# How do you guys do it?



## knmedic (May 14, 2012)

Hey guys, first time posting here but I just need to hear from some fellow EMS people I don't see everyday on some concerns I'm having. I work for an urban EMS service in Canada.

I'm coming up on my 2 year mark in EMS, did some rural for about a year and now some city stuff for a year.

I love my job, a lot. I can't see myself doing anything else, and that is why this bothers me so much.

My back hurts. Not debilitating, sometimes it doesn't hurt at all, but probably 75% of the time I have this positional dull ache in my lumbar area that is relieved by contracting my abs and almost pushing them out so that my lumbar area curves more. I have done a couple of bad lifts that I can remember, but the overwhelming  majority of the time I squat and lift very good and have had multiple medics as well as my physiotherapist comment on my squat technique. I am very conscious of my form, as well as my body, and like to think I'm pretty healthy. I eat healthy, and go to the gym 2-3 times a week doing core compound lifts like Squats, DL, Bench, Rows, etc. This never used to be like this, I know its from the work.

Couple that with an out of work knee injury (runners knee / patellofemoral pain syndrome) that I'm working on with physiotherapy, but is frequently aggravated by constantly lifting, especially *** to grass squats for immobilized patients. I just feel like this job is beating the piss out of my already and I"m only barely 2 years in. It's all "lift with your legs, not your back". I can't very well lift with my legs when my knee hurts the closer it gets to 90 degrees.

I'm not looking for any specific advice for these problems: it's the internet and it's too hard to accurately describe whats wrong / what to do about it. I see a chiropractor and physical therapist and we are working on it.

I just want to know how the hell do guys do this for 20+ years? Like I said, I love my job, and I don't want to be 'that guy', but really. These constant aches, and trying to get over them with exercise and PT is starting to affect the way I think about calls and this job. I'm a positive guy, and I've got some good stuff going for me. I recently met an amazing woman (the one that gets you thinking "holy :censored::censored::censored::censored:, this is the one"), and I really loved my work up until all this started happening. Now I just question if it worth breaking myself over. This is seriously bringing me down and making me think about finding another way to put food on the table - and I hate that.


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## ABEMS (May 14, 2012)

..... where do i begin. Most EMS practioners will have back problems sooner or later in there career. Too bad it happened so early in yours. Was it caused by a work related injury?


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## knmedic (May 14, 2012)

Not any specific thing that I can think of. It's just developed over the past few months. 

The knee issue was not at work.

So.. just part of the job eh?


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## ABEMS (May 14, 2012)

Always important to protect your back. Ask for assistance or more resources when lifting patients. And if it doesnt get better, take time off work and see if that helps.


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## Veneficus (May 14, 2012)

No work is worth breaking yourself over.

The first thing you have to do is make sure you are using proper lifting technique and not trying to be the lone ranger.

Underestimate when you need help.

Always remember, you are your first patient.

I urge you to see a doctor that specializes in sports or occupational medicine. You don't need a doctor to tell you to stop what you love, you need one who will help you keep doing it.

It's just my opinion but I would ditch the chiropracter for a DO that does osteopathic manipulation and can set you on a treatment course to prevent any more problems once they manipulate you rather than just bleeding you for temporary help.

Having said all of that, you may be reinjuring yourself and may need time off.

Definately seek help from a doctor. It is what they are for.


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## mycrofft (May 14, 2012)

Roger Veneficus above.

Most people don't stay in field EMS for any twenty years! And most long-timers haven back injuries, etc. (And that thing using abs to splint the back? Works for a while, then you start getting the same deal some pregnant mothers get, adiaphysis of the rectus abdominus; the union between the left and right rectus abdomens stretches, you get "warehouseman's belly" and it won't splint your back anymore, plus other goodies it is designed for.

Get thee to school and aim for maybe dispatch and/or other admin or instructor. Or another job but you do EMS of some sort as a hobby or as a volunteer.


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## Medic Tim (May 14, 2012)

Veneficus said:


> No work is worth breaking yourself over.
> 
> The first thing you have to do is make sure you are using proper lifting technique and not trying to be the lone ranger.
> 
> ...




this^^

I have been a medic for 5 years now and the first couple years I had similar pain. I switched to a better boot with custom insoles and it has made a world of difference.


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## Underoath87 (May 18, 2012)

In the past year I stopped doing deadlifts and heavy squats.  The results just aren't worth the risk of injury unless powerlifting is your passion.  I stick to hyperextensions (http://www.bodybuilding.com/exercises/detail/view/name/hyperextensions-back-extensions) and various ab crunches for my core development.  And leg extensions work just fine for quads without killing your knees.
I also ride a sportbike everywhere I go, so back aches can be a real issue.  I find that hyperextensions with little to no weight added (just enough to get a good pump) work wonders.  Any back ache is quickly replaced by a much more comfortable DOMs effect, which soon subsides, leaving my back feeling great.


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## FourLoko (May 18, 2012)

Get an X-Ray. Make sure the discs and such are still good. Maybe an MRI.

If it's just nagging muscle pain, time to work the back.


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## firetender (May 19, 2012)

*It's not gonna get better unless you make it better*

This job is very, very tough on backs. I'd love to hear of statistics, but I bet you'd find a VERY high incidence of semi-crippling back/joint pain amongst former medics. I'd also be interested in stats on how many medics leave the field BECAUSE OF problems like that.

But it really doesn't matter what others have experienced or think. It doesn't matter if others live with it, through it or medicate around it. What matters is for you to listen to your own body. How bad is it hurting and when? How long does it take you to recover after a shift?

If you face it to find that work is prolonging the pain, making it worse or you find yourself in a constant state of compensation to "look like" you're okay when you're not, then, please, get real!

If you're not working on doing what you must to actively lessen the pain and restrictions that come with it, then how crazy could you be to guess you're probably doing damage to yourself?

The problem is, damage like this rarely goes away. We're talking the rest of your life. I was really pretty good with covering my back. I always bent at the knees and crouched. Today, my knees won't shut the :censored::censored::censored::censored: up!

Let's put it this way; there is absolutely no mechanism in place that will assure that you will not exacerbate your problems if you report to work. By definition, with every call and for every medic you are in a position to have harm befall you. If you step in to the ring with a glass jaw, don't complain to me after you come out of the coma!


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## Devil doc (May 20, 2012)

Part of the job, try strengthing your core


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## knmedic (May 24, 2013)

Great info, thanks guys. It turned out to be a minor muscle strain in the back, and also a minor knee injury. Both have healed fine from regular rest and exercise, lots of core work!


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## J B (May 24, 2013)

Healed in a week, that was easy!  Very happy for you.


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