Improving the Health & Safety of all Emergency Responders

March Editor’s Note:

Just as we are continuing to learn more through research on the dynamics of fire behavior, we should also expand our knowledge on the dynamics of fitness. While cancer and mental health have emerged as major issues in responder health and wellness, preventable injuries still remain a complex and everyday occurrence. This month, I have reached out to the San Antonio, TX Fire Department to discuss their physical fitness programs with the use of athletic trainers on staff. While I understand that is a far reach for most every department to do, there are resources in your community that can provide assistance. It should be more than just Everyone Goes Home, we should adopt the philosophy that Everyone Goes Home Healthy!

“Never let the minimum standard be your maximum performance!” – Billy D. Hayes

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March 2018

Joe Jones has served the San Antonio Fire Department for 20 years.

Deena Kilpatrick MS, LAT, ATC is the Athletic Trainer for the San Antonio Fire Department. 

Changing the Face of Firefighter HealthCare in San Antonio
Joe Jones & Deena Kilpatrick

Lip service is not enough, and traditional thought pathways lead to tired, old, worn-out, and often ineffective “solutions.”  We must think asymmetrically when it comes to traditional, identifiable, and known health issues within public service.  Especially when the injury patterns and injury causes are both well known.  For years we professed our reality as being the “lowest paid professional athletes.”  While we are nontraditional “athletes,” the consequences of our preparation, readiness, and well-being can be deadly.  Our reality dictates no time to warm-up, stretch-out, and mobilize our bodies before beginning one of the deadliest athletic endeavors known to man: firefighting.

In 2014 we were challenged to protect our personnel “from the cradle to the grave” an ominous demand, but one that we took seriously.  Our profession has a proud identity.  We are full of sayings such as “back when men were made of steel and ladders were made of wood” and “300 years of tradition unimpeded by progress.”  While strategy, tactics, and technology in firefighting has advanced substantially, our injury numbers and patterns have remained steady throughout.  In the end, no matter the amount of bravado smothered on top of our ethos, we are human machines subject to wear and tear from repeated use and abuse.  So our team kept an open mind regarding potential solutions and while searching for answers to health questions that have plagued our profession for nearly 300 years, we ran smack into an enchanting and energetic individual who had a fantastic idea.

The idea of athletic training within the fire department had never occurred to us.  In fact we were so ignorant about athletic training that we weren’t aware that athletic training was a college education tract and degree granting program.  Although we were not previously aware of the impact that athletic training would have on our department, now that our eyes have been opened, we cannot see functioning without athletic trainers in our midst.  So valuable is our sports medicine program to our membership that firefighters credit the program with returning them to work weeks ahead of schedule and keeping them on duty where they would have otherwise been considered on line of duty injury leave.

It is a well-documented fact that firefighters sustain injuries at a higher incidence than a large number of professions.  The very nature of the job requires strength, speed, agility, and endurance.  Sprains, strains, and muscular pain account for more than half of injuries incurred by firefighters.  In the current healthcare climate, these injuries can be very time consuming and costly.

The San Antonio Fire Department Sports Medicine Facility houses a 1000 sq. foot treatment and rehabilitation area with a certified athletic trainer conducting clinical evaluations, and administering treatment and rehabilitation protocols.  Deena Kilpatrick is the certified athletic trainer for the SAFD and has documented over $800,000 in cost savings for the past fiscal year and over $1.5 million for the first two years of the program’s existence.  The Sports Medicine Facility has cared for over 800 injuries in this time period and has continued to expand.  Services provided include prevention, emergency care, clinical diagnosis, therapeutic intervention, and rehabilitation of injuries and medical conditions.

Athletic trainers are not fitness experts or personal trainers; they are health care professionals who collaborate with physicians. The American Medical Association has recognized athletic trainers as allied health care providers since the 1990s. Athletic trainers work under the direction of physicians, as prescribed by state licensure statutes and develop an understanding of the job requirements for public safety personnel.  These professionals are employed “on-site” to provide for the prevention, care, and rehabilitation of injuries.

Rehabilitation of musculoskeletal injuries includes a thorough evaluation of functional and work-related biomechanics. With this information, patients then receive individualized treatment and rehabilitation plans designed to correct deficiencies and weaknesses. As patients progress through their rehabilitation plan, exercises increase in intensity and difficulty.  “While tackling the topic of enhanced firefighter care and maintenance, we left no stone unturned.  It wasn’t enough to have a health and wellness office and psychological support.  Instead, we sought a truly complete system for getting in shape or staying in shape by encumbering resources dedicated to fitness education, fitness training, fitness programming, and fitness equipment provision.  We added the extra layer of care by providing the office of sports medicine for our tactical athletes”(Joe Jones, 2017).  It is for this reason that the SAFD gym is connected to the SAFD Sports Medicine Facility and is utilized for functional rehabilitation and every conceivable fitness pursuit.

San Antonio Fire Department CrossFit classes are led by uniformed personnel.  San Antonio Fire Department Captain Andy Fields modifies (or “scales”) exercises for individuals and instructs proper form.  This collaboration allows personnel to benefit from both treatment and rehabilitation with a certified athletic trainer and promotion of greater health through physical activity. The nature of the San Antonio Fire Department’s various fitness programming and dedication to the health of our departmental family have reaped rewards such as reduced injuries, improved health, and a boost in overall morale.

Takeaway Tips
1. A comprehensive Health & Wellness is the most effective approach for prevention of injuries.
2. As demonstrated by the San Antonio Fire Department, athletic trainers have proven favorable return on investment.
3. Fire and emergency services departments should reach out to athletic trainers, who are healthcare professionals trained in the prevention, assessment, treatment, rehabilitation, and reconditioning of injuries, to assist in departmental health, wellness, and fitness programs
4. Health and Safety Officers should continue to research the benefits of athletic training for emergency responders and implement best practices within their organization as possible.


Joe Jones has served the San Antonio Fire Department for 20 years. Having worked his way up through the ranks, he served in demanding positions within the Technical Rescue Team at every rank through Captain while also taking his turn in the Emergency Medical Services as an Engineer-Paramedic. During his tenure as the Chief of Training, Joe was able to kick-start the fitness revolution that has swept the SAFD and initiate the department’s first successful Officer Training Program and Incumbent Training Program. While serving as an Assistant Chief, Joe was instrumental in developing and reforming a number of programs within the SAFD to include Media Production, Fitness, Sports Medicine, Safety, Cancer Prevention, and Training. Joe currently serves as a Battalion Chief in Operations.


Deena Kilpatrick MS, LAT, ATC is the Athletic Trainer for the San Antonio Fire Department. She received her Bachelor’s degree in Athletic Training from Texas Lutheran University and her Master’s degree in Athletic Training from West Virginia University. She has athletic training experience working at the Division III, Division I, and secondary school setting as well as working with the U.S. Olympic Fencing Team. Deena holds an Athletic Training License for the state of Texas (LAT) as well as a National Certification (ATC). Currently, Deena serves as the President of the Public Safety Athletic Trainer’s Society (PSATS) and is the Public Safety liaison to the Committee on Practice Advancement for the National Athletic Trainers’ Association.