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Firefighters, law enforcement officials, military personnel and emergency medical
workers are the first responders in emergencies, risking their lives daily to save
others and provide critical aid.
These tactical athletes are thrust into life-threatening situations at a moment’s
notice to ensure people’s security and safety, which can put them at risk of unique
health problems and even premature death.
Often, first responders’ health and fitness are overlooked, and the resources to make
changes are limited.
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In 2019, Oklahoma State University took a step to optimize health, fitness and performance
for these populations by establishing the Tactical Fitness and Nutrition Lab. Drs. Jay Dawes and Jill Joyce
Co-directors Dr. Jay Dawes, professor of applied exercise science, and Dr. Jill Joyce,
associate professor of nutritional sciences, created the lab to help tactical athletes
perform their jobs safely and efficiently during their careers and retire healthy.
Together, Joyce and Dawes are exploring opportunities to work with OSU’s Human Performance
and Nutrition Research Institution to accelerate the land-grant mission and fuel the
work they are already doing with tactical athletes.
“There’s this awesome culture on campus when it comes to research. People often get
very competitive, and it’s cutthroat. That is not the culture here,” Joyce said. “We
are very supportive, and I think HPNRI fits in beautifully with that. I expect them
to continue helping make connections.”
The lab collaborates with an organization to evaluate their fitness and nutrition.
OSU then provides strategies to guide personnel toward a healthier path.
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Forty-five percent of firefighter on-the-job deaths are from heart attacks, not fire,
Joyce said.
As firefighters rush to the scene, their hearts race and blood pressure spikes. The
combined stress of the urgent task, along with personal factors such as fitness level,
hydration and nutritional status can increase strain on their heart.
Despite these demands, a healthy firefighter’s body can handle the pressure, minimizing
the risk of major health issues or death.
“Research on big groups of national firefighter deaths found that none occurred in
healthy individuals,” Joyce said. “They all occurred in people who had underlying
heart disease, high blood pressure, which could be because of the job, but also factors
like high cholesterol, obesity. Nutrition, followed by physical activity are the leading
risk factors for those. I would say the job pulls the trigger, but lifestyle loads
the gun.”
Joyce collaborates with first responders and their families on nutrition. Common practices
for the general public often don’t work for tactical athletes, making it challenging
to meet their nutritional needs.
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“If somebody eats out too much, and they’re not eating healthy food when they eat
out, my students always suggest they should pack their lunches, but when you work
in a car for 10 hours a day with no fridge, freezer or microwave — it’s a curveball,”
Joyce said.
There’s this awesome culture on campus when it comes to research. People often get
very competitive, and it’s cutthroat. That is not the culture here. We are very supportive,
and I think HPNRI fits in beautifully with that. I expect them to continue helping
make connections.
— Dr. Jill Joyce, associate professor of nutritional sciences
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Brittany Wheeler, Colorado State Patrol wellness and fitness coordinator, learned
that officers want more nutrition material, which prompted her to connect with Joyce.
“This whole concept of making wellness more important in our agency is probably like
six, seven years old now, but it takes forever to change culture,” Wheeler said. “She
helped me dial down the material to the specifics, like learning how to read a nutrition
label.”
As an instructor at the academy, Wheeler has 23 weeks to work with cadets teaching
them the basics of nutrition and wellness.
Outside the academy, Wheeler provides officers with resources such as Joyce’s nutrition
classes and a handout showing how to eat healthily at a restaurant.
“That was huge just to start that conversation,” Wheeler said. “We can’t always bring
our food. We’ll have 14-hour shifts, where you have to go to a gas station, or you’ll
have to stop for fast food, but to create that awareness piece is great.”
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Tactical athlete requirements are like professional athletes as far as strength and
power, speed and agility, except they perform on a moment’s notice with occupational
loads and wear personal protective equipment.
It’s challenging to find tactical athlete specific resources in a world where new
health trends emerge every day. Wheeler said having access to Joyce and Dawes is important
to ensure the information she shares is accurate.
“It’s just one of those things that you’ve got to start somewhere,” Wheeler said.“… You have to meet people where they are. They have to start changing, changing
the culture, and creating those conversations and just start super simple.”
