Pilates for Dental Profession
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Transcript of Pilates for Dental Profession
8/17/2019 Pilates for Dental Profession
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PILATES AND STRETCHES
FOR THE DENTAL PROFESSIONAL
West Coast District Dental Assoc.
Friday, February 4, 2011
Juli Kagan, RDH, M.Ed.Certified Pilates Instructor
Certified Yoga Teacher
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Course Overview:This course reviews postural considerationsfor the seated dental professional, including:
the prevalence of neck and shoulder injuries,spine and hip positioning, neutral seatedposture, and the importance of movement.Pilates and specific seated exercises &stretches, which can be done chair side, to
help combat poor posture, are presented.
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Objectives:
At the end of the session, the attendee
will be able to:
• Identify the cause of forward flexion of the spinewhile seated.
• Discuss the prevalence of neck and shoulder injuries
for the dental professional.• Explain neutral pelvic position while seated,
including neutral spinal alignment.
• Recommend appropriate strategies for sitting as well asergonomic strategies in the dental treatment room tominimize physical strain or injury.
• Demonstrate at least five exercises, specific for thedental professional, that can be performed chairside, tohelp prevent or maintain musculoskeletal health.
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What is Pilates?
• Pilates is actually the name of a person whocreated the Pilates Method of exercising.
• Every exercise focuses on abdominal strength andcorresponding oppositional stretching.
• The primary benefit is postural alignment and abalanced body.
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Have you ever seen adentist with a hunchedback? Or even womenwho have osteoporosis?These posturesepitomize muscles,bones and joints that areimbalanced and weak….
So the operative questionis: Are you sitting withyour back straight?….
Why not?
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The dental professional, more than anyother, is notorious for slouching.
It seems almost inherent in our work as we need toget closer to a patient to see better or reach over apatient for better access. Even the receptionist who
is required to use a computer keyboard is oftenfound in a slumped position.
Gravity alone wreaks havoc on our backs andshoulders.
It is really no wonder why we are prone to such severeback ailments.
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Something to think about
When the muscles
of the back (erector
spinae) are weaker
than the muscles of
the front (abdominals)
you will slump and
slouch.
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Believe it or not!
Because Dental Professionals are in
forward flexion most of the day, their
abdominal muscles are relatively
stronger, compared to the back
muscles.
HOWEVER….the rectus abdominisis often short AND weak---like the neck
and hips.
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Dental Professionals Beware:
Studies have shown that dental professionals havenot been dealing with back, neck, shoulder andother posture related problems very well!
Study by Oberg and Oberg:
62% of the subjects reported complaints of theneck.
81% reported complaints of one or both shoulders
during the previous 12 months.
Neck and shoulder complaints showed a clear predominance over other locations. *
11 Oberg T, Oberg U. Musculoskeletal complaints in dental hygiene: A survey study from Swedish country.Journal of Dental Hygiene. 1993;67(5):257-261.
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• 1994 study, Visser and Straker:
Since the 1960’s-the introduction of the sittingposture, which was recommended to decrease lower-extremity problems, has not eliminatedmusculoskeletal injuries.
• The study further showed that hygienists experienced
discomfort associated with work, especially the back,neck and shoulder areas.
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“Four-handed dentistry” began in the late 1960’ s in some of the
more progressive dental schools, because dental professionals
were complaining about back strain. Equipment designersbegan making chairs for “sit-down dentistry.”
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Sit-down, four-handeddentistry may haveincreased production, but it
did not reduce the number of problems that dentalprofessionals facedregarding musculoskeletaldisorders….
It may have had aninverse effect.
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Consider this:
When you are slouched over, your
lungs and internal organs are being
compressed. In this state, you are not
able to fully breathe in or out.
“Above all, learn how to breath. “
Joseph Pilates
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Spinal instability and spinal
pain go hand in hand
The opposite is true too!When your back is
aligned, stable andupright, the spinalligaments, skeletalbones, muscles of thebody and the central
nervous system (whichemanates directly fromthe spinal cord) are allin accord.
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The hips and spine
are at odds with
each other when thepelvis is tilted
forward or worse yet,
when the pelvis is
tilted posteriorly.
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• The key to preventing this natural tendency is to train the back
and abdominal muscles so they are strengthened and
stretched, and work in balance for and with each other.
• Aligning your spine is what Pilates will enhance and improve.
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Think of your hips as a large salad bowl
whose base is smaller than its rim.
On a chair, often you sit on the edge instead of
the center. SIT IN THE CENTER! Be mindful of this vital position.
