Why ER Rotations Require a Physical Fitness Plan Too

Nobody Told Me My Back Would Hurt More Than My Head in ER Rotations

Surprise! It’s Not Just Your Brain That Gets Battered in the Emergency Department

You go into emergency medicine rotations bracing yourself for the mental overload — the trauma cases, rapid decisions, constant multitasking, and unpredictable chaos. And yes, all of that is real. But what no one really warned me about? The physical toll.

More specifically: the back pain.

Somewhere between hour six and twelve of standing, leaning, twisting, charting at weird angles, pushing stretchers, and holding retraction for just-one-more-minute, I realized that while my brain was still firing on adrenaline and caffeine… my spine was plotting mutiny.

The Hidden Physical Labor of ER Rotations

Emergency departments are not ergonomically friendly.

• Charting computers are mounted too high or too low.
  
  
• Beds are stuck in one position.
  
  
• Procedures require contortionist-level flexibility.
  
  
• You bend, reach, rotate, hover — and rarely sit.
  

And when you do sit? It's on a stool from the early 90s with no lumbar support.

What Hurts and Why

• Lower back: from leaning over patients for wound cleaning, suturing, or assisting with intubation
  
  
• Neck and shoulders: from peering at monitors or craning over mobile documentation carts
  
  
• Feet and calves: because you’re standing for 10+ hours in shoes you swore were “comfortable” until they betrayed you
  
  
• Wrists: from hurried typing on hard keyboards with zero wrist rests
  

And somehow, your stethoscope still weighs 100 kilos after hour 8.

The Problem Is… No One Mentions It

Everyone talks about mental toughness in emergency medicine:

• Decision-making under pressure
  
  
• Handling emotionally charged situations
  
  
• Juggling multiple priorities
  

But no one pulls you aside and says: “Hey, do some core work. You’re going to need it.”

The Physical Pain Is Real — But So Is the Lack of Preparation

In med school, we’re taught how to manage septic shock, but not how to manage the post-shift stabbing pain between our shoulder blades. We learn about rapid diagnostics, but not rapid stretches to survive a shift.

How I (Sort of) Survived It

• Stretches between cases: Even 60 seconds of spinal extension between charts made a difference.
  
  
• Supportive footwear: I traded fashion for orthopedic-level comfort.
  
  
• Compression socks: Game changer.
  
  
• Mini massage gun in my locker: No regrets.
  
  
• TENS unit at home: Thank me later.
  

And eventually… I started strength training. Because if I was going to lift patients and carry trauma bays on my back, I might as well train for it.

Why It Matters

Pain isn't just discomfort — it's distraction. When your back is screaming, your focus suffers. Your patience thins. Your decision-making falters. In a department that runs on razor-sharp attention, this is dangerous.

Taking care of your body isn't vanity. It's clinical hygiene.

What I Wish Someone Had Told Me Before My ER Rotation

• “Charting hurts more than chest compressions.”
  
  
• “You're going to stand for hours — stretch like it’s a sport.”
  
  
• “Don’t cheap out on your shoes.”
  
  
• “Every break is a chance to move, not just snack.”
  
  
• “Your brain’s fine. Your back’s the real casualty.”
  

Final Thoughts

ER rotations challenge you in every way — mentally, emotionally, ethically. But don’t underestimate the physical cost. Just because you’re not running marathons doesn’t mean your body isn’t under siege.

If you’re about to start your ER rotation, take this as your warning and your permission: take care of your back like your license depends on it. Because, honestly… it just might.