BRYAN FASS, ATC, LAT, EMT-P, CSCS
LESSONS FROM THE FIELD —
A PERSONAL RETROSPECTIVE
Public safety is a profession for a very unique group of individuals.
If you have worked on the street, it is a calling. I was called to
public safety, paramedicine specifically, during my clinical practice
days. I began my journey as an athletic trainer who focused on
spine rehabilitation, chronic pain, and sports performance. Early
in my career, I spent time in various outpatient clinics where I
picked up techniques and methodologies for decreasing pain and
returning my patients to normal function.
It was early in my clinical days that I earned my Certified Strength
and Conditioning Specialist® (CSCS®) certification which helped
me to refocus on my roots of strength and conditioning. During
this stretch, I was also introduced to a lot of alternative medicine
techniques and became certified in a number of manual therapy
techniques. Nutrition also became a clear link to pain and
performance during this time.
Eventually, I became unchallenged and, like many, I wondered
about medical school and the prospect of becoming a physician
assistant (PA) or physical therapist (PT). So an easy path to get
some additional experience outside of the rehabilitation realm
was to “get my patch.” So into paramedic school I went, and 16
months later I emerged as a newly minted, wet behind the ears,
and frankly, scared medic. This is where my education truly began.
Enter the world of public safety, fire and Emergency Medical
Services (EMS), and law enforcement. Enter a world where
everything I know to be true, just, proper, and proactive does
not exist. It is a world where sleep, coffee, and fast food are an
accepted way of life; a world where fitness and wellness makes
you an outcast; and I realized that I did not fit the “mold.” Back
then, catchy phrases like “tactical athlete” and “tactical facilitator”
did not exist.
For eight years, every weekend I would leave my scrubs at home
and gear up into my uniform and leave the safe clinical world
behind to work as a paramedic. Every shift and every call was an
education in the inner workings of the human body and humanity.
I also had the privilege of working with some truly amazing and
dedicated individuals that would and did lay their lives on the line
for complete strangers. I also had the privilege of helping many
of my partners, peers, and brothers in all services begin to heal
themselves. Almost all of these responders had let their bodies
go: sleep was far more important than exercise to them, and they
ate a lot of food from the gas station. They all had some sort of
pain and injury. All of them had sustained multiple soft tissue
injuries from patient and equipment handling, and the only path to
retirement was medical disability.
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For 14 years, I have had the privilege of learning from and helping
our dedicated first responders; so what have I seen and learned?
1.
There is what you should do and what you could do: I would
love to ask my responders to lay on the floor and stretch,
do some focused spine stabilization, and maybe some core
work but many first responders are also inherently lazy and
the floor is probably dirty. Keep the stretches functional,
quick, and very job-specific. Even better, if you can tie it to
their apparatus or the TV, your success rate will skyrocket.
2.
Exercise is still mired in gym class, football practice, or
academy physical training: Almost all first responders we
have trained across the country will ultimately relate fitness
to what they did or learned in the past. In many cases, their
idea of exercise will be filled with bad experiences and
pain or injury was involved because they were ultimately
coached poorly. For other ex-athletes that revert to their
competitive training programs from years past, they should
proceed with caution. Important variables such as training
intensity and exercise selection should reflect current goals
and be realistic given their time away from training. Design
exercises that are progressive, easy to perform, include all
personnel, and can be done with simple equipment.
3.
Everything gets donated (or made): I cannot tell you
how many departments and bases we have gone to and
simply had our jaws drop, and not in a good way (although
there are a few that make coaches very happy). Most
departments have been “given/donated” equipment that
is so old, poorly designed, rusty, or simply broken that it is
sometimes dangerous. When we as a profession of tactical
facilitators make recommendations and “design” programs,
please keep in mind that behind the scenes this is what
many tactical athletes have to work with.
4.
There is no exercise that is truly job specific: This is a tough
one and always open for debate—I for one have spent
countless hours trying to come up with a solution. For
example, how do we create/modify/use an exercise that
will prepare the body to lean over a bathtub at 03:30 (after
running 16 calls already) and rapidly extricate a patient that
has gone into cardiac arrest and needs cardiopulmonary
resuscitation (CPR) immediately. Also, the patient is in one
of those old ranch style homes that was built in the 1960s
with a very small bathroom. So only two people can get
into the room and the patient is wet and they are covered
in excrement—welcome to the real world. The tissue
torques and loads placed on these two responders, who
NSCA’S TSAC REPORT | ISSUE 33