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How paramedics can fix and prevent neck pain

Neck pain among EMS providers is common, but it doesn’t have to be; here are exercises and mobility tips to remove neck pain from your life

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Pain while at work, running calls or after work is a problem.

Photo/Bryan Fass

Before I became a paramedic, I had spent over 15 years treating patients in physical therapy and pain clinics. Most of my neck pain and headache patients had the same presentation. Forward head posture, rounded shoulders and a weak upper back.

It amazed me that they sat in the waiting room with their heads in a phone screen even after I taught them that a root cause of modern neck issues is technology. Think about that the next time you are charting or reading an article on your smartphone.

Pain is not normal, unless you are exercising, and then it’s a good thing. Pain while at work, running calls or after work is a problem. Just like a TIA or angina, it is a precursor to a much bigger problem; neck pain or headaches are a warning sign that a bigger issue is hand.

Neck pain and headaches can spring from dozens of causes. For this article, we’ll assume that the underlying issues are either postural, muscular or both. Often the pain can be attributed to simple things like chewing gum, dehydration or nutritional deficiencies; think EMS diet.

Watch this video for an explanation of how neck and back pain is caused by regularly leaning forward in an upper body anterior bias.

The first step is to reset your posture and give your body a chance to balance its self out. This requires opening the chest wall, the lats and subscapularis, abdominal wall, hip flexors and neck flexors.

For each area being treated, spend at least 60 to 90 seconds looking for the most painful tissue; it’s this tissue that is causing the pain.

You have to get your upper back and spinal extensors stronger. Making them stronger will give them the ability to keep your shoulders back and thoracic spine extended throughout the shift.

This is no easy task as it takes time and constant work. The day you stop training is the day your body starts to get weaker and the pain comes back.

There are hundreds of exercises that will benefit you, help you at work and make your neck stronger. The exercises, shown below, are just a start. For each one do three sets of 10 to 15 repetitions at least two days per week.

The plan is simple. You need to move well and move pain free. To get there do your mobility work anytime there is pain and always before you train.

Your job is 100 percent physical, so learn to move well and be strong. This means being job strong, so that you can safely lift, move, push, pull, carry, and of course, charting and reading on your phone.

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Bryan Fass, ATC, LAT, CSCS, EMT-P (ret.), dedicated over a decade to changing the culture of EMS from one of pain, injury and disease, to one of ergonomic excellence and provider wellness. He leveraged his 15-year career in sports medicine, athletic training, spine rehabilitation, strength and conditioning and as a paramedic to become an expert on prehospital patient handling/equipment handling and fire-EMS fitness. His company, Fit Responder, works nationally with departments to reduce injuries and improve fitness for first responders.

Bryan passed away in September, 2019, leaving a legacy of contributions to EMS health and fitness, safety and readiness.