- Continuing Education
Into the Operatory
Into the Operatory
So now let's go into the operatory. There are certain steps that we want to do before we just start charging in there and getting to work on our patient. First off, we're going to establish our positioning first. So this means if you're, if you're using a stool, you want to adjust your stool so that it fits you, okay. This might be easy if you're if you just work in one op and you're not switching around a whole lot. This is a pretty easy step. But a lot of offices people are hopping around to different operatories, the doc is coming in doing hygiene checks and then going somewhere else. Every time you sit on a stool, I don't care if it's for two seconds or for 20 minutes, you want to adjust it so that it supports you. And then you're gonna adjust your patient. So we're gonna start with ourselves first and then we'll adjust our patient. We'll tip them back, adjust the vertical height of the patient chair. And then also if you have a chair that has an adjustable headrest, you want to adjust that as well.
So let's talk about your stool. I know I'm pictured on a saddle stool here, but the rules are essentially the same whether we're dealing with the traditional stool or a saddle stool. So when you first sit on the stool, if you have a back rest, you want to make sure that you're, you feel that backrest. You want to feel that support against your lumbar spine. So before us, I do use a saddle stool, but before I switched to a saddle I was using a traditional school, and I would be perched on the edge of the stool, okay and there would be like, this much room in between my back and the actual back rest, which I wasn't used, I wasn't using the the stool correctly. So if you have a stool with a backrest, you wanna be fully seated in that stool so that you feel the contact there in your lumbar spine and just a quick tip for you if you notice that you're a percher on the edge of your traditional stool, a lot of times it's because of that seat pan is too long for your legs, that's why you're perched on the edge like that. The next thing you want to do is adjust the seat pan, so the seat pan is the part of the stool that your butt sits on. You wanna make sure that that is tipped forward a little bit, not so much that you're sliding out of the chair, but just a little, and what that does is it opens up the angle of your hips. And it relieves some pressure in between the disc in your lumbar spine. So our lumbar spine does have that inward curve, okay, and we want to preserve that curve, it's there for a reason. Once we start to develop pain or discomfort in our low back, a lot of times, it's because that curve is starting to flatten out and then we start having like pinching up the disk and the nerves, and it could just be very uncomfortable. So just that slight tip of the seat pan just a few degrees can help preserve that curve. And then it also reduces pressure in your hips. Now for the height of the stool, you want it to be so that your hips are above your knees. When I was in school, I was taught to have my thighs parallel to the floor with a 90 degree angle in my hips. We don't want to do that, especially with my tendency to lean forward. That's even more pressure on the hips, and I can tell you over years that did not help my low back issues at all. So whether you're in a saddle or a traditional school, you want your hips to be above your knees, so that your thighs are slanting downwards toward the ground. Again, this reduces pressure in the hips, helps the low back, but also the higher you sit, the more downward your thighs will be, which means they're getting out of the way so that you can get closer to your patient. I know when I was and I'm, I'm taller, I'm about 5’9”, and when I was sitting on my operator stool, my traditional stool and I tried to get close to my patient, my legs would run into the patient chair and I wouldn't be able to get as close as I wanted to and that's when I started to reach and lean and and do all that crazy stuff. Another thing when you're sitting is you want your weight evenly distributed, so you want some weight in your butt, you want some weight in your legs. We've got very strong muscles in our legs, much stronger than the muscles in our low back, and so we want to use those. We want to recruit those muscles as much as possible. So when you're sitting in your stool, don't have all of your weight in your butt, you want to shift some of that weight forward into your feet and remember, your feet should be flat on the floor so that you can shift some of that weight forward.