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Editorial Spotlight | February 2018

Spilling the Beans

Docs share their experiences and strategies to prevent ergonomic injuries.

Lisa Brothers Arbisser, MD





Have you experienced any work-related repetitive use injuries?

Nothing chronic.

Do you have strategies to make your OR ergonomically optimized?

I take care in positioning the patient, footpedals, and scope at the start of the case. I work with a trainer weekly and focus on core, balance, strength, and undoing my daily bad postural habits.


Sondra Black, OD




Have you experienced any work-related repetitive use injuries?

I have neck pain, generally from desk work. I have a herniated disc in my back from working in the exam lane and leaning.

Do you have strategies to make your OR ergonomically optimized?

I use back support.

Do you perform any stretches or exercises to prevent injury?

I exercise four to five times per week.


John Davidson, MD





Have you experienced any work-related repetitive use injuries?

Yes, right wrist tendinitis and neck strain.

Do you have strategies to make your OR ergonomically optimized?

I make my primary incision at 30° rather than 180° to relieve wrist strain, and I tilt the microscope almost 45° to relieve neck strain. I recently began using the Ngenuity 3D (Alcon) heads-up digital microscope, which allows me to sit back comfortably and watch the surgery from a monitor.

Do you perform any stretches or exercises to prevent injury?

I play full-court basketball every other day.


David A. Goldman, MD




Have you experienced any work-related repetitive use injuries?

No.

Do you have strategies to make your OR ergonomically optimized?

I make sure my positioning is proper before starting any exam or surgery.

Do you perform any stretches or exercises to prevent injury?

No.


Leon W. Herndon, MD




Have you experienced any work-related repetitive use injuries?

Early in my career, I had neck pain after surgery.

Do you have strategies to make your OR ergonomically optimized?

It is all about positioning myself properly at the microscope.

Do you perform any stretches or exercises to prevent injury?

Not before surgery.


John A. Hovanesian, MD




Have you experienced any work-related repetitive use injuries?

No.

Do you have strategies to make your OR ergonomically optimized?

I tilt the microscope about 15° so that I don’t need to stretch my back and neck to be directly over the patient.

Do you perform any stretches or exercises to prevent injury?

I swim about 7 miles a week. This builds a lot of core strength and neck flexibility, and I think is responsible for my avoidance of injuries.


Mitchell A. Jackson, MD




Have you experienced any work-related repetitive use injuries?

No.

Do you have strategies to make your OR ergonomically optimized?

I keep all technologies in one room with a no-movement strategy. I just slide the chair out from the femtosecond laser and place the patient under the microscope to complete the procedure.

Do you perform any stretches or exercises to prevent injury?

I do a psoas muscle stretch and hamstring stretches daily.


Cynthia Matossian, MD





Have you experienced any work-related repetitive use injuries?

Neck and back pain and occasional wrist aches.

Do you have strategies to make your OR ergonomically optimized?

Yes.

Do you perform any stretches or exercises to prevent injury?

Yes, on a regular basis, in addition to working out with a trainer and getting a therapeutic massage the night of my surgery days.


Audrey Talley Rostov, MD





Have you experienced any work-related repetitive use injuries?

Yes. I had some neck pain and also leg pain secondary to an old OR chair that was not ergonomically suited for me. We replaced the chair, I had physical therapy, and this resolved.

Do you have strategies to make your OR ergonomically optimized?

Yes. I make sure that I adjust everything to me so that I am not hunched or overextended in my neck, my back is straight with good posture, and my legs comfortable. I have longer oculars so that I can sit straight without hunching over the microscope.

Do you perform any stretches or exercises to prevent injury?

I do yoga.


Mitchell Shultz, MD




Have you experienced any work-related repetitive use injuries?

Yes, including neck, lower back, and wrist pain that is associated with use of the phoropter and operative microscope. I also have cramping in my wrist and hand when operating.

Do you have strategies to make your OR ergonomically optimized?

No.

Do you perform any stretches or exercises to prevent injury?

Yes, I do core exercises 3 to 4 days per week.


Michael E. Snyder, MD





Have you experienced any work-related repetitive use injuries?

No.

Do you have strategies to make your OR ergonomically optimized?

No. 1: Tilted microscope and tilted patient head;

No. 2: Ergonomic chair from Reliance Medical Products with lumbar lordosis to the seat back;

No. 3: Footpedal elevators to tilt foot pedals (Reliance Medical Products); and

No. 4: Attentiveness to bed height so my spine remains upright.

Do you perform any stretches or exercises to prevent injury?

No.


William B. Trattler, MD




Have you experienced any work-related repetitive use injuries?

I have not. I was taught by my professor, Michelle Piccone, MD, at Scheie Eye Institute, how critical it is to keep proper positioning at the slit lamp and in surgery.

Do you have strategies to make your OR ergonomically optimized?

I use the TrueVision heads-up display (TrueVision Systems) for most procedures. I can sit in a comfortable position for every case.

Do you perform any stretches or exercises to prevent injury?

I should do more.

BY THE NUMBERS

57% of survey respondents have experienced a work-related injury

23% of survey respondents have strategies in place to prevent injuries

23% of survey respondents stretch or exercise

89% of physicians across multiple specialties exercise at least once per week

Gary Wörtz, MD




Have you experienced any work-related repetitive use injuries?

Chronic neck and lower back pain, not requiring surgery or therapy but definitely annoying. I fixed it by starting a workout program including yoga, high-intensity training, and weightlifting.

Do you have strategies to make your OR ergonomically optimized?

No. It’s a huge unmet need in our profession.

Do you perform any stretches or exercises to prevent injury?

Yes. Surprisingly, deadlifts, squats, and core training, along with yoga, have really helped.

Fitness and Ophthalmology

Darrell E. White, MD, joins Gary Wörtz, MD, to highlight the value of exercise to reduce the physical and psychological stresses of ophthalmic surgery. Dr. White explains how the fitness regimen CrossFit has helped him become a better surgeon, highlighting that the intense workout regimen has helped him not only to stay in peak physical shape but also on an emotional level.

Click here to listen now!

Robert J. Weinstock, MD





Have you experienced any work-related repetitive use injuries?

Yes, I have experienced back pain in the past.

Do you have strategies to make your OR ergonomically optimized?

Yes, I perform heads-up 3D surgery. I also operate with sneakers on and use a specific bed and chair height and patient positioning. I orchestrate turnover so I keep moving.

Do you perform any stretches or exercises to prevent injury?

I stretch and do isometric exercises daily.

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