The Role of Resistance and Plyometric Training in Firefighter Safety and Performance: A Narrative Review

Abstract

Firefighting is a physically demanding occupation that requires optimal fitness and coordination in addition to other physical and cognitive skills. When firefighters lack the physical fitness necessary to perform their duties, they put themselves and others in danger of injury and even death. The heavy, unbreathable personal protective equipment worn to shield firefighters from harmful conditions also promotes overall performance decrements via restricted range of motion as well as energy expenditure and heat-related fatigue. Firefighters are expected to carry other heavy loads, such as hose packs, tools, and victims, while working in hazardous environments. In addition to external load carriage, many firefighters also carry excess body fat that may contribute to poor physical fitness and performance. Therefore, it is imperative to incorporate training strategies to optimize load carriage and improve body composition for improved physical performance during emergencies. Thus, the aims of this narrative review are to (1) explore the impact of firefighter-specific issues on physical performance and safety and (2) identify strategies to assess and optimize occupational performance and safety. Plyometrics; resistance training; and exercise selection, volume, and intensity specifically for improving physical performance in firefighters will be discussed.

1. Introduction

In response to fires and emergency situations, firefighters often push themselves to their maximal limits to successfully abate the situation and protect others by rapidly deploying their skill sets while risking musculoskeletal injuries due to overexertion, falls, slips, or trips [1,2,3,4,5]. Underlying causes that may contribute to these issues merit consideration. Musculoskeletal injuries are likely influenced by personal protective equipment (PPE) worn on scene which, although imperative for occupational health, substantially increases energy expenditure and decreases gait stability [6,7]. These effects of wearing PPE are observed during normal movements but are more pronounced when performing challenging activities such as crawling, climbing stairs with a heavy hose, dragging a victim, and dismantling structural and insulation materials in buildings (ceiling overhaul) [8].

Musculoskeletal fatigue is common in many professions, but it is accelerated by the occupational demands of firefighting. Fatigue and the resulting decrease in motor performance and coordination may lead to a slowed rate of movement through a dangerous environment, the inability to perform high-intensity physical tasks, and/or direct injury via slipping, tripping, or falling. Unfavorable body composition is another factor that may prevent peak physical performance and/or cause fatigue, increasing the risk of injury.

Many aspects of firefighting that may prevent optimal performance are difficult or impossible to change [6,7,8]. For instance, PPE use among firefighters is required to protect them from the dangers of the firefighting environment. Likewise, the physical tasks that must be performed by firefighters are, in a sense, “non-negotiable,” given the nature and gravity of the profession. Rather than try to change these factors that present persistent health and performance hazards, it may be more effective and appropriate to promote adaptations to overcome the resulting detriments. Several training methods and fitness objectives exist that facilitate adaptations and ameliorate the negative effects of firefighter occupational hazards.

An examination of the factors associated with occupational and performance decrements in firefighters is necessary to properly develop strategies to overcome these deficits. Thus, the first aim of this review is to explore the impact of firefighter-specific issues on physical performance and safety. The implementation of practical and effective training strategies also needs to be considered so that fire stations can determine which ones are most appropriate for them. Aerobic training has been the primary focus in previous review articles [9,10], and while improving aerobic capacity is of the utmost importance to firefighting performance, strategies for developing optimal strength and power are also required. The use of such interventions in firefighters is invaluable from a safety and performance standpoint, yet this area has received considerably less attention in the literature than training for aerobic capacity. Therefore, the training focus of this review is strength and power. Thus, the second aim is to identify plyometric and strength-specific strategies to assess and optimize occupational performance and safety.

2. Threats to Efficient Physical Performance and Safety

2.1. Range of Motion and Balance Impairment

Fire service PPE is certified by the National Fire Protection Association (NFPA) and includes protective coats and pants, helmets, gloves, boots, and a self-contained breathing apparatus (SCBA). PPE is designed to protect firefighters from environmental stressors such as extreme heat from fires, toxins from exposed gases, physical injuries, and bloodborne pathogens [11]. Although PPE is designed for safety from those extreme conditions, the required bulkiness and weight to be protective have detrimental effects on gait and balance. These detriments induce greater physiological demands on firefighters to maintain footing, speed, and proper biomechanics [6,7,8,12,13,14]. Each piece of PPE promotes changes in gait through decreased mobility and/or increased demand on the metabolic system when worn [15,16].

