Poorly designed uniformed shirts are a real pain in the neck…literally. They are the number two culprit on my list of reasons why your uniform wrecks your body.  Generations of cops have been using uniform shirts with polyester blends that have no give when pulled tight. So what do we do?  Pull them tight over a semi ridged vest. The vest and shirt combine to create a rigid mechanical system. Think about it like this: early airplanes were constructed by stretching canvas over a wood frame because it was light and made a mechanical system rigid enough to withstand the forces of flight. We do the same thing, but instead of achieving something cool we cast ourselves into the hunched back, forward head on neck shape.  Your x-ray of the bone spur on your neck is pretty cool I guess.

The shape of your uniform is important.

If you’re going to have a form fitting uniform shirt that doesn’t give then it had better fit

you perfectly. The number one thing I look for is the shape of the upper back and how the collar sits on the neck. Ideally you should be able to stand up and sit down in a good position without any increased pressure on the neck. Remember I said in a good position. We tend to hack this problem without thinking about it. The tension of the collar on the neck is a noxious stimuli so your body tries to avoid it. It has two choices:

1. You can thrust your head further forward which at first seems ridiculous until you look around and see how many cops look like Skeskis from The Dark Crystal.
   
   

   +10 super nerd points if you knew who Skeskis was.

2. The other option is the getting all puffy chesty. You can sit in a ribs flared shape with an overextended low back sometimes called “sway back”. This rotates mechanical stress to the back and away from the neck. Biomechanist Katy Bowman might argue that it’s actually rib thrusting and not over Whether it’s overextension or thrusting, it’s going to take its toll on your low back.

One key cue for standing and sitting in a better position is “rib cage down.” Try the basic bracing sequence and have a seat in your squad car. The vest will rotate down with your rib cage and your shirt will tag along pulling your head forward. If you lower your ribs and you feel your head/neck being pulled forward like you have a Flava Flav clock necklace hung round your neck, your uniform is poorly shaped. This exacerbates forward head on neck issues that spread to your thoracic spine and kill shoulder function.

You can be laser focused on your position and fight the mechanical force pulling on your neck, but you will eventually lose position with your shirt collar pulling forward on your neck for hours.

If you find that this is an issue you can tuck the rear of your shirt in last and extra tight to try to pull some tension on from the collar away from the neck, but this is ultimately a temporary fix. Your shirt will work its way back and ends up looking like a soup sandwich and still puts pressure on your neck. Just give it a re-tuck and order a better shirt.

The material your shirt is made of is important.

Chances are you’ve noticed how much more comfortable a training polo is pulled over a vest. This is largely due to the fact that most polo shirts are not only shaped better than common  uniform shirts but most cop polos are now made with athletic fabrics that have a little stretch and give. Find a uniform shirt with similar qualities if you can, and your neck will thank you for it.

An exterior vest is a superior option.

Putting the shirt under the vest disassociates the juggernaut of a single mechanical system into two lesser systems. Putting the shirt under the ridged structure of the vest keeps it from being pulled too tight, allows for slack and therefore less tension on the neck. Don’t have an exterior vest? Just try it with your concealed vest real quick to prove the point. Compression forces still pin the shirt between the vest and your body will keep them loosely connected but it’s fairly minor and easy to adjust for.

Final thoughts

Simply enough having a uniform shirt with a head hole that comes out of the top of the shirt instead of the front made of stretchy athletic fabric that is placed under a vest is about as good of a situation as you can get. It’s still far from perfect, but remember the realistic goal is less bad. It’s still on you to spend time on daily maintenance especially getting in some thoracic extension to undo what we cant mitigate at work.

Sitting as much as cops do is disastrous to say the least, but add in the duty belt and it’s a whole new level of suck.  If you really want to take a whack at resolving your low back pain, you need to understand two quotes. The first from Jazz Musician Lena Horne:

“It’s not the load that breaks you down, it’s the way you carry it.”

And the second from Physical Therapist DR. Kelly Starrett:

“Your pain has a position.” 

From these two ideas I came up with the concept of “uniform dynamics.” I’m looking at the body as a mechanical system that has a primary function of movement. I see the uniform as a load on the mechanical system. If you start to break down the how the load affects the mechanical system you can start to see the real issues at hand.

