Surgeons are well known for their fine motor skills. However, standing in theatre for long periods- whilst maintaining finicky postures is hard work, and requires more gross stability from the outer extremities. It is common for a physician to experience musculoskeletal pain with his/her craft. A recent surgeon of mine has received many compliments on his improvements in postural stability whilst consulting and in theatre. Recent compliments have sparked interest in strength training among other surgeons- leading to myself and other colleagues seeing more surgeons in the clinic wanting to improve his/her musculoskeletal pain.
Now, in no way am I a hero here. Managing musculoskeletal pain suits my own finicky personality; nor is a complex algorithm required. Taking a sound clinical history along with a good understanding of contemporary pain science goes a long way! What I want discuss is utilising time under tension (TUT) with surgeons- along with other age cohorts when prescribing strength exercises. Keeping this blog anecdotal. TUT can be described as: time taking to complete a single repetition. With any exercise, one has to withstand forces great enough to complete each lift. Surgeons are required (as mentioned) to maintain gross stability, sometimes hours on end. Movements such as: deadlifts, bent over rows, KB front squats, kneeling fitball roll outs and seated rows in hip flexion. Are all great movements to introduce TUT into ones exercise regime. Using a TUT of: 5-1-2 for a deadlift for example, for a set of 5 repetitions equates to a total set volume of 40 seconds. Now 40 seconds does not seem like much. However, if you include 5 sets, now you have 3.33 minuets for the exercise alone. Add two to three more exercises that were aforementioned- you then have 10 minuets of TUT! Next would be prescribing a safe adequate load that doesn’t mess with his/her loading mechanics. O’Sullivan & colleagues (2014) systematic review on heavy slow resistance training is a neat read and complimentary. Lastly, gradually increasing TUT and load improves gross motor control- which is especially helpful in theatre and in the everyday contexts, while also strengthening neuromotor pathways (which anecdotally) is one of the biggest winners in improving gross motor tone- reducing the “stiffness” that is often subjectively reported. Through brain plasticity: the brain learns how to turn on, and turn off tone.. winning! Turning off tone can be a surgeons omen..
As always: consult with your GP and exercise physiologist/scientist to be cleared to move with safety.