Allan Katz loves bartending. Since the late ‘90s when he used to lobster claw bottles to speed-pour Long Island Iced Teas at TGI Fridays, he’s been hooked on the rush of delivering liquid happiness.

But these days he can’t spend more than a few hours at a time behind the bar before needing to be relieved. His medical history — over a decade of invasive surgeries, physical therapy, painkillers, workers’ comp claims, and disability leaves — fits the profile of someone twice his age. Katz is only 42 years old. His decades-long battle with chronic pain didn’t result from a freak accident or a sports injury; it’s the result of over two decades of bartending in craft cocktail bars across the country.

The Occupational Hazards of Mixology

Bartending can be glamorous. But behind the whip shakes, the double-fisted pours, and the flaming orange peels, is a physically demanding job that exacts a steep toll on the body. Every bartender knows that managing shoulder soreness, elbow tendonitis, and aching feet is as much a part of the job as serving delicious drinks. Katz belongs to a generation of mixologists who earned their stripes at a time when few gave much thought to repetitive motion injuries or ergonomic bar design. During the cocktail revolution, self-medicating with alcohol was often the preferred method of numbing the pain.

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After working his way up during the cocktail renaissance in the early aughts at places like SoHo House in New York City, Katz was diagnosed with severe carpal tunnel syndrome — a condition caused by pressure on the median nerve in the carpal tunnel of the wrist — in 2006. Years of grabbing heavy bottles and shaking mixing tins had severely damaged the nerves in both hands, but like many bartenders, he soldiered through the pain. When he moved to Los Angeles in 2010 to run Caña, a high-volume rum bar, the pain became unmanageable. At one point, the carpal tunnel was so bad that he couldn’t even turn the key to lock up the bar at the end of the night.

Six months after moving west, Katz consulted with specialists at Cedar Sinai hospital in L.A. and elected to undergo surgery on both hands. The spindly scars are still visible across his palms and wrists where the doctors performed bilateral carpal tunnel release surgery to ease the impinged nerves. The delicate procedure involves cutting the nerve that runs up the wrist through the hand and stitching it back together to alleviate the pressure. But the initial surgery didn’t yield the desired results. When Katz finally returned to work months later, his condition worsened, hastening the need for three additional surgeries over the next three years.

“I get bilateral radio frequency ablations (invasive laser treatments) every four months with trigger point injections in between,” says Katz, who now co-owns Jammyland, a bar and live music venue in Las Vegas. He’s had to limit the length of his shifts, which makes an early retirement from bartending seem inevitable.

Constant Hits Cause Problems

In 2013, Freddie Sarkis took a six-month leave of absence from his bartending job. He was at the peak of his career, working behind the bar at Sable Kitchen & Bar, one of Chicago’s hottest cocktail destinations at the time, but he couldn’t shake a drink without debilitating pain shooting down his back.

“We used to do all kinds of weird shakes with Kold-Draft ice to increase aeration,” Sarkis says. “Bartenders do all kinds of crazy stuff because you’re onstage and that’s part of the game.” At that point, after almost a decade in the bar industry, Sarkis developed six herniated discs in his lower lumbar spine and edemas in both shoulders. “Walking was not really an option for me for a while,” he says.

Many bartenders like Katz and Sarkis who were on the front lines of the cocktail revolution are now over 40 years old, and they carry the battle scars to prove it. For tenured mixologists, the physical demands of working behind the bar have completely altered the trajectories of their careers. “Not to compare it directly, but it’s like CTE (chronic traumatic encephalopathy, a disease associated with head injuries in football),” says Sarkis, who co-founded the Liquor Lab in New York City. “It’s not the big hit. It’s the constant little hits that cause the problem.”

Injuries to the shoulders and elbows from the repetitive stress of shaking and stirring cocktails are most common among bartenders in high-volume restaurants and bars. Even the act of lifting and pouring heavy bottles can cause collateral damage over time. “The New York bartenders used to call Carpano Antica vermouth the ‘elbow breaker’ because it was an extremely popular ingredient, so they had to grab this big heavy bottle hundreds of times a night and their elbows were always giving them hell,” says Benjamin Schiller, the 43-year-old former beverage director of Boka Restaurant Group in Chicago.

“Vocal cords don’t repair themselves. Polyps will go away, but if you’ve torn it, the tissue doesn’t regenerate.”

Schiller had to give up hands-on bartending six years ago to avoid aggravating lingering back, shoulder, and elbow injuries. The constant need to lean over a bar sink to hand-wash antique barware all night long was torture on his spine. While he was working regular bar shifts at places like The Girl and The Goat in Chicago, managing chronic pain wasn’t only physically taxing, it was also financially draining. “I was paying $300 to $400 a month for massage and physical therapy sessions,” he says.

Not every injury traces back to the act of making drinks. Club bartenders often suffer tinnitus (ringing in the ears) from working in venues with loud music. Amie Ward, who founded The Healthtender, an organization that advocates for healthier lifestyles in the bar industry, needed surgery to repair a torn vocal cord in 2018, a condition caused by the need to strain her voice over long shifts in a noisy bar. She’d been bartending at R. Bar in Baltimore, a converted auto body garage with cinder block walls and poor acoustics that made it almost impossible to be heard by customers without yelling.

When a nagging raspy voice lingered for months, she consulted with an ear, nose, and throat doctor. A scope revealed that one of her vocal cords was completely shredded. “Vocal cords don’t repair themselves,” Ward says. “Polyps will go away, but if you’ve torn it, the tissue doesn’t regenerate.” She underwent surgery later that year, which required weeks to recover and months of speech therapy.

A Healthier Bar Industry

More than a decade after his first carpal tunnel surgery, Katz needs a battery of maintenance treatments and medications to manage the pain today. Among other side effects, he’s struggled with stomach ulcers, kidney damage, constipation, hemorrhoids, and memory loss. “It takes four outpatient surgeries a year to keep me in the game,” he says. “Obviously that’s not tenable, and I’m strongly considering my next chapter now.”

“I would love nothing more than to hold down a bar somewhere, but I don’t know if I could handle it now.”

Ward still occasionally pulls a few shifts at a local dive bar, but she’s since taken a position as the executive director of Safe Bars, a nonprofit that helps to create safer, healthier environments in alcohol-serving spaces. “I get really scared whenever my voice feels like it gets raspy,” she says, “I’m still loud, but I find different ways to be loud.” Her organization, the Healthtender, provides free mental and physical health resources to the next generation of bartenders to improve longevity in the industry.

Electing to eschew surgery on his herniated disks, Sarkis, who now works as a consultant, found relief in power lifting to strengthen the back muscles around his injured spine. Despite warnings from doctors against lifting heavy objects, weight training was the only measure that provided comfort. A decade after his injury, he still makes a minimum of six trips to the gym every week to keep his body resilient.

But the risk of re-aggravating his sciatica is too great to return to regular bartending. “I miss it every day,” he says. “I would love nothing more than to hold down a bar somewhere, but I don’t know if I could handle it now.” Sarkis and Katz both look back with a degree of regret that they weren’t more aware of the injury risk from bartending. But both are encouraged by the fact that more bars are emphasizing wellness and investing in better ergonomic design. “I wish someone would’ve given me this advice back then, but I know I wouldn’t have listened,” Sarkis says. “Injuries can be permanent. Take it seriously.”

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