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V O L 4 2019 I S S U E
• Back and trunk: Avoid pelvic girdle Cardiovascular exercises, strength training and
asymmetry by keeping feet hip’s width stretching. All three types are equally important
apart with weight evenly distributed. for overall physical fitness.
Engage deep muscles of trunk and pelvis
to maintain neutral position. Perform Cardiovascular exercise is repetitive,
postural “resets” both for the surgeons and rhythmic exercise that increases your heart
the assistant. Prolonged static positioning rate and requires you to use more oxygen. It is
should be avoided. often called aerobic exercise, cardiovascular
exercise, or “cardio” for short.
• Lower extremity: Avoid locking of knees.
Consider antifatigue mats in the operating This includes walking, jogging, swimming,
room to decrease lower extremity fatigue. biking etc. This can be done indoor in a
Surgeons should perform intraoperative gymnasium or outdoor.
stretching with squats to relax the muscles.
Surgeons should also consider elastic The importance of cardio cannot be
stockings if prolonged standing is required. overemphasized for general healthy lifestyle.
However, stretching and strength training
• Retraction although not taken seriously, is form the workhorse for preventing surgery-
an important cause of fatigue and muscle related musculoskeletal injuries.
strain for both the surgeon and the assistant.
It is important to use ergonomic retractors. Stretching or lengthening the muscles helps
Also, the surgeon and the assistant should one become more flexible, which makes
take a pause and release the retractor certain activities of daily living easier. Plus, the
periodically and rest the extremity. improved flexibility gained from stretching
regularly help prevent aforementioned
musculoskeletal injuries. Stretching also
reduces muscle tension, increases circulation, Figure 3. Pre-operative stretching
improves posture and elevates mood.
Examples of stretching exercises include stretching exercises before the surgery. This The last thing a patient would want to have is
ballistic stretching, dynamic stretching, active can be done 10-15 minutes prior to scrubbing a surgeon with trembling hands injecting or
stretching, passive (or relaxed) stretching, in the office or even the operating room. operating them!
static stretching, isometric stretching, PNF Surgeries like liposuction which involve
stretching (proprioceptive neuromuscular repeated movements using shoulders Intraoperative stretching
facilitation)
necessitate warm up of shoulder joint using In surgeries with long duration, it is important
Lets simplify things for the readers. specific shoulder stretching exercises. that the surgeon keeps stretching his neck,
back and hamstrings.
When and What to do?
What not to do? Micropauses (20 second pause after every 20
Preoperative stretching minutes) is a good way of preventing muscle
Figure 2. Physical Conditioning (Figure 3) Avoid weight lifting especially heavy weights fatigue especially in surgeries involving
(in case of fitness junkie plastic surgeons)
Physical conditioning Just like a bodybuilder stretches and warms in the morning, at least 6-8 hours before the repeated movements like liposuction.
(Figure 2) up before working out on a particular part, surgery. Heavy weights cause tremors in the Use of power assisted devices in liposuction
similarly, surgeons need to prepare their body hands which can be a potential hinderance in can cause trembling of hands due to vibration
Simply put, it means training in physiologically for the plastic surgeries. surgeries involving finesse like microsurgeries, and need micropauses more often. It’s a good
proper techniques for repetitive tasks. hair transplant or even botox and filler
Surgeries like microsurgeries, hand surgeries injections. idea to shake off the wrist joints periodically.
Physical activities can be broadly classified into or hair transplant need neck and lower back Carpal tunnel syndrome though not proven
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