rhythmic, and comfortable.
Occasionally, emergency situations or job tasks will require firefighters to work above
their maximum aerobic capacity for brief periods of time. These episodes of "anaerobic"
work can be both extremely physically and mentally challenging. Brief intervals of
intense activity can help prepare for this. This can be accomplished, for example, by
increasing the pace up a hill while jogging for 30-60 seconds, or increasing the resistance
on a stationary or recumbent bicycle for 30-60 seconds. This should be followed by a
decrease in pace or resistance until you have recovered to the same level of exertion as
before the interval. Although exercise at this intensity can sometimes be uncomfortable
and intimidating, when done reasonably and with the proper precaution interval training
can add variety and help round out a fitness program. High volume, high-intensity
intervals or performing them on every workout is not necessary, nor is it advised.
Warm up
Training is designed to allow us to perform job-related tasks in a safe, controlled
environment where skills and technique can be perfected. Unfortunately, despite the
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controlled environment injuries continue to occur at an alarming rate. It may be possible
to prevent over 50% of them from occurring by following two basic concepts. The first
is simply to increase our overall fitness levels. The second is the warm-up principle.
Before participating in any vigorous physical fitness program, a warm up period should
be observed. The warm-up should consist of an activity that:
1. involves the whole body
2. resembles the specific activity to follow, i.e., if preparing to run, walk and/or jog
the first half-mile
3. has a low, but sufficient enough intensity to break a light sweat
4. whenever possible, includes static (non-bouncing) stretching of all major muscle
groups
The reason for the warm-up period is to prepare your body for the physical demands of
the exercise and increase body temperature. The warm-up will increase heart rate,
increase blood flow to skeletal muscle, help relax and increase range of motion of
muscles and assist in mobilizing energy stores in your body. All these changes ultimately
result in an increased level of performance during the chosen activity and a safer
experience with less chance of injury. When planning a warm up, keep in mind the
factors of time, intensity, activity and flexibility. See appendix for sample active warm
up.
TIME
The warm-up period only requires a minimal amount of time, approximately 5-15
minutes, and provides a maximum amount of protection against injuries.
INTENSITY
The human body works much like the engine of a car. Before you can expect top
performance from an engine several things must occur. Let's look at this simple analogy
in the example below:
1.
2.
3.
4.
5.
6.
Engine:
Turn key-start to idle.
Oil pump-circulate oil to working parts of engine.
Air and fuel intake.
Engine temperature increases to optimum range for top performance.
Water-pump, radiator and fan, keep temperature in optimum range.
ALL SYSTEMS GO!
1.
2.
3.
4.
5.
Human Body:
Fight or flight mechanism activates.
Heart rate increases and blood circulated to working muscles.
Respiration becomes deeper and more rapid, energy sources liberated for use.
Body temperature increases to optimum range for top performance.
Sweating mechanism is activated, keeping the body at optimum temperature.
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6. ALL SYSTEMS GO!
The warm-up is designed to prepare your body for the task it will be asked to perform, so
the intensity level should be decreased. At the end of the warm up the heart rate should
be increased, ideally to between 100 and 120 beats per minute, and you should have
broken a light sweat.
ACTIVITY
The types of activities that can be performed are varied, but all fall into the general
category of whole-body activities involving all the major muscle groups of the body.
General warm up activities serve to increase the core body temperature and cause light
sweating, but not fatigue. Aerobics and calisthenics are excellent examples of
whole-body activities that are familiar to most of us. Specific warm up activities are
performed after the general warm up and mimic the actual performance activity. Ideally
they are interspersed with light, movement-specific stretching. For example, if you are
going to jog or run, you should start out by walking and include some light stretching.
Start out slow to avoid overextension of cold muscles. Stretching techniques are most
effective during the specific warm up and even more so in the cool-down phase.
FLEXIBILITY
Following a warm up activity, it is extremely important to utilize stretching exercises.
Stretching will help ensure that the maximum range of joint motion is maintained. The
body is then more flexible and has less chance of injury. The stretching should be
performed in a static manner, which utilizes slow deliberate movements to place muscle
groups in a position where a gentle stretch or pulling sensation can be felt. Bouncing or
jerking types of movements are not recommended and should be avoided. The stretch
position should be held for a minimum of ten seconds, followed by an equal amount of
rest. This should be repeated three to four times for each muscle group involved. The
type and amount of stretching performed may vary, but it is essential that two areas be
always included; lower back and hamstring muscles. The stretches should be done a
minimum of three times each to be increased as flexibility progresses. Should you feel
any pain or aggravation to an existing condition, eliminate that particular movement and
continue with the warm-up.
Exercise
Any exercise that uses the large muscle groups and allows individuals to achieve and
maintain their target heart rate for the prescribed exercise session is acceptable. Which
activity or apparatus is "best" is largely a matter of personal preference. With weightbearing exercises that use a large muscle mass (e.g., running, elliptical-cross training,
cross country skiing), most people are able to maintain higher heart rates and burn more
calories with less perceived effort when compared to exercises that focus on a lesser
muscle mass (e.g., cycling, stepping). In other words, the same amount of exercise will
feel easier for most people.
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Weight-bearing activities such as uphill walking, running, stair climbing, or interval
training are best at helping to maintain bone density and very effective in burning calories
for weight loss. Weight supported exercise, such as upright or recumbent stationary
bicycles, can provide an effective workout with less orthopedic stress. Swimming, crosscountry ski machines, elliptical cross-trainers, and rowing machines help develop both
upper and lower body muscular endurance. By exercising on a variety of apparatus, an
individual will reduce the risk of developing overuse injuries, reduce monotony, and
experience the specific benefits of each activity.
Cross training is an effective way to improve performance, because it works the same
muscles in different ways. If you always perform the same activity you will be in great
cardiovascular and muscular shape for that specific activity, but won’t be in shape for a
different activity. Because firefighting uses so many muscles in so many different ways,
you will increase performance, cardiovascular fitness, and muscular endurance by doing
a variety of cardiovascular activities. Also, by using different muscle groups, the risk of
injury is decreased. Bones and joints are not continuously subjected to the stresses of the
same activity.
Cool Down
After physical exertion, a cool-down period is also recommended. A cool-down period is
similar to the warm-up period in that it provides a means for your body to return back to
resting levels safely and quickly. The cool-down period can be performed with activities
similar to the warm-up period. This time aids the body in expelling and neutralizing the
by-products of vigorous activity that produce muscle fatigue and soreness. It also
prevents blood pooling in the extremities by actually aiding the return of blood to the
heart. Blood tends to pool in the area of most use (if you were running the blood would
pool in your legs) and your body needs time to redistribute this blood more evenly
throughout your system. The problem of "tight" muscles or muscle fiber shortening can
be eliminated as well. And last but definitely not least, the cool down facilitates
muscular relaxation.
The cool down should be performed within 5 to 10 minutes of the activity to take
advantage of the increased body temperature. As you come to the end of your exercise
program slowly decrease the exercise pace until your heart rate is below 120. When you
feel comfortable repeat the static stretching you used to warm-up with. The cool down
period is an ideal time to work on long-term flexibility, so static stretches should be held
for 20 seconds or longer.
Progression
Achieving and maintaining a high level of cardiovascular fitness is a long-term and life
long goal, which requires patience, persistence and consistency. The concept of
progressive overload applies here, which says that in order for in fitness levels to
increase, the individual's cardiorespiratory system must be subjected to increasing
demands. Also, the principle of specificity applies to cardiorespiratory training. If you
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train in your workouts by running 10,000 meters (6.2 miles) you will see a vastly
improved cardiorespiratory system, but you cannot expect to experience the same training
benefits as an individual participating in marathons.
However, attempting to accomplish too-much, too-soon, with insufficient recovery, can
result in overuse injuries. Often injuries which result from improper training changes will
not surface until several weeks later. Therefore, it is imperative to make changes
gradually. Do not increase more than one training variable at a time (i.e., frequency,
duration, or intensity), and allow only a 10% increase per week. Treating minor injuries
appropriately is imperative. Progressive fatigue or soreness warrant reduced or modified
training.
