Tactical HIGH Performance Training


Firefighting is an occupation that produces unique physiological and psychological challenges that negatively affect firefighters' performance, safety and quality of life. It is crucial that firefighters are provided with proven and feasible strategies to manage these challenges. The First Twenty's Tactical High Performance Program™ takes an unrivaled foundational approach that addresses the unmet performance, safety and health needs of the American firefighter. Our holistic program provides critical performance fundamentals specifically designed to address the unique physiological and psychological challenges facing today's firefighting force.

Physiological Problems


Cardiovascular Disease & Obesity

  • Sudden cardiac death is the number-one killer of firefighters, resulting in half of all LODD each year. For every LODD due to heart attack, 16 additional cardiovascular events occur each year on the fireground.
  • Dehydration: Research has shown that the number-one mitigating factor for firefighter heart attacks is dehydration.
  • Obesity: 80 percent of firefighters are overweight or obese, substantially higher than the general population (60%). Increased body fat has been associated with greater arterial stiffness in structural firefighters.
  • Sleep deprivation: Research indicates that reduced sleep quality and quantity are associated with obesity.
  • Sedentary lifestyle: Firefighters do not achieve the recommended amount of physical activity to reduce the risk of chronic diseases.

Musculoskeletal Injuries

  • 55 percent of fireground injuries incurred by firefighters are classified as sprains, strains or muscular pain, far and away the leading types of injuries incurred on the fireground. Furthermore, the average workers' compensation cost of treating strains and sprains is $11,925 per claim.
  • 26 percent of fireground injuries occur as a result of overexertion. The average workers' compensation cost for injuries caused by overexertion is $14,425 per claim.
  • The NFPA has reported that the causes of workrelated musculoskeletal disorders/injuries includes repetitive lifting of heavy objects, performing tasks in awkward postures, forceful and repetitive exertion, regular overhead work and work with the neck in a chronically bent position.
  • Furthermore, the NFPA suggests that the occurrence of sprains and strains may be reduced by implementing programs that utilize functional movements to enhance aerobic capacity and trunk stability.



Crash Fire Fitness™ Program

Using a functional approach combined with science, we designed a comprehensive, cutting-edge program that addresses firefighters' unique physiological challenges by simulating the tasks performed on the fireground. Specifically, its goals are to optimize a firefighter's:

  • occupational performance
  • resilience to injury
  • stability
  • mobility
  • endurance
  • strength

We teach firefighters to move more proficiently on the fireground and at the gym. In addition, we teach firefighters to both establish a baseline for each movement and understand the mechanics of mobility and stability.

The Crash Fire Fitness Program™ is anchored by (five) fundamental movement patterns (Push-Pull-Lift-Step-Rotate) that are used to perform (eight) critical firefighting tasks, as identified by the U.S. Air Force's validated

Firefighter Occupational Assessment. These tasks include carrying and hoisting equipment, climbing and raising ladders, advancing hose line, forcible entry and rescuing a victim.

Crash Fire Fitness™ is designed to teach firefighters how to progress and egress through each movement, and how to progressively add resistance to each of these movements via body weight exercises, firefighting equipment and suspension devices.

Vital to mobility is the concept known as midline stabilization: tightening the body, bracing the abdomen and stabilizing the trunk. Our program teaches firefighters how to engage their core before performing any activity in the gym or on the fireground. This greatly enhances their ability to perform at maximal capability while reducing risk of injury.

Our program has no walls. By utilizing portable and inexpensive equipment, firefighters can exercise anywhere, thus enhancing exercise participation and program compliance.

U.S. Air Force's Firefighter Occupational Assessment

The U.S. Air Force Fire Emergency Services built on previous research to establish a scientifically proven occupational metric that incorporated the most common and demanding tasks performed on the fireground. The outcome of this research resulted in the development of the 10-task U.S. Air Force Firefighter Occupational Assessment.