Typically, unhealthy snacks or baked goods are found on fire station countertops that
firefighters picked up at the store or were delivered by the community, Joyce said.
Often those foods are leading to health issues.
“Usually, the food environment is set up to destroy them,” Joyce said. “That’s not
going to fuel performance or health. We are looking at department-level changes. Should
we have a policy that says no junk food on the counters? Should I put out a PSA that
says bring fruit baskets and veggie trays? We’re trying to set up systems so that
they have knowledge and skills, but also the environments, the cultures, the people
that allow them to do that.”
As part of dietary assessments, Joyce provides nutrition report cards with color codes
and letter grades to highlight areas of concern and how to improve. Then, they teach
them how to set up their home food environment to support instead of sabotage them
and how to eat healthy while dining out.
“I can teach firefighters all day long how to eat healthy, and that gives them knowledge
and maybe even skill, but if the environment isn’t set up to let them use that knowledge
and skill, then they can’t use it,” Joyce said. “I need to figure out what’s going
on beyond them, to get them to be able to do that.
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“We create interventions that departments can put their people through, that will
address knowledge and skill and readiness of the group, so they’re all more supportive
and ready to do this, and then we’ll work with departments to alter the food environment.”
Kim Wiesmann, public health specialist for the Indianapolis Fire Department, evaluates
firefighters’ health and safety issues and identifies interventions to mitigate or
prevent them.
“We’re always trying to reduce our overweight and obese firefighters,” Wiesmann said.
“We’re trying to reduce cholesterol, blood pressure and metabolic syndrome, and so
one of the big areas that we feel that we can do that is through nutrition.”
The resources Dawes and Joyce supply aren’t one size fits all. In fact, they give
detailed assistance in specific areas.
“I can take a look at our data, see where we’re having issues, and then utilize Jay
or Jill as a resource to help us, then focus on what we really need to do that could
maybe help with that issue,” Wiesmann said.
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Currently, in the IFD recruit school, recruits are taught how to cook healthy meals
in the station and meal prep dishes to better prepare them to be healthy on the job.
The lab collaborates with an organization to evaluate their fitness and nutrition.
OSU then provides strategies to guide personnel toward a healthier path.
As a government agency, resources can be limited when trying to implement evidence-based
practices and it can be hard to find individuals who are willing to help.
“I’m just so grateful for Jill and Jay because they are so willing to offer up advice
and resources when I can’t always give them something back,” Wiesmann said.
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Tactical athlete requirements are like professional athletes as far as strength and
power, speed and agility, except they perform on a moment’s notice with occupational
loads and wear personal protective equipment — which, combined with shift work and
unhealthy lifestyles, puts stress on the body. Typically, unhealthy snacks or baked goods are found on fire station countertops.
Joyce is teaching them how to set up their food environment to support eating healthy.
On the physical fitness side, Dawes conducts research on topics ranging from public
health to high-level performance to help first responders efficiently perform throughout
their careers.
“We look at what fitness standards will help best predict job suitability, health
status and fitness status,” Dawes said. “We also look at different types of practices
within the profession to see if they are the most efficient ways of going about performing
certain job tasks.”
Exemplifying OSU’s land-grant mission, the lab is a mobile unit where the testing
and assessment equipment is easily transported into a community to meet the needs
of tactical athletes to help combat the challenges they face in their jobs and everyday
lives.
“We’ve done physical assessments, provided some sample training programs and individualized
wellness programs. We work with their lead wellness team member to implement different
strategies to help them continue to be more fit, and we really introduce that health
and wellness lifestyle within the organization to help transition the culture to one
that’s more health and wellness oriented,” Dawes said.
Along with the Warriors Rest Foundation, the lab is working with the Edmond Police
Department to set up an in-house wellness program.
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“In a lot of cases, what we have to do is undo what the job does to them,” Dawes said.
“At the end of the day, they’re not playing for trophies and medals. It’s about life
and death, public safety and national security. At the end of the day, they’re trying
to preserve safety and lives.”
Following a nationwide push for holistic wellness programs in law enforcement, the
EPD started a wellness program.
Stephanie Williams recently became the full-time wellness coordinator, but her work
with EPD began in a smaller capacity in 2022 as she provided counseling services following
the department’s first line of duty death.
