HOW TO MANAGE AND RESOLVE COMMON FRONT LINE INJURIES WITHOUT LOSING STRENGTH

IMPORTANT: Use Common Sense and be Guided by Medical Experts

Before we get into it, it’s important to emphasise that if you’ve sought medical advice for the treatment of your injury, it supersedes any advice that follows in this article. Circumstances surrounding injuries change on a case-by-case basis, and the general advice given in this article may not suit you. Additionally, if resistance training causes the pain to worsen, or you suffer sharp, stabbing, shooting or burning pain, stop immediately and seek medical advice.

A study published in December last year found that over a ten-year period, the most common injury sustained by emergency service personnel in one particular Australian Emergency Service Agency was of the lower back [1]. These injuries accounted for 27.9% of total injuries. Furthermore, the most common injury-type was soft-tissue (59.7%), and ‘body stressing’ – stress, load or tension applied to muscles, tendons, ligaments and bones – was the most common cause of injury at 45.5%.

Injuries will inevitably form a part of majority of first responder careers, but a significant factor influencing the long-term outcome of these setbacks is the level of fitness, strength and resilience the individual has prior to the injury. Unfortunately, a lack of appropriate strength training prior to the onset of an injury contributes heavily to the far too common tale of a police officer becoming non-operational, or a firefighter heading to early retirement.

While it’s a fact that fitness plays a part in a first responder’s ability to perform on the job, research shows that many first responders lack the strength necessary to perform their regular duties safely [2] and part of the problem stems from a misconception of what injury prevention and injury management should actually look like.

"The fitness components that will get you out of a jam when push comes to shove are far more likely to come from the weights room than the Yoga studio."

Resistance Training for Injury Prevention

For a lot of people, the phrase ‘injury prevention’ inspires thoughts of Pilates, bodyweight movements, static stretches, recovery sessions and foam rolling. Don’t get me wrong, they all have their place and deserve to make up part of every good training program, but there is no amount of bird dogs alone that will prevent frontline injuries suffered from slips, trips and falls, impact or body stressing. The fitness components that will get you out of a jam when push comes to shove are far more likely to come from the weights room than the Yoga studio.

In a trip, slip or fall, those who have developed their speed, strength and reaction time will often be able to prevent themselves from hitting the ground. In the event that they can’t, they are still more likely to avoid serious injury because extra muscle-mass means the force of impacts are significantly decreased, and higher bone density allows the skeleton to absorb more force without breaking. The same goes for impacts due to violent offenders, falling structures or minor car accidents.

Additionally, resistance training helps to strengthen connective tissues like tendons and ligaments which means they are less prone to tearing or snapping due to body stressing. As a result, trained bodies are more resilient when lifting unconventional shapes and during sudden explosive movements like racing from the truck into a burning building or taking off after a fleeing offender.

Resistance Training for Injury Management

"In a trip, slip or fall, those who have developed their speed, strength and reaction time will often be able to prevent themselves from hitting the ground."

It is simply untrue, however, to suggest that even the perfect training plan will prevent 100% of injuries suffered in the gym. It will go a long way to preventing some injuries, and it will absolutely minimise time lost due to injury, but first responders will, unfortunately, always have to manage front line injuries in some form or another.

So, if it happens to you, what should you do? The common pathway is to stop all activity until the pain subsides and the injury is healed. For example, most of the individuals from the introduction who suffered a lower back injury would be inclined to stop deadlifting until it gets better, but research suggests this might not be the most effective solution, and life suggests it might not be the most realistic.

Just because you stop deadlifting in the gym, it doesn’t mean you stop deadlifting in life. A deadlift is, after all, just picking something up off the floor. Groceries still need to be brought inside and packed away, kids still want to be picked up, and you still need to clean up after your dog. And remember, this is all assuming you’ve been granted time off from work to recover from your injuries. For those working through their injuries or suffering from daily back pain and discomfort, you still have patients, tools, offenders, and victims to lift up off the ground.

So, while heavy deadlifting might be off the cards for a while, a lighter deadlift or a variation of the movement could still form an important part of your rehab. By continuing with these lifts, or reintroducing them as soon as you’re physically able, your nervous system remains primed, your other muscles are still being stimulated, and your body is less likely to reinjure down the track.

Application

We’ll stick with the lower back example because it’s so common, but the same theory can be applied to most soft tissue injuries. In the immediate aftermath, inflammation and acute trauma may require a period of rest, but the pain won’t necessarily have subsided entirely before it’s time to get back into the gym.

Deadlifts, squats, and some row variations are likely to cause you trouble if you have lower back pain, but the high levels of occupational transfer mean we don’t want to remove them from the program entirely, so what kind of things can you modify to find a pain-free alternative?

• Lighten or Move the Load:

Lightening the load is fairly straightforward – if the weight you’re using is causing pain, you may be able to complete the exact same movement with less weight. While this is an option, depending on how light you need to go to avoid the pain, and how many reps you’re doing, you might have lost the stimulus required to make this exercise worthwhile.

Instead, consider moving the load. For example, a barbell back squat is going to directly load to the spine which, depending on the type of injury, is likely to cause pain. By moving the load from back to front, you get a front squat which you might be able to complete pain-free. Similarly, while a barbell bent over row is likely to cause pain, a seal row might work because the isometric load is no longer being held in the erectors and hamstrings, but by the bench instead.

• Change the Stance:

By swapping bilateral movements for unilateral, we can take some strain off the lower back by holding the hips still and removing some erector activation. For example, even the smallest amount of pelvic tilt may cause pain for someone with a lower back injury, so swapping a squat for a lunge can help to steady the hips, remove the pelvic tilt and perhaps allow for heavy, lower body loading with no pain.  

• Swap the Method of Resistance:  

This might sound similar to moving the load, but it’s essentially using a different piece of equipment to achieve a stimulus as close as possible to the one causing you pain. It frees up more options, but it may also change the focus of the lifts more than the other two solutions.

For example, instead of using a barbell for your deadlift, you could use a trap bar. If this still doesn’t solve your problem, you might end up at something like a machine hip thrust which, although it will work similar muscle groups, it is a significantly different lift. It’s important here to remember why you programmed that exercise initially and ensure your replacement still satisfies the need.

Summary

Injuries are an unavoidable reality for some first responders, but their long-term impact doesn’t have to be. While a well-structured training program will not prevent injuries entirely, it will definitely help you to minimise the initial damage, recover quicker, avoid significant setbacks, and reduce the likelihood of reinjuring. When injuries do happen, an educated approach to exercise modification – rather than total avoidance – helps to maintain physical capacity, reduce time in rehab, and supports a faster return to occupational readiness. By understanding adjustments like load, body position and exercise selection, you can continue to train safely and remain fit and healthy, all while respecting the necessary healing process.

Ultimately, injury prevention and injury management are not about doing less – they’re about doing what’s necessary to stay strong, capable, and ready, not only for the job, but for everything life throws at you.  

References

1. Marvin, Graham, Canetti, Elisa, Orr, Rob & Schram, Ben 2025, ‘A profile of injuries within an Australian Emergency Service Agency: a retrospective study’, BMC Emergency Medicine, vol. 26, no. 2.

1. Sheridan, Samantha 2019, ‘Paramedic health status, fitness and physical tasks: A review of the literature’, Australasian Journal of Paramedicine, vol. 16, pp. 1-7.