Getting Firefighters Back on the Job Following an Injury

By: Robert Avsec, Executive Fire Officer

A firefighter injury can happen, even with the best of efforts by the person and their department. This despite having firefighter injurytop-notch personal protective clothing and equipment, well-developed SOGs, and equally well-developed training and education

Why? Because despite these positive measures, and others such as physical training programs, the job requirements are still physically demanding for the individual. The risk of physical injury escalates as the firefighter becomes fatigued. “A tired firefighter is a firefighter injury waiting to happen.”

I’ve often told my student firefighters during training sessions that a firefighter is very much akin to a linebacker in football. The linebacker must be the most versatile athlete on the field for their team because they must be strong enough and fast enough to stop a running play, while being agile and fast enough to cover a running back or receiver on a pass play. And both of those defensive functions need great stamina.

Do you see the parallels now? Firefighters must also have the physical skill set to do physically demanding, and often hard, work for extended periods of time. They must have the flexibility and agility to do that work in tight spaces or elevated positions.

And like the linebacker who must go right back on the field because their offensive team just ran three plays and a

punt, the firefighter must often take a quick break (rehab) before getting right back to work (due to a limited number of available firefighters on the scene).

The Denver (Colo.) Fire Department has embraced this paradigm in their new approach to getting injured firefighters “back in the game.” The Denver department has taken best practices in how athletes in professional sports are assessed and treated following injuries and created its own program focusing on:

  • Preventing firefighter injuries, particularly those caused by overexertion;
  • Returning injured line firefighters to duty more quickly; and
  • Reducing the department’s worker’s compensation costs.
Positive Results for Denver Fire Department

According to a December 2016 story published in the Denver Post, the Denver Fire Department saw a 42 percent decrease in worker’s comp claims from overexertion as well as the cost of treating injuries to lower backs, shoulders and knees (Which, along with overexertion, accounted for the majority of the department’s worker’s compensation costs).

Keys to Denver’s Success

Denver fire department’s leadership “bought into” the similarities between firefighters and professional athletes. Professional sports teams have long recognized that the key to getting their athletes back on the playing field is aggressive treatment followed by equally aggressive physical therapy. Professional athletes return to action more quickly because they report for physical therapy every day.

In most fire departments, the traditional path for the injured firefighter has been removal from active duty, rest at

DENVER, CO – December 14: Jackie Fehr ,Denver Fire Department fire fighter and peer fitness trainer doing a hurdle step watched by director of the physical therapy department, Casey Stoneberger, during a functional movement screen at the Rocky Mountain Fire Academy. December 14, 2016 Denver, CO. (Photo By Joe Amon/The Denver Post)

home, and then physical therapy 2-3 times per week at a facility with no affiliation with the department. The determination for when a firefighter can return to active duty is primarily in the hands of disinterested third parties, e.g., treating physician and physical therapist.

Denver has taken a completely different approach. First, they conducted a pilot project for a new departmental wellness program. That pilot project spent two years looking at how injuries could be prevented and how the department could return firefighters to full duty more quickly when they did get injured.

Following the completion of the pilot project, the fire department launched its new in-house wellness program. A fire department lieutenant coordinates the program, which covers fitness and behavioral health, along with two physical therapists, who are also fire department employees.

Lt. Shawn Brooks, the program coordinator at the time of the Post’s article, was quoted as saying that those physical therapists see about 230 people a month at that time. He also said that often firefighters drop by after a shift to ask for therapy or specific exercises for an injury they may have suffered that day.

Begin with the end in mind

Denver Fire’s wellness program is open to everyone in the fire department, and new firefighters are introduced to it on their first day at the department’s training academy.

The wellness program staff run every recruit through seven tests that evaluate functional movement (Like such tests developed by the NFL and now widely accepted in other sports). Those movement tests involve lunges, squats, steps and reaches that measure coordination, flexibility and motor control needed on the job.

Denver Fire modified those tests to more closely relate to the job requirements of a firefighter: climbing on to and off of fire apparatus; wearing PPE and SCBA while working; hoisting equipment with ropes; and advancing charged hose lines.

The results of the evaluations were then used by the wellness program staff to develop individualized physical training programs for those entry-level firefighters while they are in training.

The wellness program also addresses the needs of incumbent firefighters. Along with the functional movement testing, the wellness staff also instructs firefighters in the correct techniques for lifting, pulling and moving, the activities that most often contribute to a firefighter injury.

Program Benefits

When a firefighter is injured in the line of duty, it’s more than just a physical injury. First, there’s the injury to the firefighter’s psyche. Firefighters closely identify with the job; how often do we hear them say that, it’s not a job, it’s a calling? For most firefighters, not being physically able to answer their calling is more traumatic than just not being able to do a job.

Then there’s the separation anxiety. In a workplace culture where teamwork and camaraderie are such critical elements, being separated from one’s team for weeks or months following an injury is in many ways more significant than the physical injury.

As I learned about Denver Fire’s wellness program, it immediately struck me that they may have found the “silver Abullet” for dealing with firefighter injuries. Yes, there’s the emphasis on prevention education and physical training, but in my mind, it’s much bigger than that.

I believe their program, with its in-house staff and open accessibility to that staff and their resources, is a big factor changing the way that firefighters recover physically from an injury. More importantly, the program’s setup helps the injured firefighter deal with the separation anxiety aspect of their injury.

Rather than being relegated to being at home and going to physical therapy a couple of times per week, the injured Denver firefighter remains within the department’s “sphere of influence.” Think about it:

  • Fire department employees—their colleagues—provide their care and physical therapy. They’re still part of a fire department team, albeit just not their regular team.
  • They’ve got a job with a purpose: working hard every day—doing physical therapy—with an end goal in mind. And it’s an end goal that they can buy into: returning to the job they love doing.
  • Their teammates back at the fire station can know and respect that their teammate is working hard and with a purpose: to rejoin the team

Certainly seems to be a firefighter wellness program with many upsides, no?

About Robert Avsec, Executive Fire Officer

Battalion Chief (Ret.) Robert Avsec served with the men and women of the Chesterfield County (VA) Fire and EMS Department for 26 years. He’s now using his acquired knowledge, skills, and experiences as a freelance writer for FireRescue1.com and as the “blogger in chief” for this blog. Chief Avsec and his wife of 30+ years now make their home in Cross Lanes, WV. Contact him via e-mail, rpa1157@gmail.com.