How do you get used to standing for 4h + ?
By - clashofpotato
I learned to suck it up after me and a vascular surgeon worked together honestly.
7ish hours in a lead vest…. Didn’t bother him at all…. He was probably like 80 years old and I was the one who couldn’t move after the surgery.
The pain in my shoulders from wearing lead all day during vascular surgery lmao, pls admit me to the ED for rhabdo (after the case ends ofc, not trying to get a bad eval)
Experiment with different shoes / soles / clogs
Also compression socks
I alternated between running shoes and clogs and can confirm the danskos were MUCH better. Also got compression sleeves for my lower legs which may help or may just be placebo.
Yes, Dankso’s helped my back so much. They take a a while to break in but after that they made a huge difference. And keep them updated….I used the same ones for 4 years and had a huge back problem by the end of residency.
This. My body felt so much better with good, supportive shoes and compression socks.
Clogs seem pretty popular
Too true with the compression stockings.
Compression socks made a bigger difference than any choice in footwear. That plus the mesh crocs for ventilation=silly good. Yeah, I wouldn't have believed it either.
1. You just do
2. Make sure to keep moving every now and again. I do calf raises for a few second just to get the blood in my legs moving
3. Thick soles with tons of cushioning and tons of arch support
4. Be decently healthy in terms of diet, exercise, and weight
Aye Bondi 6
You genuinely just get used to it. I’m not sure where you are at in training, but I always found the more involved I was in the procedure, the less I noticed my feet hurt.
M3 = Mindlessly standing there trying to act interested in a two inch incision not seeing a damn thing. The only thing you can think about is your feet.
First assist = you are so invested in the case and predicting the surgeons moves that you don’t have time to think about your feet
The only solution I’ve found is being allowed to actually participate in the surgery. Feet don’t hurt when you’re actually doing something instead of standing in the corner.
Try compression socks or sleeves. And try brooks glycerine
Do ophtho and do surgery on a chair 😎
Haha funny bc I actually want to do ophto but I’m also exploring other specialities
Do it its the best
No bias here whatsoever
I would like to know this as well. I have osteoarthritis in my spine and I'm pretty worried about how it's going to go.
Edit: Danskos are very reliable, though. I also like Clarks (the oxfords are somewhat stylish too).
Used to stand 8 hours a day as a scribe. Your feet get used to it, but good quality shoes with a cushioned sole and medical grade compression stockings reallllllly help.
Compression stockings! For me, the only ones that helped are the kind you have to actually measure yourself for, with standardized mmHg that also compress your feet and are graduated. Sadly, if the cute generic rainbow ones are not as helpful, you may want to try for the ugly medical ones. Be careful to hand wash them and don’t put them in the dryer!
Do you go to a doctor's office to measure the mmHg?
Sorry, I meant you measure your leg circumference!
Took me about 2 weeks before my feet stopped hurting. It sucks the most when you’re not doing anything but when you’re in on the action you don’t even notice.
Yes I’ve noticed!!!
By loving surgery so much that you are ok with it
I used to tell myself that the attendings and residents are human too and if they can focus on the case enough that their feet don’t bother them, then I can too
But then I realized that in fact no, they are not quite human… they’ve morphed into something else, something… sinister
Being dead on the inside will do that to you.
I have never understood that approach.
It’s legit about being interested and involved, which MS3’s are rarely allowed to be.
I wear all-white NMDs while volunteering as a surgical first assistant. I get blood on them all the time but it’s funny, I always know where the drops of blood are, can throw the shoes in concentrated bleach for 20 minutes, and voila!
They were $45 cause I guess no one likes all-white NMDs, but they’re super lightweight, comfy, and make the hours go by like cake.
90% of the surgeons i've seen wear crocs, so maybe that's the answer. Never tried it tho
Crompression socks / stockings. My feet feel fresh after all day
Some people say you do and I will argue not everyone does. I am one of those that don't. Personally, a career in surgery is special kind of hell. Standing for 6+ hours bent over a stank ass ruptured bowel? Hell no. Give me a chair and let's talk. #psychgang
Seriously though I got heel inserts. Game changer.
You just get used to it. My first job was a convenience store clerk where I stood at a register looking down for 10 hours a day standing on a piece of plywood. No chairs. There were times I was moving around doing other things but never sat from the time I clocked in to the time I clocked out. After the first couple weeks you stop noticing the pain/your body gets used to it
-Custom orthotics if you would like to be a surgeon (a bit expensive If not)
-Leaning on the table
-Squeezing your glutes and holding-sounds a bit weird but helps the back and legs so much.
Bro my surgery rotations gave me the worse plantar fasciitis
Changing shoes didn't really make a difference for me. Medical grade compression stockings made things MUCH better
Have really liked anything with the adidas boost midsole
Compression socks, get fitted for shoes, green super feet inserts
You eventually get used to it
Compression socks, clogs, trying to move your legs / bend them / stay loose.
I got a pair of Dansko's early in MS3 and even just having them for the clinical years felt completely worth the money, let alone beyond.
Hoka shoes are getting really popular for long hours on your feet. I’m a fan of mine for sure.