Through that experience, Williams sparked conversations surrounding mental health
and self-care and learned the officers were interested in their health.
“One of the things people were really interested in is physical fitness and nutrition,
because it is different for law enforcement officers than it is for me or the general public, because of their shift work and the high cortisol levels,” Williams
said.
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Through the partnership with the lab, Dawes performs assessments and then creates
strategic workouts for the officers that Williams can post around the gym for optimal
performance.
“The difference between his type of workouts and what other people do is he’s able
to put in both strength and flexibility exercises, because if you get called out in
the middle of your workout, you’ve got to go. He wants to make sure there’s not going
to be any injuries,” Williams said.
You have to meet people where they are. They have to start changing, changing the
culture, and creating those conversations and just start super simple.
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— Brittany Wheeler, Colorado State Patrol wellness and fitness coordinator
Williams said many times officers don’t know where to start because their body is
in a different condition than when they left the academy. So, EPD hosts social functions
to encourage officers and their families to start their physical fitness journey which
also helps strengthen their mental health.
“What we know about wellness is that wellness works within police departments, wellness
works when we include the family,” Williams said.
Williams has worked with first responders for 20 years and has seen how those that
lack fitness or nutrition struggle with sleep, clear thinking and mental health issues.
People in these careers also tend to retire earlier than those in other career fields,
but they typically live just five to seven years after retirement.
And while EPD is still new to the lab, Williams is already seeing changes in how officers
reach out to Dawes about tiny injuries instead of pushing through the pain. Her goal
is for everything to come together to help people feel better physically and mentally
on the job and in retirement.
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“What this partnership is offering is so amazing,” Williams said. “It has a ripple
effect, not just within our law enforcement officers or our first responders and their
families, but also, that ripple effect goes to the community. These officers are dealing
with people on their hardest days, and so when they’re taken care of, their family
life is better, but I think our communities are better too.”
As little as 4 to 5 minutes a day of vigorous activity are linked to substantial changes, says Stamatakis. “Four and a half minutes are associated with approximately 35 to 50% lower risk for incident cardiovascular disease,” he says.
How can you tell if exercise counts as “vigorous?”
“If you can speak comfortably, that means that you are still in the moderate zone,” says Stamatakis. “When you enter the vigorous zone, you will get out of breath.” Vigorous exercise is often fairly uncomfortable, and most people who don’t exercise often are unlikely to be able to sustain it for more than a minute or two at a time.
The glutes are a group of muscles in the buttocks and hips that are crucial for balance, posture and movement. They also help keep the lower back and hips mobile and ache-free, making them especially important for those who spend a lot of time sitting down throughout the day.
Glute exercises (like squats and lunges) help build strength for these purposes, and regular exercise is recommended for general fitness and wellbeing. But, in the short term, you don’t have to whip out your dumbbells to get these muscles working again after a long day at your desk or on the sofa.
“Our bodies are intended to move, and it’s really unnatural to spend so much time sitting in one position,” says Fatema Contractor, a consultant osteopath and director at The Health Suite. “It can lead to pain in the lower back, hips, shoulders and neck, especially if you have poor posture.”
Article continues below
Try this exercise for your lower back
Sit straight on your chair, upper body relaxed and looking straight ahead.
Squeeze the muscles in your buttocks, lifting yourself slightly out of your seat.
Repeat for 10 seconds.
“It’s a good idea to train your brain to remember that the muscles are there by squeezing them before you stand up,” says the osteopath.
It’s an exercise that works to alleviate a very common problem called ‘glute amnesia’ (or ‘sleepy glutes’) by firing up the muscles again. In turn, this can reduce tension in the back muscles and increase stability in the joints that connect the base of the spine to the pelvis (called the sacroiliac joints).
“Squeezing your glutes for 10 seconds before you stand up retrains the connections and means you’re activating the right muscles before you move,” she says.
“When you sit down all day, your brain forgets how to ‘fire up’ your glutes – essentially meaning they’re not being put to work in the way they should. That means your back muscles take over every time you stand or walk. Over time, this causes your glute muscles to become increasingly weak, and the problems continue.
