By Michael Krueger
We don’t think much about our ability to maintain our balance until we lose it. If you’ve ever had an ear infection that compromised the vestibular (equilibrium) component of balance, you are aware of how disorienting and scary that can be.
Firefighters need to train in every aspect of fitness, and balance is just as important (yet often neglected) as any other part.
Where Does It Come From?
Balance is a complicated thing that I will try to make simple and understandable. There are three parts to balance: vestibular, which is the part that comes from your inner ear and is often referred to as your equilibrium; proprioception, which is body awareness in space–the feedback you get from the adjustments your muscles, ligament, tendons, and joints make that helps you maintain stability on uneven, changing surfaces; and vision, the easiest to understand. We make use of visual constants in our environment such as knowing that trees are, for the most part, vertical and our body position while walking is perpendicular to the horizon. If all three of these are working in harmony, we are likely to remain upright without any problems.
Now, what happens if one or more of these are compromised and you are unable to use them to help you to remain “rubber down and helmet up”? The short answer is, nothing good.
If your equilibrium is compromised, you will experience severe dizziness even when lying down with your eyes tightly closed, which, by the way, is the position you will most likely assume if you are ever afflicted with a loss of equilibrium. It is disorientating, nauseating, and very scary. Usually this is caused by an infection, a breakdown of your ability to maintain normal sodium levels, or a head injury.
If your proprioception isn’t what it should be, you experience a lack of stability; you are no longer “sure footed” and tend to stumble. This is usually caused by insufficient muscle strength in the lower body or a lack of practice caused by an inactive and sedentary lifestyle. This is frequently what causes falls among the elderly.
The contribution to balance that comes from vision is easy to demonstrate. Just stand on one foot and close your eyes. Most people will begin to sway within a few moments, and some will tumble over in short order. We are very visual creatures and glean a lot of our balance information from sight.
Under normal circumstances, these three systems contribute more or less equally to our sense of balance. This being said, it is nearly impossible to function normally if you have a vestibular problem, whereas if your body awareness or sight is temporarily impaired, you can make adjustments and still perform quite well.
This temporary loss of proprioception and vision cues is what I want to address, since working in a smoky, rumble strewn, unpredictable environment is par for the course for firefighters.
Balance Training
Basic training for improved balance is actually remarkable easy. It is something anyone can do and is as simple as standing on one foot and bending over to pick an object up off the floor. This is an excellent way to first test your balance and then to improve it. That simple move employs all three aspects of the balance continuum. Once that gets easy, do it with your eyes closed or in the dark. Once you get good at this simple exercise, it is time to make it firefighter specific and considerably more complicated.
Your protective gear imposes additional challenges to your balance, which the average person never encounters. It adds 60-plus pounds and thereby shifts your center of gravity. The bulky coat, pants, and gloves impede the feedback loop from external stimulus to your nervous system. Your boots make it difficult to get useful information from your feet and ankles to really “feel” what you are standing on. Your helmet and visor obstruct your vision as well. But, since this is the environment you work in, this is where you must train.
Full turnout gear balance training is something that you do every time you train skills while wearing it, even if you are unaware that that is what you are doing. Just quickly putting it all on is a challenge to your balance. Getting into a truck, connecting a hose, climbing a ladder–they all tax your sense of balance.
I’ve known firefighters who have tripped over hoses, stumbled into holes, slipped on ice, fallen off ladders, and caught a toe and fell while getting out of a truck. All of these incidents resulted in injuries serious enough to put them out of commission not only on that particular call but for weeks and even months. The investigations turned up the usual suspects: not following procedures, faulty equipment, and human error. The one thing that no one specifically mentioned was balance.
Watch a football player get battered from all sides while running with a ball. He spins and twists all the time looking downfield, employing his vision to help keep him going in the right direction. He is constantly adjusting his body position through feedback from the position of his feet, legs, and hips and the challenges to his equilibrium. To some extent this comes naturally (it does to all of us), but through exhaustive training he has honed his abilities to perform on the football field to the point where he appears almost superhuman.
Football players run drills where they are pushed and shoved from all directions to stress their balance. They do it at the start of practice when they are fresh and at the end when they are tired. They train in the environment and under the circumstances they are expected to perform in, not on a Bosu ball in the controlled comfort of the gym.
The Fitchburg (WI) Fire Department has an elaborate maze that it has constructed in the basement of one of its stations. This maze is a building mock-up that is modular so it is infinitely changeable. Members can run it in total darkness or with disorienting sound and lights.
Most firefighters correctly equate this maze with skill training but don’t think too much about the workout it gives their balance. The low visibility, cramped quarters, changing environment, cluttered surfaces, and full turnout gear all challenge their ability to maintain their equilibrium, visual cues, and sensory/body awareness. It is an excellent training tool, and it has improved their performance in ways that they didn’t originally even anticipate.
Balance and Age
Unfortunately, as with so many things, balance is a “use it or lose it” proposition. Fortunately, if you do use it, you may maintain stability throughout your life. Many of the elderly break bones through falls, most of which could have been avoided through simple balance training. Falls are the number one cause of disability among those over 65 years of age. I can imagine how many EMS calls you’ve responded to that involved someone who had “fallen and can’t get up.” Maintaining muscular strength along with training balance using the simple exercise outlined above could change the whole landscape when it comes to injuries caused by falls.
A Balanced Life
Balance training is important for everyone, not just firefighters and athletes. Encourage your spouse, your children, your parents, and your grandparents to take a few minutes every day to improve their balance. This small investment can prevent a fall that may result in a permanent disability, robbing them of a full and productive life.
Michael Krueger is an NSCA-certified personal trainer. He got his start in fitness training while serving in the United States Coast Guard. He works with firefighters and others in and around Madison, Wisconsin. He is available to fire departments, civic organizations, and athletic teams for training, consulting, and speaking engagements. He has published numerous articles on fitness, health, and the mind-body connection and was a featured speaker at the IAFC’s FRI 2009 Health Day in Dallas, Texas. E-mail him at MKPTLLC@gmail.com.
