Healthy vs. Unhealthy Alignment

Dentists, dental assistants, hygienists and front office staff all have a high incidence of positional imbalance and overuse syndrome. While treating patients, not only are they seated but likely rotated at the hips, leaning forward and likely looking down. This causes us to rely heavily on the front body in (tight) flexion and the back and side body in (long, weak) extension to achieve visual access. Foot placement, leg positioning, pelvis, sacrum and low back are directly involved in how this is managed. Leaning the torso with arms lifted against gravity increases the probability of stress-induced chronic pain and injury.

At the beginning, ambitious young dental practitioners start out working more hours to gain experience and soon come to feel the effects in the body. Hours of work loss, hundreds, if not thousands, of dollars in doctor visits and physical therapy will certainly result in our feeling better. Returning to work, the cycle starts over again. This continues until education and awareness is discovered by the practitioner thus empowering them with the tools to achieve and maintain a balanced working posture.

Exploring the working muscles will help identify where to strengthen weakness and where to stretch congestion in tissues. Consider the legs with a common placement in a “10:00 and 2:00” position which can be much wider than hip distance apart. The feet are not often in full contact with the floor and placed with more outside edge. The sacrum itself is likely in posterior tilt, while the lumbar curve is compromised and the abdominal/chest area collapsed, as well as the neck likely in hyper flexion. This, in time will result in low back pain, piriformis issues, as well as the shoulder and neck pain (Figure 1).

Figure 1.
Photo showing unhealthy alignment.

It is useful to visualize “good” alignment while working. As the connective tissue (fascia) changes shape and strength, obtaining good posture will be an easier task. Eventually it will feel natural to be straight in posture. Ideally they would be just slightly more than hip distance apart. Likewise, it is important to ensure that there is no slumping or rounding of the low back. Attempt to keep the torso centered or at a line angle which agrees with tilt and core strength. Lifting the belly button to visualize it just equal or a little above the line of the horizon. Shoulder blades should be gently drawn back and down, as equal length in both sides of the torso is engaged (Figure 2).

Figure 2.
Photo showing healthy/good alignment.