Occupational Musculoskeletal Injuries: Building Habits for Surgical Longevity

In this episode of the AAOS Career Podcast, host Ellen Lutnick, MD, is joined by Ronald Navarro, MD, FAAOS, to talk about occupational musculoskeletal problems among orthopaedic surgeons and why it’s never too early to focus on preventing them.

Dr. Navarro shares how his interest in the topic began after seeing colleagues develop neck pain and radiculopathy, some of whom ultimately required surgery. He discusses his published survey studies on occupation-related cervical spine disease, which found that older age, female sex, job stress, and greater surgeon experience were associated with neck problems. That’s in addition to frequent and prolonged use of arthroscopes, endoscopes, and loupes.

Dr. Navarro also highlights the risk of injuries from hammering in hardware and how OR ergonomics – things as seemingly simple as monitor placement and table height – can lead to aching joints in the surgeons who treat aching joints. In addition to neck pain, common problem areas include the shoulder, hips, knees, hands, and feet.

The conversation then turns to practical solutions. Dr. Navarro and Dr. Lutnick discuss the importance of making equipment adjustments, how attendings can advocate for both their own occupational safety and that of trainees who may be reluctant to speak up, and how a culture shift is needed to make the surgeon’s physical safety as much of a routine priority as the patient’s.

Key topics covered in this episode:

• Common problem areas for orthopaedic surgeons, including the cervical and lumbar spine, rotator cuff, hands, hips, and knees

• Findings from studies of neck pain among surgeons who use arthroscopes, endoscopes, microscopes, and loupes

• The role of job stress and mental health in musculoskeletal symptoms

• Why surgeons may not connect operating room ergonomics to their own aches and pains

• Practical ergonomic fixes, such as monitor placement, table height, stools, risers, and loupes designed to keep the head in a neutral position

• The idea of observing colleagues' OR setups and offering peer feedback

• Building ergonomic checks into existing safety routines, such as the surgical time out

• How attendings can set the tone by modeling breaks and self-care, so residents feel comfortable doing the same

• Warning signs not to ignore, including persistent pain and radicular symptoms, and why seeking an outside evaluation matters

• The value of stretching and core strengthening for long cases

• Why prevention is worth prioritizing early, much like planning for disability insurance

As Dr. Navarro emphasizes, a long orthopaedic career depends on taking care of your body just as diligently as you develop your technical skills. Starting healthy habits and open conversations now can help protect the career you have worked so hard to build.

Host: Ellen Lutnick, MD, Resident Assembly Executive Committee Chair

Guest: Ronald Navarro, MD, FAAOS, Sports Medicine Surgeon and Regional Chief of Orthopaedic Surgery, Southern California region, at Kaiser Permanente