1. Back Health and Safety Back Health and Safety Why is this Important to firefighters?

2. What do you lift?

3. Topics Injury Statistics Anatomy How do back injuries occur? Injuries Signs & Symptoms DiagnosisTreatmentRehabilitationPrevention Lifting Safety

4. Stats Injury Rate –2.9% of 4,411 reported injuries Based on 2004 NFIRS 5.0 data –73% occurred on scene –38% occurred outside the fire building L&I –1/3 of all claims –½ of all insurance dollars collected Cost –Direct Lost wages if benefits exceeded Overtime, above paying injured firefighter Medical Costs Time spent investigating incident and filing report Litigation costs –Indirect PPE PPE maintenance Cost of training Insurance administrative costs Return to Work Status –Depends on severity of injury

5. Anatomy Parts and Pieces C1 - C7 T1 - T12 L1 - L5 S1

6. How do back injuries occur? Improper lifting technique Lifting too heavy Improper weight lifting Repetitive movements or a Single event –Bending –Stooping –Lifting / Twisting –Lifting in Awkward positions

7. Injuries Types –Annular tears –Internal disc disruption –Herniated disc –Facet joint arthritis –Segmental instability –Spinal stenosis –Foraminal stenosis

8. Signs & Symptoms Low back pain Pain spreading into the buttocks and thighs Pain radiating from the buttock to the foot Back stiffness and reduced range of motion Muscle weakness in the hip, thigh, leg, or foot Sensory changes (numbness, prickling, or tingling) in the leg, foot, or toes

9. Diagnosis X-rayMRIMyelogramDiscogram

10. Treatment Options –Rest –Back brace –Medications –Epidural Steroid Injection (x3 over 12 months) –Physical Therapy –Surgery LaminectomyDiscectomy Lumbar Fusion

11. Rehabilitation Electro-shock therapy Medications –Pain killers –Muscle relaxers Physical Therapy –Stretching –Strength training –Job related task analysis

12. Prevention Exercise –Exercise Safety –Back Safety Principles: Stretching & Strengthening Proper lifting Technique

13. Exercising Safety Always assume proper lifting form Make sure there are no obstructions in the lifting area Wear proper footwear to ensure stability Avoid horseplay Follow a proper progression of weight advancement Concentrate on your exercises Use as much resistance as possible without sacrificing proper technique Stay in control and lift through a full range of motion Moderate muscle soreness is normal

14. Exercises Stretching / Range of Motion HamstringsLegs/CalfHips/ButtocksAbdominals

15. For the back Bent Over Row Transverse Extensions Roman Chair Torso Lifts

16. For the legs Leg press Leg extensions SquatsLunges Calf raises

17. For the Abs Crunches Leg lifts Leg lift and raise Planking exercises Balance / Stability

18. Yoga Stability Ball Bosu Ball Any exercise that alters your center of balance –One leg standing row –One leg sissy squats –Toe reaches

19. Proper lifting technique Size-up Plan your move Have a solid base Bend at the knees Have a good grip Lift with your legs Keep the load close

20. My Back Injury Injury Occurred on March 31, 2007 (C Shift) –Drilling for JATC @ station 35 LDH hose lays Fire hose up a ground ladder Back bothered me after drill Worked next day (back bothered me) –Told co-workers that I was having pain –Rested over the next few days –On my third day off could not get out of bed (4/5/07) –Went to OHS Renton to see Dr. Hasanoglu DrugsMRI Assign to light duty April 10, 2007 –Training Division pin cushion Back to shift June 29, 2007