Dr. Patrick Vavken is a recognized expert in shoulder and elbow surgery and plays a key role in the ADUS Clinic’s success story in the Zurich Unterland region. As Chief of Orthopedics and Traumatology, he is a cornerstone of a team known for its excellent medical care and patient-centered approach. With extensive training and many years of experience at renowned medical institutions, Dr. Vavken has developed a deep expertise that makes him a leading authority in his field.
His focus is particularly on the treatment of joint instability and hypermobility, cartilage damage, and joint-preserving procedures on the shoulder and elbow. Dr. Vavken’s commitment to advancing shoulder and elbow surgery is also evident in his research and his dedication to innovative treatment approaches. He relies on both proven methods and the latest technologies to provide his patients with the best possible care.
As part of the medical team at the ADUS Clinic, it is particularly important to Dr. Vavken that patients feel well cared for from the very beginning. Dr. Vavken brings not only his expertise as a specialist in orthopedic surgery and traumatology but also his particular interest in joint-preserving procedures, especially for children and adolescents. His work as a senior physician at renowned medical institutions such as the University Hospital and University Children’s Hospital of Basel, as well as at Boston Children’s Hospital/Harvard Medical School, has established him as a highly respected specialist in his field.
At the ADUS Clinic, patients can be confident that they are being cared for by a first-class team of specialists who are passionate and dedicated to their health. With Dr. Vavken at the helm, the clinic stands for outstanding medical care and an atmosphere where patients can simply feel well taken care of.
The editorial team at the Leading Medicine Guide had the opportunity to speak with Dr. Vavken, focusing on measures that athletes—as well as the average active person—can take to maintain and improve shoulder function and overall health.
The shoulder is an extremely versatile and important joint in the human body, especially for athletes, whose performance depends significantly on the health and functionality of this joint. Various factors play a crucial role in achieving and maintaining optimal athletic performance. In addition to targeted training and exercises, factors such as sleep, nutrition, and protein intake are also of great importance.
Poor sleep quality can also lead to reduced recovery of the shoulder muscles, which in turn increases the risk of injury and can impair athletic performance.
There are several measures that can be taken to promote restful sleep and thereby improve shoulder function—and, ultimately, overall quality of life. These include maintaining a regular bedtime and wake-up time, creating a quiet and dark sleeping environment, and avoiding stimulating activities before bedtime. “Sleep is actually the new craze among young people! But exactly what sleep does is still not fully understood. We’re gaining a better understanding of the effects of sleep, but we don’t quite get it yet. What is certain is that sleep patterns change over the course of a lifetime. Parents are familiar with the phenomenon of the fetal sleep rhythm, in which babies in the womb are awake for 3–4 hours, then take a half-hour nap, and are awake again for 3–4 hours —this 4-to-0.5–1-hour rhythm is the typical fetal sleep pattern, which is sufficient for the little ones. As an adult, you could technically maintain that pattern for a while (I was trained to do so for a time in the military), but ultimately, your sleep needs are greater. Sleep is important for physical recovery, but also for cognitive recovery. Sleep is also important for metabolism, insulin production, muscle building, heart health, and so on. In a classic comparison regarding cognitive performance, a night without sleep is equivalent to having a blood alcohol level of one per mille. For this reason, pilots aren’t allowed to fly for too long, and bus drivers aren’t allowed to drive for too long. In Formula 1, for example, some drivers’ contracts with their teams specify exactly how much sleep they must get before a race. The average person needs eight hours of sleep. However, studies have also shown that too much sleep is just as harmful as too little—eight hours is ideal,” explains Dr. Vavken by way of introduction, before mentioning other important aspects of sleep hygiene and aids:
“For instance, you shouldn’t drink coffee 3–4 hours before going to bed and should get into the habit of a so-called ‘wind-down routine,’ that is, winding down completely and putting your body into sleep mode. You should sleep in a room designated specifically for that purpose—one where you don’t watch TV or do other activities—and you can also pay attention to the room temperature. If you have trouble falling asleep, taking ashwagandha—which comes from Ayurvedic medicine and promotes relaxation—can help. Taking melatonin can also help; it’s normally produced in response to darkness and signals to the body that it’s time to relax and sleep. You shouldn’t take conventional sleeping pills—these are sometimes reserved for people who, for example, are sleepwalkers.”
Ashwagandha, also known as winter cherry, is a perennial plant in the nightshade family that is native to India, the Middle East, and parts of Africa. It has been used for centuries in traditional Indian medicine. The plant’s roots and berries are valued for their medicinal properties and are said to offer a variety of health benefits, including stress relief, improved cognitive function, reduced inflammation, and better sleep quality. Ashwagandha is available in various forms, including powder, capsules, extracts, and tea. It is advisable to consult a doctor before taking it, especially if you are taking other medications or have existing health conditions, to consider potential interactions or side effects.
