White coat --> Back Pain

[cushie]

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[km11]

What do you have you in labcoat?

 

[cabinbuilder]

have one of your fellow DO medical students give you an adjustment. Trust me it only gets worse as the time goes on. Just wait until you are in residency.

 

[cpants]

I would suggest some increased physical activity. Light cardio and weights (light weight/high reps) focused on the upper extremities shoulders and back. Also stretching. There is no reason a white coat, even a fully loaded one should be causing you back pain. Also, reevaluate your footwear.

 

[facetguy]

have one of your fellow DO medical students give you an adjustment. Trust me it only gets worse as the time goes on. Just wait until you are in residency.

You mean a "manipulation"; chiropractors do adjustments.

 

[a winner is you]

1. Work out more.

2. Unload your white coat of all the trash that's in there, you don't need more than a stethoscope and maybe the red book.

 

[cushie]

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[turkeyjerky]

it's probably a somatization response to stress. Try some deep breathing exercises twice a day. And drink more.

 

[doctorbaker]

I also have this same problem, despite working out regularly. My pockets are relatively empty as well. I find that the coat often weighs down in the front and my back is sore. Ihave to readjust my coat throughout the day, but I haven't found any relief from the neck pain either. I'm pretty sure it is from standing iwth it though - its definitely not as bad when I don't wear it or if I'm sitting during the day!

 

[Antibodies]

I found that having my stethoscope around my neck for a while will cause some neck pain. Which seems silly since it is pretty light weight, but still...

 

[Roslind]

Try buttoning your coat, it redistributes the weight so it isn't so much on your shoulders. It helps alot with my neck pain.

 

[pulsepro]

Try buttoning your coat, it redistributes the weight so it isn't so much on your shoulders. It helps alot with my neck pain.

why not try button up your coat, get rests comfortably in it.

 

[McGillGrad]

This is normal and it will pass. Your body will adapt to the extra walking and standing and you'll forget about it in about a month.

 

[PokerDoc]

I have a lengthy history of back problems that only got worse this year for the reasons you describe. I find that wearing a back brace (tons on amazon) reduces my pain easily by 70-80%). I wear it every day.

 

[silas2642]

I've been getting some serious back and neck pain this month on my medicine rotation. Even on neuro, when my pockets were more loaded down, it wasn't this bad. It seems like it's more the long hours of walking and standing with the coat on that are making me ache. I can't be the only one with this problem...anyone have any advice or exercises that have helped?

Are you sure that it isn't your shoes or your posture?

 

[McGillGrad]

People in the military wear 40-50 pounds of gear and run. Anyone who has back pain from rotations after the first month has a medical problem that should be checked out.

 

[cabinbuilder]

You mean a "manipulation"; chiropractors do adjustments.

Seriously? The general public doesn't understand manipulation and I wouldn't expect an MD student to either. I say adjustment every day in practice otherwise I get a blank stare and a "huh?"..

 

[cushie]

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[H2DO]

Ive noticed back pain this month too and never before, even tho before I was carrying much heavier things in my white coat. I think a lot of it has to do with standing in one place for a long time and also i have noticed if I have my hands in my pockets sometimes that makes it worse. I do agree with the having my stethescope around my neck making the neck pain worse.

 

[McGillGrad]

Ok, to be clear: this is my fifth month of M3 rotations. I believe the issue has started now because of much longer rounding time than any of my previous rotations despite carrying the same load, or less, in my pockets. Also, I am not physically trained like a person in the military.

I've been working on some upper body strengthening every other day and it seems to be helping a little; also trying to button the jacket more but I'm not so sure if it helps. (Shoes and posture shouldn't be the issue since I feel better on days off and over the weekends).

I'm assuming that you're a female so you will have less muscle mass than a male. That isn't helping you, but the point I am making is that you will on day be pregnant and that is going to be more stressful than walking a lot with a white coat.

