Workout Program for a Posted Ambulance

In the August 2000 issue of Emergency Medical Services Magazine, I wrote an article that dealt with the need for EMS personnel to exercise and maintain proper fitness. The article covered the possibilities that exist for EMTs to work out at a station during their downtime. Admittedly, that workout doesn't apply very well to units without stations. Despite the many differences between roving units and ones with stations, there is still a constant in EMS of all sorts: downtime. Let's kill two birds with one stone--kill the downtime with activity, and keep our fast-food-eating, couch-potato lives from killing us. Posted EMSers need a workout, too.

EMS is one of the few professions that allows employees to work out while on the clock. The principles involved in posted fitness are the same as for a stationary unit. Both have slow and busy times, so don't worry if your workout is interrupted. Just come back to it later. Exercising in small blocks of time throughout the day is far more beneficial than not exercising at all. It all adds up.

On the other hand, exercise can hurt you if you go about it incorrectly. Consult a physician before undertaking any rigorous exercise regimen for the first time or after a significant period of inactivity.

Exercises

The workout contained in this article represents a balance of aerobic and anaerobic exercises. Unless you have a specific goal in mind and are designing your own workout program, try to maintain this balance. If you err, err on the side of the aerobic exercises. Aerobic exercises work more toward cardiovascular fitness and show a lesser chance of injury when compared to anaerobic exercises.

Since you can't carry barbells and weights on the ambulance all day, each exercise can be done with equipment normally found on the unit or with no equipment at all. After you learn the basic exercises, you'll be able to improvise your own, focusing on the target areas that need extra work on your own body.

If there is a fitness center near your assigned area, see if they will let you use their facilities for free or at a reduced rate while you are in uniform. But make sure you clear these activities with your supervisor.

1. Walking

Unless the weather is poor or the neighborhood unsafe, you can always get out and walk around the general area where your ambulance is posted. My former partner and I used to post in the parking lot of a mall. We would walk around the mall. Walking for 5--10 minutes is an excellent way to warm up cold muscles before stretching. After stretching, a brisk pace will give you a good overall aerobic workout. When walking, never go more than a minute's trot away from the ambulance. Although exercise is important, you should never sacrifice a quick response time in order to get in a workout while on the job.

2. Stretching

Proper stretching is paramount to any exercise routine. It is important for preventing injuries and should be part of your warm-up and cool-down routines. I urge you to never lift weights or engage in other strenuous activity until you have stretched. Even if you complete a 10-minute stretching routine and miss your workout, you'll still see improvement; but go easy on stretching cold muscles. It can strain and even tear them. Stretching should always be gradual and gentle, held for 10--20 seconds only to the point of resistance--never bounced. An excellent book that describes and illustrates specific stretches to do for certain activities and exercises is Stretching by Bob Anderson. By adding stretching to your workout, you'll be more flexible for those calls that require heavy lifting.

3. Crunches

Crunches strengthen your abdominal muscles. Lie with your back flat on the stretcher and your knees bent at roughly a 45º angle. You can secure your feet under the seat belt or have your partner hold them. Cup your hands over your ears or cross them on your chest. By contracting the abdominal muscles, slowly curl your upper body up until your shoulders leave the mat, then slowly lower yourself back down. Do not pull on your neck or swing your head up and down. The trick is to keep the small of your back flat and let your abdominal muscles do the work. Begin with one set of 10 repetitions and gradually increase the number of sets. Always rest between sets or alternate them with another exercise.

4. Presses and curls

These are for arms, strengthening biceps, triceps and forearms. There are many different variations to the press, such as the military press, bench press and standing overhead press. Adjusting your position between sitting, lying and standing can also create variations. Experiment. Use the stretcher for bench presses. From any of the three positions--lying, sitting or standing--simply press the weight straight up. Maintain good form and posture during standing or sitting presses. Keep the back straight and the elbows bent. Curls are pretty basic, all variations on the standard barbell curl, either with one arm or two. Keep the upper arm stationary alongside the body and "curl" the weight toward your shoulders.

Find the variations you enjoy most and use them to work on those personal target areas. Items from the unit can be used to add weight resistance, increasing the benefit. Usable items would be IV bags, the clipboard or, if you feel up to it, the first-in bag. Start out with three sets of 10 repetitions, if possible.

5. Step-ups

Step-ups will strengthen the legs, specifically the quadriceps. Use the rear bumper as the step. Facing the truck, place one leg on the bumper with the other in a natural position on the ground. Simply step up to the bumper with the other leg and back down. After a good set of 8--12 repetitions, switch legs and repeat with the other. Three sets should be sufficient.

6. Push-ups

Push-ups are a simple exercise that most people are familiar with, but we'll change it for EMS. You're going to do this exercise from the rear bumper to keep your uniform from getting dirty or scuffing the toes of the boots that you work so hard at shining. Place your hands on the bumper with your legs out behind you. Lower your body until your chest almost touches the chrome. For people who cannot do a military-style push-up because of their body weight, this type of push-up is easier. The upright angle of the body places most of the body weight onto the legs rather than the arms. Do three sets of 8--12 repetitions.

These six exercises are only a starting point. There are many more requiring no extra equipment that can be adapted to the posted ambulance. Do some research or consult other paramedics who exercise often. Once you begin your program, change it occasionally. Add new exercises or modify the old ones. You can also add more weight and more repetitions. Each workout should last at least 30 minutes, even if it takes several blocks of time to add up to that. Anytime you make changes to the program, do so gradually.

Sustenance

Aside from a proper exercise routine, nutrition and hydration are essential aspects of any fitness program. If you don't eat right, all the exercise in the world won't shrink your waistline. Research the restaurants in your posted area and find some healthy fare or just pack something healthy and well-balanced at home. Hydration is something that's often overlooked. Many people assume coffee and sodas provide enough water to satisfy their bodies' needs. They don't. What your body really needs is a good 64 ounces--eight glasses--of pure water every day, uncompromised by sugar or caffeine. To help curb your appetite, you can try drinking a glass before meals and another glass during. Save the other drinks for snacks or dessert.

Wrap Up

Being physically fit in EMS will help prevent work-related injuries and early retirement due to bad back or messed-up knees. We also need to present a shining example to our patients of what an active, fit person looks like. It does no good to counsel a heart attack patient regarding risk factors when you keep bumping him with your gut. We need to be professionals in every sense of the word and that includes appearance and fitness.