Preparing for TMCO Class - by Brian Brzowski, MD
When we talk to students about preparing for our Tactical Medicine for the Concealed Carry Operator Classes, it is imperative that we address a few preparatory issues. In order to ensure that you successfully complete the two-day course, and that you benefit maximally from the training, you must prepare yourself physically for the class.
Participation in TMCO Class does not require Olympian levels of fitness, but flexibility and sufficient cardiovascular fitness and strength to withstand the maneuvers that you will be engaged in is helpful. You will be bending, stooping, and dragging things around in this class. Additionally, you can expect to sprint for short distances, and explosive movements are commonplace in the Force on Force segments. If you have any questions about your present level of conditioning, please consult with your physician before preparing.
Your physical preps should include short intensity aerobic activity such as burpees, and sprints. If you can knock out 50 burpees in 15 minutes, you should be GTG. Interval training at maximum intensity for 1 minute with 2 minutes of rest for a total of at least 20 minutes is another good preparation for the physical requirements of the class.
Good flexibility is a fundamental trait for safe and successful participation in these two days. Of particular interest, a flexible and supple Achilles Tendon is paramount. This is especially important for those of us who are over 40 years of age. There are a multitude of stretches to lengthen the tendon and lessen the likelihood of injury; the most useful stretch is described here: http://www.mayoclinic.com/health/medical/IM04167. Take note that Achilles Tendon injuries tend to occur as a result of rapid contraction (i.e., sprinting to get off the X) and when substantially increasing the frequency and intensity of your activities. This is why starting your preparations early and gently easing into your training is so critical.
Another critical consideration is your hydration level prior to and during the class. In previous courses, we have had students and instructors feel the effects of heat and dehydration with negative outcomes. Here in Utah, our desert environment dries one out fairly quickly with a minimum amount of exertion. Couple that fact with the reality that the majority of us tend to run a little on the dry side, and you have a set up for trouble. The onset of dehydration is especially insidious because our relative lack of humidity doesn't lead to recognizable sweating. While we all have our own favorite hydration drink, you should stick to whatever you find palatable and are willing to chug. If you are well hydrated, you should feel the need to urinate at least every hour, and your urine should look clear.....dark yellow is a sign that you are behind the curve. Water is preferable in most situations, but Gatorade, Powerade, etc are acceptable if you feel the need to have something with more taste. Be aware of the possibility of causing diarrhea as a result of the sugar load from these hydration drinks! With regards to volume needs to remain hydrated, plan on bringing at least a gallon of liquid per person per day. I find that a cooler full of ice from which you can refill your drinking implement works best to keep you cool and hydrated. Lastly, you should begin your hydration preps 2-3 days BEFORE the class. In fact, if you get up to urinate in the middle of the night after going to bed on Friday before the class, you are on the right track. One additional benefit of starting the class well-hydrated is that this will raise your sensitivity to the ill effects of heat.
When we are exerting ourselves in high heat, we are at risk for two big problems: heat exhaustion and heat stroke. On the continuum of heat-related illnesses, heat cramps are the mildest and heat stroke is the worst. If you don’t know much about them, suffice it to say that they will quickly ruin your training effectiveness. As with most things, prevention is preferable to treatment. We’ve already mentioned how being well-hydrated helps, but there are other maneuvers that are beneficial.
Keeping cool will reduce the risk of developing heat-related problems. The benefits of a wet, cold Shemagh or Bandana around your neck cannot be overstated. With some really big blood vessels passing through your neck to your brain, cooling your neck is an excellent way to keep your system from overreacting to the heat. Bring two and keep one in the cooler. Swap out when the one on your neck warms up. Another recommended way to keep cool is through your choice of clothing. In addition to good headwear, a long-sleeve shirt and long pants made of a light, breathable fabric will help keep you cool. Direct sunlight on your skin when wearing shorts or a short-sleeve shirt actually raises your core body temp more than covering up. When possible, stand or sit in the shade; avoid direct sunlight when possible.
Sensitivity to sunlight can be worsened by some medications. The short list includes: antihistamines; some antibiotics and high blood pressure medications; and Ibuprofen/Motrin. The long list can be found at your pharmacy. Of course, some of these medications cannot be stopped without problems, so you are best to discuss with your physician beforehand. Remember if you must remain on one of these medications, you need to follow all the other risk-reducing behaviors to try to avoid a problem.
Lastly, acclimatizing your body to heat is one of the most effective ways at producing resistance to heat illnesses. If you have an indoor job, you will need to exert special effort to prepare for exposure to the heat. It normally takes the body around two weeks to become accustomed to heat, so start preparing early. One way is to start exposing yourself to warm temps and SLOWLY increase the time of exposure. If you have any health issues, clear this with your MD first! A simple way to do improve your ability to tolerate heat is to turn off the A/C in your car and raise the thermostat at home and work if you are able. During my drive from Houston to Orange, TX for the inaugural TMCO class, I drove the entire way with the A/C off, and the windows rolled up. For two weeks before the class, I also sat in my sauna for 20-30 minute stretches with the heat up as much as I could stand.
Following these few simple precautions should increase your ability to concentrate and fully participate in the amazing class that SI has put together. You will definitely finish the class with an ability to handle a large number of medical issues that may result from a violent altercation. This stuff is critically important, because winning the fight means going home afterwards.
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