Back Pain and Veterinary Surgery

Posted: Jun 25, 2014
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Ergonomic (adj): intended to provide optimum comfort and to avoid stress or injury.

There is absolutely nothing ergonomic about the veterinary surgical setting. Until they figure out how to suspend me Mission Impossible style over the patient, able to see in every nook and cranny but still not actually “over” the incision, I am doomed to muscle strain.

Nowhere in the job description did it say “applicant must have a strong back resistant to repetitive motion injury.” I knew when entering a surgical internship, then residency, and finally my current staff surgeon position, that long hours, irregular eating habits, coffee obsession and bad hair days were to be expected. What I didn’t get was the memo informing the future surgeon that you will eventually walk like Grand Maester Pycelle.

Sure, we are all told in school to stand up straight in surgery. Don’t lean, don’t slump, and for goodness sake don’t lock your knees or you will pass out. All true, but sooner or later you will need to look down at your patient. A full day of arthroscopy will give you a pretty good shoulder ache. Back-to-back cholecystectomies will spawn a crick in your neck limiting your drive home to a series of left hand turns as you can no longer look to the right. Lifting an impacted colon out of a horse’s abdomen will threaten your lumbar spine no matter how fit you are. There just isn’t a "safe lifting technique" when you are restricted by surgery tables, sterile and non-sterile areas and tissue fragility. And lengthy orthopedic surgeries…don’t get me started. Granted, there are a few surgeries where I can sit down like a civilized human being, but the vast majority of my work has me leaning, twisting and bending in precisely the way that back specialists warn against.

Two years ago, after my umpteenth lower back strain, I decided to take some proactive measures. I started a workout program designed specifically for back strength. I figured if I could do a one armed push-up, no paltry Billroth procedure could undo me. I wasn’t exactly a couch potato before starting this program. However, there is a big difference between running up Mt. St. Helens and successfully holding the wheel yoga position for 30 seconds. On the bright side, I have not strained my back, neck or shoulders (more than the typical ache of all day surgery) in almost 2 years. On the down side, I’m afraid to stop working out for any significant length of time for fear of the dreaded incapacitating back spasm.

The Wheel

Wheel pose in yoga

Before you ask, yes, I wear good shoes. Air Jordans in fact. I find they have excellent arch support and heel cushion. And the shiny ones are really easy to clean post-op. I find cheap pairs in the kids section. I can’t tell you how many clients have remarked on my shiny basketball shoes. I tell them the shoes make me faster.

Yes, I have tried acupuncture, acupressure and chiropractic intervention periodically. I adjust the surgery table height every single time and only have a twinge of regret for the 5’4” intern who is balancing on a step stool during the entire surgery. Been there, bought that t-shirt. Half of my internship was spent standing on tip-toe to match the table height of the 6’3” surgeon. That said, there is only so much preventative strategy one can do. I’ve come to realize that the typical surgeon is a bit like the typical farrier. Eventually, bending over to hold up a horse or dissect an adrenal gland will wear out your back.

In the meantime, I will keep up my core strengthening exercises. Sadly, after two years I still cannot master the one-armed push up. I can, however, hold a crane pose for a reasonable amount of time without crying. Much.

The Crane

Crane pose in yoga

I said give me two pairs
I need two pairs
So I can get to stomping in my Air Force Ones
(Big boys) stomping in my Air Force Ones
Nelly (Air Force Ones)