You avoid as much surgery as possible and pick a different specialty
Compression socks and ibuprofen.
Merrell Jungle Mocs are very comfortable for long standing and you won’t break your ankle in them like Danskos. You can move fast in them too.
Compression socks are very, very effective even if you are in excellent physical condition.
A roommate of mine told me about how much better his feet felt after he started wearing compression socks a few weeks into our Surgery block and was like DUDE you have to try this, I mean I can stand all day and it'a fine now.
Keep in mind this guy was totally sedentary, had flat feet, and was about 300 lbs.
I was in very good shape at the time. 6'2", 225ish lbs, 10-12% body fat (3 and 7 site caliper), could keep a 6:30 mile pace for 5-6 miles and did so several times per week, 24 reps of full-ROM bench with 235 lbs, 10 weighted pull ups with 100 lbs added, 500 lb deadlift and 10 reps with 405, 10 reps of split squats with 295 lbs, ran in 5-finger Komodo as well as normal running shoes, etc... my feet didn't really bother me, but I was curious... so I got some knee-high compression socks.
They made a surprisingly big difference for me also, to my surprise. I thanked him, and I still wear compression socks when I am on inpatient services with long rounds.
Thanks so much for sharing. Any tips on what brand
Sure. I have a bunch of these and love them: [https://www.amazon.com/gp/product/B078YNYG33](https://www.amazon.com/gp/product/B078YNYG33)
Unfortunately the brand I have seems to no longer be available on Amazon, but these are a fantastic deal: [https://www.amazon.com/dp/B097R6L41X](https://www.amazon.com/dp/B097R6L41X)
Whatever you get, make sure they're actually knee high at least and that the pressure is specified as "20-30 mmHg:" those numbers are the pressure differential from knee to toe for the brand's standardized "correct fit" and this particular pressure differential is what has been validated as the most effective.
A lot of socks on the market are only rated as 8-15 mmHg or 15-20, and that's honestly not sufficient... people get those either because they are afraid that the real deal is going to be uncomfortable or because they get frustrated with trying to put the socks on.
The 20-30 mmHg socks aren't uncomfortable at all, and I have big calves so I'm definitely experiencing more tightness than the average consumer. They actually feel really damn good.
Frustration usually hits people who try to put on compression socks the same way they put on their normal socks: Just grab the top of the sock and shove your foot in, or bunch the whole sock up in your hands so that just the toes get covered and then pull it up and around. Either of these approaches will make things difficult for no reason.
Instead, just grab the inside collar of the sock with your thumbs and hook your fingers into the sock wherever they are and push your foot in until you start noticing it is quickly starting to feel difficult. Instead of fighting your way in, just use your fingers to "walk" a few inches of the sock up, and pull again. Repeat this a few times and you'll have your foot all the way in to the toes quite comfortably, and the rest of the sock will be bunched up above your ankle but under your calves.
Now all you need to do is hook the sock collar again with thumbs and fingers (easy to do) and just pull with your hands while you push with your legs: The sock will slide up over your calves really easily, and you'll just slide your fingers around to get it the way you want it and BOOM, done.
The easiest way to take them off, by far, is to just pull the collar down and slide it over your heel and then toes so that the sock is basically turning itself inside out without bunching up. Once the collar is past the heel, only pull it over the foot to the point that it's even with the toe of the sock.
At this point you'll either have the entire sock down past your heel or it will be so close that you can use a finger or thumb to pop the small remaining amount down past your heel.
Now you can just pull from the toe and the sock will come right off with minimal effort, which is nice because they are kind of a pain to turn all the way right-side out if you let them completely go inside-out, which will happen if you keep sliding the sock collar over your foot once you get it over the heel and down to your toes.
That's just my recommendation for technique, it probably sounds stupid to talk about "sock technique" but it'll make a LOT more sense once you actually have the socks and put them on.
BONUS INFO FOR PATIENTS:
I find that a surprising number of us doctors, both residents and attendings, as well as nursing staff and PT/OT, are either completely unaware of the "Sock Aid" devices or we all fail to make sure that we both tell patients and families who have indications for daily use of compression socks (venous insufficiency/congestion, T2DM, CHF, Lymphedema, etc) AND give them practical sources for both obtaining the device and how to actually use it without losing their minds.
What you need to know is that many patients will have one very common problem that makes this video useless for them: upper extremity strength and/or pain issues and/or very dry skin, which result in the socks slipping out of hands when they try to load the device and/or when they try to pull the sock the rest of the way up their leg.
There is a super, super simple fix or this: Just tell your patients to wear grip-enhancing gloves when they put them on! They're cheap and you can get latex or latex-free versions.
PT and OT can provide the written recommendation for compression socks and Sock Aid devices, and all we have to do is get the Rx over to care coordination.
I actually have a print-out with instructions and sourcing options for both Sock Aids and the grip gloves as well as a file I can cut and paste into EMR patient portal messages that contains the following info:
[https://www.amazon.com/RMS-Deluxe-Sock-Foam-Handles/dp/B00U9TWCXU](https://www.amazon.com/RMS-Deluxe-Sock-Foam-Handles/dp/B00U9TWCXU) 12 bucks, totally worth it. It is VERY important to note that for this to work well the knot needs to be on the OUTSIDE of the device. Sometimes this means you have to untie and retie the ropes, which I didn't expect but found out through personal experience as my dad is 89 and has lots of issues, and he needs the sock aids + gloves to be able to put on his own socks.