Training is designed to increase our proficiency in carrying out the duties of our job, and
ultimately allow us to reach our goals of property conservation and protection of life in
the community we serve. It is important to remember that fire fighting is not a steadystate activity. It involves highs and lows of activity, and employs both aerobic and
anaerobic activity. Development of a well rounded program for physical fitness is
imperative in order for a firefighter to achieve an optimum level of fitness. It is hoped
that the information provided here, and its subsequent inclusion into each individual’s
training program, will help to allow training to be what it is intended to be: a part of the
solution, not a part of the problem.
PF&R Peer Fitness Trainers have designed many types of workouts for firefighters. To
access a variety of sample workouts, go to PF&R intranet and click on Employee Tab,
Training & Development, Health & Wellness. You can also get extensive nutritional
information at this site.
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Section 4: Rehabilitation and Prevention
Over Training
The most common training error is probably OVER TRAINING. It is not enthusiasm
that should be discouraged, but rather the concept that more is always better. It is true
that overload is needed to induce improvement. Overload, in the context of a physical
training program, is exposing your body to an activity that is of sufficient intensity,
duration, and frequency to produce the desired training effect. However, overload carried
to the extreme of over-training leads to injuries; injuries lead to inactivity; and inactivity
leads to decreased fitness levels.
Over-training creates an imbalance between training and recovery. This happens when
the body has not fully recuperated from previous workouts before encountering
additional overloads. This can have long-term detrimental effects on performance. Overtraining can result from the combination of high motivation levels, high or unrealistic
expectations, lack of knowledge of exercise principles, high total volume of work
performed and low initial fitness levels.
How do you tell when you've gone beyond overload into over-training? Listen to your
body! Watch for signs such as resting pulse rate increasing more than 10 bpm, fatigue,
lack of motivation, tired and sore muscles that do not improve within 48 hours, insomnia,
loss of appetite or strength, lack of improvement, increased injury rate and irritability. If
any of these conditions are present your body is telling you "I'm stressed out, today let's
take a break." This is where common sense comes into play. If your body says NO, don't
go!
Over-training requires a long recovery period of several weeks up to one year. During
this recovery period, an individual could easily lose motivation to workout, become
apathetic about the job, and suffer illness or injuries. Loss of motivation or additional
injuries during this period can be detrimental in motivating a person to enjoy a life-long
commitment to exercise and wellness.
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Special Need for Rehab in Firefighting
Firefighting is a dangerous job! In some departments, medical disability from on the job
injuries and illnesses account for over 50% of the retirements. According to the IAFF
Death & Injury Survey, low back injuries and other strains and sprains accounted for over
50% of total injuries. Firefighter job related injury is 4.5X higher than workers in private
industry. The most common injuries for firefighters are:
 Back: Lifting patients, lifting and twisting, lifting and carrying heavy equipment,
uneven/unstable environments, etc.
 Knees: Sliding down fire poles, jumping off engines, uneven/unstable
environments, crawling in confined spaces, etc.
 Shoulders: Lifting heavy equipment overhead, using high repetitions with arms
outstretched, lifting heavy patients, etc.
One low back or knee injury costs approximately $18,000. This includes the cost of
replacing injured firefighter on an overtime basis, but does not include the mental anguish
of the firefighter or his or her family. In addition, without proper rehab the firefighter
may be re-injured and raise costs even higher.
Prevention
A comprehensive rehab program includes the areas of medical treatment, fitness training,
physical and occupational therapy and an alternate duty program. Of course, an injury
prevention program should also be employed to help avoid the problem before it becomes
a problem. Ideally, injury prevention should comprise a comprehensive and effective
wellness program, a physical fitness program, strong individual and company-wide
commitment to safety, attention to ergonomics, education, and a recognition program for
safe practices.
Here are a few steps you can take to reduce your risk of injury:
 Warm up your muscles before beginning – warm muscles are easier to stretch and
are less likely to become injured.
 Pace yourself and take breaks – most injuries are the result of overuse and occur
when you are tired. If you are trying something new, start slowly. As you
strengthen your muscles, you can lengthen the time you participate in the activity.
 Protect your joints – this includes your back! Minimize bending and twisting,
change position and activities often (this can help prevent cumulative trauma
disorders), use appropriate tools and equipment, and get help if a job is too big.
 Invest in a good pair of shoes
 Cross-train
Stay fit – weak muscles are not only more susceptible to injury, but they are also less able
to protect bones and joints from injury.
Treatment for Sprains and Strains
In the first 24 to 48 hours following the injury, the goal is to reduce pain and swelling.
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



Rest: Reduce activity to the injured area immediately to minimize hemorrhage,
injury and swelling. Your doctor may advise you to put no weight on an injured
area for 48 hours.
Ice: Apply an ice pack to the injured area for 20 minutes at a time, 4 to 8 times a
day. This will cause vasoconstriction and help limit inflammation and reduce
pain. A cold pack, ice bag or plastic bag filled with crushed ice and wrapped in a
towel can be used. To avoid cold injury and frostbite, do not apply the ice for
more than 20 minutes.
Compression: Compression of an injured ankle, knee or wrist may help reduce
swelling. Examples of compression bandages are elastic wraps, special boots, air
casts and splints. Ask your doctor for advice on which one to use.
Elevation: If possible, keep the injured ankle, knee, elbow or wrist elevated on a
pillow above the level of the heart to help decrease swelling.
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Section 5: Nutrition
Training and nutrition are natural compliments when one is striving to achieve a
particular fitness goal. Like flying a two engine plane, you can get to your destination
with one engine, but using both will get you there faster. If we truly expect to reach the
highest state of total fitness we must provide our body with the nutrients it requires.
The food we consume every day contains nutrients that are essential to the proper
functioning of our body, and provides the ability to effectively respond to the day-to-day
stresses we face. Nutrients are classified into six separate categories: carbohydrates,
proteins, fat, vitamins, minerals and water.
Carbohydrates
Carbohydrates are the first choice for our body to provide energy. This is their primary
purpose, though they also provide a protein-sparing function. The majority of your
calories should come from carbohydrates. Carbohydrates fuel both aerobic and anaerobic
exercise. As exercise intensity increases, we rely solely on carbohydrate for fuel. With
lower intensity, we initially use carbohydrate, but fat kicks in so that we can conserve our
glycogen stores. You also need to have adequate carbohydrate in order to oxidize fat.
Carbohydrate is like the kindling of a fire- it burns quickly. Fat is like the logs- it
produces the most flame.
Carbohydrates are basically sugar. Some are in the form of simple sugar, such as candy,
while others exist in more complex forms in foods like cereals, vegetables and fruits.
The complex forms of carbohydrates are preferred because they generally provide
additional nutrition, while the simple sugars tend to be extremely high in caloric content
with no other nutritive value. When you eat carbohydrate foods, they are broken down
into glucose. Interestingly, glucose is the only source of carbohydrate that the body can
use directly for energy and the only energy source used by the brain and the nervous
system.
Carbohydrates are also seen in the form of fiber. Fiber is that part of food that is not
digested by your body and serves as a cleansing agent for the intestinal tract. Research
has shown that the importance of fiber in the diet is in its relationship with reduced risk
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of developing obesity, diabetes, CHID, cavities and periodontal disease, constipation,
varicose veins, hemorrhoids, colon spasm, appendicitis and large bowel cancer.
Glycogen is the storage form of carbohydrate found in the muscle and liver. Muscle
glycogen breaks down to fuel the muscles for exercise. Liver glycogen breaks down to
either maintain blood sugar or fuel muscles (if muscle glycogen stores are low). The
glycogen stores available right now are the result of how you've eaten and exercised for
the past several days. High carbohydrate stores increase both endurance and
performance. Once glycogen stores are exhausted, it takes at least two days to fully
restore them. Recovery days (with no exercise) replenish carbohydrate stores. Also,
varying duration and intensity of training will also help replenish carbohydrate stores.
When it comes to carbohydrate and performance, you should know that it is essential to
eat a high complex carbohydrate diet. Storing carbohydrate in the muscle and liver
means that you have adequate stores to think and perform in a variety of situations.
You need to eat enough calories and carbohydrate to maintain muscle and liver glycogen
stores. When your muscle glycogen is depleted, you "hit the wall" and feel
overwhelmingly fatigued and ready to quit. When your liver glycogen is depleted you
"bonk" (feel uncoordinated, light-headed, weak, unable to concentrate) because
inadequate glucose is available to the brain.
