Osteopath Sam Leopold talks about how dentists can overcome the common issue of musculoskeletal problems…
Back pain, poor posture and tension headaches are common workplace health issues suffered by dentists. As dentists, you spend a large proportion of your day sitting in an unsupported asymmetrical static posture with your arms raised away from your body and your head forward from your centre of gravity. How long you spend in these positions depends fully on the treatment requirements at the time.
This creates repetitive strain and ischemia through the muscles and joints of the lower back, cervical spine and shoulders, leading to headaches, shoulder pains and impingement, lower back pain and even cervical and lumbar disc damage and prolapse.
So here are a few things you can do.
Before you even get into your treatment room there are things you can think about to maximise health and repair.
First – good nutrition and a healthy diet.
Our bodies need the right building blocks to heal and repair themselves. Diets filled with refined carbohydrates slow down our gut motility and increase our global levels of inflammation, slowing tissue repair and increasing pain. Look at introducing a higher proportion of plant-based whole grain foods within your daily diet.
Second- good sleep.
Our bodies repair while we sleep. Regular bedtimes, avoiding caffeine or alcohol before bed and keeping away from blue light can all make a massive difference. Blue light (the sun, phones, TVs etc) is a short wavelength and high frequency light that blocks the production of melatonin (the hormone that makes you sleepy), so when exposed, you feel energised and awake. This is great in the morning but not what you need just before bed. We are all attached to our screens for socialising and work, but try to have some time off devices before heading to bed.
Third – Stress management.
This is easier said than done as stress comes in so many forms from so many triggers. Stress induces the production of hormones (cortisol), which promotes the production of inflammation in our bodies.
So, where possible, look after your mental health by letting go of emotional clutter, exercising regularly, practicing deep breathing and meditation techniques. Also, don’t be afraid to ask for help.
All of these will help reduce the strain on your body before you even get into the practice room. Once you are at work, there is still plenty you can do.
In the practice.
Ensure you have assessed the ergonomics of your workplace. This is essential to minimise any additional strains on your body from work. Chat with colleagues to see if there are any improvements that you can make and take regular breaks between patients.
Now for the stretches! In your breaks in between patients, you need to move and stretch as much as you can. I know from my own practice, time is always limited, and between cleaning protocols, writing notes and getting time for a drink it can feel like there isn’t space to do anything else.
But if you can do any of the following stretches, once a day or more, you will be helping strengthen and stretch your body and ultimately reduce the risk of pain, injury and damage.
I have put together a specific selection of exercises, amended to reflect the needs of dentists and designed to work within the confines of your clinic room with limited time, space and equipment.
Stretch your pecs
- For this exercise you need a wall; to begin, you will start by stretching out your right arm.
- Stand about a foot away from the wall with your right side facing it and lift up your right arm, placing your elbow and forearm onto the wall at shoulder height.
- Now check on your posture and make sure your shoulder is not up around your ears, making any adjustments to put yourself in a comfortable position so your arm is level with your body at shoulder height and your shoulder is relaxed and in a neutral position.
- You’re going to step forwards with your left leg into a gentle lunge, keeping both knees soft with a slight bend, leaving your arm fixed on the wall. At this point, you should start to feel the stretch in the front of your right shoulder, over the pec region.
- Keep your head facing forwards, chest up and don’t lean into the wall.
- Hold the stretch fortwo to three deep breaths.
- Repeat this stretch two or three times per arm throughout the day.
Standing child’s pose
This exercise encourages thoracic extension and all you need for this is a desk or a wall.
- Stand facing the wall or desk and take a large lunge backwards as far as you can go.
- Keep your feet hip width apart and gently bend your knees and reach forward to place your hands on the desk or wall. As you reach forwards, keep your back flat so you’re bending from the hips.
- Your body and legs will be at a right angle to each other; at this point, gently stretch your chest down towards the floor, allowing your head to pass between your arms.
- Keep your neck nice and relaxed. Stay here for at least three to five breaths and repeat throughout the day.
For this you don’t need any props, just a little bit of space.
- Stand with your feet hip width apart and with a gentle bend in your knees.
- Bend forwards, keeping your back flat, bending your hips, and rest your left forearm across your thighs.
- With your free right arm, rotate around your right side, reaching your fingertips up towards the sky.
- As you do this, follow the movement with your gaze so you’re rotating your head as well.
- Hold this position, lifting through your rib cage on the upper side, breathing into your lower ribs.
- Hold this position for two to three breaths and gently release.
- Repeat on the other side.
- Remember to keep your back flat to protect your spine, using your abdominal and back muscles to create the rotation.
- Again, do this three times throughout the day.
This is great for strengthening the upper back and scapular muscles as well as stretching the chest, and all you need is a hard surface, like a bit of wall.
- Stand with your back against the wall, feet slightly away from the wall, hip width apart.
- Sit your bottom against the wall and glue your entire spine all the way up to your shoulder blades against the wall.
- Take your arms out to the side of your body at 90 degrees and bend your elbows, keeping your palms facing forward and your arms in contact with the wall at all times.
- Gently raise your arms towards your ears, keeping your arms against the wall. Slide them up as far as is comfortable, then slowly slide them all the way down, contracting through your scapula as you bring them down towards your side. Raise five times and breathe throughout.
- Repeat this two to three times a day.
This stretch is to open up the front of your hips, your hip flexors, stretching the psoas muscle, that extends from the low back to the femur.
All you will need for this is a chair.
- The chair needs to be knee height and you’re going to stand facing the chair about a foot away from it. We will start with stretching the right hip flexor.
- Raise your left leg onto the chair, and then check your body posture, making sure your head and body are upright.
- Tuck your tailbone and your sacrum under, tightening your buttock muscles and the lower abdominal muscles. Then gently lean and lunge into the leg up on the chair.
- Make sure you push through the buttock muscle, particularly on the standing leg.
- Once you feel a stretch tightening in the front of the right upper thigh, take your right arm up and over your head to side bend left.
- Look up to the ceiling with your head, let your gaze go upwards and keep your chest facing upwards and your buttock tucked under.
- Stay in this position, gently taking this stretch further with each breath for two to three breaths, and then gently release and repeat on the other side.
So, there are a host of small tips you can do that will make a big difference to your physical health in practice. If you get into the routine of doing these exercises each day, you will feel more energised and lessen the chances of developing back or musculoskeletal problems.