This is a 58 second Youtube video showing the device and good advice on how to use it: [https://www.youtube.com/watch?v=Us0bcyyoAaE](https://www.youtube.com/watch?v=Us0bcyyoAaE)
Technique for elderly: Sometimes people can load the sock but just aren't strong enough to pull it over the foot once loaded, and sometimes they're strong enough but it makes them really out of breath... it really helps to know that they can make this almost effortless if they just wrap the rope around their hands and lean back. Obviously this means they need to be sitting on something that allows them to safely lean back without falling, which may not be appropriate for all patients, but for a lot of people this is super super helpful.
Latex options: [https://www.amazon.com/3100XL-DZ-Gloves-Textured-Construction-12-Pairs/dp/B014F03PM0/](https://www.amazon.com/3100XL-DZ-Gloves-Textured-Construction-12-Pairs/dp/B014F03PM0/) (my personal favorite due to number of pairs for the price)
More expensive option: [https://www.amazon.com/KIM-YUAN-Resistant-Breathable-Construction/dp/B07M6JFL5K](https://www.amazon.com/KIM-YUAN-Resistant-Breathable-Construction/dp/B07M6JFL5K)
It's a bit difficult to find good quality truly latex-free gloves that will work the way you want them to work for gripping compression socks, so having this link can be really helpful.
Walking actually helps, less time having pressure on the ground, when I was a cashier my feet would be dead at the end of the day, but when I was a manager and had to walk/run back and forth it wasn't as bad.
Kind of hard to do that in the middle of surgery in the OR
I sometimes pace on the spot but if it’s a very boring procedure all I can think about is auuuuch
I understand that it's not always possible. Was just giving advice. Posture is important. Making sure to stretch your legs so that your tendons in your feet aren't tight and pulling. Shoes with correct arch support (most athletic shoes now a days don't actually have that). Etc
You don't... you just go into anesthesia instead.
You don’t 🙃
I just got some allbird tree runners because I was having back and heel pain. Best decision of my life. Has helped tremendously for my standing stamina. Also made sure to hit leg day to get some lower extremity bulk
Hyperfocus on the work and tune it out
Some things aren’t that interesting especially if you’re only watching :(
I got a $30 pair of clogs after my feet fell asleep during a TAH that went sideways. That and keeping your back straight
I’m training for this now by getting a standing/treadmill desk
Also take some advil
On running sneakers!!
Compression socks and Altras - I need that extra padding and wide toe box
You go into radiology
Keep doing it. You’ll get used to it.
Dr schols baby
Yeah, you'll just get used to it. Even with the right pair of shoes (and you're gonna get a bunch of recommendations ), it isn't going to make a difference on day 1. After several hours, you'll be in pain regardless of what you are doing or wearing. After a couple of days to a few weeks, you'll just get used to it.
When you get home (and even during the day), try to stretch your feet. This can help prevent things like plantar fasciitis, and it just feels nice when you come home
You don't and you switch to anesthesiogy. :-)
Following this for M3 year
Compression socks and danskos. You’d think running shoes would be good, but danskos are worlds better. The difference is shocking. They are hideous…the only reason everyone in hospitals wears them is because they are the best
Hey! I have a pair of Danskos (arch support) that I alternate with a pair of Bala shoes (fluids-resistant, arch support). The latter looks like running shoes that I could also wear on a casual basis because they just look that good. I also always wear compression socks. Half of the game is figuring out what personally works for you
Same thing a lot of others have said — increase your tolerance/stamina, get good compression socks and shoes, aND buy arch insoles. I have flat feet and getting insoles specific for flat feet made a world of difference.
Soaking your feet after work also helps in getting them to stop pulsing.
I used to think of mind games with my body - focusing on one part of the lower extremity and flexing it and relaxing it ten times. Ex- focus on right bie toe, push into the ground then relax, then move on to next toe etc all the way up to buttocks lmao. So weird but it passed 10 hours once on the OR and it got my mind off thinking how my entire body is actually broke
Good shoes (think good arch support athletic shoes or the ugly ones you see everyone wearing), compressions socks if needed (I don’t really like longer socks so they bother me sensory wise but I notice my legs feel a bit better when I use them), standing with a wider stance as opposed to feet together.
Also moving more than standing in one place if possible.
When you’re able to be more involved in surgeries/procedures you don’t notice as much either because you’re happy to be there instead of just standing barely able to see anything thinking about all the other things you could be doing.
Oh and if your feet still hurt with good quality shoes try adding some of the gel things from the drug store or Walmart I hear the work pretty well too!
Soft clogs + gel insole.
Get rid of firm/stiff heel clogs
Do radiology lol
I think you’ll get used to it over time I remember my first day as a cashier and was wearing boat shoes and was so miserable… I switched to sneakers and over time I got used to it