There is a window after you train where muscles are the most receptive to replacing
glycogen. You should eat 50-100 grams of carbohydrate within 15-30 minutes after
working out to replenish the stores you lost. It will also reduce muscle fatigue and
soreness. By adding 10-40 grams of protein with that carbohydrate, your cells will
absorb the glycogen quicker. The bottom line is that the majority of your diet should
come from carbohydrate sources to insure adequate fuel for performance.
There is no doubt that carbohydrates are essential to your diet. Research indicates that
approximately 60% of your diet should be composed of carbohydrates. However, do not
forget that too much of a good thing can lead to FAT! Excess carbohydrates that the
body is unable to use immediately or in the near future will be stored in the form of fatty
deposits, saved as a store of untapped energy.
CARBOHYDRATE TRUE OR FALSE:
1. Filling up on potatoes and bread will make you fat.
FALSE: Potatoes and bread won’t make you fat if you are eating normal portion
sizes. Their high-fat friends: butter, cream cheese and sour cream will increase
your calories.
2. If the bread label says it is wheat, it must be good for you.
FALSE: Look for labels that say 100% whole-wheat and whole-wheat flour as the
first ingredient. A label that just says “wheat”- fools many people and the first
ingredient is enriched wheat flour. You can also look at the fiber content of the
bread to make sure that it is unprocessed.
3. Sugar is quick-energy food.
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4.
5.
6.
7.
8.
FALSE: Sugary foods may temporarily raise blood-sugar levels, but extra insulin
released to return them to normal often overcompensates, dropping them to lower
than before the snack.
Glycogen is the storage form of carbohydrates.
TRUE: Your body stores carbohydrates in the form of glycogen in the muscle and
the liver.
You need to limit carbohydrates in order to burn fat.
FALSE: The complete breakdown of fatty acids depends on the breakdown of
carbohydrate. When carbohydrate levels in the body fall, the body’s ability to
break down fat also falls.
Only old people need fiber in their diets.
FALSE: Everyone needs fiber in his or her diet. Soluble fiber helps lower
cholesterol, regulates appetite. Insoluble fiber increases regularity and lowers the
risk of colon cancer. Fruits, vegetables and whole grains are great ways to get
plenty of fiber in your diet.
Having high stores of carbohydrates improve performance.
TRUE: Having high stores of carbohydrate gives your muscles and brain plenty of
fuel to perform.
All carbohydrates are broken down the same.
FALSE: Carbohydrates fall into two categories: simple and complex. Simple
carbohydrates are rapidly digested and absorbed. There are good simple
carbohydrates, which include fruit, and milk-, which provide vitamins and
minerals. But most of the simple carbohydrates consumed come in the form of
soft drinks, cakes, cookies and candy-, which provide little more than calories.
Complex carbohydrates (starchy foods) take longer for the body to break downproviding long-term energy. They include bread, rice, cereal, starchy vegetables,
potatoes, dried peas and beans.
Fats
While excess fat is not good for you, fat is still essential in our diets. Fat serves several
functions by providing essential fatty acids, serving as an unlimited energy source,
providing for uptake of fat-soluble vitamins, insulating the body, protecting internal
organs, adding flavor to foods and by making you feel full and satisfied after a meal.
However, fat in the diet, and more specifically saturated fats, have been linked to a rise in
blood cholesterol levels which is a risk factor for arteriosclerosis.
Fats are classified into different groups: monounsaturated, polyunsaturated, saturated and
trans fat. The important difference between each type of fat is how it affects blood
cholesterol levels. All fats are made up mixtures of these, but usually one type
predominates.
 Monounsaturated fats decrease LDL cholesterol without decreasing HDL cholesterol.
This may lower the risk for coronary heart disease. But remember to still eat in
moderation because these fats are high in fat and calories.
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

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Polyunsaturated fats can lower LDL cholesterol, but it also lowers HDL (“good”)
cholesterol. The unsaturated fats generally have a vegetable origin and are liquid at
room temperature.
Saturated fats increase LDL cholesterol and decreases HDL cholesterol. This
combination is not heart friendly. This is a bigger problem than dietary cholesterol.
The easiest way to identify saturated fats is that they are of animal origin and are solid
at room temperature.
Trans Fats are formed when liquid oils are made more solid but not totally solid. This
process is called partial hydrogenation. When oils are partially hydrogenated trans
fats are formed which act like saturated fats; they increase blood cholesterol levels
and may make blood platelets stickier.
Fat is a more efficient fuel than carbohydrate. But in order to burn fat for fuel, you must
have enough oxygen. This means you can only do low-intensity activities burning fat.
The more in shape you are, the higher the intensity you can go with burning fat. You
become more efficient. By using fat for energy, you can conserve glycogen stores.
The following is a list of suggestions that can help reduce your intake of saturated fats
and do not require radical changes in your diet.
 Select very lean meats and trim off the excess fat. Avoid eating large amounts of red
meat.
 Broil, bake or boil rather than fry foods. If you must fry, remember to use
unsaturated fat, i.e., vegetable oil.
 Try to increase the percentage of fish, poultry, mature beans and peas in your daily
intake of protein.
 Use only moderate amounts of eggs and organ meats, i.e., liver, heart and kidney.
 Reduce your intake of foods containing butter fat, i.e., butter, cream, ice cream, whole
milk and cheese (unless otherwise specified).
 Substitute a soft-tub margarine for butter and stick margarine.
 Avoid commercially fried foods.
 Substitute skim or low fat milk for whole milk.
Remember, fat is essential to your diet. In fact, it is recommended that approximately
10% of your caloric intake consist of fat. However, it is most important for you to be
selective in the type of fat you ingest.
FAT FACT OR FICTION:
1. Butter is healthier than margarine.
FICTION: Butter has so much more saturated fat and cholesterol than margarinethat the trans fat the margarine has still doesn’t make it worse than butter. Look
for a margarine that contains a liquid vegetable oil as its first fat ingredient (some
margarine has water as its first ingredient) instead of partially hydrogenated oil.
(Butter has 33mg of cholesterol and 8g of saturated fat per tablespoon and
margarine has no cholesterol and 6g of saturated fat per tablespoon. Margarine
does have more trans fat than butter- 1-3g per tablespoon vs. .3grams per
tablespoon.)
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2. “Choice” and “Prime” cuts of meat are the lowest in fat.
FICTION: Choice and prime cuts are the most tender but they have the highest fat
content.
3. Cutting back on saturated fat is a more important diet strategy than cutting back on
dietary cholesterol.
FACT: Only 20% of cholesterol has a dietary influence; 80% is produced by the
body. Saturated fat promotes the liver to produce more cholesterol.
4. Chicken has less fat than beef.
FICTION: Not necessarily. A skinless thigh contains more than twice as much fat
as an equal serving of an eye of round roast.
5. Olive and canola oil are healthy- so you can eat unlimited amounts.
FICTION: Olive and canola oil are healthier oils, but gram for gram they contain
just as much fat as any other oil- and excess will cause weight gain. They also have
some saturated fat in them, so in excess, they can raise cholesterol levels.
Proteins
Protein is needed to fulfill numerous jobs in the body: building, maintaining, and
repairing muscles and other body tissues; forming antibodies to fight off infection and
disease; and producing enzymes and hormones that help regulate body processes. Protein
can be found in most of the foods we eat every day, like milk, eggs, cheese, meat,
poultry, fish, cereals and vegetables. Therefore, it is rare today to see an individual whose
diet is insufficient in protein. In fact, the opposite is true. Most American diets are too
high in protein content.
The side effects of a high-protein diet are primarily seen in the place that it hurts the most
– your pocketbook. Proteins are normally the most expensive item you consume. If your
diet already meets your protein requirement the extra protein only serves to provide
additional energy or is deposited as fat. It has been argued that physical activity increases
the body's demand for protein, but research to date indicates the increased requirement, if
it exists, is so minor that a well-balanced diet should still easily meet the protein
requirement. In a well-balanced diet, protein should represent approximately 30% of
your diet.
