The Difference Is Physical

In an industry where musculoskeletal injuries are prevalent,preparing the body for such stresses and mitigating the risk of injury is essential.

However, the reality is that the fire service andtraining methodologies have largely been developed around male anatomy and physiology. So, what are we missing?

Physiologically,female firefighters have less hemoglobin per deciliter of blood. Hemoglobin is a protein in red blood cells that binds to oxygen to transport it to the working muscle. Without oxygen, muscles fatigue much quicker.

In addition to a lower concentration of hemoglobin,female firefighters have lower stroke volume, which means less oxygen is pumped out of the heart with each contraction. Collectively, less oxygen is being pumped into the system per heartbeat and less of what is available is being transported to the working muscles.This has a big impact on cardiovascular and muscular endurance.

Considering these physiological differences, there are steps female firefighters can take to mitigate some of these limitations.

One is the use ofBFR, or blood flow restriction, training with cardiovascular exercise. One way to do this in training is to place a BFR cuff on the lower limb and/or upper limbs during an assault bike with a Tabata-like training protocol. The advanced BFR Tabata version looks like this: 30 seconds at 50 percent VO2 max, then 30 seconds at 80 percent VO2 max, and repeating this cycling up and down for six to eight minutes.

Studies show that when this is done, there is not only asignificant increase in VO2 max, but also a substantial systemic release of growth hormone and IGF-1. These two hormones aid in soft tissue repair and bone healing (IGF-1 also aids in mitigating the risk for osteopenia). This type of training allows you to take your cardiovascular training to a higher level of intensity without the wear and tear on your joints.

When comparing males to females, there are alsosignificant differences in anatomical structures and biomechanical alignment of the lower quarter that impact the way a female firefighter moves.

For example,women tend to have a wider pelvis than men. The wider pelvis changes the angulation of the femur as it comes off the pelvis, resulting in alarger Q (quadriceps) angle. This has a big impact on the strength of the quadriceps, as well as the pelvic stabilizers (gluteus medius).

In addition to the Q angle, there are alsostructural differences in the femur that increase the risk of injury. For example, the femoral notch at the end of the femur (location for the ACL or anterior cruciate ligament) is narrower in females than males. This results in increased stress to the ACL when the knee goes in toward midline (dynamic valgus) during single leg activities.

A larger Q angle leads to a greater propensity for females to fall into dynamic valgus position when landing or pushing off on one leg (jumping off a truck, running up or down stairs). Additionally, there tends to begreater pelvic motion when standing on one leg, resulting in increased movement of the upper body. This adds to theincreased stress on the lower back and the SI (sacroiliac) joint. This is one reason that females are three to eight times more likely to suffer a knee injury and are more susceptible to back injuries.

If you combine the above physiological differences, then this meansthe muscles responsible for stabilizing the knee, pelvis, and core are at a mechanical disadvantage and are likely to fatigue more quickly in a female firefighter. Knowing this, you can train to mitigate the impact of these differences.

To do so, your program should include some exercises targeting:

Quadriceps

Training in bothopen kinetic chain (isolated exercises like leg extension) andclosed kinetic chain (compound exercises like squats) are important to include in your program. These should also include somesingle leg exercises (like a single leg squat) with a focus on preventing excessive knee movement toward midline and control of the pelvis.

Gluteus Medius

This is one of the hip muscles that aids instabilizing the pelvis during single leg activities and prevents the knee from going in toward midline. These should be high reps, performed in closed kinetic chain, and include some single leg activities.

Rotational Training

Single leg stance rotational training types of exercises are key tostabilizing the lower limb and pelvis to resist the types of forces that firefighters must restrain. In this picture, the individual is performing a hip hinge movement with a strap that is pulling her shoulder and pelvis into rotation while performing the activity.

When female firefighters do training that considers their physiology, anatomy, and biomechanics, it can havea huge impact on their performance and mitigate their risk of musculoskeletal injuries.