Standing straight and tall: Posture, ergonomics and wellbeing (part 2)

Adopting a new attitude to dentistry, that involves not only a better approach to posture but also to general fitness and wellbeing, is no longer a good idea, but imperative, says exercise physiologist Dr Adam Fraser.

"Dentists need to adopt a twin strategy – to work on their overall fitness and strength, and to also stretch and move more throughout every day," Dr Fraser says.

"The problem with the flex position that dentists spend so much time in is that everything in the front of their bodies becomes so tight, and from a spinal point of view, you are putting a lot of pressure on the front of the disc and pushing out the back of the disc, making it bulge."

The most effective way to counter that, he offers, is to include regular stretches in the daily routine, so that an opposite movement assists with achieving a basic balance.

"It is a matter of moving throughout the day. So, stand up regularly, adopt an extended position where you gently lean back with your hips forward, or do stretches in the doorway with your arms

up against the door frame and gently push your chest forward.

"Or lie down on the floor and do a push up where your hips are still flat on the floor – that is ideal for the back. Doing this in between patients and at other times through the day can make the world of difference to how your body copes with your work."

As for an exercise regime, Dr Fraser recommends anything that improves strength and flexibility. "Those two aspects are critical, so anything like Pilates, yoga, swimming or resistance training is gold."

THE POWER OF PILATES

It was Pilates that completely changed Dr Jean Wu's life only a few years ago when she was suffering from chronic pain. Through Pilates, Dr Wu found a new way to function after the wear and tear from years of working as a dentist had resulted in her suffering a prolapsed lumbar disc.

"I was not physically strong enough for our physically demanding job, and the pain and the time off from work made me realise I needed to prioritise my own wellbeing," she says. "So, I started clinical

Pilates to build my core strength and improve my overall posture."

Through Pilates, Dr Wu strengthened the entire core of her body, developing deep, supporting muscle to help stabilise the spine so it is less prone to disc injuries. "The most important thing is to find a balance within the body – to strengthen areas that are underworked and release those that are over-worked," she says.

Dr Wu now teaches Pilates through her Posture & Core Pilates treatment centre in Melbourne, which she set up specifically to assist dental professionals deal with the challenges dentistry puts on their bodies. She explains her aim is to help prolong the longevity of careers within dentistry.

"The most common issues we deal with are upper-trapezius and shoulder tension, hunching, lower back pain, neck pain and unilaterally imbalance from all the twisting to one side – and all of that is a lot for the body to deal with," she says. "Dentistry is a very harsh task master physically and can take a real toll on our bodies."

FORM AND FUNCTION

There was a time, not that long ago, when little thought was put into the layout of dental surgeries. Significant advances in equipment and technology have since changed, with the design of workspaces and workflows to match the user playing a major role in reducing many types of physical disorders.

An ergonomically designed dental practice with an emphasis on appropriate layout and correct equipment choice not only enhances productivity but also significantly prolongs the working life of the dental team.

Positioning of instruments, suction, materials and work surfaces all impact on the range of movements required to perform procedures without excessive twisting movements.

There have been cases, Dr Ball tells, where dentists have been able to continue or resume dentistry simply by switching to a well-designed dental patient chair and stool that enables correct posture while working.

"This was once an aspect of dentistry that few people took seriously, but they do now," she says. "Again, it is about how you use your body within that space that really matters to your overall wellbeing. I call this the 'outer ergonomics' – the complete layout of where you work. Manufacturers

are now considering biomechanical design principles in far more important ways than they did when I was first starting out – and that's a good thing for all of us."

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