Protein doesn’t want to be used as an energy source. It is inefficient and would rather be
used for tissue growth and repair. If too few calories are consumed or glycogen stores
are depleted, amino acids can be converted to glucose to provide fuel for the muscles and
brain.
High protein diets have been very popular, but the fact is that when you eat so much
protein, it takes longer to digest-, which makes you consume fewer calories. For
performance, this means that you might not eat enough calories in the form of
carbohydrates to fuel your muscles and brain properly.
PROTEIN FACT OR FICTION:
1. Protein builds muscle.
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2.
3.
4.
5.
6.
FICTION: Training and exercise build muscles. If excess calories are
consumed from protein, carbohydrates or fat, the excess is stored as fat, not
muscle.
Eating protein will delay fatigue and prevent the breakdown of muscle tissue.
FICTION: Eating carbohydrates will delay fatigue and prevent the breakdown
of muscle tissue.
The body will use protein for fuel if your glycogen stores are low.
FACT: Your body will use protein, rather than fat, for fuel if your glycogen
stores are too low. This means that you will burn muscle mass for fuel – losing
lean body mass.
The more protein you eat, the more water you need.
FACT: Protein puts stress on the kidneys – so you want more fluids.
Eating protein after working out helps replenish glycogen stores more quickly.
FACT: Eating small amounts of protein along with carbohydrate rich foods
helps replenish glycogen faster and helps with muscle repair.
If you don’t eat enough calories, your body will conserve protein stores.
FICTION: If you don’t eat enough calories, your body will have to use your
lean muscle mass for energy.
Vitamins
The role of vitamins with respect to developing total fitness can be divided into two
broad categories: prevention of disease and regulation of body processes. The first
category is self-explanatory. The second involves the concept that vitamins are essential
to facilitate the various chemical reactions that occur in the body. This can include
reactions that produce energy chemical reactions that build muscle.
Vitamins are divided into two categories: fat soluble and water soluble. Fat soluble
vitamins require the presence of fats in order to be absorbed by the body, while water
soluble vitamins require the presence of water. The fat soluble vitamins can be stored in
the liver if present in excessive amounts, and because of this the potential exists for toxic
levels to be reached. The water soluble vitamins, if present in excess, are eliminated in
the urine. The only negative effect is very expensive urine.
The best recommendation for determining your dietary requirements for vitamins is to
follow the National Nutritional Council Recommendations for maintaining a wellbalanced diet that includes foods from the four major food groups. It is felt that the
necessary types and amounts of vitamins can easily be obtained by this recommendation.
Vitamin supplements are not encouraged unless it is difficult for you to maintain a
balanced diet, and if supplements are to be taken look for those that provide the vitamins
in moderate percentages, or as close to the 100% daily RDA as possible.
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Minerals
Minerals serve two main functions. The first is as actual constituents of the body (i.e.
calcium, magnesium, and phosphorus) which are extremely important to the development
and structure of bones and teeth. Minerals also play an important function in the role of
certain body systems. For example, the proper functioning of our nervous system and the
production of energy both depend on minerals. The recommended daily requirements
(RDA) for minerals, like vitamins, can be met with a well-balanced diet.
Water
Water is not only the most important nutrient; it is also the most abundant in the body.
The water content of your body is approximately 65 to 75%. Water is essential to a
variety of different bodily processes, ranging from controlling body temperature to
serving as a lubricant in joints.
Under normal conditions, you lose a minimum of eight cups of water a day through skin,
lungs, feces, and urine. You can easily lose more every hour during exercise. There is a
built-in control center in the brain that monitors the body’s water requirement. When this
center sends out a signal indicating a need for more water, the individual will become
thirsty. The thirst mechanism works quite well, except in extreme cases where water
depletion can occur quite rapidly. In these cases, a conscious effort must be made to keep
fluid intake up with the body's demand. In addition, it is important to keep in mind the
fact that by the time a person feels thirsty, he or she has already become dehydrated and
will be playing a game of catch-up to correct the situation.
The recommend minimum intake of water is 1-1/2 quarts for an individual who is not
engaged in exercise or exposed to a warm environment. If the individual participates in
physical activity and/or the environmental temperature increases, so does the requirement
for water. Sweating reduces your blood volume even more so. This drop in blood
volume will reduce your ability to take in and use oxygen, which decreases endurance
and the ability to handle heat. These factors may cause the recommended minimum to
increase by a gallon or more per day.
Sweat is more than just water. Sodium and potassium are two important electrolytes that
help your muscles contract and relax. When you are working hard for a long period of
time, you need to replenish your electrolytes or you will throw off your electrolyte
concentration. This can result in muscle cramping and impairment of temperature control.
There are many ways to replenish electrolytes. Plain, cool water is the fluid of choice
when the actual exertion time does not last longer than 60 to 90 minutes. However, it has
been shown that consuming beverages that contain carbohydrate during exercise lasting
longer than 60-90 minutes provides muscles with a ready supply of blood glucose for
immediate energy.
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Sports drinks also provide sodium, which replaces the needed electrolyte and helps speed
the rate at which fluid and carbohydrate empty the stomach. Another benefit is that the
salt keeps your mouth thirsty, and you tend to drink more than if you were just drinking
water.
You want to look for a sports drink containing 6-8% carbohydrate concentration. You
can figure this out by dividing the number of grams of carbohydrate in an 8-ounce
serving by 240 and multiply by 100. If the carbohydrate percentage is too high, your
body has to dilute it (taking away body water) in order for it to pass through the GI tract.
Fruit juice and soft drinks are too high in carbohydrate and too low in sodium.
Under normal conditions the body can adequately regulate body water. But as a
firefighter, water losses are increased acutely with PPE and high heat environment. The
thirst response becomes delayed and dehydration can set in without much warning.
Research has shown that working fire fighters can lose more than 2.6 liters of body fluid
per hour. Drinking about one liter of fluid per hour helps prevent these health effects and
makes it easier to continue performing required tasks. Maintaining a high level of fitness
and decreasing body fat also aid in the efficiency of the body’s ability to cool itself.
Dehydration poses both short and long-term dangers to your health. In the short-term,
your body's cooling system can't work properly which may cause you to overheat, suffer
heatstroke, and possibly die. The skin and muscles compete for blood supply. If your
skin gets the supply it needs then you can cool yourself, but the muscles don’t get the
oxygen they need, and vice-versa. Mental performance is also affected: decision making
skills, eye-hand coordination and skills all suffer.
There are plenty of warning signs that you are suffering heat stress. It is your job to
recognize these and take them seriously. They include: dizziness, headache, cramps,
nausea, increased heart rate, dark urine, premature fatigue, irritability, thirst and dry
mouth.
Dehydration happens in cold weather similarly to hot weather. When you work in the
cold, the peripheral blood vessels constrict to maintain your core body temperature. This
vasoconstriction raises your blood pressure- including in your kidneys, which induces
you to urinate and lose fluid. You also lose fluid through respiration when you are
warming the cold air coming in.
Follow these tips to help stay hydrated:
 Don't wait until you are thirsty before drinking water
 Drink plain water throughout the day
 Avoid beverages containing caffeine
 Drink more than enough to satisfy your thirst
 Keep fluids with you for easy access
 Drink more than you think you need before class or evaluations to make sure you
are fully hydrated
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Body Composition
Deposits of fat on the body serve to protect internal organs and bones from trauma, such
as falls or direct blows. These deposits also serve as stores of concentrated energy to be
called upon in times of need, as well as storage for the fat-soluble vitamins. However, it
is only when these deposits are kept within acceptable limits that they serve a beneficial
function. Outside these boundaries, fat deposits begin to have a detrimental effect on the
health and safety of the body. This manifests as a decreased ability to dissipate heat,
decreased cardiovascular and overall fitness because of reduced activity levels, and
increasing muscle and joint strain.
One study indicated that the percentage of fat that a firefighter carried was one of the
most important factors determining his/her ability to perform assigned job-related tasks.
This finding relates back to the relationship of body fat to physical performance – a
higher percentage of body fat lowers the capacity for physical performance because of
the high intensity levels at which the firefighter must work. Any factor which negatively
affects the physical efficiency of the body, no matter how insignificant it may appear on
the surface, usually has far-reaching implications on actual performance. Therefore, that
extra 1-2% of body fat you carry could make the difference between a good day and a
bad day at your next fire.
