First Responder Fitness
Mitchell Christman
January 22, 2025
I grew up playing sports and this transitioned into high school and intramural level college sports. I was competitive, but one thing that always set me back was my overall physique and conditioning level. When I made it to college, I was introduced to my now close friend who was a college basketball player and devout gym fanatic. This relationship fostered me into becoming engrossed in a fitness lifestyle. Due to my devotion to physical wellness, the basketball coach approached me and asked me to create and facilitate fitness routines for the team in the off-season.
After graduating college, I began my career in law enforcement in December 2014. When I was initially accepted by the Tioga County Sheriff’s Office and began my education at the Pennsylvania Sheriff and Deputy Sheriff Academy, I made it my goal to maintain the level of physical fitness that I had developed. With the help of fitness coaches at Penn State University, I was able to break the record for the timed 1.5-mile run (I never considered myself a “runner”). Although much about me has changed, I still strive to maintain a semblance of fitness while navigating life’s obstacles that all of us face daily. For those that work in the first responder realm (firefighters, paramedics, emergency medical technicians, and law enforcement to name a few), a devotion to physical fitness is a smart idea, and may be lifesaving.
Heart disease is the leading cause of death in the United States for both men and women (Kulbarsh, 2018). First responders navigate perils that few other careers have to contend with, including physically and emotionally taxing environments, poor shift rotations, long work weeks, non-existent sleep patterns, dietary inflexibility, lack of political and administrative support, and extended time away from family. Perhaps because of these perils, the risk of heart disease and sudden cardiac death is more severe for our men and women in uniform.
According to Joseph Heaton, MD, myocardial infarction (heart attack) is the lead cause of in-the-line-of-duty death for firefighters (Kuehn, 2021). In addition to the aforementioned stressors, unique exposures for firefighters such as smoke and other particle inhalation can elevate their risk for cardiovascular disease (Kuehn, 2021). Although there are few studies to back this assertion, surging adrenaline during responses may also be a contributing factor in the development of heart disease. This problem can be exacerbated by the fact that approximately 67% of firefighters in the United States operate strictly as volunteers (Fahy, Evarts, & Stein, 2021). In addition to the obstacles faced by career firefighters, these men and women have other full-time occupations. They may wake up at 3:00 A.M. after working twelve hours the day before to rescue those in need for no additional compensation. Regardless of the science, one would be hard-pressed to find arguments in support of the fact that such repeated activity is good for the heart health of firefighters.
Long working hours plague the first responder profession. According to the World Health Organization (WHO), heart disease deaths associated with working 55 hours or more per week increased 42% from 2000 to 2016 (French, 2021). Greg Friese, EMS1 Editorial Director, believes this study is especially detrimental to those in the EMS profession. Many EMTs and paramedics, according to Friese, “work greater than 55 hours per week because of late calls, accepting overtime shifts or having to work multiple EMS jobs to make a decent living” (French, 2021). Thus, in addition to the occupational hazards already discussed, the simple fact that responders spend more time at work puts them at increased risks for heart issues and resulting death.
Finally, stressful events on the job put first responders at increased risk of heart disease, heart attacks, or sudden cardiac deaths. Police officers are 30 to 70 times more at risk for sudden cardiac death during restraints and altercations, driving pursuits, and medical/rescue operations as compared to “routine” non-emergency duties (Kulbarsh, 2018). All first responders engage in these activities to greater or lesser degrees and a similar parallel of risk likely exists. Studies of the fire service have shown that engaging in fire suppression activities versus non-emergency duties increases the risk of heart attack by 10-100 times, depending on the pre-existing health conditions of the firefighter in question (Webb, 2019). Further, approximately 32 percent of cardiac deaths occur during or immediately after fire suppression activities, which encompass only between one to five percent of a firefighter’s typical day (Webb, 2019). Surely, stressful events encountered by first responders represent significant risk of heart-related deaths, and this risk can be mitigated with proper preparation.
How can first responders reduce their risk of heart disease, heart attack, and sudden cardiac death associated with their lines of work? Routine changes including dietary modifications, smoking cessation, limiting alcohol use, and stress management are vital. However, the focus of this article is on the ability of first responders to create a fitness mindset and lifestyle as they continue down their chosen career paths. The following suggestions come from my seven years of experience and how I was able to preserve a proficient level of physical fitness while navigating the struggles associated with the first responder profession. My goal is for you to share these suggestions with your organizations and peers in pursuit of establishing fitness-minded responders who are healthier and better prepared to serve their communities.
Aerobic exercise, often referred to as “cardio”, is a solid way to build a foundation of fitness for first responders. When people hear cardio, a common response is, “I hate running!” Although running is an efficient form of cardiovascular conditioning, it is by no means the only form. Other types of cardio conditioning include walking, jumping rope, riding a bicycle, HIIT (High Intensity Interval Training), using an elliptical machine or other varieties you see at fitness gyms. The important thing to remember about cardio is that it involves exercise that engages the heart, lungs and circulatory system and is performed for a sustained period. Such exercise is vital to heart health as it facilitates the heart’s ability to pump blood more efficiently and therefore makes it less prone to attacks (where blood flow to the heart is temporarily blocked). More specifically, aerobic exercise also improves muscular endurance, lowers blood pressure, strengthens the immune system, regulates sleep, improves mood, slows brain loss, regulates weight, and reduces chronic pain (Marcin, 2020). Additionally, depending on personal preference, aerobic exercise can be inexpensive as no equipment is required— just one’s own body and the ability to move it.
