Fire Fighters (Full Version)

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gomez2 -> Fire Fighters (February 10, 2006 7:07:00 PM)

What experience is anyone having with firefighters? Types of injuries, fitness level, compliance, success rate, re-injury rate. Return to work criteria/testing.



pwrandall -> Re: Fire Fighters (February 11, 2006 7:45:00 AM)

As a former firman myself I'm going to through out a couple of unsolicted comments. You are going to find two types of fireman out there. There are those that will do what ever you ask and push themselves to the limit to rehab and get back on the job following injury--these guys (and gals) love their jobs and will do anything to get back to it. The other type has huge secondary gain issues...disability retirement from a public safety position is very generous in many places, especially here in CA. There are a few people who are trying to get out of the job on disability and then go on to pick up side-jobs and under the table work. These guys drive me nuts, but I have found them to be quite common. Obviously this is a broad generalization, but I speak as someone who has been on the inside of the job. I'm not trying to minimize the extent of legitimate disabililty claims--their are plenty out there. Firefighting is a tough gig and people really get beat up on the job, and a few can't recover to full-duty. Personally, I chose to leave the profession before it crippled me for life and I love my new found career.

PETE



gomez2 -> Re: Fire Fighters (February 12, 2006 5:52:00 PM)

i AGREE WITH YOUR COMMENTS AND IT IS A FRUSTRATION. I am in the opposite position, PT 14 yrs and FF the last 5 doing both. Do you feel that PT's understand the job and what it takes to get back to 100% safely?



pwrandall -> Re: Fire Fighters (February 13, 2006 5:17:00 PM)

This really varies. Firefighters truely manage to injure everything: knees, shoulders, spine, ankles, hips, etc... It is difficult for someone who has not done the job to appreciate that the job demands vary and can be quite unpredictable...the very thing most of us love about it. At one time I worked with the training division and we created a great job description that tried to include every task imaginable. We were all suprised at some of the things we were supposed to do or had done.

In terms of what it takes to get back to 100% safely, I'm not even sure if that is possible (the 100% that is). In my limited experience as a PT, this is going to requie some honest collaboration between the MD (if WC), the PT and the patient. In terms of returning to work criteria, I don't have any specific references, but in my opinion the ability to perform/pass their departments physical agility exam may be an acceptable/appropriate criteria...just my thoughts.

Pete



gomez2 -> Re: Fire Fighters (February 14, 2006 7:53:00 PM)

My ideal scenario would be a recommended network of docs and PT's that would be educated as to our requirements of the job and have a realistic functional assessment (before the actual PAT) to return to work. Also a list of trainers (in house or community) that would fill the gap between PT and back to work.

The other issue is so many of my guys are living with pain. This leads to compensations that alter the body's posture and efficiency which leads to so many "-itis'" and then ultimately injuries. More than 50% of the injuries that I see in the dept. can be traced back to signs they have been living with and haven't addressed. Dealing with these issues (postural/musculoskeltal) are easy to correct.



gomez2 -> RE: Re: Fire Fighters (October 28, 2007 12:09:04 AM)

please read the following article published in the PT Advance and the IAFF site

http://physical-therapy.advanceweb.com/Editorial/Search/AViewer.aspx?AN=PT_07oct8_ptp30.html&AD=10-08-2007



jma -> RE: Re: Fire Fighters (October 28, 2007 11:25:29 AM)

I would think those PT's who do functional capacity evaluations and do on-site physical therapy, would be the best for the firefighters. One cannot duplicate what they do, wear and manipulate at the same time in an outpatient setting.



gomez2 -> RE: Re: Fire Fighters (October 28, 2007 11:54:29 AM)

I would have thought that too, the majority of FF's think that. Then explain why so many FF's return to work way below 100% recovered? If you read the article, I believe it is
1) the lack of understanding by the medical/rehab community as to our job requirements
2) the FCE's are a start but they are task specific and don't always take into account the athleticism that is required. Also the FCE's are usually generic not specific to our lob
3) w/ the lack of understanding, the MD asks the PT and the PT asks the FF whether they are ready for work. My guys will say yes if they can get by
4) insurances/disability boards can and manytimes pressure return to work or won't reimburse for hip exercise ( for instance) when there is a knee or back issue
5) a PT degree does not qualify us to train a client like an athlete, many PT's can't do that. Be responsible and refer a client that needs it to a competent trainer prior to return to work

My hope is to present this issue to all the powers that be and begin to solve this severe issue. If a FF is less than 100% it can mean life or death. I just presented this to the International Association of FF in Chicago and got a huge amount of response that this is a problem 

JMA: talking to FDNY trainers with more than 19 y/r in they say it is a problem in the FDNY as well.



jma -> RE: Re: Fire Fighters (October 28, 2007 12:34:40 PM)

If I would ever want to treat figher fighters, I would go straight to their training academy and talk/watch what the FDNY trainers teach and see what the trainees have to go through. But more importantly, feel the experience as well, that would be a start I think in the right direction.



gomez2 -> RE: Re: Fire Fighters (October 28, 2007 7:46:18 PM)

that is absolutely right. glad to see someone understands. Too many times the results fall short. I hope to further this cause and change this[:D]



orthotherapist -> RE: Re: Fire Fighters (October 29, 2007 10:52:17 AM)

I think the nail was hit on the head when the unpredictable nature of the job was mentioned.  No matter how much testing is done you can not test for the demands that may be met while on a call.  You may be able to test for a majority of the demands but not all.





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