The percentage of body fat that is considered acceptable ranges from 15% to 21 % for
men and 19% to 26% for women. Methods for determining appropriate levels of body fat
are varied and some require specialized equipment. There is one method, however,
which requires no specialized equipment and is still accurate enough to be useful.
Known as the pinch an inch test, this involves taking the thumb and index finger and
"pinching" several different sites on the body. If you are able to pinch more than an inch
of skin and underlying fat, your percentage of body fat is considered too high.
Distribution of body fat is also a factor in determining healthy fat levels. Recent data
suggests that patterns of distribution may be an important predictor of health risk.
Individuals with more fat on the trunk, especially abdominal fat, are at increased risk of
hypertension, non-insulin dependant diabetes mellitus (NIDDM), hyperlipidemia,
coronary artery disease and premature death. An apple shape is more common in men,
and a pear shape more common in women.
A method for determining fat distribution is to divide your waist measurement by your
hip measurement (men measure their waste at the belly button, women measure their
waste at the smallest section, and both measure their hips at the widest section), which
gives you your waist to hip ratio. Men with a ratio greater than .95 are said to be apple
shaped, and women with a ratio greater than .80 are said to be pear shaped.
Obesity
Will Rogers once said, "Only two things cause people to become overweight – chewing
and swallowing; and the best exercise for losing weight is pushing yourself away from
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the table." Obesity has become a major concern in our society today because of the
recognition of its relationship to disease and general decrease in the quality of life. This
concern has also spawned a billion-dollar industry which ranges from diet books to
fat-burning solar belts. Obesity and the control of obesity have become increasingly
convoluted as waves of unsubstantiated claims surface to sell a product or service. In our
attempt to sort through these claims and reflect only that data that can be substantiated by
controlled scientific research, we have found that there appear to be three theories about
how obesity comes about: physiological, psychological and environmental. It is felt that,
to some extent, all theories of obesity could apply to almost any case. The difference is
the extent to which each theory contributed.
The physiological theories for obesity are based on the concepts of heredity and
abnormalities within the center for appetite in the brain. One popular thought among
obese people is that their obesity is a result of problems with glands in the body that
control metabolism. Research reveals, however, that very few obese individuals show
any clinical or laboratory evidence of difficulty with the glands. Therefore, no further
discussion will be provided on this topic other than the recognition that it does exist and
accounts for an extremely small percentage of obesity cases.
The importance of heredity at this point is unclear. Studies have shown that children of
obese parents tend to have high risk of obesity, but fall short of determining if genetics
are responsible. Possibly it is the environmental factors in the home that establish the
eating and thought patterns that lead to obesity.
The appetite is thought to be controlled, to some extent, by a center in the brain. If injury
or disease affects this center dramatic shifts in eating patterns may develope, ranging
from starvation to obesity. Presently, this theory is based primarily on animal research
and no conclusive human research has been completed.
The psychological theory is based on the concept that food is often related to pleasure or
satisfaction, replaces feelings of being inadequate, or is seen as a method of relieving
stress or boredom. It is not uncommon for an individual who is nervous about an
impending situation to start snacking in an attempt to deal with the stress.
The environmental theory is based on the concept that our modern society and the
people we interact with greatly influence our tendency to over eat or eat a poor diet. For
example, in our society today, machines are making the necessity of physical activity
almost obsolete. Also, we are constantly bombarded by advertising with the objective of
making you hungry and getting you into the store to buy a product. The immediate
environment you find yourself in is often not conducive to a good diet. Nutritious foods
like fruits and vegetables may be conspicuously absent and are often replaced with junk
foods. Meals are often planned with the concept of quantity rather than quality, and
usually meals are consumed in a matter of minutes.
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Weight Control
The simple concept of weight control is important, but it is also important to utilize a
variety of means to achieve this goal. Too often individuals choose only to work on
changing their diet and not on changing their level of activity as well. The benefits of
physical activity are then lost. If both sides of the scale are affected, the process of
weight loss and control becomes easier and can even be enjoyable.
It is the recommendation of many experts that not only should physical activity be a part
of a sound diet, but also the emphasis of the diet should be on increasing physical
activity. An increase in activity levels, despite popular belief, reduces your desire to eat
in proportion to the energy expended. Therefore, if you exercise more, you will expend
more energy and eat less in return. Vigorous physical activity will also increase the
amount of energy expended during non-active times throughout the rest of the day.
Studies have shown that following vigorous exercise the basal metabolism, or the number
of calories your body burns at rest, is increased 7.5 to 28% for as long as four to six hours
AFTER exercise has ceased. Physical activity also increases general fitness-level, which
is known to produce a better self-image and may increase an individual’s desire to eat a
better diet.
Reduced physical activity and lower metabolic rates (caused by a loss of lean body mass)
contribute to weight gain. When body fat percentages increase, it produces an everdecreasing caloric requirement. Exercise can help you burn calories and offset the loss of
muscle mass.
Weight gain is even more unhealthy for a firefighter than a regular person because there
is more strain on your joints. Especially when wearing PPE, extra body fat requires more
energy to do the same job, and it is a contributor to heart disease – which is already the
number one killer of firefighters and doesn’t allow the body to dissipate heat as well.
WEIGHT LOSS
Changing eating habits can be a very difficult task. It is something we have practiced
every day of our lives. Not many of us can completely abandon how we eat, but there are
ways to make our choices healthier. Here are some ideas for changing habits:
1. Skipping breakfast or grabbing a doughnut: substitute a quick bowl of cereal with
sliced fruit and low-fat or non-fat milk.
2. Eating a whole bag of chips while watching TV: substitute chips with baked
chips or pretzels. Also, limit portion size by pouring the snack into a small bowl.
3. Eating ice cream out of the carton: choose a lower fat substitute such as yogurt,
sherbet or sorbet, and scoop a small amount into a bowl.
4. Eating a whole bag of fat free or reduced fat cookies: replace the same portion
size of reduced fat food for the conventional version. Two non-fat cookies for
two regular cookies.
5. Drinking a double big gulp of regular soda every day: buy a 12 oz can of regular
soda, or change to diet so you don’t get all those empty calories.
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6. Picking up a double cheeseburger with fries and a shake: plan ahead and pack a
balanced lunch. If that isn’t an option, get a small hamburger and milk.
STEPS TO LOSE WEIGHT
 Keep a food diary. Find out what works and what doesn’t for you. Also, selfmonitoring forces you to be accountable for daily actions. It also strengthens your
commitment to the goal of losing weight.
 Reduce your current intake. Don’t reduce by more than 500 calories per day. If
you go too low, you will feel deprived and your body will slow your metabolism
down.
 Eat enough real food. Whole foods are nutrient dense, which means that they
give you energy, vitamins and minerals without giving you too many calories.
There are many drinks and boxed foods that you eat to control your calories, but a
lot of times they don’t satisfy and you end up eating excess calories.
 Eat calories when you need them…during the day! If you eat every 3-5 hours you
keep your metabolism revved up and are more likely to use those calories before
the next meal. If you don’t eat all day, you will usually make it up and then some
at night.
 Eat breakfast. Most people who struggle with weight don’t eat breakfast. It raises
your metabolism first thing in the morning.
 Keep some fat in your diet. You don’t want to drop your fat below 20% of your
daily intake. Excess fat isn’t good for you, but you need some fat in your diet.
 Exercise. Aerobic training complemented with strength training will have you
burning excess calories.
 Control your portions. Realize that the “single-serve” snack or drink you buy is
often two servings. Snack from a bowl or plate, not from the bag. Use smaller
plates and arrange the food so the plate looks full. Share meals when eating out
or take home part of the meal.
TIPS FOR HEALTHIER FOOD ON THE GO
Eating a meal or two at a fast food restaurant is not going to hurt too much, but you can
make healthier choices when going for convenience:
 Do not supersize
 Lose the cheese
 Hold the mayo and “special sauce”
 Go for the grilled chicken instead of the burger
 If you want the burger, get the smaller one
 Consider ordering a baked potato or salad
 Drink water or a small diet soda
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Suggestions for Nutritional Health
So far in this section we have identified the importance of good nutrition to your total
fitness program. We have also discussed the basic components of good nutrition and
their function. The process of weight loss and weight control has also been included.