Simply stated, this evaluation provides us with not only the most common/demanding tasks performed on the fireground, but also offers a definable, science-supported baseline metric of how hard firefighters' bodies need to function in "real settings" while performing the assessment.

The First Twenty used these tasks to define/inform our firefighter performance perspective. In doing so, we developed critical performance fundamentals for our Tactical High Performance™/Crash Fire Fitness Program™.

Another vital component the U.S. Air Force Fire Emergency Services established is an eight-minute minimum to complete one evolution of the assessment. The First Twenty, however, is not concerned with what a firefighter performs in eight minutes or less. Instead, we focus on their ability to use this assessment to develop a personal baseline. This baseline will evaluate the effectiveness of the Crash Fire Fitness™ performance program during fireground activity. For example, a firefighter may complete the assessment in nine minutes, 34 seconds. After completing the Crash Fire Fitness™ program and its post-test, the hope is this 9.34 time will have substantially decreased. This test not only measures their performance, but also a firefighter's overall health.

The occupational assessment is designed to be compatible with any fire station layout. A schematic will be available for download, allowing every fire station to assemble their own occupational assessment. This download will also provide specific directions for you to execute the assessment. You can also view our videos of each task showing how they are performed correctly and what muscles are firing, along with specific exercises that help you train for each task.

The U.S. Air Force Firefighter Occupational Assessment consists of the following tasks:

Task One - One Arm Hose Carry. Carry one 50-ft section of 2½ or 3-inch hose 100 feet.

Task Two - Ladder Raise. Carry a 12-ft ladder 50 feet, and raise it against a wall.

Task Three Charged Hose Drag. Drag a charged 1½ or 1¾ -inch hose 100 feet.

Task Four First Ladder Climb. Climb a 24-ft ladder (10 rungs) three times.

Task Five High Volume Hose Pull. Pull a section of 4½ or 5-inch hose 100 feet.

Task Six Forcible Entry. Move a 225½-lb tire 12 inches using a 10-lb sledgehammer.

Task Seven Victim Drag. Drag a mannequin weighing 150 pounds 100 feet.

Task Eight Second Ladder Climb. Climb a 24-ft ladder (10 rungs) twice.

Task Nine Ladder Lower. Lower a 12-ft ladder, and carry it a distance of 50 feet.

Task Ten Spreader Tool Carry. Carry an 80-lb Hurst spreader tool 100 feet.





Tactical Nutrition™ Program

We designed an innovative yet simple nutrition program to address firefighter eating behaviors and hydration. Using research on eating behaviors of hundreds of firefighters across the US, we developed a program which addresses the shortfalls in firefighters' diet. In addition, we looked at the latest research on eating behaviors and hydration in relation to physical performance to enhance the program to meet the demands firefighters face on the job. This nutrition program is the first program tailored specifically for firefighters using evidence based recommendations using a three pronged approach:

Changing eating behaviors is hard, and education alone won't ensure success. Firefighters will be assigned a nutrition goal to achieve each week, with tasks, recipes, and videos to help them achieve the weekly goals. In addition, useful nutrition handouts for use in the grocery store, the fire station or at home will be provided.

This program was designed to build on itself. Firefighters will maintain the healthy eating habits and goals achieved in previous weeks while continually working on the new goals in order to live a healthier lifestyle and be ready for anything they face on the job.

Psychological Problems


Psychological Issues





Tactical Stress Tolerance™ Program

Our groundbreaking Tactical Stress Tolerance™ (TST) program brings many of the same foundational mental performance techniques currently utilized by elite military personnel (such as U.S. Navy SEALs) and professional athletes into the fire service. These performance techniques are designed to meet the unique mental and physical demands of today's Time Critical Athlete™, be it as an elite athlete, tip-of-the-spear military operator or a U.S. firefighter. Our program combines validated metrics and techniques that enable a firefighter to manage and off-load operational stress while simultaneously achieving higher levels of operational self-awareness, effectiveness and performance.

