Grip It, and Rip It

How musculoskeletal injuries are quietly draining fire and EMS budgets

By Michael Harvey, FF/Paramedic, RN

Co-Founder, Emergency Medical Resolutions Inc.

My partner got hurt today.

It was nothing dramatic. No fire. No car wreck. No beach rescue. It was just a routine transfer from the stretcher to a hospital bed.

One, two, three. I lift and push. She pulls across.

But on three, she jolted.

It was that subtle pause you recognize instantly if you’ve been around this job long enough. I saw the tinge in her face. That look that says something isn’t right.

We reset and slid the ninety-pound octogenarian across to the bed, but I could already see the cost of that move written all over my partner’s face.

We called the chief, headed to the county wellness office

Three hours later, she could finally stand up straight without crying.

So now we wait. Maybe it’s a few days, a few weeks or even longer.

All from a routine lift.

The phrase that shows up everywhere

There is a phrase you hear in all kinds of physically demanding jobs. From construction sites to moving crews, warehouses to mechanic shops.

And yes, firehouses and ambulance bays.

You’ve heard it and have probably even said it.

“Just grip it and rip it.”

Patient on the floor? Grip it and rip it.

Heavy object in a tight space? Grip it and rip it.

Awkward carry with no good angles? Just grip it and rip it.

It’s not written in any policy manual, but it lives in the masculine undertone of culture.

It's a quiet, unspoken machismo. Just be strong enough and get it done. Don’t overthink it and never slow the job down.

In fire and EMS, that mindset has real consequences.

The real leading cause of responder injuries

When people imagine firefighter or paramedic injuries, they think about dramatic calls seen in the media. But nationally, the most common injuries come from the most common calls.

Data from the National Fire Protection Association consistently shows that:

• Overexertion and strain are the leading cause of firefighter injuries

• They account for roughly one quarter of all reported injuries each year

In EMS, the pattern is even clearer.

Research from the National Institute for Occupational Safety and Health shows that:

• A large portion of EMS injuries are related to lifting, carrying, or moving patients, deemed “Overexertion”.

• Back and shoulder injuries are among the most common causes of lost work time

It's not fires, shootings or even technical rescues. Just moving patients.

What these injuries actually cost

Musculoskeletal injuries are not just aches and pains with a few days off. They are some of the most expensive claims a department will face.

Across municipal workers’ compensation systems back and shoulder injuries are among the costliest and longest-duration claims. Even moderate strains can result in weeks or months away while on light duty. More serious cases can lead to surgery, long-term disability, and likely early retirement.

Beyond the claim itself, departments absorb overtime to cover vacant positions, light duty assignments, training costs for replacements, and increased insurance premiums. These costs quietly add up to hundreds of thousands of dollars or more in many departments.

And most of those claims start the same way:

A routine lift. A simple shift or transfer. A call no one thought twice about.

The cultural blind spot

Back at the station, the guys joked:

“How could you, Mr. Safety, let her get hurt?”

And they were right to say it. This past year I’ve been preaching on a loop:

“We don’t work without a plan.” “Use your tools, it’s what separates us from animals.” But even with all that talk, the culture creeps back in.

The grip it and rip it mentality.

No one on that call thought moving a small, elderly woman could possibly end a career. It was routine and simple; just another transfer.

And eventually, one of those routine lifts is the one that ends a career.

The budget conversation we keep avoiding

Departments will spend millions on apparatus and stations and endless hours debating staffing models, but very few take a hard look at this question:

How much are we spending every year because our people are getting hurt just moving patients?

Because when the leading cause of injuries is overexertion and strain, reducing those injuries is not just a safety issue.

It is a budget issue, a staffing issue.

A career longevity issue and a human issue.

We talk about toughness, grit, and intensity in the fire service.

But none of that fixes a blown disc. None of that reduces a workers’ compensation claim. None of that stops the grip and rip it mentality from shaving years off your career.

We can’t save the injured if we become the injured in the process.