Range of motion becomes restricted when firefighters wear PPE, which negatively impacts gait and, therefore, performance on the job. For instance, full PPE has been shown to reduce the range of motion of the hip and knee, thereby limiting mobility, reducing gait speed and stride frequency, and increasing stride length to compensate [17]. Additionally, compared to running shoes, firefighter bunker boots significantly limit the ankle’s range of motion, an effect that must be compensated for by producing more movement at the hip and knee joints [17,18,19,20]. When PPE and boots are paired together, this compensation becomes more difficult to achieve and results in impaired balance and, ultimately, gait. PPE has been modified to be lighter and less restrictive while maintaining sufficient protection from hazards and meeting NFPA standards, yet gait impairments similar to standard PPE persist [21].

Aside from the boots and protective clothing, the SCBA has pronounced effects on balance. The SCBA consists of a metal cylinder (or multiple other containers) of compressed air that is carried on the back using a harness and weighs between 9.9 and 13.3 kg when full [22]. The added weight on the back transfers the firefighter’s center of gravity posteriorly, resulting in more errors when navigating obstacle courses and increased time to overcome obstacles [22,23]. Bottle design, including bulk and weight, also increases side-to-side sway, and the SCBA facepiece reduces vision. Forward-to-back stability was only affected when firefighters had their eyes closed [23].

2.2. Fatigue

PPE is heavy; thus, performing high-intensity movements while wearing this external weight increases the metabolic cost of activity, which accelerates the onset of fatigue [24,25,26]. The metabolic cost of activity is compounded when duties require a high level of coordination and balance like in two-person lifts or carrying tasks (i.e., carrying a downed firefighter in a hazardous environment) [27]. Metabolic costs of load carriage, which includes PPE plus any tools or objects carried, vary based on the speed of the movement, degree of grade, absolute load carried, load distribution, and body composition of the firefighter [15,24,26,28,29,30,31,32,33,34,35]. A firefighter’s duties often require repetitive reaching, bending, lifting, and pulling, such as lifting a hose above the shoulder or rolling a hose on the ground [36]. Such movements compromise stability by requiring firefighters to perform high-intensity work in disadvantageous postures, thus limiting potential biomechanical advantages (i.e., “lift with your legs”). Therefore, increased mechanical work, inefficient movement patterns, and balance challenges are potential mechanisms for increasing metabolic costs [24,29,37].

Load carriage is associated with biomechanical changes in balance, muscle activity, joint moments, and musculoskeletal stiffness which becomes exacerbated as fatigue increases [6,23,24,25,29,32,37,38,39,40]. Rice et al. [41] demonstrated that increased load carriage resulted in fatigue-related gait impairments, which may contribute to musculoskeletal injuries like stress fractures. Similarly, Kong et al. [42] reported increased gait variability of double-support time following 50 min of walking in a hot environment while wearing PPE and concluded that this could lead to slips, trips, falls, or other occupational injuries. Biomechanical changes may occur from reductions in muscle force production post-load carriage [38]. Firefighters are further disadvantaged when considering that grip strength detriments from stretcher carrying lasts for more than 24 h [43]. This also aligns with full recovery from a simulated victim drag can take at least 50 min post-drag to recovery, which is far greater than the 10–20 min rehabilitation protocol for fire service [44].

It is worth noting that, compared to industrial or military PPE, firefighter PPE resulted in a greater increase in metabolic demand when walking, stepping, and completing an obstacle course [15]. Specifically, the metabolic demand was greater from wearing the firefighter suit than from carrying the firefighter tools [15]. Also, the bunker clothing and boots in firefighter PPE contributed more to the metabolic cost of exercise than the SCBA [35]. The protective boots, alone, are heavy (>4 kg) and induce fatigue quickly due to the physical demands required by the legs to lift the boot with each step [45]. Thus, improving work capacity to better match the metabolic costs of operating in PPE and carrying external loads should be a pillar of firefighter training. Furthermore, firefighters are at risk of hyperthermia due to the proximity to active fires, intense physical activity during firefighting, and low breathability of the PPE, which limits any convective or evaporative heat loss. Excessively high body temperature contributes to fatigue and inability to sustain neuromuscular capabilities [35,46,47]. Coupled with PPE movement restriction and intense physical exertion, fatigue-related gait impairment is a key component of movement inefficiency in firefighters.

