Firefighter Back Injuries: Why They Happen and How to Prevent Them
Firefighting isn’t just about running into burning buildings—it’s about hauling heavy gear, awkward lifting, and sudden bursts of movement under extreme conditions. With all that, it’s no surprise that low back injuries are one of the most common reasons firefighters go out of service.
But here’s the kicker: most of these injuries don’t come from one catastrophic event. They’re usually the result of years of poor movement, lack of strength, and ignoring early warning signs. The good news? You can do something about it.
firefighters rolling hose rounded back
Why Firefighters Are Prone to Back Injuries
1. The Job can be Unforgiving on Your Spine
Firefighters don’t get the luxury of setting up perfect lifting mechanics before dragging a downed victim or hoisting a ladder. Combine that with heavy loads, unpredictable environments, and long shifts, and you’ve got a recipe for wear and tear on your back.
2. Core Weakness (And No, Crunches Won’t Fix It)
Your core isn’t just your abs—it’s everything from your shoulders to your hips that stabilizes your spine under load. If your core isn’t strong and able to react quickly, your lower back takes the hit.
3. Poor Mobility (AKA Your Hips Don’t Move, So Your Back Picks Up the Slack)
If your hips and upper back (thoracic spine) don’t move well, your lower back will compensate. That’s when you start feeling stiffness, tightness, or worse—pain.
4. Deconditioning & Fatigue
Exhaustion is a part of the job, but when you’re tired, your movement quality tanks. The more deconditioned you are, the faster you hit that fatigue wall, and the more likely you are to tweak your back doing something routine.
One single thing didn’t cause it, one single thing won’t fix it.
Just like responding to a scene takes more than one single tactic, handling low back pain shouldn’t be approached in a single direction. Low back pain is usually caused by a combination of things and is improved with a combination of things as well.
How to Keep Your Back Injury-Free
You can’t control the chaos of the job, but you can build a back that’s strong and resilient enough to handle it. Here’s how:
1. Train Your Core for Stability, Not Just Aesthetics
Forget endless sit-ups. Your core needs to resist movement, not just create it. Your core aesthetics from your nutrition, your core’s strength - that’s what keeps injuries at bay. Start here:
Anti-rotation: Pallof presses, suitcase carries
Anti-extension: Dead bugs, ab rollouts
Anti-lateral flexion: Side planks, farmer’s carries
2. Fix Your Mobility
Mobility isn’t about being able to touch your toes—it’s about having the right joints move at the right time. Work on:
Hip mobility: 90/90 stretches, deep squat holds
Thoracic mobility: Open book stretches, foam rolling
Ankle mobility: Calf stretches, dorsiflexion drills
3. Train Your Spine to Move—Not Just Brace
A strong back isn’t just one that can hold rigid under load. It’s one that can move through flexion, extension, and rotation without breaking down.
Flexion and extension: Situps, Jefferson curls, controlled cat-cow drills
Rotation: Landmine rotations, cable wood chops, med ball rotational lunges or slams
Loaded movement: Sandbag shouldering, rotational deadlifts
🔥 Important: These movements need to be progressed properly. Jumping straight into heavy loaded flexion, extension, or rotation without control is a recipe for injury. Start with unloaded or lightly loaded movements and build up as your body adapts. Train control first, then strength, then power.
4. Get Stronger (But Train Smart)
Strength isn’t just about lifting heavy—it’s about being able withstand demands from multiple directions. Focus on hinging, squatting, pressing, and pulling movements, with an emphasis on unilateral exercises (like single-leg or single-arm work) to fix imbalances.
Prioritize deadlift variations, split squats, and single-arm carries - getting strong in multiple patterns is required for a resilient back.
Train your back in all directions—hinging, twisting, and stabilizing against movement.
🔥 Progressive loading matters. Don’t start with heavy weight or complicated movement on Day 1. Build movement competency first, then add load in a way that makes sense. If you struggle to control your hinge pattern unloaded, adding weight to it isn’t going to magically fix your mechanics—it’s just going to make you hurt faster.
5. Stop Ignoring Recovery (Yes, That Includes Rest Days)
Your back won’t hold up if you’re constantly running on empty. Get sleep when you can, fuel your body, take rest days, and manage stress. Yes, we want to build the resilience of your back, but we can’t go balls to the wall and expect the progress we’re looking for. Being unprepared to go balls to the wall is what got you injured in the first place.
If you’re always stiff and tight, you might be under-recovered, not just weak.
Rest days aren’t optional—your body needs time to rebuild and adapt. This is when we actually get strong.
Sleep - you know I couldn’t go one blog post without discussing sleep! Yes, I know it’s tough when on shift, but there are still a few things you’re in control of in regards to your sleep - what time you TRY and go to bed on shift, whether or not you’re slamming energy drinks later in the afternoon, and not to mention everything about being off shift.
The Bottom Line
Back injuries don’t happen overnight—they build up over time. The strongest firefighters aren’t just the ones who lift the most; they’re the ones who train smart, move well, and take care of their bodies.
If your back is already bothering you, don’t wait for it to get worse. Start addressing mobility, core stability, and strength today, so you can stay in the fight for the long haul.
Want a structured plan? Check out the 'Back in Service' program—built specifically for firefighters who want to get out of pain and back to strong work.
Want individual guidance in training? Schedule a Size-Up Session or Start with 1:1 coaching, and we’ll talk through exactly how to progress your training based on where you are right now.
References:
Frost DM, Beach TA, Crosby I, McGill SM. Firefighter injuries are not just a fireground problem. Work. 2015;52(4):835-42. doi: 10.3233/WOR-152111. PMID: 26409354.
Moon TY, Kim JH, Gwon HJ, Hwan BS, Kim GY, Smith N, Han GS, Lee HC, Cho BJ. Effects of exercise therapy on muscular strength in firefighters with back pain. J Phys Ther Sci. 2015 Mar;27(3):581-3. doi: 10.1589/jpts.27.581. Epub 2015 Mar 31. PMID: 25931685; PMCID: PMC4395669.
McGill, S. M. (2007). Low Back Disorders: Evidence-Based Prevention and Rehabilitation. Human Kinetics.
Zedka, M., Prochazka, A., Knight, B., Gillard, D., & Gauthier, M. (1999). Voluntary and reflex control of human back muscles during induced pain. Journal of Physiology, 520(2), 591-604.
Willardson, J. M. (2007). Core stability training: Applications to sports conditioning programs. Journal of Strength and Conditioning Research, 21(3), 979-985.
Peate, W. F., Bates, G., Lunda, K., Francis, S., & Bellamy, K. (2007). Core strength: A new model for injury prediction and prevention. Journal of Occupational Medicine and Toxicology, 2(1), 3.