When we look at the duty belt it’s so easy to blame the weight, but the weight is hardly the primary offender. If we take the focus off the 10-12 pounds for a bit, we can start to see the forest through the trees and realize that the pain we have is due to position.

I like to call the issue the artificial impingement. This problem occurs in our hips because we have a large block in the front of the hip, usually a magazine pouch and Taser, but it can be anything on your belt and the belt itself.

To illustrate take your right arm and bend at the elbow through full range of motion. You should be able touch your hand to your shoulder (unless you’re super jacked). Do it again but add in a mechanical block or “impingement.” Make a fist with your left hand and put it in the crease of the elbow on your right arm and flex.

What we have here is a model for what’s going on in the hips with the belt. The difference is the spine is composed of several joints and happens to be more bendy than the humerus so our back can still work around the issue in order to sit in the squad car. This working around the issue is the position that causes our pain.

 

 

 

 

Throw on your duty belt and bring one of your knees into flexion until you start to meet resistance in the front of the hip. For most the hip starts to come on tension between 30 and 45 degrees of hip flexion. Is that enough range of motion to sit? Absolutely not but our body is pretty quick to hack this issue, so we can externally rotate our hips and sit on the side of our butt and we can use the low back to bend around the impinging blockage and still sit “uprightish.” This is really an ugly position so if you want you sit more upright and work on your posture you can leverage your psoas against the spine to overextend it and all of a sudden you’re resistance training it for hours on end. Fighting against the duty belt with muscular contraction gets old, so we start to see adaptive shorting of the psoas and now or back gets really pissed off.

 

 

The answer becomes fairly simple. Remove the artificial impingement by raising the belt. Still got your duty belt on? … good. Grab the front of the belt and pull it up out of the hips and raise your leg again. You’re much closer to 90 degrees and with that extra range of motion you can sit in a “less bad“position and save the world…with less back pain.

 

 

 

 

 

The high duty belt was fairly popular in the mid 1900’s era of law enforcement when they adopted the Sam Brown duty belt. The single strap was a mechanism to lift he belt out of the hips and remove the impingement. The Sam Brown belt started to be pulled from service when departments realized that it was an officer safety issue having a strap that a suspect could grab onto. For most departments the Sam Browns went into storage only to be used for ceremony and enter the modern day low hanging duty belt, an utterly unmitigated disaster of that has wrecked backs for generation after generation until present day.

 

 

The best option I can think of is ditching the belt altogether and transitioning to a load bearing vest. There’s a great debate about the appearance and fear that it looks too militarized to the public. A pretty effective middle ground solution is the suspender system.
When it comes to uniforms having a professional look that is functional and allows for good body mechanics is a difficult balance. Many departments won’t allow exterior suspenders. They also provide the same officer safety problem as the Sam Brown. The market has two really good solutions out there right now. The first is the back defender, which is what I use. It is an under the uniform shirt suspender system that conceals the straps nicely.  The second is the Blauer Armorskin solution. This product uses an exterior non-load bearing vest and suspenders under the vest. Having the shirt under the vest has other mechanical advantages which I’ll get to another time.

The quick and free fix is that you can pull the front of your duty belt up and out of the hip every time you sit. Unfortunately this is just another thing to think about and the fix is only as good as your ability to do it. You can also take a little time to rearrange your belt to facilitate better hip flexion. Got something that hangs way below the belt? It probably shouldn’t be in the front of the hip…I’m looking at you Taser. This idea of the artificial impingement also explains why our more “puffy” coworkers are likely to have more back pain. With a larger belly you start to run into resistance sooner and have to compensate more to complete the arduous task of sitting. let’s be honest, if you’re like most cops you can probably stand to drop a few pounds while you’re at it.

Removing the artificial impingement is a huge step toward sitting in a better position. Let me be clear, This is not the magic bullet. It’s really just a less bad, and I think a best, current option. The uniform has other issues that I’ll address in the upcoming weeks. Even if you have the best possible uniform you still need to find a way to sit less and do some daily maintenance to your body if you’re ever going to get ahead of the problems causing your pain.

Breaking news!!!! The modern police uniform is uncomfortable. Okay maybe not so newsworthy but I’m going to spend the next few weeks explaining how the uniform causes mechanical compensations that trash your body. When I say trashes your body I mean it TRRRRAAAAASAAAHHHHEEEESSSSS your body.  If you’re a uniformed officer, this is something you need to read and understand.