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“Long sedentary periods can also lead to hip tightness and discomfort around the hip area as the muscles remain in a shorter position when we sit,” she says.
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“So, combine this glute exercise with regular desk breaks as well. Ideally, we want to be getting up and moving around every 30 minutes or so if you spend eight hours a day sitting down.”
Light desk exercises and short walking breaks can also help, Fatema says. “But if any pain is severe or prolonged, it’s important to see an osteopath or a physiotherapist for a thorough assessment.”
Other desk exercises to try
Seated spinal rotation: Sitting at your desk, cross your arms over your chest and hold your shoulders. Twist the top half of your body gently from left to right, going as far around as you can.
Shoulder shrugs: Sitting up straight, gently raise your shoulders up and slowly let them drop.
Neck rotations: Keep your head straight, looking ahead. Gently, turn your head fully from one side to the other. Try to move your head past your shoulder if you can.
Shoulder extension: Raise both your arms above your head, linking your hands together at the top. Make sure your palms are facing up. Stretch your arms as high as you can.
Shoulder stretch: Sit on one hand. Tilt your head slightly to the side in the opposite direction to your hand. Swap hands and repeat.
At the peak of his adventuring career, Luke Tyburski was a man of extremes. The former pro-footballer, then in his early 30s, had dedicated himself to intense endurance challenges, of the sort that make a marathon look like a fun run. Beginning with the Marathon de Sables (a notorious multistage ultramarathon in the Sahara desert), he then ran the world’s highest ultramarathon at Mount Everest base camp, battled dehydration during a 100km run on a tropical island, and took on the vividly named Double Brutal Extreme Triathlon in north Wales. The endgame in all of this was a self-designed challenge, which saw him swimming from Africa to Europe, cycling through Spain and running to Monaco – 2,000km in total, in just 12 days.
Tyburski was a professional adventurer, financing his pursuits via magazine articles and speaking gigs, and even making a documentary about his quest. His whole raison d’etre was to push past his limitations, showing what a person is capable of when their mindset is strong enough. Yet, privately, he was dealing with depression, related to a loss of identity after the end of his footballing career, which took in Australia, the US and Belgium before he tried out for clubs in the UK. “Training and racing creates an escape, and the highs are extremely high,” says Tyburski. “But when I returned home from an adventure, the lows were extremely low, because I hadn’t addressed what I was running away from.”
He began to spend even more time training. If he was planning on doing a four-hour bike ride on a Saturday morning with friends, and a two-hour run on the Sunday morning – normal enough for a triathlete – he might fit in a secret training session on the Saturday afternoon. He developed crippling insomnia, which he used as a pretext to run what he called “midnight marathons”, and would binge eat between training sessions to prolong the high.
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Tyburski at the end of his 2,000km Ultimate Triathlon. Photograph: Courtesy of Luke Tyburski
It is possible to take on big endurance challenges without spinning out of control. Indeed, performing at your best requires a balanced approach to rest and fuelling. But in Tyburski’s case, they enabled a self-destructive tendency. All the hallmarks of an addiction were taking root: the secrecy, the persistence through negative consequences, the need for more, the sense of having something to escape. “But nobody suspected anything, because my weight didn’t change, my performance didn’t change, my demeanour didn’t change. I was a very good actor,” he says.
Exercise addiction isn’t officially recognised as a psychiatric disorder. In common with most behavioural addictions, it doesn’t feature in either of the key psychiatric manuals, the DSM-5 or the ICD-10. As a result, there are no standardised criteria for diagnosing it. You’ll often hear people describing themselves as “exercise addicts” – an affliction on a par with “chocoholic” – when rhapsodising about how much they love the gym.
That said, for a subset of regular exercisers, there is clearly something more damaging going on. Studies have suggested that around 0.3-0.5% of the general population may be dependent on exercise, rising to 3-9% of regular exercisers and athletes. Many researchers believe the framework of addiction is fit for purpose here. There is even a growing body of evidence to suggest that behavioural addictions function like substance addictions neurologically, through dysregulating the motivational pathways in the brain. Indeed, the phenomenon of cross-addiction – when a person replaces one damaging substance or behaviour with another – is well documented when it comes to exercise.