The eight vital mental toughness/performance techniques that constitute our Tactical Stress Tolerance™ program are as follows:

  1. Performance Routines and Mindset
  2. Goal Setting and Goal Segmenting
  3. Tactical Visualization
  4. Tactical 4 Breathing
  5. Contingency Planning
  6. Positive Self-Talk
  7. Compartmentalization
  8. Self-Awareness (F-PRE™)

Self-Awareness, our eighth technique, is an essential element of our mental performance program. Being able to self-assess, do it as objectively as possible and make the changes necessary is paramount in order for firefighters to operate effectively on or off the fireground.

The First Twenty has its members assess these factors on their own by using an instrument we call the Firefighter Performance Readiness Evaluation or F-PRE™. The F-PRE™ allows firefighters to assess their "mental vital signs" by evaluating eight human factors known to affect mental fitness and performance:

  1. Life Events
  2. Sleep
  3. Stress
  4. Mood
  5. Legal Substance Use
  6. Attention
  7. Workplace Climate
  8. Physical Conditioning

This audit not only immediately alerts a firefighter of unwanted/unknown factors that adversely impact their ability to perform on the fireground, but it also provides validated feedback to change those unwanted behaviors and rapidly implement change. The F-PRE™ provides all firefighters with a mental performance baseline that can be accessed and taken at all times.

The entirety of our groundbreaking mental performance program empowers firefighters with the long-overdue tools needed to effectively combat the psychological issues they face on a daily basis. Tactical Stress Tolerance™ allows them to make the immediate ground-floor behavioral changes, along with foundational long-term behavioral modifications, that are necessary to combat operational stress and achieve peak operational performance.

Delivery Mechanism

The entirety of The First Twenty's Tactical High Performance Program™ is delivered online and through mobile technology. The idea is to have our program in a firefighter's hands whenever it is convenient for them to participate. It allows them to track and record every piece of data that comes out of the program. Our delivery mechanism includes:


To facilitate firefighter engagement and better program adherence, The First Twenty utilizes our weekly blog, JAKE™. We will send firefighters a weekly email that'll apprise them of the progress they're making in our Tactical High Performance Program™, plus relay any program tasks they have for that week. Firefighters also receive other, more informal weekly dispatches from JAKE™, fire service-oriented emails meant to keep them inspired and in-the-know, with practical news and views aimed at improving their performance and enhancing their lifestyle. Most importantly, JAKE™ helps us forge - and keep - close connections to the firefighter community, emboldening and enabling each one to get motivated, stay encouraged and keep them moving forward along their path to better performance.


  • After an exhaustive two-year search, we were selected by the US Air Force Fire Emergency Services to orchestrate the new fitness and wellness program for their firefighters.
  • Due to the strength of our program and proven results, we were awarded two prestigious grants to perform two clinical trials.



1.FEMA awarded $1.5 million to perform a 2.5-year control cluster clinical trial on The First Twenty program

2. NIH awarded $500,000 to perform a two-year clinically based control cluster trial on The First Twenty program

Health Coaching
(Coming summer of 2016)

The First Twenty's Tactical High Performance Program™ is designed to be a self-directed mobile intervention. To facilitate longer-term change, we are also implementing a health coaching system that will train and embed a health coach at each fire station participating in our program. Our train-the-trainer health coaching system is conceived around a strengths-based coaching model used by the US Army to train their "health coaches". Our model relies on a tactic known as motivational interviewing as its primary mover. Our health coaching model, along with the Crash Fire Fitness Program™, will be studied in the clinical trials.

The program is conceived to run in a six-month cycle. All program content is synchronized and meant to be taken weekly over 24 weeks.

Studies have shown it takes approximately six months to form a new habit. Our goal is, with the aid of our health coaches, to have firefighters form three new habits every six months: one physical fitness, one mental fitness and one nutritional habit.

This program seeks to facilitate the development of foundational habits that are maintained for the entirety of a firefighter's career.