Stress management techniques such as relaxation exercises, meditation, or breathing techniques can help reduce stress and promote restful sleep. Eating heavy meals shortly before bedtime should be avoided, as should excessive consumption of caffeine and alcohol. Regular physical activity as part of an exercise program can also improve sleep quality; however, intense workouts immediately before bedtime should be avoided, as this can disrupt sleep. A comfortable sleeping environment with a suitable mattress and pillow can help improve sleep quality and allow the shoulder muscles to recover optimally.
“A real sleep killer is the personal processing of daily life, which many people associate with stress—and this is more pronounced in women. There’s a specific technique you can use here. Imagine placing the stress and the day’s concerns into a box before going to sleep and setting the box outside the door. When stress is carried into the night, it manifests in many people as teeth grinding or snoring, which causes a loss of energy—energy that is actually needed for sleep—and prevents you from finding rest. But rest is essential, including for the recovery of the muscles and the musculoskeletal system. Neuromuscular—that is, cognitive—recovery of the brain is also important. After all, if the nerves aren’t functioning properly, then muscles can’t function either, and even the strongest person will be unable to perform at their best, thereby risking injury during sports or other activities. Restful sleep is also important for cardiovascular health and managing insulin resistance. “If you gradually undermine this, you’ll also gradually gain weight, and your metabolism will be disrupted—which ultimately takes a toll on your joints as well,” explains Dr. Vavken.
A healthy and balanced diet is especially important for athletes, and protein intake plays a particularly important role.
Proteins are essential building blocks for the repair and growth of muscle tissue, including the muscles that stabilize and move the shoulder. Adequate protein intake supports muscle recovery after intense training and helps improve shoulder function. “If there’s one thing I’d strongly emphasize to improve performance, it’s protein intake. Most people don’t get enough. For an average person who engages in regular physical activity—for example, playing on a volleyball team or going to the gym three times a week—the daily requirement is approximately 1.5–2 grams of protein per kilogram of body weight. So someone who weighs 90 kilograms needs about 135 grams of protein. That’s a lot. Even if you like meat, that would be the equivalent of two steaks. Awareness of sustainability and animal welfare has grown—for example, 500 grams of low-fat quark contains 50 grams of protein, so meat doesn’t always have to be your protein source. Hummus and lentils are also very high in protein, so there are plenty of vegetarian and vegan options available. An additional benefit of protein is that it’s very filling. If you start your day with a croissant—that is, with carbohydrates—you’ll be hungry again after three hours. Not enough insulin is produced, so you don’t experience a long-lasting feeling of fullness. “If you eat eggs, low-fat quark, or yogurt in the morning instead, you’ll stay full much longer,” says Dr. Vavken.
In addition to protein, other nutrients are also important. Antioxidants found in fresh fruits and vegetables help reduce inflammation and promote muscle recovery. Healthy fats found in nuts, seeds, avocados, and fatty fish support joint health and help reduce inflammation. A balanced diet rich in protein, fruits, vegetables, and healthy fats can help improve athletic performance. By ensuring they follow a varied and nutrient-rich diet, athletes can promote shoulder health and prevent injuries, which in turn supports their athletic performance.
Proper hydration plays a crucial role in supporting the joints, including the shoulder, and can help prevent injuries.
Water is an essential component of synovial fluid, which acts as a lubricant and shock absorber for the joints. Adequate hydration supports the production of synovial fluid and helps keep the joints supple and well-lubricated. “Unfortunately, most people don’t drink enough water. However, you should also consider how much water you actually need. For example, if I eat a lot of protein—which is good—then I also need a lot of water because protein draws water. You should aim for about 2–3 liters of water a day. Unfortunately, most people start their day with a bad habit. You get up, having lost a lot of fluid and electrolytes through normal sweating during the night, and then drink a cup of coffee. The coffee stimulates the kidneys, and electrolytes are flushed out the next time you urinate. It’s much better to start the morning by drinking a large glass of water with a small pinch of salt (to replenish electrolytes) and wait an hour before having your first cup of coffee. Internally, humans are saltwater organisms anyway, not freshwater ones. And in the 1980s, the theory emerged that low protein and low salt intake were beneficial—a notion that persisted in people’s minds for a good 20 years but is now completely outdated. “Of course, you should still keep an eye on your salt intake,” explains Prof. Dr. Vavken, adding a comment on alcohol consumption:
“Alcohol consumption doesn’t directly damage the joints, but it does cause indirect harm—because if you fall while intoxicated, you can hurt yourself. Having a glass of wine now and then in the evening is fine, but if you drink three glasses or more, you’ll sleep poorly and usually wake up with a mild hangover, dehydrated, and not feeling refreshed. Then you start looking for energy boosts, maybe drink two more cups of coffee and eat another chocolate bar—all of which increases stress—and arguments with family or coworkers are bound to happen. Here, you just have to be a little careful and make some changes, following the motto, “Oh, I’ve lost my way—I need to turn back.”
