Exercise for the Surgeon: Part 3 of Counteracting the Effect Surgery Takes on the Surgeon
Warning: As the exercises become more advanced, it is always important to maintain good form. Form fatigue is a common source of injury and can decrease the effectiveness of the exercises. It is better to do fewer repetitions with correct form than more with incorrect form. Discomfort is ok but if you experience pain during any of these exercises, it is best to stop instead of trying to push past the pain.
STANDING ROW AND BABY COBRA
Steps to perform:
|1.||Set a cable to just below shoulder height with an attachment that allows you to grasp it with two hands evenly (often two single handles attached to the same carabiner).|
|2.||Grab onto the handles and pull the weight a distance away from the machine that will allow the movement of the weights without the working load coming to a rest when the arms are outstretched.|
|3.||Stand in a high squat position that allows your spine to be perpendicular to the floor and your weight evenly distributed in the feet (Figure 1).
Hint: With the weight of the pulley pulling you forward it is common to have too much weight distributed in the ball of the foot. Lowering into the squat and shifting back will redistribute the weight closer to the heel.
|4.||Once positioned pull the weight in toward the ribs fully retracting the shoulder blade as you pull (Figure 2). Ensure the scapula only retract and does not upwardly rotate (Figure 3,4). When upwardly rotating the medial border of the scapula increase in distance from the spine defeating the benefit of the movement for improving posture.|
|5.||Remember, it is important to allow the scapula to protract on the eccentric action of the movement with every repetition.|
A progression to this movement is to increase the rotary challenge to the abdomen by performing the row just on one side (unilaterally).
- One option to accomplish this is to perform the same cable row with one hand.
- Another option is to perform a bench supported row with a free weight. Steps for this are:
- Place the same side arm and leg on a bench with the opposite leg posted to the side on the ground (Figure 5).
- Row a single free weight up to the rib cage (Figure 6).
- Hint: To achieve the desired stability in the trunk with the rotary challenge, minimal rotation of the torso is a primary goal. It is also important to keep the supporting shoulder active by pressing firmly into the bench. Even though it is not moving it is still a supporting limb and plays a large part in the rotary stability.
|Figure 1||Figure 2|
|Figure 3||Figure 4|
|Figure 5||Figure 6|
The Baby Cobra Stretch/Position is a good compliment to the Rowing exercises for encouraging a healthy spine and good posture.
Steps to perform:
|1.||Lie prone on the ground with the web of the palm centered under the shoulders (Figure 7,8). Every spine has its own unique range of extension and the range of this movement should respect this.|
|2.||Enter the position, without actively lifting the torso with the hands, even though they are in a good pressing position.|
|3.||Using the extensors in the trunk lift the chest off the ground as high as is available with your own mobility.|
|4.||When full range is achieved press the hands into the ground taking the burden of the extensors with the upper limbs (Figure 9,10).|
|5.||A regressed version of this stretch/position is with the forearms on the ground. Instead of the hands.|
|6.||The Anterior Superior Iliac Sine (ASIS) should remain in contact with the ground.|
|Figure 9||Figure 10|
Chicago Review Course in Neurological Surgery
Jan. 24-Feb. 3, 2019; Chicago
Richard Lende Winter Neurosurgery Conference
Feb. 1-5, 2019; Snowbird, Utah
2019 NASBS Annual Meeting
Feb. 15-17, 2019; Orlando, Fla.
12th Annual International Symposium on Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery
Feb. 22-24, 2019; Lake Buena Vista, Fla.
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