Effect of core strengthening on musculoskeletal pain in general surgery residents: is ergonomics awareness enough?

Abstract Purpose The rate of musculoskeletal injury among surgeons is nearly 90%. Despite recent improvements in surgical ergonomics education, the physical demands of surgery are often unavoidable, and trainees are at an inherently increased risk. This study sought to determine the feasibility of completing a core strengthening exercise program (CSEP) amongst general surgery residents (GSR) and to assess for changes in core strength and work-related musculoskeletal pain. Methods All GSR at one program were invited to participate. Pre-intervention surveys and core strength assessments were completed prior to a 6-week CSEP, consisting of a 5-minute home exercise program 4 times a week and a 10-minute group exercise session once weekly. The Wilcoxon Signed-Rank tests were used to compare pre- and post-intervention surveys and strength assessment scores. Results Twenty-three residents were enrolled and 17 residents completed all components of the study. There were statistically significant improvements in core strength in Biering-Sorensen test from 41.20 s to 60.00 s, front plank test from 41.95 s to 49.05 s, and left side plank test from 47.85 s to 51.11 s (all p < 0.01) and reduced frequency of back pain to no or 1–2 times a week ( p = 0.01). The participants reported an overall positive experience with the program. Conclusion Implementation of CSEP for surgical residents is feasible and shows improved strength and reduced frequency and severity of back pain. Core strength equips the surgeon with the foundation necessary to prevent pain and injury in the setting of fatigue or unfavorable ergonomic circumstances. Larger studies with more robust data are needed to confirm the efficacy of core strengthening programs among surgical trainees.