2.3. Body Composition

Despite high levels of occupational physical activity and above-average scores on select fitness parameters, a substantial portion of the male firefighter population in the US is classified as overweight (50.6%) or obese (30.8%) using the criteria of BMI of 25.0–29.9 kg/m² and >30 kg/m², respectively [48,49]. The rate of obesity is even greater among volunteer firefighters (43.2%) [49]. Firefighters who are classified as obese are 5.2 times more likely to experience a musculoskeletal injury [50]. Furthermore, for each one-unit increase in BMI, there is a 9% increase in missed workdays due to injury [51]. Although high rates of obesity are not unique to firefighters, this is still a factor of concern because the negative consequences associated with obesity pose a greater safety risk in firefighters than in the general population.

Individuals with obesity show impairments in gait as assessed by the Functional Gait Assessment (FGA). In addition to lower FGA scores, gait parameters were also less efficient than normal weight control subjects [52]. These findings were consistent when subjects moved over obstacles of varying heights as well, an element that is occupationally relevant to firefighters [52]. Other researchers have reported similar gait and movement impairments in people with obesity, such that any class of obesity (I, II, or III) was associated with significantly higher ground contact time and lower velocity of movement compared to normal-weight counterparts [53]. As with the factors discussed previously, any underlying biomechanical issue can culminate in detrimental safety and performance outcomes, making body composition an area of concern for firefighters.

3. Use of Physical Training to Overcome Threats to Performance and Safety

The sources of most threats posed to firefighter safety and performance cannot be changed (i.e., the weight of equipment that must be carried or worn). Rather, it may be more feasible and appropriate to implement strategies to limit the resulting risk of these threats. One such strategy is physical training with the purpose of inducing physiological adaptations to meet the challenges of unavoidable occupational demands for both structural and wildland firefighters. The following training strategies will focus on optimizing firefighting performance to add to the literature on physical training to improve health outcomes, as focused on in previous review articles [54,55,56,57]. Furthermore, readers interested in the benefits of circuit training to firefighter fitness and performance are referred to Loewen et al. (2020) [58].

3.1. Plyometric Training

Plyometric training has been a training strategy of choice for people seeking to improve the performance of tasks involving high-intensity running, jumping, and changes in direction [59]. This type of training is distinct from traditional resistance training in that movements utilize the stretch-shortening cycle, in which an eccentric movement is followed immediately by a concentric movement (contraction) of the same muscle or muscle group [60]. The stretch reflex activation paired with the conversion of elastic potential energy stored in the muscle–tendon unit to kinetic energy results in enhanced mechanical force production [61]. Musculoskeletal improvements are similar to those observed following resistance training, including improvements in the rate of force development [62,63], tendon stiffness [64], muscle fiber size and strength [65,66], endurance performance [67,68], and altered landing mechanics [69]. Such adaptations may better position firefighters to overcome the physical challenges posed by their occupation. The increase in musculotendinous stiffness that is observed with plyometric training enhances joint stability during eccentric muscle contractions [64], a notable advantage for firefighters carrying heavy equipment and PPE that must be accommodated with each ground contact period.

Plyometrics are generally recommended when developing an overall training plan for athletic populations due to performance increases and possibly lowering injury risk [66,70]. Firefighters’ occupational demands vary in the velocity and force required for job tasks, which range from forcible entry to hose stabilization, with everything in between. Due to this, maximum force and rate of force development are key to maintaining performance in each of these movements, especially when considering the amount of time to reach maximal force. In a 12-week pilot study by Lui et al., firefighters were placed into either resistance training or resistance training plus plyometric training. They were then assessed for occupational task performance, and the results demonstrated significantly greater improvements in occupational task performance (i.e., 60 m shoulder ladder run, fourth-floor climbing rope, countermovement jump with arm swing and seated medicine ball throw) from the combination group when compared to resistance training only [17]. Furthermore, Gutiérrez-Arroyo et al. demonstrated significant improvements in occupational task performance (i.e., abdominal, lumbar, and upper limb strength and speed to reach their ventilatory threshold) for wildland firefighters when high-intensity plyometric training was included for 8 weeks [71]. Thus, the rate of force development derived from plyometric training to enhance higher velocities is required for optimal job-related demand.