Our bodies are designed to adapt quickly to rapidly changing stimuli. If you have chronic back pain from walking and wearing 10 extra pounds, then you have a musculoskeletal imbalance or weakness. Or just awful posture.

Either way, you have to be proactive and find a solution because residency is only going to be worse/harder.

BTW- Posture is related to how relaxed you feel. The more stressed you are, the worse your posture becomes. That is probably why you feel better on your days off.

 

[PokerDoc]

I'm assuming that you're a female so you will have less muscle mass than a male. That isn't helping you, but the point I am making is that you will on day be pregnant and that is going to be more stressful than walking a lot with a white coat.

Our bodies are designed to adapt quickly to rapidly changing stimuli. If you have chronic back pain from walking and wearing 10 extra pounds, then you have a musculoskeletal imbalance or weakness. Or just awful posture.

Either way, you have to be proactive and find a solution because residency is only going to be worse/harder.

BTW- Posture is related to how relaxed you feel. The more stressed you are, the worse your posture becomes. That is probably why you feel better on your days off.

I think it also has to do with a lot of standing still during the day.. be it in the OR or on rounds.. I find myself standing motionless for long periods of time every day. I always feel worse after that than I do walking for the same period of time.

 

[Phillyborn]

I've been getting some serious back and neck pain this month on my medicine rotation. Even on neuro, when my pockets were more loaded down, it wasn't this bad. It seems like it's more the long hours of walking and standing with the coat on that are making me ache. I can't be the only one with this problem...anyone have any advice or exercises that have helped?

At the national PM&R (AAPM&R) conference in Seattle last weekend, there was a case series where this was referred to as "the other white coat syndrome". 5 3rd year students at Temple experienced the same type of pain when transitioning to wearing a heavy coat on a regular basis. You may want to contact them to add to their cohort.

Poster 209
http://download.journals.elsevierhealth.com/pdfs/journals/1934-1482/PIIS1934148210007768.pdf

 

[libo1369]

here is what lightened my coat. A Kindle have alot of books I carry around on it so I can reference them then I recommend Maxwells, I like a pharmacopia and some of my tools Penlight reflex hammer etc. Maybe toss in an article or two into one pocket overall still very light.

 

[end stage fibro]

keep your glutes squeezed. i'm not kidding

further reading: anterior pelvic tilt, glute activation, tight hip flexors

 

[coldweatherblue]

bumped into some pollen the other day from a pt's flowers, so I'm washing my white coats today..

contents of coat:

1 steth
1 reflex hammer
1 safety pin
1 penlight
1 maxwell's medical reference
1 tongue depressor
1 roll transpore tape
4 ID badges
1 set steri-strips
2 pens
1 pocket medicine book
2 team lists
5 blank H&P forms
1 presentation on "refeeding syndrome"
1 presentation on "SBO"
1 rubber band
1 pharmacopoeia
2 separate clinical skills logbooks
4 pairs large exam gloves
4 EtOH prep pads

and..

a business card for a pt's typewriter repair service.

wtf? i've been carrying this around 14hrs a day 6 days a week x 6 wks. lol

 

[illixir]

Like others have said, unload your white coat of the stuff. Put the stethoscope around your neck since that is probably the only weighty item, the only thing with weight should be pocket medicine, you don't need a reflex hammer if you're not on neurology. You can leave pocket medicine and papers at wherever your team room is. In reality, there doesn't need to be anything at all in your white coat pockets, hardly anything will help you with the patient encounter itself, and the patient room or the area outside it has all of the supplies you need for whatever small procedures you might do. A pager can go attached to some clothing article instead of the coat. A phone should go in a clothing pocket or in your purse.

I also ditch my white coat whenever possible. On pediatrics I didn't wear it for a single day, especially not on rounds(this was the longest rounding time for us, medicine probably beat it on just a couple days). On consulting services, you can just put it on when you go see a patient, same with inpatient services where you have a team room.