Fatigue makes cowards of us all. And that is not what you want when a surgeon is putting in the hours inside you: it can change a surgeon’s decisions when exhaustion sets in on the ninth hour of work. Furthermore, unlike most other surgery, brain surgery requires placing unconscious patients in various positions, such as on their chest, side and even sitting up. Accommodating this is part of the surgeon’s job.
After the heavy lifting (like powerlifting) comes the endurance part. Sometimes I’m wearing 2kg of equipment on my head and looking down for hours; other times I have my arms out in front of me for hours. Both require me to stay at my best physically. Often I’m leaning forward in awkward positions, so I rely on a long stretch of muscles to keep me at my best. These are the unheralded extensors that run from that bump on the back of your skull all the way down to your pelvis; muscles I train to make sure fatigue and pain don’t cloud my judgement and concentration in 14-hour-long operations. Steady hands begin with steady shoulders.
Why would a surgeon’s workout be relevant to you?
Life (sitting, smartphones, laptops) put us in flexion (think fetal position) and the muscles that oppose this collapse are called the extensor muscles. If we don’t use and exercise them they go into spasm and, by not providing supplementary support to your neck and spine, these joints wear out and get early arthritis. It’s a cascade of common maladies of modern living: neck pain, headaches, back pain, hunching shoulders, hunched mid back and loss of the normal curve in your back.
The surgeon’s workout can give you the look you want as well. In some ways we have been misled by the myth of the perfect body with photos that emphasise biceps, abs and pecs. These muscles may give you that look you want from the front, but they do nothing for the look that matters most, the 3-D look, the oblique views people have of you from 360 degrees that are part of your aesthetic. The muscles that give you great posture are also the ones that give you a great aesthetic. And, as you get older, keeping these extensors in shape will keep you from getting shorter, since bad posture leads to more height loss than any shrinking of the spine.
Below are some workouts designed for just this purpose. If you're a beginner, you'll need a non-slip mat and you should aim to do the bird dog, back arch and airplane. For intermediate exercisers, do the same trio of exercises but add on wrist and ankle weights. If you want to go for advanced, do the full selection. Try and do three sets, with as many reps as you can do for each. When it burns, hold for a few more seconds. The burn, plus a bit more, is the goal. Only that will send the triggers from your brain to strengthen the muscles that are causing the burn, which physical therapists call isometric contraction.
Exercise one: airplane
This is my favourite and can even be done lying on your chest in bed. The key here is to lay flat on a mat and try to lift your chest and hips upward, all while looking forward and with arms to your side or tucked next to you. It’s important to not bend the legs. Even clearing the mat by a few centimetres will require contraction of your extensors. See how long you can go; when it burns hold on a little longer before you relax and lay completely flat.
Exercise two: back arch
This one is pretty straightforward. Lay on your back and with your arms along your side. Simply lift your entire pelvis toward the ceiling and hold. Then release and repeat.
Exercise three: bird dog
This a classic! And similar to “airplane” and “back arch” in that it requires a non-slip mat. The key here is to look forward while on hands and knees. Lift one arm and raise the opposite leg and hold. Elevation of opposite limbs will keep you balanced. And like the other two exercises, the muscles are held in contraction without movement.
Exercise four: lateral raises
Do while standing with your chest out. Take a light dumbbell in each hand and let them dangle on the side of your hips. Simultaneously raise and lower the dumbbells away from your body. This will strengthen and shape your deltoids as well as include some work on your trapezius.
Exercise five: upright rows
This is a great exercise for your trapezius: the diamond-shaped muscle that connects the back of your neck to the shoulder blades. It's often the area that aches when we are on our computers looking down too much or, for me, operating for extended periods of time. It's a great way to train your shoulders as well. While standing, chest out, take two dumbbells and let them dangle on the front of your thighs. Simultaneously lift your hands up as if you want to place the dumbbells under your chin and on top of your chest. When you get to that spot, slowly bring them back down. The pause in the movement is in the dangle position.
Life Lessons From A Brain Surgeon: The New Science And Stories Of The Brain by Dr Rahul Jandial is out now in paperback (Penguin Life, £9.99).
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