AANS Neurosurgeon | Volume 29, Number 2, 2020

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Exercise for the Surgeon: Part 9 of Counteracting the Effect Surgery Takes on the Surgeon

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The views expressed in this presentation do not represent the official policy or opinion of the United States Navy, Defense Health Agency, Department of Defense, or the United States Government.

As with any exercise program, maintainance of good form is critical. Form fatigue is a common source of injury and can decrease the efficacy of the exercises. Fewer repetitions done with correct form are superior to an increased number of repetitions done with incorrect form. If you experience pain during any of these exercises, it is best to stop instead of trying to push past the pain.

Post-Operative Recovery

Many of the previous installments of “Exercise for the Surgeon” have focused on strengthening and stretching the key muscle groups that we use and often ignore when we perform surgery. Specifically, the upper back, gluteus, and hamstrings- commonly referred to as the posterior chain.  But what happens when you can’t go to the gym? For many of us, visits to the gym are hard to fit into our schedule; we need the gym to come to us. This is where a small investment in items that can be kept in a drawer, on a shelf in your office or near the operating room, can have a huge impact. Props such as suspension training straps, and myofascial release/trigger point tools such as a foam roller or a lacrosse ball can be helpful.  Regular exercise with these props promotes  good posture and reduces the pain and tightness that often affect surgeons.

Suspension Training Straps

A suspension training strap system can be mounted to the wall or over a doorframe (Figure 1), providing multiple ways to promote recovery or provide strength training.  For recovery, just focus on 5 letters: A, I, T, Y and W.  (Figure 2-6, Video 1) With the suspension straps properly anchored, step forward with one leg and the other back. Hold the handles and position the arms so that your body is making the shape of either A, I, T, Y or W. Step into the position so you feel the stretch. Different letters will focus on different aspects of the arms, shoulders, and upper back. Each form will allow a hamstring stretch in the posterior leg. Alternating legs allows for hamstrings to be stretched bilaterally.

By altering how you use your body weight with the straps, these same exercises can also be used as a strengthening regimen (Video 2).

Figure 1. Suspension straps secured over a door

Figure 2. “A” shape stretch

Figure 3. “I” shape stretch

Figure 4. “T” shape stretch

Figure 5. “Y” shape stretch

Figure 6. “W” shape stretch

 

Myofascial Release

A foam roller (Figure 7) or firm lacrosse ball can be used to provide myofascial release. Using your body weight, you can adjust the depth of the release (Figure 8). Moving or rolling across the roller or ball will allow you to precisely align the device with the tension. Sometime your full body weight may provide too much pressure. Putting the foam roller or ball against the wall is another alternative (Figure 9). The foam roller works particularly well for the upper and lower back, hamstrings, glutes, and quadriceps while the lacrosse ball can provide more focal myofascial release such as in the area medial to the scapula (Video 3).

Figure 7. Different sizes and styles of foam rollers allow for different levels of sensation.

Figure 8. Lying across the foam roller allows you to use your body weight to adjust the depth of sensation.

Figure 9. An alternative is to use a wall to support the roller or ball as you lean into it.

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