HEMS fitness – train movements, not muscles

Weight training

Dan Leary, a retired US Coast Guard helicopter pilot and current HEMS pilot in Astoria, Oregon, shares his insights into the kinds of exercises that can help flight and medical crew maintain their fitness levels to ensure they are performing at the top of their game

As a helicopter pilot at a HEMS base, our fitness is essential for our profession; but more importantly, for our own longevity. We will always be called on to help lift patients, carry medical equipment as well as climb all over our helicopter on preflight. As a certified weightlifting coach/trainer, I’d like to share with AirMed&Rescue’s readers some simple ideas to keep you ahead of the fitness curve, in good shape, and to ward off any chance of injury at work.

First and foremost, make sure a medical professional approves you for physical fitness. Assuming you undergo a yearly flight physical, this should not be an issue. Next, the Functional Movement Screen is a great step to see any movement imbalances/deficiencies you may have: check out functionalmovement.com

Start at the very beginning: Warmup

The goal of the warmup is to prepare the muscles to prepare them for exercise. It can be as expansive or simple as you like. Five minutes of jump rope, or some crawling, come to mind. There are a ton of warmups you can find online, but two that stand out are by Team EXOS and StrongFirst. Check them out. The warmup should take between five and 10 minutes.

Next, I want you to think about the following words: push, pull, legs, hips, core, carry. In my opinion, we are better training movements than muscles, and these are the movements we will train, as they encompass moving in all planes (sagittal, frontal or transverse)

Every workout should have these movements in it: Upper push (push up, bench press, military press), pull (chin ups, barbell, TRX rows), legs (squat, lunge, step up), hips (think hinging at the waist – deadlift, glute bridge, kettlebell swing), core (sit ups, leg raises, planks), carry (farmers, suitcase, rack, overhead).

Practicalities

Now how do we make this all work? Set it up in a circuit and move from exercise to exercise. Do three to four rounds of this, and I recommend between six and eight repetitions per exercise. Your workout would look like this:

Day one workout:
  • Push: Pushups x8 reps
  • Pull: TRX row x8 reps
  • Legs: Bodyweight lunge x8 reps each leg
  • Hips: Glute bridge x 8 reps
  • Core: Plank for 20 seconds
  • Carry: Suitcase carry (one dumbbell at your side) walk 20 yards then return 20 yards in the other hand.

Complete this circuit four times.

Day two workout:
  • Push: Standing Dumbbell press x8
  • Pull: Chin Ups x8
  • Legs: Goblet Squat x8
  • Hips: Kettlebell swing x8
  • Core: Leg Raises x8
  • Carry: Kettlebell Rack Carry (same as day one)

If you still have energy left, I’d recommend some sort of metabolic conditioner such as walking on the ramp for 30 minutes, sprinting, pushing/pulling a sled, rowing or running.

Planes of motion

All the gear

As far as gear is concerned, it is up to you. You can do bodyweight, dumbbells, barbells, kettlebells (my favorite), TRX, or sandbags. Let’s discuss the benefits of each.

Bodyweight: the bodyweight option is truly the easiest, as it requires no gear other than a pull-up bar. The downside is that, after a while, you can’t challenge your body in the same way as you would with gear.

Dumbbells: These are very popular and easy to transport. The downside is you need multiple sets or the interchangeable multiple weight sets, which can get expensive.

Barbell: The barbell is the go-to for weight training, but can be unwieldy and space can be an issue. You may also need a squat rack.

Kettlebells: I love kettlebells for the versatility. Kettlebells are a worthy investment as they are a pocket gym that train all human movement in six basic exercises – aka The Big Six:

  • Kettlebell Swing
  • Goblet Squat
  • Press
  • Clean
  • TGU (Get Up)
  • Snatch

I love complexes with kettlebells as they are time efficient. A complex is a series of exercises done in a row without putting the kettlebell down. This does three things:

  • Metabolic conditioning, which trains us to work under stress while building endurance.
  • Trains strength, getting us stronger, which is always better!
  • Time under tension builds our muscles as we don’t put the weight down for one to two minutes.

There are many kettlebell complexes out there, but a simple kettlebell complex would look something like this:

  • 5x Kettlebell swing
  • 5x Clean & Press
  • 5x Front squat

This simple complex addresses four of the big kettlebell six exercises and saves time as well. I’d do three to four sets of this complex, with anywhere between one and three minutes of rest between complexes.

As a StrongFirst certified kettlebell instructor, I recommend you get some training before you start kettlebell exercises. Their website has everything you need for more info on kettlebells.

TRX: TRX is a suspension system created by a Navy SEAL. It’s a great piece of gear and I keep one in my truck. It is a simple go-to piece of gear.

Sandbags: These are nice because you can make them (inexpensive) or buy them. As the sand moves, it requires more bracing and will really challenge you. The folks at Ultimate Sand Bag training have a ton of information on their website. Check them out!

Hybrid workouts: These involve using whatever gear you have available. I’m a huge fan of mixing bodyweight, kettlebell and TRX to create a great workout. Zach Even Esh and his Underground Strength Gym are industry experts at this.

There are lots of ways to get/stay in shape. I truly believe it is our responsibility to our crew that we arrive in the best shape we can when we come to work. The people we work with and serve deserve nothing less.