Moving from a sitting to a standing position
gives the pelvic girdle a rest and at the sametime allows the joint to become more neutraland natural in its alignment.
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Movement is vital inprevention of
musculoskeletalinjuries
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Dental assistants were shown to
experience significantly lower levels
of discomfort than hygienists.
WHY???
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Assistants move
around all day!
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• The assistant moves more than any other
team member, including the receptionist.
• Discomfort experienced by dental hygienists,increases significantly across the working day.
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Lehto et al, concluded that physical exercisecould act as a prophylaxis against
musculoskeletal illness and stress for dentists of a wide range of ages.
Lehto TU, Helenius HY, Alaranta HT. Musculoskeletal symptoms of dentists assessed by amultidisciplinary approach. Community Dentistry and Oral Epidemiology . 1991;19(1):38-
44.
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• Shortened muscles are not always
strong!
• Consider the neck:
Always shortened and not very strong.
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If physical movement is one possible
solution, why is it not a prerequisite in
dental hygiene and dental schools?
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A Study with a Considerable Result: Andersen L, Kjaer M, Sogaard K, Hansen L, Kryger A, Sjogaard G. Effect of Two Contrasting Types of Physical Exercise
on Chronic Neck Muscle Pain. Arthritis Care & Research 2008; 59:84-91.
• Recruited subjects
from workplaces
characterized by
monotonous work.
• 48 employed women withchronic (neck) trapeziusmyalgia were randomlyassigned to 10 weeks of:
• specific strength training for the offending muscle
• general fitness training (usinga stationary bike with relaxedshoulders)
• no exercise, (control) but met
for lectures promoting generalhealth.
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RESULTS:
Specific & general strength training had statistically
significant effects on chronic neck muscle pain.
The Specific strength training group demonstrated a79% marked decrease in pain over the trainingperiod AND after cessation of the training.
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BOTTOM LINE:Specific strength training of neck and shoulder muscles
showed a high clinical relevance and therefore, the
most beneficial treatment in women with chronic neck
muscle pain.
Specific strength training led to marked prolonged relief
in neck muscle pain (trapezius myalgia).
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THE SPECIFIC EXERCISES:Videos on MindYourBodyBook.com
• 1 Arm Row
• Shoulder Abduction
• Shoulder Elevation
• Reverse Flies
• Upright Row
• Supervised high intensity (8-12 RMMaximal Reps) dynamic strength training 3times/week for 20 minutes.
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ONE WAY TO WORK:
SIT FOR
THE MAXILLA &
STAND FOR THE MANDIBLE
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Sitting down and standing up :Changing operator positioning is foreign
to most dental professionals, however,
sitting and standing to treat patients canrelieve the back from undue forces.
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HELPFUL HINTS-Chairside• Replace curly tubing on dental
equipment!
• How heavy and vibratory is your handpiece/ultrasonic?
• Selectively polish
• Consider ergonomic seating – Saddle stool or with arms
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More Helpful Hints• Use SHARP instruments!
• Consider varied instrument handles
• How do your gloves fit?
• Loupes?!? Resounding yes!
• Computer monitor-eye level
– Keyboard position
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GOAL: Proper Positioning Unstressed neutral position, relaxed hands and
arms and a neutral neck and back.
Keep muscles stretched and strong. Watchduration and frequency!
MOVE YOUR PATIENT-NOT YOURSELF!
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NEUTRAL POSITIONING!
• It’ s EVERYTHING!
• 130 degrees at the hip----NEW INFO!
• Weight evenly distributed
• 9:00-12:00=TRIPOD
• …..80% of RDH’ s:COMPLAIN OF PAIN OFUPPER BODY ANDBACK!
Photo courtesy of PostureDontics
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How do you balance it all?
• Sprinkle your seated
exercises/stretches
throughout your
day….ANYTIME! While on
the phone, in between
patients,…?
• Exercise; lift weights; WALK!
SWIM!
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WHAT ARE YOU WAITING
FOR?
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Crack a Walnut!
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Roll Down
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Up and Over!
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Lift Back
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Spinal Twist & variation
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Wrist Relaxer
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This little finger….
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Finger Flexor & Variations
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The all important Thumb!
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“Open and Close”
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My Aching Neck!
Ear to Shoulder-Rainbow
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Ear to Armpit and
Chin to Chest
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“U”-What a Relief!
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Shoulder Rolls
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AAhhh….my aching back!
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Calf & Quad Stretch
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“The Wall”
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Out the Door
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The Future?
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Computer Set-Up:
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Maintain a Neutral Wrist
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MindYourBodyBook.com