“The brain doesn’t necessarily care so much where it gets the spike of dopamine or serotonin from,” says Kanny Sanchez, an addictions therapist supporting patients within the Priory’s Flourish addiction treatment programme. “In all cases, there is the same need for an external source to come inside and regulate the internal turmoil.”
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Exercise addictions, he says, generally take the form of an obsession. Rather than being just another part of your day, exercise becomes the centrepiece, often to the detriment of everything else. You may keep training through injuries, and even experience a form of withdrawal when unable to work out. “Exercise in itself is a really good way of handling stress,” says Sanchez. “But if it’s the only tool you have in your arsenal, that’s when it becomes an addiction.”
Negative cycle … Micheál Costello, in his kit for team Optimal Endurance. Photograph: Courtesy of Micheál Costello
Micheál Costello, 30, is a PR account manager, writer and triathlete. He was diagnosed with depression and atypical anorexia at the peak of the pandemic. Before Covid, he had been working out a lot and practising intermittent fasting, a combination that provided a focal point for his anxieties but didn’t ring too many alarm bells. As the world went into lockdown, and Costello moved back in with his parents, his behaviours spiralled. “If exercise addiction could be formally diagnosed, I would have been diagnosed with it, is what my psychiatrist said at the time,” he says.
Atypical anorexia is a form of the condition where patients restrict their food intake but are not medically classed as underweight. In common with other eating disorders, it is often accompanied by excessive exercise. One study found that up to 48% of people with eating disorders show symptoms of exercise addiction. This may stem from body dissatisfaction, or compensatory behaviours around food, but there can be an emotional element too. “A lot of the clients I work with use exercise to get rid of unwanted and uncomfortable feelings,” says Stacey Fensome, a sports and exercise psychologist who works with the eating disorder treatment clinic Orri. “Exercise can be a tool to override the nervous system and generate a kind of numbness, as well as produce a release of endorphins.”
In Costello’s case, underfuelling and overtraining went hand in hand. He bought an exercise bike for the house and spent most of the day on it. “I would wake up, go for a walk, have something small to eat, get on the bike for two hours, do half an hour of bodyweight exercises, and an hour and a half of constant skipping,” he recounts. “That would bring me to evening time. I’d go for a 20-minute walk with my mum, and then I’d get back on the bike for up to three hours. It was a relentless existence, but I was also terrified to step out of it.”
It was only after some suicidal thoughts that he admitted to himself he needed help. While that help was not easy to come by – his GP dismissed his concerns as those of a “fine, healthy young lad” – he eventually received some talking therapy and a course of antidepressants. Further down the line, he discovered triathlon, a sport he credits as resetting his relationship with exercise.
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Costello competes in the London T100 Triathlon, August 2025. Photograph: Courtesy of Micheál Costello
“I wanted to do something with all the fitness I had built while I was in the midst of the eating disorder, and to shift my perspective,” he recalls. “I completed my first Ironman in 2023 and was hooked. I’m now training for my fourth one, and have qualified for the Irish triathlon team. I can’t abuse my body in the way that I used to if I want to be able to do those races.”
When you’re talking about these kinds of extremes – Tyburski’s midnight marathons, or Costello’s stints on the exercise bike – it’s obvious that there is something awry. But for many endurance athletes and gymgoers, it can be difficult to know where discipline shades into compulsion, and compulsion into full-blown addiction. For instance, the Exercise Dependence Scale, one of the main screening tools used by clinicians, asks participants how much they agree with the statement: “I continually increase my exercise intensity to achieve the desired effects/benefits.” This reads a lot like the principle of progressive overload – a key prong of any respectable training programme.
Similarly, some compulsive behaviours around exercise look innocuous enough from the outside. Fensome says they can include struggling to rest and have days off; prioritising exercise over other activities; being unable to sit still; choosing to walk everywhere; even using a standing desk. As red flags go, these are subtle ones. “Wanting to take care of our health is wonderful, but what is the intention behind it?” she says. “Is it because being still causes a lot of distress and fear, or is it because we actually want to be physically active?”
