Being an equine veterinary professional is physically demanding and, at times, dangerous. It’s clear from the literature: Equine vets have injury rates five to eight times higher than average, with 64% reporting work-related injuries. Ninety percent of vet techs reported physical injuries within five years of working. And among farriers, 38-50% reported chronic musculoskeletal injuries.
So beyond simply being safe around horses, how can you reduce your risk of getting injured? You can make a conscious effort to practice proper posture, biomechanics, and ergonomics when working with and around horses.
On Nov. 12, the AAEP Wellness Committee presented a webinar on how to use ergonomics to reduce your risk of career-ending injuries, hosted by Deborah Spike-Pierce, DVM, MBA, of Rood and Riddle Equine Hospital, in Lexington, Kentucky. Kevin Balcirak, of Body Structure Medical Fitness Facility, who has worked with the veterinarians at Rood and Riddle, described ways practitioners can protect themselves through body biomechanics and ergonomics.
“It’s almost not if you’re going to get injured, it’s when,” he said.
Proper Posture and Biomechanics
“When speaking about good posture and standing and biomechanics, we’re talking about the alignment of the body,” Balcirak explained. “And we need to think about that when we’re at work.”
He advised keeping the following injury-reducing principles in mind when working:
- Always position yourself close to objects.
- Increase your base of support by widening your stance.
- Maintain a vertical line of gravity.
- Keep joints stacked (e.g., keeping the knees over the ankles and in the direction of your toes when you change levels) to limit shear forces.
- Use big muscle groups vs. small.
- It is easier to push and pull than to lift.
- Friction increases work, using sliders when possible.
- Pay attention to your wrists, and keep them straight when pushing or pulling.
- Minimize twisting movements.
- Avoid bending and turning simultaneously.
He then described a series of positions veterinarians often find themselves in and how to make ergonomic corrections to prevent injury.
Working with the hands above the head or the elbows above the shoulder for extended periods.
Veterinarians might find themselves in this position when performing dental exams and floats, and it can lead to shoulder and neck problems. Balcirak recommended using a step stool or platform to bring the horse within comfortable reach and reduce the need to raise your arms above shoulder level. If you must examine or treat a horse above shoulder height, try to keep your shoulders down and not in a shrug position, he said.
Balcirak encouraged veterinarians to switch arms and alternate tasks to prevent fatigue and strain on the shoulder and neck muscles. Taking small breaks can also relieve continuous shoulder strain.
Working with the neck, back, or wrists bent more than 30 degrees for extended periods.
Balcirak said veterinarians should work to keep their wrist angles in alignment with the forearm. “Keep your wrists straight, grip loose, and try to use your larger muscles,” he said.
If possible, use an adjustable table or work surface to reduce your need to bend the neck or back. “If not, squat with your legs and control your wrist, trying to keep it neutral,” he added. “If you don’t have the quad strength and glute strength to squat, it’s going to be hard for you.”
Balcirak urged veterinarians to stretch and strengthen their flexion and extensor muscles when they can’t make these ergonomic adjustments physically or with adaptive devices. He also encouraged taking frequent microbreaks to allow your muscles to relax and prevent strain from prolonged postures.
“Every 20-30 minutes, pause for one to two minutes to stretch or reset your posture, especially after long periods of bending,” he said.
Squatting or kneeling for extended periods.
The only ergonomic adjustment for periods of kneeling, said Balcirak, is to use a stool or cushioned knee pads, so long as it won’t put the veterinarian in an unsafe position. Weak legs make kneeling even more unsafe, he added.
Periods of squatting can be physically challenging. “To have the leg strength to be able to squat and keep a straight back takes a lot of glute and hamstring strength,” he said. “If you don’t have a lot of quad strength, you’ll lean into that knee,” which can cause pain and strain.
For these scenarios, Balcirak recommends adjusting your body position and shifting your weight from one knee to the other, which “prevents fatigue by allowing different muscles to bear weight at intervals.” You can also alternate squatting with brief standing breaks or switch to a half-kneeling position periodically.
Repetitive motions with the neck, shoulders, wrists, elbows, or hands.
In some situations, such as surgery, it might be almost impossible to avoid these repetitive motions with little variation for extended periods. But Balcirak recommended, if possible, alternating tasks and movements to give your muscles and joints recovery time.
“Switch between tasks that use different muscle groups, ideally alternating every 20-30 minutes to avoid continuous repetitive motion in one area,” he said.
When reducing the impact of repetitive motions is not feasible, Balcirak advised positioning your tools and equipment within easy reach to minimize awkward movements. “Place tools and supplies at shoulder or waist height to limit repetitive reaching, and consider using support aids like wrist rests or forearm supports for long sessions,” he said.
Tasks requiring pinching or gripping with more than 2 pounds of force.
For these types of tasks, Balcirak said ergonomic corrections primarily come down to buying tools that require less force to maintain grip and lower the strain on your fingers and hands. “Choose tools with thicker, padded handles to lessen the pinching force required during procedures,” he said.
You can also alternate hands to distribute the workload and prevent prolonged strain on one hand or the other. He reiterated the importance of taking one-minute microbreaks every 20-30 minutes, as well. “There are so many things in this profession where I know that’s just not feasible (to stop for breaks), but you have to make the time in between to do some stretches of your fingers, your flexor and extensor muscles, and just get used to that habit,” Balcirak said.
Performing intensive keying for extended periods.
If you’re sitting at a keyboard, use an adjustable chair with wrist support to keep your wrists in a neutral position and reduce strain while typing. The goal, said Balcirak, is to ensure the chair and desk are at a height that keeps your forearms parallel to the ground. Also pay attention to keyboard and monitor position, he said.
“Position the keyboard so the elbows are close to the body, with wrists straight, and place the monitor at eye level to reduce neck strain,” he said. “Your eyes should be hitting that top third of the screen without your head looking down or up.”
Lifting heavy objects repeatedly.
Teamwork is your best option when maneuvering heavy objects. “When things are heavy and we can team lift, we’ve got to do team lifting,” said Balcirak. “But obviously lifting technique and getting into the squat position are very important,” for minimizing strain on the lower back and reducing injury risk.
He said proper lifting technique involves bending at the knees and hips, keeping your back straight, and lifting with the legs while keeping the load close to your body. “Be robotic,” he added. “Avoid twisting the spine during the lift.”
Opt for lifting aids or mechanical assistance with extremely heavy loads. “Use carts, handles, or lifting straps for heavy items and, if possible, ask for help to distribute weight when lifting large or awkward objects,” said Balcirak.
Take-Home Message
In closing, Balcirak outlined his main points of advice to help equine veterinary professionals reduce injury risk and avoid chronic conditions:
- Understand the basics of posture and body mechanics and apply them to everything you do. “If you can’t modify your work environment to make ergonomic corrections, you’re going to have to take care of your body,” he said, through stretching, strength training, exercise, and nutrition.
- Take action at the first sign of discomfort. “Early injury management is crucial—address issues as soon as something doesn’t feel right,” said Balcirak.
- Build muscle mass through strengthening exercises and metabolic health.
AAEP members can watch Balcirak’s presentation in its entirety, including stretching and strengthening demonstrations and information about metabolic health, at https://learn.aaep.org/p/AAEP_ergonomics_11-12-24.
Related Reading
- Veterinary Wellness Briefs: Living With Chronic Pain
- Design Your Equine Clinic for the Team
- Vet Wellness Briefs: Preventing Chronic Pain
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