Now, let's put it all together to plan how we will incorporate it into our everyday lives.
The following general guidelines may prove useful in helping to create a better diet.

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Eat a variety of foods, preferably from the four basic food groups. Doing so
assures you of an adequate intake of all the nutrients you need. If you are unable
to do this, consider supplementing your diet with a multivitamin mineral tablet.
Avoid foods with too much fat, particularly the saturated (animal) fat and
cholesterol.
Eat foods with adequate starch and fiber, i.e., pasta, potatoes, beans, grains, etc.
Avoid too much sugar; instead of candy, try some fruit.
Avoid too much salt, which has been associated with health problems like
hypertension.
Eat meals at regular times; remember moderation.
Avoid the common pattern of no breakfast, little or no lunch and a huge dinner.
It is best to have equal, smaller portion meals more frequently.
Eat slower and chew food more thoroughly to help prevent over eating.
Remember that successful weight control means a permanent change in your
eating habits.
Keep in mind realistic weight loss is one to two pounds a week.
Be sure to engage in some form of regular exercise.
FIREFIGHTER FOOD RECOMMENDATIONS
Before Activity:
 Eat a carbohydrate rich diet- will give greater glycogen stores to draw on and will
delay onset of fatigue.
After Activity:
 Consume about half a gram of carbohydrate per pound of body weight within 30
minutes following activity when body is most receptive to replacing glycogen.
 Add protein- boost the rate at which the body stores glycogen
 After initial recovery- get 50-100 g of carbohydrate every 2 hours until the next
full meal.
FIREFIGHTER FLUID RECOMMENDATIONS
When not on shift:
 For every pound lost drink two 8 oz. glasses of fluid
 Drink 2 ½ cups of water before working outside
 Drink 1 cup of fluid every 20 min while working
 Avoid beverages containing caffeine or alcohol
When at the station:
 Drink plain water throughout the day, avoid beverages containing caffeine
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 Urinate every hour to avoid getting a call with a full bladder
At the fire scene:
 Begin drinking water on your way to the fire
 When fighting fires lasting longer than an hour- drink fluid replacement
 Continue drinking back to the station
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Section 6: Behavioral Health
When we operate at less than optimal levels of health and fitness, our body will begin to
decompensate at some point. It is important to be aware of some negative coping skills
that an individual may employ in order to avoid falling into this trap. Some behaviors to
be aware of, and avoid, are: denial, refusal to ask for help, responding with anger,
developing a negative outlook, assigning blame to innocent bystanders, neglecting to take
care of yourself, sleeping to escape, eating to relieve stress, smoking to relieve stress,
drinking or using drugs to relieve stress, and blowing things out of proportion. This
section discusses some behavior modifications that will help enable you to most
effectively handle all the stresses of life in EMS.
Positive Coping Skills
A logical place to start is with positive coping skills. Here are some ideas to that end:
 Identify negative thoughts and replace them with positive ones.
 Surround yourself with positive people when you can.
 Make time just for you.
 Talk to someone who will really listen.
 Use outside resources when necessary.
 Practice relaxation techniques.
 Practice healthy habits.
 Pick up an outside interest or hobby.
 Laugh!
 Learn to better manage your time.
 Practice acting like a relaxed person, even if you are not.
 Stop saying yes to everything.
 Plan a day once in a while where you do absolutely nothing.
 Take a yoga, pilates or Tai-Chi class.
 Stop judging others by your values.
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Techniques to Manage Stress
Positive coping mechanisms help us manage stress in the short-term and the long-term,
and are healthy for our minds and bodies. Try to use these as much as possible to help
cope with the stressors in your life:
 Realize that stress comes from response to pressure. No one can put undue
pressure on you unless you accept it. It is important to know your breaking point
and eliminate any obligations that take you over this point.
 Learn to say no. It is okay to say that you are too busy, most importantly if it is to
free up some time for just yourself.
 Make a list of stresses and simplify. Keep a stress journal. Figure out what you
must live with and what you can eliminate. Simplify in order to have more time
for yourself.
 Look at your problems objectively. Some we have control over, others we don’t.
 Seek support before you feel overwhelmed. Social support is very important in
dealing with stress. Everyone needs someone to talk to, and there’s no greater
medicine than the healing power of love and intimacy.
 Choose your battles wisely. Save an argument for things that really matter, and
don’t waste your energy on pointless arguments.
 Use humor. Laughing releases the tension of pent-up feelings and helps keep
things in perspective.
 Take time off. Take a vacation or a long weekend. Take breaks during the
workday. Take short breaks to stretch, walk, breathe slowly and relax.
 Recognize warning signs and pay attention to them.
 Exercise as a form of stress release.
GETTING HELP
There are many ways to seek support. Here are a few ideas:
 EAP’s (Employee Assistance Programs) can address a wide range of issues
pertaining to the health and well being of active and retired uniformed personnel
and their families.
 Chaplains help uniformed personnel and their families in time of crisis, and help
them with their spiritual needs.
 Peer counseling can greatly aide personnel.
SUBSTANCE ABUSE
ALCOHOL
Alcohol is by far the most abused substance. Alcoholism has been recognized as a
treatable disease by the American Medical Association since 1956. Because it is a
progressive illness, it takes time for alcoholism to become a chronic problem resulting in
deteriorating job performance.
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If you have a parent or grandparent with alcoholism, you may have approximately four
times greater risk for developing alcoholism than people without a family history of
alcoholism.
There are both risks and benefits to drinking alcohol. According to the American Heart
Association, the incidence of heart disease in people who consume moderate amounts of
alcohol is lower than the rate for nondrinkers. Alcohol can have a relaxing effect and
increases HDL cholesterol levels (the good kind). Research is showing that all types of
alcohol, not just red wine, can elicit the decreased risk of heart disease if consumed in
moderation.
However, with increased consumption of alcohol, there are increased impairment-related
and health-related dangers. The benefits are only achieved from drinking no more than
one to two drinks per day. Health benefits are not achieved in groups of drinkers who
normally drink one to two drinks per day, but occasionally binge on four or more per
sitting.
The health benefits of alcohol are substantially smaller than those offered by exercise and
eating right! The official government stance, as presented by the US Department of
Agriculture and the US Department of Health and Human Services, is to refrain from
making any recommendation to drink. But, the agencies add, “If you do chose to drink
alcohol, do so in moderation. Moderation is the operative word, since the benefits
decline as both consumption and dependency increase. The difference between a little
alcohol and a lot may be the difference between preventing premature death and causing
it.
Effects of heavy drinking on the body:
 Cirrhosis of the liver
 Brain cells in various centers die and do not regenerate
 Reduces reaction time, spatial perception and complex reasoning
 Increased risk of stomach and intestinal ulcers
 Blood pressure increases
 Sperm production decreases
 Emotional problems increase
 Cancer of the esophagus, mouth and larynx
 Reduces cognition and memory
 Increased risk of pulmonary infections
 Varicose veins
 Kidney failure
 Anemia
 Abnormal blood clotting
 Atrophy of muscles
 Irritable when not drinking
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Effects of daily drinking:
 0 per day: Live longer than people drinking three or more per day
 1-2 per day: No known increased risk for men
Increased risk of breast cancer for women
 3 per day: Blood pressure increases
Heart disease increases
Shortens life span
 4 per day: Cirrhosis increases
 5 per day: Pacreatitis increases
Much shorter life span
 6 per day: Cancer of mouth, throat, and digestive system increases
When death rates are compared among heavy drinkers (three plus drinks per day) to those
who drink moderate amounts of alcohol (1-2 drinks per day), studies have shown that
heavy drinkers may be at greater risk of dying from certain cancers. The risk of cancer is
magnified when a person combines heavy drinking and smoking.
What about the beer belly? Many people think that alcohol, distilled from grain, is
treated as a carbohydrate. Instead, alcohol is treated metabolically as fat. One ounce of
alcohol is treated as one half ounce of metabolized fat. For every gram of alcohol, there
are 7 calories. Therefore, it is not surprising that many people that like their alcohol gain
excess fat; often in the “belly” region. Remember that light beers have almost the same
amount of alcohol as regular beer. So even if you are getting fewer calories, the majority
of them are being processed as fat.