Adequate hydration also ensures that the ligaments, tendons, and muscles that stabilize the shoulder are sufficiently supplied with fluid. Well-hydrated tissues are more resilient to stress and less prone to injury. In addition, adequate fluid intake promotes blood circulation, which improves the supply of nutrients to the joints and contributes to faster recovery after exercise. To optimally support the joints—including the shoulder—and prevent injuries, it’s important to drink water regularly and compensate for fluid loss during exercise by drinking additional fluids. Athletes should make sure to stay adequately hydrated before, during, and after exercise, especially during intense or prolonged activities and in hot environments. Individual hydration needs can vary depending on body size, metabolic rate, activity level, and environmental conditions. It is advisable to use your own thirst as a guide and to drink small amounts of water regularly to ensure optimal hydration. A balanced diet that includes hydrating foods such as fruits and vegetables can also contribute to fluid intake and support overall hydration.
There are a variety of exercises and training programs specifically designed to improve shoulder stability and mobility.
“Generally speaking, people lose 1% of their muscle mass per year starting at age 30. If injuries or surgeries occur during that time, the loss is even greater. And this is where you need to take action. Physical activity is the ultimate elixir of longevity; it counteracts mental and physical decline and helps prevent dementia. Ideally, you should focus on the two major muscle groups: the thighs and glutes, and the second-largest muscle group, the shoulder girdle. So if I can engage these two muscle groups, I’ve already accomplished a tremendous amount. Here are five simple exercises that anyone can do—and it’s enough to repeat them for the required 15 minutes 3–4 times a week: Deadlift (a strength exercise in which a barbell is lifted from the floor to hip height), squats, pull-ups, overhead press (pressing something heavy upward), and push-ups. You can do these exercises anywhere. Studies have shown that the muscle’s response to growth is completely independent of age. So a 60-year-old can build muscle just as effectively as a 16-year-old. It’s just that people’s tendency to make excuses is quite high… And for those with primarily sedentary jobs, you can roll your shoulders every now and then, should get up from time to time, and take the stairs instead of the elevator,” Dr. Vavken strongly recommends.
Certain dietary supplements and vitamins can help support the health and function of the shoulder joints and thus improve athletic performance.
Taking dietary supplements and vitamins alone is no guarantee of improved athletic performance. A balanced diet, regular exercise, adequate rest, and targeted training remain the key elements. Before starting to take dietary supplements, it’s definitely advisable to consult a doctor or nutritionist to ensure they’re suitable for your individual needs and health status.
Everyone is probably familiar with this situation: You’re standing in front of the shelves at a health food store or pharmacy, for example, and see hundreds of different packages of vitamins and supplements, all heavily advertised. This can often lead to feeling overwhelmed. Dr. Vavken can shed some light on this: “As I mentioned, protein—which can also be taken in capsule form—is intended to support muscle health and thereby stabilize the joints. Creatine (about 1–3 grams per day) is also important for muscle health. Vitamins aren’t bad in principle—but a healthy diet usually provides enough of them. You can take vitamin D after a long, cold winter or if your job keeps you indoors and you don’t get enough sunlight. Turmeric (combined with black pepper) is highly recommended because it has the same anti-inflammatory effect as ibuprofen and also supports cognitive function. Omega-3 is also beneficial. “Vitamin B12 is important for vegans because of the essential amino acids; mammals cannot produce these on their own.”
Athletes can take preventive measures to avoid overuse injuries to the shoulder and ensure optimal performance in the long term.
An essential part of these strategies is proper warm-up and stretching before training or competition to prepare the muscles, tendons, and ligaments for the upcoming strain and to promote blood flow. Through targeted strength training aimed at strengthening the shoulder muscles, athletes can improve the stability and support of the shoulder joint. Exercises such as shoulder presses, lateral and front raises, and back exercises are helpful in this regard. In addition, proper technique during athletic activities is crucial for preventing overuse injuries. Athletes should take care to maintain good posture and proper form. A slow and gradual increase in training intensity, along with sufficient rest periods between workouts, is important to allow the shoulder muscles to recover and repair themselves. Varying training exercises and sports can reduce one-sided strain and ensure balanced training of the shoulder joints. Finally, avoiding overexertion is another important aspect. Athletes should also take care not to place excessive strain on the shoulder, especially during one-sided movements or repetitive gestures.
“The key is striking a balance between recovery and strength building. And ultimately, it always comes down to a healthy diet, sufficient sleep and hydration, and exercise. Ballet dancers and young female swimmers actually have it particularly tough in the athletic world. The former can really struggle to build muscle and often suffer from overuse injuries, while the swimmers are deterred from additional exercise because swimming already develops a broad upper back. Nevertheless, it’s always the four components—nutrition, sleep, hydration, and exercise—that make the difference,” says Dr. Vavken, and with this enduring message, we conclude our conversation.
Thank you very much, Dr. Vavken, for your insights on optimal performance!
