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Solving Work Related Pain in Dentistry

Exercises that Dental Professionals Should Avoid!

by Dr. Bethany Valachi, PT, DPT, MS, CEAS

When dental professionals come to understand the muscle imbalances to which they are predisposed, the proverbial ‘light bulb’ often appears…”Ah, that’s why I always had pain after that exercise.” Here are some of the most common muscle imbalances to be aware of…..while not a problem for the general population, these exercises can throw the dental professional into the vicious pain cycle!

Unbalanced Muscles – Exercise Caution!

Fig 1A Primary shoulder girdle stabilizing muscles.
Fig 1B Muscles that compensate when stabilizer muscles fatigue.
Fig 1C Vertical row exercise can worsen trapezius myalgia.

In order to perform the precision tasks of dentistry, the arms must have a stable base from which to operate.  For example, dentistry requires excellent endurance of the shoulder girdle stabilizing muscles, for safe shoulder movement and working posture (Fig 1A).   These shoulder stabilizing muscles tend to fatigue quickly with forward head, rounded upper back and elevated arm postures-all  commonly seen among dental professionals.

When these muscles fatigue, other muscles must compensate and become overworked, tight and ischemic (Fig 1B).  One exercise that can easily exacerbate this painful imbalance is the vertical row exercise (Fig. 1C).

Another common imbalance among dental professionals is in the shoulder, caused by over-strengthening the deltoid and supraspinatus muscles.  These muscles already tend to be strong in dental professionals due to frequent shoulder abduction (lifting the arms away from the sides of the body while working).  This imbalance can cause improper movement of the shoulder joint and scapula, causing impingement and pain.

 

Fig 2A Shoulder abduction machines can worsen rotator cuff imbalances.
Fig 2B Deltoid lifts can also worsen the rotator cuff imbalance.

Exercises that can worsen the rotator cuff imbalance and lead to impingement:  (Fig 2A), and shoulder abduction machine (Fig 2B).

Another imbalance often occurs between the pectoralis muscles, which become short and tight when working in front of you for prolonged periods of time and the interscapular muscles.  Bench presses and push-ups (Fig. 3) can put you on the fast track to worsening this imbalance, resulting in rounded shoulder posture, impingement or thoracic outlet syndrome.  Push-ups also require weightbearing through an extended wrist, which is a high risk position for female dental professionals.   Full sit-ups target the rectus abdominis, and when done excessively, full sit-ups can cause flattening of the lumbar spine. (Fig 4)  The last half of the full sit-up strengthens the hip flexors–something that dental professionals should avoid!  Rather, dental professionals should be focusing on strengthening the transverse abdominal muscles to stabilize and protect the lumbar spine.

Fig 3 . Push-ups strengthen the pectoralis muscles, which are already short and tight in dental professionals.
Fig 4 Full sit ups can cause flattening of the lumbar spine when done in excess.

 

 

 

The ‘bicycle’ exercise places an unsafe compressive force on the cervico-thoracic junction, and should be eliminated altogether.

 

 

The ‘superman’ exercise places high compressive loads on the lumbar spine and should be avoided by persons prone to low back pain.

Many more Pilates, P90x, Crossfit & Yoga Exercises Should be Modified or Eliminated Entirely!


Dr. Valachi developed the Home Exercise for Dental Professionals DVD kit to help dental professionals balance their musculoskeletal health, and prevent painful muscle imbalances.  This is an evidence-based exercise regimen that fuses dental ergonomic movements, yoga, pilates and traditional physical therapy.

 

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Dr. Bethany Valachi

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Dr. Bethany Valachi has helped thousands of dental professionals for over 20 years, and is recognized internationally as an expert in dental ergonomics. Let Dr. Valachi help you work pain-free and take back your practice!

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