For those who have a strong distaste for running, your feelings are not completely misplaced. Running or other cardio exercises is important. However, as is the case with many things, too much of a good thing can become a bad thing. The American Heart Association recommends 30 minutes of cardiovascular activity for five days of the week for a total of 150 minutes within target heart rate zone. Target heart rate zone is usually defined as 50% to 85% of maximum heart rate, which is calculated as 220 – subject age (Target). On the other hand, too much cardio can have a detrimental effect on one’s health. Cardiologist James O’Keefe states that according to an exercise study of 400,000 Chinese participants, mortality reduction due to vigorous exercise fails to increase in exercise lasting longer than 60 minutes per day. Put differently, one does not see positive health effects from sustained exercise beyond 60 minutes per day (TedXTalks, 2012). O’Keefe also relates that an often-replicated study of runner’s post marathons has surprising results. Indeed, over half of the participants will have elevated levels of troponin in their blood following the race. The presence of this chemical indicates to doctors that heart muscle has died, or a patient is experiencing a heart attack (TedXTalks, 2012). So, the moral of Dr. O’Keefe’s story is that balance is the key. He states that “there is no single step to ensure robust health and remarkable longevity other than a habit of daily exercise” but stresses the need for moderation as well.
Some may feel that another deterrent to a healthy lifestyle is the lack of access to a gym or exercise equipment. Fortunately, with the right knowledge, first responders have the ability to maintain healthy lifestyles without the extensive use of gym equipment. Body-weight exercises or calisthenics serve as a solid foundation for those without the access or availability of time to spend at gyms. The most important concept is establishing a routine and consistency versus simply lifting aimlessly. In my experience, push-ups, pull-ups, sit-ups, squats, lunges, and other so-called body-weight exercises are solid ways to maintain a proficient level of fitness without the need for expensive equipment. The aim of this article is not to sell any products, but there are several smartphone applications and videos on YouTube all based around calisthenics that can be completed nearly anywhere. My personal favorite is the Seven-Minute Workout Challenge application that provides times and a structure to guide the user through workouts.
Rarely do first responders have the time to devote hours per day to gyms— especially those with families at home. As is the case with many families across the country, when my wife and I had children, we sacrificed personal time (including hours at the gym) to raise our children. To that end, I had to find other times and avenues to maintain the level of physical proficiency required by my job. My solution I called “cheating” workouts whenever I could. If I worked the morning shift, I would wake up early to run or do calisthenics. If I worked overnight, I would start my run immediately after my shift so I could go home and sleep. Additionally, I was able to conduct both foot and bicycle patrol of my patrol area, which served to both change my perspective from vehicle patrol and provide me with a form of exercise. A long time is not always necessary. My advice: “cheat” the time in whenever it is possible.
One final note regarding developing a mindset focused on physical fitness involves keeping track of your progress and frequency of workouts. When the trend of fitness trackers, such as Fitbit, Apple Watch, and Garmin Watches first began its steady increase, I was completely against them. My thought was that I did not need a device to tell me how active to be. After receiving one as a gift, I feel that they are vital. These devices all easily allow users to verify steps taken, intensity minutes (as previously discussed), water intake, shoe usage, and other useful features depending on the device. Also, most of the devices have social networks attached which allow users to choose to compete against others or not. Such devices serve as instant feedback and accountability trackers for fitness progress.
In short, maintaining a healthy heart and lifestyle is vital to those of us who have served or continue to serve our communities. First responders who lay their lives on the line are predisposed to conditions that make their lives even riskier than the physical risks inherent in their day-to-day activities while on the clock. By simply starting and executing a small exercise routine, first responders can mitigate much of this risk and hopefully live longer, fuller lives after they retire from public service. Although it seems a daunting task, starting and establishing a devotion to a basic level of physical fitness can be accomplished. If I did it, anyone could do it. As discussed, find little ways to “cheat” time and get moving. With a little imagination, one can turn the most mundane places, conference rooms, parking lots, and even your desk into areas where working on physical fitness is possible. Supervisors in the public service realm can support their members in this endeavor by promoting wellness plans, providing access to gym facilities, and, at the very least, relaying the message of this article to their teams. Organizations have an opportunity to both better the lives of their members and create a stronger sense of comradery by taking small steps in support of the physical health of their members.
References
Fahy, R., Evarts, B., & Stein, G. (2021, December). U.S. fire department profile. National Fire Protection Association. https://www.nfpa.org/News-and-Research/Data-research-and-tools/Emergency-Responders/US-fire-department-profile#:~:text=Key%20findings,67%25)%20were%20volunteer%20firefighters
French, L (2021, May 21). WHO: Long working hours led to increase in heart disease, stroke. EMS1. https://www.ems1.com/health-wellness/articles/who-long-working-hours-led-to-increase-in-heart-disease-stroke-deaths-prXDsKOh4Z6PWoBX/
Kuehn, B. (2021, August 16). Studies detail heart risks for firefighters. Circulation. https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.056119
Kulbarsh, P. (2018, March 13). Heart disease and law enforcement. Officer. https://www.officer.com/command-hq/supplies-services/healthcare/article/20998653/heart-disease-and-law-enforcement
Marcin, A. (2020, February 25). What are the benefits of aerobic exercise? Healthline. https://www.healthline.com/health/fitness-exercise/benefits-of-aerobic-exercise
Target heart rates chart. American Heart Association (n.d.). https://www.heart.org/en/healthy-living/fitness/fitness-basics/target-heart-rates#:~:text=Know%20Your%20Numbers:%20Maximum%20and%20Target%20Heart%20Rate,%20180%20bpm%20%206%20more%20rows
TedXTalks. (2012, November 27). Run for your life! At a comfortable pace, and not too far: James O’Keefe at TEDxUMKC. [Video]. YouTube. https://www.youtube.com/watch?v=Y6U728AZnV0
Webb, J. (2019, February 4). Surviving the fire service cardiac epidemic. Fire Engineering. https://www.fireengineering.com/health-safety/firefighter-cardiac-health/#gref