TOBACCO
If you smoke, the decision to stop smoking is probably the single most important step you
can take to reduce your risk of heart disease and improve your overall health. Smoking
adversely affects both the cardiovascular and respiratory systems. The firefighter, as a
result of job responsibilities, is likely at some point in time to involuntarily be exposed to
toxic smoke and fumes. Subjecting your body to voluntary introductions of toxic smoke
and fumes only increases your risk of contracting a disease that can affect your ability to
function at work, and decrease your quality and enjoyment of life overall. It has been
shown that the average age of heart attack victims who smoke is ten years less than that
of non-smokers. The decision to quit smoking should be an easy one when you consider
the facts, however the problem lies in following through on that decision.
Cigarettes and other forms of tobacco are addictive. Physically, nicotine’s addictive
nature is due to its stimulation of the brain and heart. Psychologically, cigarette use is
reinforced by specific activities and social interactions.
Why is nicotine so addictive? It acts as a mood leveler, works as a primary means of
coping with stress, reduces aggressive and stressful responses, suppresses appetite and
weight, and improves general performance and memory in the addicted smoker. Nicotine
reaches the brain within 8 seconds after someone inhales tobacco smoke. Milligram for
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milligram, nicotine is more potent in producing these effects than amphetamines, cocaine
or heroin.
Long-term smoking raises blood pressure, dulls sense of smell and taste, reduces stamina
and wrinkles your skin. It can lead to fatal heart attacks, strokes, emphysema, and
cancer. Tobacco use causes far more illnesses and death than all other addicting drugs
combined. One out of every six deaths in the United States is a result of smoking.
Smoking just once or twice a week can still have negative effects on their health. People
who smoke less than a pack a week seem to have just as much blood vessel damage as
those who smoke a pack each day or more. Smoking interferes with the lining of blood
vessels and can cause atherosclerosis.
Men who smoke between six and nine cigarettes each day and women who smoke
between three and five double their risk of heart attack. Smoking can interfere with
estrogen- so the risk for women is higher.
Smokeless Tobacco
One pinch held between your cheek and gum for 30 minutes puts the same amount of
nicotine in your body as if you smoked three cigarettes. Chewing is more addictive and
harder to quit than smoking cigarettes. Smokeless tobacco increases the risk for cancers
of the lip, tongue, cheeks, gums, and the floor and roof of the mouth.
Studies have shown that about 7% to 27% of regular smokeless tobacco users have gum
recession and bone loss around the teeth. Up to a certain point, if you quit, your body can
heal itself, but the longer you chew, the bigger your risk of getting cancer. Once you get
mouth cancer it spreads very quickly. If not caught right away, major surgery is often
needed to take out parts of your mouth, jaw and tongue.
See your doctor or dentist if you have:
 A sore that bleeds easily and doesn’t heal
 A lump or thickening anywhere in your mouth or neck
 Soreness or swelling that doesn’t go away
 Trouble chewing, swallowing, or moving your tongue or jaw
Even if you don’t inhale, cigars still can be harmful to your health. All cigar smokers,
whether or not they inhale, directly expose the lips, mouth, tongue, throat and larynx to
smoke and its carcinogens. When saliva containing smoke constituents is swallowed, the
esophagus is exposed to carcinogens. Large cigars typically contain between 5 and 17
grams of tobacco while cigarettes contain less then one gram of tobacco each. Alcohol
with cigars dramatically increases the risk of mouth and throat cancer.
Find out from your local department what resources you have for smoking cessation.
The following are tips to help you quit:
 Make the decision to quit.
 Plan ahead (start 2 weeks before).
 Make a list of your reasons for quitting.
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Place a list of stumbling blocks and brainstorm how to avoid them. What tripped
you up before in a previous attempt to quit?
Pick a stop date. Make it special. Pick a day that has meaning for you. Choose a
day that will not be too stressful for you.
Use less. Cut back on the amount you are already using.
Avoid peer pressure.
Remember the reasons you are quitting.
Ask family and friends for support.
Use substitutes - find other ways to satisfy your oral fixation (cinnamon sticks,
gum, etc.)
Don’t give in to cravings - find other activities to do in place of smoking.
Talk to your doctor or dentist. They can prescribe medication and talk to you
about what would be the best choice for you.
Medication help
There are many options for you to choose from.
Non-nicotine Treatments: Zyban
 Nicotine-free pill that helps reduce withdrawal symptoms from nicotine by
increasing the levels of serotonin, norepinephrine and dopamine.
 Should only be used for 6 weeks.
 Long-term side effects include insomnia and bad dreams.
 Should not be used by people who have had closed head trauma, seizures, eating
disorders or heart disease.
Nicotine Replacement Treatments: patch, gum, inhalant or nasal spray
 Goal is to prevent the onset of withdrawal symptoms and reduce nicotine
cravings.
 Studies have shown that, in combination with counseling, these methods can
double your chances of staying permanently off cigarettes.
 Not likely to form an addiction to nicotine replacement treatments.
If you do start smoking again, don’t give up. Many smokers try to quit several times
before they succeed. Try to understand what made you start smoking again, and try
again.
There are many sources of support in the private sector, including the Bureau Employee
Assistance Program, and the Risk Management Health and Fitness Program, to help you
once you have decided to quit. In addition, the IAFF has The IAFF Smoking Cessation
Manual: Issues, Policies, and Programs to assist in smoking cessation efforts.
Sleep
Sleep plays a major role in preparing the body and brain for an alert, productive,
psychologically and physiologically healthy day. It is essential for health and well-being.
But as a firefighter, it is challenging to get enough quality sleep. If you are up once or
more during the night, this disrupts the natural wake-sleep pattern. Sleep is more than
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just “beauty rest” for the body, it helps restore and rejuvenate the brain and organ systems
so that they function properly.
The human body naturally follows a 24-hour period of wakefulness and sleepiness that is
regulated by an internal clock called a circadian rhythm or clock. In fact, the circadian
clock is linked to nature’s cycle of light and darkness. The clock regulates cycles in body
temperature, hormones, heart rate, and other body functions.
Our desire to sleep is strongest between midnight and six a.m. For most people, it is
difficult to concentrate and maintain alertness at night and to sleep during the daylight
hours. Many people are alert in the morning, with a natural dip in alertness in the midafternoon. Because of this alertness in the morning, it makes it hard to obtain long blocks
of daytime sleep- not to mention that noise, sunlight, and obligations can interrupt or cut
sleep short. As a result, quantity of sleep suffers. What is less well known is that sleep
quality suffers during the daytime. People spend less time in the deeper stages of sleep,
which are critical for recovering from physical fatigue.
If three or more of the following describe you, it’s possible that you need more sleep.
1. I need an alarm clock in order to wake up at the appropriate time.
2. It’s a struggle for me to get out of bed in the morning.
3. Work mornings I hit the snooze button several times to get more sleep.
4. I feel tired, irritable, and stressed-out.
5. I have trouble concentrating and remembering.
6. I feel slow with critical thinking, problem-solving and being creative.
7. I often fall asleep watching T.V.
8. I often fall asleep in meetings, drills and in warm rooms.
9. I often nod off after heavy meals or after a low dose of alcohol.
10. I often fall asleep while relaxing after dinner.
11. I often fall asleep within five minutes of getting into bed.
12. I often feel drowsy while driving.
13. I often sleep extra hours on the mornings I don’t have to go to work.
14. I often need a nap to get through the day.
15. I have dark circles under my eyes.
Firefighting is a demanding job that doesn’t have set work hours. You never know when
you are going to get a call- and you can’t afford to not be aware and alert. You know that
your job is going to affect the quality and quantity of your sleep. The next step is to
become aware of the effects of chronic lack of sleep on your body:
 GI difficulty
 Ulcers
 Fatigue
 Irritability
 Depression
 Anxiety
 Lower social and emotional wellness
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Higher Risk of:
 High cholesterol
 Heart disease
 Hypertension
 Accidents
Aggravates:
 Diabetes
 Epilepsy
To help maintain a healthy lifestyle within the fire service, utilize the following
strategies:
 Go bland before bedtime – drink water instead of coffee.
