Here is my latest project - the military residency wiki. As a student, I felt…
Preventing Operating Room Aches and Pains
So it’s August, and if you have been spending any amount of time holding a retractor in the last month, I would bet I can point to at least a few body parts that are pretty sore by the end of the day. For me, it’s usually my upper back between my shoulder blades (rhomboids, a.k.a. my retractor-holding muscles) and my lower back right in the lumbar curve. After a fair bit of practice (and some yoga), I have figured out some ways to prevent and deal with these aches and pains.
Problem #1: Sore upper back from holding retractors
The complete yoga pose shown here, eagle pose, is pretty challenging, and I’m not suggesting that turning yourself into a human pretzel is the solution to sore muscles. What I do really love, and recommend to others, is to do just the arms that you see here as an upper back stretch. To do this, you:
- Put both arms out in front of you, palms up
- Place one arm on top of the other keeping the elbows straight
- Bend both elbows to a ninety degree angle
- Wrap your wrists around to try to bring your palms together
Start with your hands in front of your face, then move your elbows up or down until you feel the stretch in the right place. To me, this is just about the best stretch in town for your rhomboids, which will be burning after enough hours of retracting. Don’t worry about the leg positioning shown in the picture unless you are actually into yoga – just do the arms-only version sitting in your chair when the case is over.
Bonus: Because your arms stay in front of you and above your waist, you can do this while scrubbed if you really need to!
Problem #2: Sore lower back
As a student (and an intern!) the first thing I wanted to do after every case was to bend over and touch my toes. My lower back was always really tight and sore! Finally, I figured out why: my posture. Take a look at these diagrams of the spine. The picture on the left shows correct standing posture. The pelvis is tucked under and the upper back is fairly straight. Maintaining this posture requires strong core muscles. If your back muscles are stronger than your abdominal muscles, or if you are trying to get some extra oomph in your retractor-pulling by using your back muscles instead of your arms, there is a tendency to turn into the picture on the right: the pelvis is tilted forward, exaggerating the lumbar spine’s natural curve. This is also the position that you can end up in when you lock your knees because you’ve been standing forever and your legs are tired. This position puts extra strain on the lumbar spine, and makes the muscles in the low back tighten even more. Several hours of this WILL make your lower back sore.
So how do you fix it? First and foremost, you need to be conscious of your posture, and make a concentrated effort to tuck your pelvis underneath you when you are standing at the operating table.
Second, choose comfortable and supportive shoes so you can stand with your weight on both feet.
Finally, strengthening your abdominal muscles helps to balance out the strength of the back muscles, which seem to usually be much stronger in retractor-holding residents 🙂
Problem #3: Aching legs
Sometimes, at the end of the day, your legs just feel soooooooo heavy. You’ve been standing all day and you just want to lie down and put your feet up.
The solution to this is well-known and no super-sexy. Compression garments. Compression tights are easily available for women, and compression socks or compression leggings can be had for men who don’t want to wear tights. Think I’m crazy? Buy one pair, wear them for a day, and decide for yourself.
Alright, I think those are the “big three” aches and pains that I came across as an intern. What’s making you sore today? Share your medical work-related aches and pains in the comments and let’s see if we can find a solution!
(Obvious disclaimer: This does not constitute medical advice, there is no doctor-patient relationship, and I am not diagnosing/treating/preventing any specific disease. Duh.)