3.2. Resistance Training

Resistance training is a basis for strength and power development in strength and conditioning programs. Although strength coaches differ in their priorities of exercises, periodization techniques, and training times, it is common practice to include resistance training within programs [72]. This is likely due to the many noted benefits of resistance training, such as strength, muscle mass, power, muscle fiber characteristics, and reduction in injury risk [73,74,75,76]. These are all essential traits for fire personnel, as occupational performance, injury prevention, and health status are all critical aspects of any physical fitness program designed for fire personnel. The benefits of resistance training are well-cited. Neurological adaptations and increases in cross-sectional muscle area are the two primary outcomes of strength training [77]. These influence the overall ability of the firefighter to maintain balance and lift heavy objects/equipment/fire victims during fire calls, and also to expedite inter-shift recovery [78,79]. Chronic resistance training improves neuromuscular function by improving motor unit activation, firing frequency, synchronization, and intermuscular coordination [77,80]. Resistance training also improves cross-sectional area when performed in sufficient repetition range and loading [77]. Thus, resistance training improves both cross-sectional area and the neurological components of strength, which are related to balance, muscular endurance, firefighter work capacity, and load carriage performance.

Chronic resistance training can benefit body composition in addition to the structural and functional musculoskeletal benefits previously discussed. A recent meta-analysis of the effect of resistance training on body composition in healthy adults showed that significant reductions in body fat percentage (−1.46%) and fat mass (−0.55 kg) resulted from at least 4 weeks of resistance training, compared to no-exercise control groups [81]. The reduction in body fat percentage noted in this meta-analytic review is similar in magnitude to those reported for high-intensity/sprint interval training (−1.26%) and moderate-intensity continuous aerobic exercise (−1.4%) [82]. Resistance training has the added benefits of increasing the total lean body mass and resting metabolic rate [83,84], thus increasing the potential for continued favorable changes in body composition with long-term adherence. These benefits to body composition are somewhat subdued in active-duty firefighters, with a recent meta-analysis indicating a body fat reduction of 0.87% following at least 8 weeks of resistance training [55]. Nonetheless, the resultant improvements in both fat mass and whole-body lean mass make resistance training an important intervention with which to overcome common threats to firefighter safety and performance. Additional dietary strategies, which are beyond the scope of this review, are likely to compound the improvements in body composition observed with resistance training alone [85].

4. Implementing and Modifying Training Strategies

4.1. Plyometric Training Strategies

Similar to when prescribing training programs to athletes, strength and conditioning professionals who work with fire personnel should consider multiple characteristics of plyometric training. Exercise variables of interest include the direction of force, upper or lower-body focus, frequency of training, and load volume (volume and intensity of each exercise). Firstly, upper and lower plyometric training is recommended for athletic environments, and due to the unpredictability of the fire ground, a combined approach would be warranted [86]. The benefits of horizontal and vertical plyometrics are well documented, and due to the demand for fire service, a combination approach would be the most fitting [67,87,88,89,90]. Figure 1 provides examples of typical upper and lower-body vertical and horizontal movements performed by firefighters, along with exercises that correspond to these movements.

With a combination of upper and lower-body plyometrics, programmed with horizontal and vertical components, frequencies should be kept lower (1–2 days per week for upper and lower components separately), as lower frequencies can produce similar results to higher frequencies (4 sessions per week) [91]. These frequencies also need to be monitored with a 72 h recovery window between plyometric sessions [92,93]. Similarly, a low volume of plyometric training may be most appropriate for firefighters as there appears to be no additional benefit with higher volumes. Contact volume should be prescribed based on the training age of the firefighter with the consideration of the intensity of the chosen exercises. When defining contact volume based on training status, beginners are suggested to have 80–100, intermediate athletes 100–120, and advanced athletes 120–140 foot contacts per session [94]. Volumes for upper-body plyometric exercises are considerably lower at 5–10 repetitions per set, with three sets recommended for athletes [95]. Substantial volume increases do not necessarily yield greater training improvements, as there is no reported additional benefit to doubling training volume in athletes (180 foot contacts compared to 360) [90]. Thus, volumes and frequencies should be kept relatively low and managed with individual recovery. It is worth noting that if career firefighter workouts are the program’s goal, and the department follows a 24/48 work shift (i.e., 24 h on and 48 h off), this might be suitable for fitting into this lower frequency window [92,93].