To realize how bad the uniform is we need a standard of movement to test, something that’s scientifically validated, widely used, reliable and a good predictor of injury. Enter Gray Cook and the Functional Movement Screen.

What is the Functional Movement Screen?

Think of the screen as standardized field sobriety tests for your movement quality. It uses seven movement tests all scored from 0-3 and three clearance tests which are not scored but simply look for pain.

0 Means you have pain in the movement pattern.

1 Means you can’t perform the movement pattern but have no pain.

2 Means you can perform the movement pattern, but it has some issues.

3 Means you have are competent in the movement pattern.

The screen also looks for asymmetries in the movements.

Predicting injury

If you score below 14 you are at an increased risk for injury during physical activity.

If you have asymmetries you are at an increased risk for injury during physical activity.

If you score a 1 on any test you area at an increased risk for injury during physical activity.

The goal is to have a total score above a 14 with all 2’s or 3s, no pain and no asymmetries.

The experiment

I’m not certified in the FMS, but I do have some coach friends down at Catalyst Strength that are. They were cool enough to screen me three times: the first with my normal gym clothes, the second with my best looking uniform, and the third with my modified working uniform. Using the gym clothes screen as my baseline, I wanted to see how much of an effect the uniform really has on my movement and how well I’ve mitigated it.

 

The results

My gym clothes score was a 19, well above the 14 mark which means I move pretty well and I’m not at increased risk of injury.

In my ultra-professional snug fitting version of my uniform, my score dropped down to a 12, below the cut point of a 14 which is a bad thing.

My working uniform scored above the cut with a 16. Still not as good as the gym clothes, but at least it’s above the cut here and theoretically moving well enough to be not at an increased risk for injury based on score. I did have some ones and asymmetries, so there is still need for improvement.

Implications

Movement quality and injury are related. At the most basic level the intent of the screen is really to see if someone moves well enough to increase physical activity without increased risk of injury, and it’s not like we’re hitting the gym in full uniform (By the way you cops that run marathons in full uniform—good job raising awareness for whatever it was but bad idea for your body). The reality is, however, on any given night you need to be able to run, jump, fight etc. in what you’re wearing, and I’m not sure which movement pattern we can assume is okay not to own when we need to do those things. Adjusting your uniform may be the difference between going home or to the hospital after a scrap.

We can only assume that spending thousands of hours in a uniform that causes dysfunctional movement patterns will eventually start to affect your movement when the uniform is not there. This also highlights the need for a maintenance program. Your body will mold to your activities. It turns out that experts can look at skeletons and tell what kind of activities the person did. For example, they can observe twisting from repetitive rotational forces in the arm of a major league pitcher. I’m willing to bet they could pick out a cop’s jacked up skeleton out of any lineup.  Needless to say you have to do something to undo the 40+ hours a week of slow death you’re putting your body through.  I move pretty well without my uniform despite the fact I spend about 1800 hours in uniform a year. I also have a movement maintenance practice. That is the difference.

Final thoughts

I see cops posting online all the time trying to find studies to use as proof that their department needs to make a change to the uniform. Unfortunately most replies are personal and anecdotal at best. I find this concept really interesting but my sample size of one and obvious bias make this experiment inadequate, so more research needs to be done. (Any grad students out there looking for thesis research topic? Millions of cops may love you someday.)

The FMS should be considered as a part of a department’s employment screening and any annual physical testing. Consider testing when a uniform change is made. Adding a tool to your duty belt? Get screened. Getting new pants? Get screened.

Uniforms could be much more “movement friendly” if manufacturers joined the minimalist movement, minimalist (according to Katy Bowman) meaning having the least amount of impact on function, not necessarily referring to the amount of material used. Sorry Lt. Dangle. The challenge is simple: develop a uniform that looks good, can lug around all the standard duty equipment and has the least effect on your FMS screen…. Then hook me up with some cash for the idea.

Over the next few weeks I want to break the problems down a little more in depth. Stay tuned because these may be the most important articles you read all year.

For more information on the functional movement screen

http://www.functionalmovement.com/site/aboutfms

http://graycookmovement.com/?p=51

http://graycookmovement.com/