Unexpected Predictors of Back, Shoulder, and Knee Injuries in Fire Cadets: Insights from a 5-Year Retrospective Review
Poster #: 162
Session/Time: A
Author:
Hillary Lee, MS
Mentor:
Eric Schussler, PhD, MS
Research Type: Public Health
Abstract
INTRODUCTION:
Shoulder, lower back, and knee injuries are among the most prevalent and costly musculoskeletal injuries (MSKIs) in the fire service. While risk factors for MSKIs have been studied in active-duty firefighters, little is known about predictors of injury during fire cadet training. Given that fire departments invest approximately $300,000 per cadet over a six-month academy-largely funded by taxpayer dollars-injuries during training represent not only a personal health risk but also a substantial financial burden. Moreover, injuries sustained in the academy can cause lasting damage and increase long-term injury risk throughout a firefighter's career. This study aimed to identify trends and potential predictors of these injuries in cadets over a five-year period.
METHODS:
Injury reports were analyzed retrospectively from a large urban fire department's academy, spanning 10 cadet class cohorts (2019-2024). Injuries were categorized as shoulder, lower back, knee, or other. Predictor variables included the daily training schedule (e.g., classroom instruction, exams, hands-on skills training) and parameters related to scheduled physical training (PT) sessions, defined as structured workout sessions conducted as part of the academy curriculum. Binary logistic regression was used to calculate odds ratios and assess the statistical significance of predictors.
RESULTS:
A total of 307 injuries were reported, with 43% involving the shoulder (n = 29; 9.4%), knee (n = 55; 17.9%), or lower back (n = 47; 14.3%). • Shoulder injuries were significantly associated with training week (p = 0.02), occurring 3.7 times more frequently during weeks 8-14 of the 28-week academy. • Lower back injuries were 4.1 times more likely to occur on days with classroom-based exams compared to non-exam days (p = 0.02), regardless of other factors. • Knee injuries were significantly associated with the duration of PT sessions (p = 0.03), with injuries 3.1 times more likely to occur on days when workouts lasted 75 minutes or longer.
CONCLUSION:
Injuries to the shoulder, back, and knee during cadet training can lead to medical disqualification and may increase future injury risk during active duty. While three significant predictors were identified, several others approached significance and warrant further investigation. Future research should include demographic and physiological variables (e.g., age, sex, fitness level, injury history) and more detailed analysis of physical training content and intensity. Identifying modifiable injury risk factors can inform prevention strategies to reduce MSKI rates in both cadets and career firefighters.
Shoulder, lower back, and knee injuries are among the most prevalent and costly musculoskeletal injuries (MSKIs) in the fire service. While risk factors for MSKIs have been studied in active-duty firefighters, little is known about predictors of injury during fire cadet training. Given that fire departments invest approximately $300,000 per cadet over a six-month academy-largely funded by taxpayer dollars-injuries during training represent not only a personal health risk but also a substantial financial burden. Moreover, injuries sustained in the academy can cause lasting damage and increase long-term injury risk throughout a firefighter's career. This study aimed to identify trends and potential predictors of these injuries in cadets over a five-year period.
METHODS:
Injury reports were analyzed retrospectively from a large urban fire department's academy, spanning 10 cadet class cohorts (2019-2024). Injuries were categorized as shoulder, lower back, knee, or other. Predictor variables included the daily training schedule (e.g., classroom instruction, exams, hands-on skills training) and parameters related to scheduled physical training (PT) sessions, defined as structured workout sessions conducted as part of the academy curriculum. Binary logistic regression was used to calculate odds ratios and assess the statistical significance of predictors.
RESULTS:
A total of 307 injuries were reported, with 43% involving the shoulder (n = 29; 9.4%), knee (n = 55; 17.9%), or lower back (n = 47; 14.3%). • Shoulder injuries were significantly associated with training week (p = 0.02), occurring 3.7 times more frequently during weeks 8-14 of the 28-week academy. • Lower back injuries were 4.1 times more likely to occur on days with classroom-based exams compared to non-exam days (p = 0.02), regardless of other factors. • Knee injuries were significantly associated with the duration of PT sessions (p = 0.03), with injuries 3.1 times more likely to occur on days when workouts lasted 75 minutes or longer.
CONCLUSION:
Injuries to the shoulder, back, and knee during cadet training can lead to medical disqualification and may increase future injury risk during active duty. While three significant predictors were identified, several others approached significance and warrant further investigation. Future research should include demographic and physiological variables (e.g., age, sex, fitness level, injury history) and more detailed analysis of physical training content and intensity. Identifying modifiable injury risk factors can inform prevention strategies to reduce MSKI rates in both cadets and career firefighters.