Intensity should be increased throughout the program’s duration to maximize performance (e.g., the length of training for recruits or the annual plan for career firefighters). The intensity of plyometric exercises is typically modified through changes in points of contact, speed or height of the exercise, or the athlete’s body weight (this can be increased with external load) to induce progressive overload and adaptation [80]. Although evidence suggests more significant improvements from unilateral (i.e., higher intensity) plyometric training, there seem to be recommendations for a combined approach [67,96]. Progressing from bilateral to unilateral training can serve as an intensity-modifying technique while also protecting against injury. Further safety considerations, such as an 18-inch limit to vertical jumps and single-leg balance tests, may be of greater importance to the fire service to determine appropriate intensities due to higher obesity rates found within the fire service [49]. According to Staniszewski et al., who observed the detrimental effects of continuous repetitions without restin comparison to sets of repetitions with rest, the most optimal rest approach was the one with the longest rest interval, i.e., a 1:2 work-to-rest ratio. For example, if the firefighters took 15 s to perform their countermovement jumps, they should rest for 30 s before the following set [97].

4.2. Resistance Training Strategies

Practitioners should note that firefighters may range in experience with resistance training. Before selecting resistance training protocol details (exercise selections, volumes, and rest times), a needs analysis must be performed to understand the population segment of the fire service. Individual factors will influence choices in frequency, loading, and exercise selection. Therefore, a range of training frequencies, volumes, and loads should be employed to modify the exercise prescription accordingly. General recommendations for resistance training frequencies for novice lifters are 2–3 days per week and increase as the lifter advances [98]. Importantly, this frequency should change depending on the call frequency per week. Lower frequencies might need to be adopted during higher call weeks to maintain recovery. There are a few options for training splits: upper + lower, combination, and push + pull. The priorities for people in this exercise plan would be to maximize training adherence to and maintain a recovery-adaptation effect. The frequency also allows for focusing on different adaptations throughout the week while adjusting volume and load to suit each individual’s recovery. An example of how a typical resistance training plan would be structured according to these splits is available in

Table 1. Organizational approaches to resistance training programs.

	Heavy	Rest	Light	Rest	Heavy	Rest	Rest
Push + Pull	Push Back squat Bench press Shoulder press		Push + Pull Back squat Deadlift Bench press Bent-over row		Pull Deadlift Bent-over row
Combination	Back squat Deadlift Bench press Bent-over row		Back squat Deadlift Bench press Bent-over row		Back squat Deadlift Bench press Bent-over row
Upper body + Lower body	Upper body Bench press Bent-over row Shoulder press		Upper + Lower body Back squat Deadlift Bench press Bent-over row		Lower body Back squat Deadlift Lunges

Notes: Heavy—heavier loading days for core exercises; Light—days of lighter weight lifted while maintaining the same sets and repetitions; Push—upper- and lower-body push movements; Pull—pulling movements in both upper and lower body; Combination—selecting exercises for both upper and lower body, for both pushing and pulling; Upper—upper-body pressing and pulling movements; Lower—lower-body pushing and pulling movements.

, focusing on working heavy and light days. Alternating heavy and light loads allows the firefighter to recover from the loading and allows for variations in volume and intensity in the same week.

4.3. Exercise Selection and Sequence

Exercises should generally follow an order of larger exercises to smaller exercises and higher velocities to lower velocities [99]. Thus, power development (i.e., plyometrics) exercises should be prioritized first, followed by structural spinal loaded exercises (i.e., back squats), and then assistance and corrective exercises (i.e., planks or lunges) [100,101]. Therefore, firefighters will work power without fatigue, perform spinal loaded multipoint exercises, and perform single-joint or muscle imbalance exercises. Typically, 3–5 exercises from power and structural will be utilized per training session, with the remaining exercises from either assistance or corrective categories in order of priority based on the needs analysis [102].

4.4. Sets, Repetitions, and Intensity

Sets should increase progressively to increase volume with a range starting at two, as there is a dose–response relationship between the set number and physiological training outcomes. Specifically, multiple sets per exercise improve strength, muscular endurance, and hypertrophy [103,104]. There is likely an upper threshold around the 5-set mark, as no differences in muscular endurance were observed when comparing groups that completed 5 and 10 sets per exercise [105]. Similar findings of a ceiling effect at five sets per exercise were reported for strength and hypertrophy outcomes [106]. Thus, it is likely there is no garnered benefit to exceeding five sets per exercise, and the excessive time commitment of very high volumes of training makes this approach less feasible for firefighters. Notably, novice lifters tend to have higher compliance and less attrition with longer rest periods and heavier loads [107]. Thus, fewer sets and lower repetition ranges might be more appropriate if the adherence of novice firefighters becomes a problem.