To fall asleep quickly, avoid caffeine, nicotine and alcohol for at least four
hours before you go to bed. Caffeine and nicotine are stimulants and can keep
you from falling asleep. Alcohol can cause waking in the night and interferes
with sleep quality.
 Be predictable
Go to bed at the same time every night and wake up the same time every
morning including weekends. Keeping a regular schedule will make you feel
significantly more alert than sleeping for the same amount of time but at
different hours across the week and weekend.
 Don’t toss and turn
If you can’t sleep after 20 minutes, get out of bed and read or do something
that is not overly stimulating until you feel sleepy.
 Save the bed for sleep
Avoid paying bills, reading the paper or watching TV in bed.
 Exercise early
Exercise should take place two to three hours before bedtime and preferably
before dinner. It can provide stress reduction to help you sleep and also will
raise the body’s core temperature, which can lull the body to sleep.
 Get dark
People usually sleep best in a cool, dark, quiet environment.
 Deal with stress
If you have trouble lying awake worrying about things, try making a to-do list
before you go to bed. This may help you to “let go” of those overnight
worries.
 Take responsibility
You can reduce the impact of shift work on your sleep and health by actively
taking the right steps.
 Understand your sleep schedule
How many hours do you need to sleep?
 Make sleep a high priority
Leave the all-nighters and late night partying to others whose job doesn’t
depend on alertness.
 Eat a healthy diet
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
Give yourself the fuel you need to succeed.
Exercise regularly
Helps you feel more awake during the day and improves quality of sleep at
night by raising core body temperature, lulling the body to sleep.
Talk to other firefighters
See what has worked for others.
In conclusion, general health and wellness consists of a combination of factors and
behaviors, many of which are under your control, that work together to create a healthy
mind, body and spirit. Winston Churchill once said “healthy citizens are the greatest
asset any country can have.” Similarly, a healthy firefighter is the greatest asset to his or
her department and partners. Take care of yourself first, and the rest has a way of falling
into place.
The following list contains a short summation of suggestions for you to consider
implementing at work and in your entire life style:
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Behavior Modification
Forget the smoke-eater image. WEAR YOUR SCBA! There is nothing macho
about the slow death of cancer.
Stop cigarette smoking.
Stop chewing tobacco.
Go easy on alcohol.
Respect the sun's rays.
Decrease salt-cured, smoked, and nitrate cured foods from diet.
Trim fat from your diet.
Eat more cabbage-family vegetables.
Add more high-fiber foods.
Choose foods with vitamin A and C.
Keep fitness levels up and body fat down.
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Appendix
Quick Drills
Personal Stress inventory
PAR-Q: Physical Activity Readiness Questionnaire
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54
52
Personal Stress Inventory
This personal inventory will help you become more aware of your responses to stress, life events that may impact your stress level, and how you
cope with stress. There are no right or wrong answers; instead, the scoring system is designed to give a general indication of stress levels and to
help you focus on those unhealthy responses that could be changed through improved stress management techniques.
Part I: How Do I Respond to Stress?
Cognitive (Thinking) Responses to Stress
Circle the letter that most appropriately applies to you:
1. I can't concentrate on what I'm doing.
N R S OA
N: Never R: Rarely S: Sometimes O: Often A: Always
2. I forget things or I get confused.
N R S OA
Physical Responses to Stress
1. I have frequent headaches.
3. My thoughts seem to race.
N R S OA
N R S O A
4. This isn't where I want to be in my life.
N R S OA
2. I get stomachaches or experience discomfort.
N R S O A
5. I worry a lot.
N R S OA
3. My back aches.
N R S O A
6. I have recurring, troublesome thoughts.
N R S OA
4. I have stiffness in my shoulders or upper back.
N R S O A
7. I can't turn off my thoughts at night and relax.
N R S OA
5. My blood pressure is elevated.
N R S O A
8. I have trouble sleeping because of things on my
mind.
N R S OA
6. I get palpitations or a rapid heartbeat.
N R S O A
9. Things must be perfect.
N R S OA
7. I get short of breath and breathe rapidly.
N R S O A
10. I must do it myself.
N R S OA
8. I feel dizzy or shaky.
N R S O A
9. I'm fatigued, tired, or unrested.
N R S O A
10. I feel "wound up," and tense inside.
N R S O A
Total Number O's and A's circled:
Total Number O's and A's circled:
Emotional (Feelings) Responses to Stress
1. I feel depressed, sad, and unhappy.
N R S OA
2. I can't say no without feeling guilty.
N R S OA
3. I feel worthless, disappointed in life and myself.
N R S OA
Behavioral Responses to Stress
1. I eat compulsively or too fast.
N R S O A
4. I don't get a sense of accomplishment most days.
N R S OA
2. I light up a cigarette.
N R S O A
5. I feel trapped.
N R S OA
3. I drink alcohol or use mood-altering drugs.
N R S O A
6. I can't seem to share my feelings with
family/friends.
N R S OA
4. I grind my teeth.
N R S O A
7. I feel exploited, used by others.
N R S OA
5. I clench my fists.
N R S O A
8. I'm afraid of things that didn't used to bother me.
N R S OA
6. I pace, walk rapidly, or rush.
N R S O A
9. I feel cynical and disenchanted.
N R S OA
7. I tap my feet.
N R S O A
10. I feel agitated, irritated, short-tempered, impatient. N R S O A
8. I sleep a lot, or have trouble falling asleep.
N R S O A
9. I sulk and don't talk to people.
N R S O A
10. I snap back or get angry with others.
N R S O A
Total Number O's and A's circled:
Total Number O's and A's circled:
Scoring Interpretation: Total the number of circled responses in the columns indicating frequent reactions to stress (O: Often and A: Always).
Those reactions will most likely be the first to alert you that you are experiencing excessive stress.
Notice which category (physical, cognitive or emotional) has the most O's and A's. For example, if you have more frequent reactions in the
physical category, you may want to become aware of those tensions spots and learn about relaxation or biofeedback techniques to reduce stress.
By simply becoming aware of your signs of stress, you'll be taking a major step toward better managing your stress level.
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PAR-Q
Physical Activity Readiness Questionnaire
Name:____________________________ Date:________________________________
PAR-Q is designed to help you help yourself. Many health benefits are associated with
regular exercise, and the completion of PAR-Q is a sensible first step to take if you are
planning to increase the amount of physical activity in your life.
For most firefighters physical activity should not pose any problems or hazard. PAR-Q has been
designed to identify the small number of firefighters for whom physical activity might be
questionable or those who should have medical advice concerning the type of activity most suited
for them.
Honesty is required in answering these questions. Please read them carefully and circle either
Yes or No opposite the question as it applies to you.
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
Yes
Yes
Yes
Yes
No
No
No
No
1. Has your doctor ever said you have heart trouble?
2. Do you have any noticeable pain in your heart and/or chest?
3. In the last three months have you felt faint or had a dizzy spell?
4. Has any health professional ever said your blood pressure was too high?
5. Has any health professional ever told you that you have a bone or joint problems
that has been aggravated by exercise, or might be made worse with exercise?
6. Do you take any medication on a daily basis?
7. Have you gained or lost more than 15lbs in the last month?
8. Are you over 45 and eliminated any form of vigorous exercise?
9. Is there a good physical reason, not mentioned here, why you should not follow a
general firefighter workout program even if you wanted to?
IF YOU ANSWERED YES:
If you have not already done so,
consult with your personal
physician by telephone or in person
before increasing your physical
activity and/or taking a fitness
evaluation. Tell your physician
what question(s) you answered yes
to or take a copy of this PAR-Q
with you.
After medical evaluation, seek advice from
your physician as to your suitability for:
- Unrestricted physical activity which starts easy and
progresses gradually.
- Restricted or supervised activity to meet your
specific firefighter needs, at least on an initial basis.
- Ability to work with a Peer Fitness Trainer for
special programs and/or services.
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IF YOU ANSWERED NO:
If you have honestly answered PARQ, you have reasonable assurance of
your present suitability for:
A GRADUATED EXERCISE
PROGRAM OR A FITNESS
EVALUATION
Postpone:
If you have a
temporary minor
injury or illness
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