Arizona-based author Margo Steines. Photograph: Aidan Avery
A further complication is that exercise is socially validated, in a way that, say, a gambling addiction is not. Your “no rest days” approach may win you plaudits on social media; your body type may fulfil a societal ideal. Very few of the people around you, except those closest, are likely to express concerns. “I worked with one client who was doing extra training sessions and showing up early, and they were put on a pedestal for that,” says Fensome. “But what was actually happening was they couldn’t stop, and if they stopped there was a loss of control over who they were.”
Margo Steines, an Arizona-based author, has dealt with a litany of addictions and eating disorders in her life, but in some ways found recovery from exercise addiction to be the hardest. At the peak of her addiction, during grad school, she was spending seven to nine hours a day in various gyms. “I had a secret trainer who I would see before CrossFit, and then I’d go to CrossFit, and then I’d run, and then go to hot yoga and then martial arts,” she says. “I was neglecting everything else and getting the cascade of athletic injuries. But people would stop me in the store and ask what I did for my workouts. It’s easy to hide dysfunction because you’re not visibly underweight – you’re jacked and juicy and look great.”
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As she frames it, there were several layers to her addiction. Most obvious was the cultural layer, about wanting a very specific, idealised body type. There was a personal layer, about the fallout from a traumatic relationship. “Exercise allowed me to not feel how messed up I was from it,” she notes. Then there was the positive reinforcement from those around her, including doctors and therapists, who tended to toe the line that “movement is good”.
Only her partner, a strength and conditioning coach, recognised her issues for what they were. “I got very lucky, because he was my coach at the time,” she says. “He could see the red flags, but also knew how to approach me delicately, like a bunny in the woods.”
Exercise addiction can be just as damaging as other types of addiction; if you are underfuelling at the same time, you may develop overtraining syndrome, a condition characterised by a host of unpleasant mental and physical symptoms. “You can suffer with chronic injuries. You’re probably looking at hormonal disruption, burnout, low energy and low mood. There might be an element of withdrawing socially, like the social battery doesn’t even exist,” says Aaron McCulloch, co-owner and director at Your Personal Training.
Sanchez says there can be psychological, social and even spiritual ramifications too. “The mental toll that it takes, it’s just like a prison in your head,” he says. “The person will have a very external locus of identity, meaning their self-worth will be entirely dictated by how much they’re exercising. Missing the workout causes so much guilt and shame.”
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Heavy lifting … Steines in 2019. Photograph: Courtesy of Margo Steines
Since the birth of her daughter in 2020, Steines has been living with myalgic encephalomyelitis, formerly known as chronic fatigue syndrome, a condition that leaves her bedbound during flareups and naturally tempers her drive to over-exercise. While she can’t say for sure what caused it, she does believe it’s related to her exercise addiction. “I go in and out between being relatively sedentary and then working out like an average person,” she says. “On the outside, it looks like I’ve recovered. While I would say I’m two-thirds recovered on the mental side, I didn’t do the work to recover. It’s more like the exercise addiction got taken away from me.”
Tyburski, meanwhile, is “unofficially retired” from adventuring after the buildup of injuries and consequent surgeries. “In 2026, I’m paying for the detrimental behaviours of 2013 and 2014,” he says. “It’s taken me a while to accept, but I now have gratitude for the smaller things in life, to be able just to be active and healthy. Will you see me swimming between continents again? No, but when my body is ready to do it, I would love to go into the ocean for half an hour.” These days, he works as a keynote speaker and leadership coach, and says he’s in a good place.
Recovery from exercise addiction can be complex, not least because eliminating exercise altogether – as you would for drug and alcohol addictions – isn’t usually a desirable end goal. Yet however fraught a person’s relationship with movement, there are options available: entering a rehab facility, working with an understanding therapist or even leaning on peer support. Ideally, these could make it easier to spot the signs before the problem has spiralled out of control.
Costello likes to use the analogy of physical injury. “If you were experiencing a niggle in your ankle and you were concerned that it was tipping into something more damaging, you’d talk about it,” he says. “You’d mention it to a friend, and if it got worse you’d see a physio. I feel like we need to do the same with psychological niggles, to just be like, ‘Do you feel you’re getting a bit too anxious if you miss a session?’ You’d be surprised how helpful just talking out loud can be.”