These same principles apply to loading parameters. When selecting a load, a repetition range should first be identified based on the goal and training status. For endurance-related adaptations, greater than 12 repetitions are generally recommended [80]. Although hypertrophy can result from a large repetition range, 6–12 is typically recommended [80]. Strength and power adaptations require fewer repetitions due to the greater intensity and inter-set rest times and thus need to be six or less and five or less, respectively [80]. Due to the overlap between ranges, multiple characteristics might be trained simultaneously, such as strength and hypertrophy, or endurance and hypertrophy. Thus, there is potential for improving more than one characteristic at a time. Generally, repetitions completed are inversely related to lift intensity. It is therefore recommended that novice lifters start a resistance training program with repetition numbers at the higher end of the range for the target adaptation (muscular endurance, hypertrophy, etc.) and progressively increase intensity in a conservative manner (i.e., at a slower rate than their trained counterparts). A summary of the program characteristics for resistance and plyometric training is available in

Table 2. Resistance training prescription guidelines.

Training Characteristic	Resistance Training (Training Goal) a	Lower-Body Plyometric Training	Upper-Body Plyometric Training
Sets	Beginners: 2–3 sets/exercise Advanced: 2–5 sets/exercise	3–5 sets/exercise b	Beginners: 1 set/exercise Athletes: 3 sets/exercise
Repetitions	Muscular endurance: >12/set Hypertrophy: 6–12/set Strength: ≤6/set Power: ≤5/set	10–20 contacts/set	5–10 throws or catches/set
Intensity	Muscular endurance: ≤67% 1RM Hypertrophy: 67–85% 1RM Strength: ≥85% 1RM Power: 75–90% 1RM	80–100% maximal voluntary contraction	80–100% maximal voluntary contraction
Inter-set rest period	Muscular endurance: ≤30 s2 Hypertrophy: 30–90 s Strength: 2–5 min Power: 2–5 min	1:2–1:3 work-to-rest ratio	60 s
Frequency (sessions/week) c	2–3	2	2

Abbreviations: 1RM = one repetition maximum; sec = seconds; min = minutes. Notes: ^a resistance training variables differ based on training goals (muscular endurance, hypertrophy, strength, and power). ^b contacts = number of times that an individual foot or feet together contact the ground. Sets and repetition schemes will vary depending on the number of plyometric exercises selected and the training experience of the individual (beginners: 80–100 contacts/session; intermediate: 100–120 contacts/session; advanced: 120–140 contacts/session). ^c Resistance training may be combined with lower- and upper-body plyometric training.

. Regarding the progression of resistance training workouts, Graham and Cleather [108] observed evidence to suggest autoregulation as a technique for weight selection for exercises. This technique involves the athlete following an ideal number of repetitions in reserve, or repetitions away from muscular failure. This could be an applicable method for tracking the weight for each firefighter to use. The goal would be to start with greater repetitions left in the tank and to increase the weight each week. When repetitions are close to failure, recovery is not sustained, or the weeks devoted to a goal have finished; then, a reset should be employed. This would involve reducing the sets and reps, or the weight, such as going from 5 × 5 to 3 × 5 after firefighters have performed 5 × 5 s for four weeks or are getting close to failure. This method would also allow the firefighter to adjust for daily fatigue, similar to the athletes in the previously mentioned study [108].

5. Conclusions

The physical functioning of firefighters is consistently challenged by their high-intensity occupational demands and movements. These challenges are compounded by the use of heavy and cumbersome PPE and firefighting equipment, as well as the need to carry or move fire victims. Improvements in muscular strength, power, and body composition have the potential to ameliorate the risks associated with firefighters while simultaneously improving occupational performance. Plyometric and resistance training can be prescribed and modified as needed to suit various experience levels, work/rest schedules, structural vs. wildland firefighting, and individual training priorities based on needs analyses. Although there will always be health and safety risks associated with the firefighting profession, appropriately programmed resistance training offers a way to limit the risks encountered and promote safety and effectiveness among firefighters. Importantly, resistance and plyometric training are just two of the many strategies (high-intensity interval training, circuit training, balance and mobility training, etc.) that are shown to be effective to this end. Consideration of available resources, time commitment, training objectives, and firefighter preference is needed to determine the most appropriate training program. Thus, fire departments should utilize available resources (i.e., NSCA TSAC-F and NFPA 1582 and 1583) to properly design, implement, and evaluate occupational-specific training programs [102,109,110].