Can We Prevent Career Ending Musculoskeletal Injuries in Surgeons?

A recent review published in JAMA found that surgeons are at a high risk of sustaining work-related musculoskeletal injuries. It is safe to say the orthopaedic surgeons in my circle and I are not good examples of applying the knowledge we have about acute and chronic overuse injuries to ourselves. I personally believe this is part of our extremely negative healthcare culture that leaves no room for self-care. What if we started encouraging best practices in musculoskeletal health and ergonomics for all surgeons? In this article, we are going to explore some of the findings of the JAMA review article and offer some tips for surgeons to reduce on-the-job musculoskeletal injuries.

 
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Musculoskeletal Injuries

Acute

Performing surgical procedures does not often result in acute injuries, mainly due to a more present focus on surgical safety. That being said, most surgeons I know are able to share many stories of acute injuries they have sustained. Even with these events, the pervasive opinion would be that these things are inevitable, and if there is no harm to the patient, then no big deal. Needlesticks and other “sharp” injuries don’t usually involve the musculoskeletal system. However, each tool we use in surgery carries a risk of harm. Every time we lift a patient, we place ourselves at risk of injuring our neck, back, or shoulders in particular.

Acute on Chronic

At this point in my career, these are the most common. Every time I am asked to assist in the transfer of a patient to the operating table, I comment that I will do my best and that it might impact my performance of the surgery when it really matters. Rarely does anyone understand and few even care. However, on occasion, these moves lead to an increase of my baseline back pain, and at a minimum, risk causing distraction and delay in performance of the procedure. I have also performed plenty of operations where I need to hold a steady, sometimes awkward position, and I can feel a worsening of baseline numbness or tingling in my hand/arm or my foot/leg. Believe me, I am not unique. I know many surgeons who have rotator cuff problems, “tennis” elbow, wrist or thumb arthritis, and so on, where almost every move they make causes pain. We “learn” to endure and sometimes modify, but what if we could learn to prevent, mend or perhaps recover from these injuries.

Chronic

For surgeons, most musculoskeletal injuries are caused by standing in static (often uncomfortable) positions for long periods of time and performing repetitive motions during procedures. This, coupled with the fact that many surgeons wear heavy lead aprons, awkward headgear, and other equipment can lead to overuse injuries. Over time these factors can build and cause repetitive stress injuries like carpal tunnel syndrome, arthritis, and more. My goal is to raise awareness, so that most of our younger and future surgeons can either prevent or at least lessen the damage from our noble work. One effort to raise awareness was our web-conference, Ergonomics: Best Practices for Longevity. Thus far, personally, I have been successful in managing my chronic injuries with some physical therapy and a lot of yoga with core strengthening. My episodes of back pain are much less severe and much less frequent. What if you could avoid or stall musculoskeletal injuries significantly in your career?

Tips for Preventing Work Injuries

Here are a few simple tips to help prevent or delay these types of injuries at work:

  • Stay in Shape - The better shape you’re in, the better you’ll be able to handle the physical demands of being a surgeon.

  • Take Breaks - If you’ve got back to back procedures, try to take even a few minutes break to rest, take a walk or do a “mini” or 5-minute workout (cross-training) before heading back into the OR.

  • Stretch - Doing simple stretches before, during, and after a long procedure can significantly help avoid injury.

  • PRACTICE Improvement for Injury Management - We recommend taking on the complex problem of injury management in surgeons with our PRACTICE improvement methodology. Reflect on your injury situation with our 8 PRACTICEs checklist to either get back in the game sooner with the least harm or stay in the game longer. Make a plan with realistic goals. Intentionally adjust your surgical practice to recover well. Repeat until Well! Try the SurgeonMasters Performance Improvement Tool to assist your recovery. Check it out here.

SurgeonMasters

At SurgeonMasters, our goal is to provide surgeons with the tools they need to build sustainable practices. We offer a variety of educational materials including regular blog articles, podcasts, webinars, and in-person meetups. We also deliver surgeon and physician coaching to individuals and teams to power improved performance inside and outside the OR. Contact us today to learn more about our offerings, or join our mailing list to stay up to date with the latest from SurgeonMasters!


Source: Epstein S, Sparer EH, Tran BN, et al. Prevalence of Work-Related Musculoskeletal Disorders Among Surgeons and InterventionalistsA Systematic Review and Meta-analysis. JAMA Surg. 2018;153(2):e174947. doi:10.1001/jamasurg.2017.4947