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VIDEO How to Optimize Your Posture with Loupes

1.  Good declination angle and proper use of loupes. Since forward head postures of greater than 20 degrees are significantly associated with neck pain, scopes with an excellent declination angle are your first and foremost safeguard against neck pain (read 'Loupes' excerpt from "Practice Dentistry Pain-Free" book). 

Did you know you can improve your posture by up to 15 degrees simply by learning to use your loupes correctly?  Most clinicians lean their heads forward until the oral cavity comes into view.  This causes unsafe flexion of the lower cervical spine--where most disc injury occurs.  Learn how to minimize unsafe cervical flexion by viewing the above video.

2. Postural correction exercise. 

Rounded shoulders (slouching posture) can exacerbate neck pain.  The position of the shoulders in this forward postiion places great strain on the trapezius muscle which attaches to the cervical vertebrae.  This exercise re-trains the shoulder girdle muscles to develop healthy, neutral shoulder posture that will reduce neck strain.  It can easily be performed chairside, with gloves on. 

Sit tall, lift the chest toward the ceiling and maintain ear-over-shoulder posture throughout the exercise. Begin with arms at sides, palms forward, and fingers pointing up (1). Slowly raise the arms and when the elbows get to shoulder height, begin to squeeze the shoulder blades down and together (2). Continue to raise the arms up and outward in a "V" shape, still squeezing shoulder blades down and together, till arms are fully extended (3). Repeat 3-5 times.

3.  Support the cervical curve.  The natural curve of your neck is constantly pulled into a flattened position during the delivery of dental care.   The loss of this curvature can result in a myriad of musculoskeletal problems, and to restore the cervical curve, you will likely need the help of a licensed healthcare practitioner.   Therefore, it makes sense to do everything you can to prevent flattening, by supporting and re-inforcing your cervical curve.

Use of a neck support pillow at night will greatly aid in preserving your natural cervical curve.  These come in a variety of shapes and sizes.  Contoured memory foam pillows will support side-sleeping and back-sleeping postures, but discourage stomach sleeping, which is the worst position for the health of your neck!  A cervical roll can be inserted into your pillowcase for added support.  Studies show that rubber and latex pillows may be best for chronic neck pain, while feather pillows should be discouraged. 

4.  Endurance strengthening. Specific endurance exercise of the neck & shoulder stabilizing muscles can significantly reduce neck pain.  The Chin Nod exercise is one example of an exercise that strengthens the deep cervical flexors (this can also be done lying on the back).  Other helpful exercises involve using an elastic exercise band to strengthen specific shoulder girdle stabilizing muscles.  View more stabilization exercises. 

CHIN NOD:  Sit tall, focusing the eyes on a distant object at eye level. Keeping the eyes level, bring your chin in and up. You should feel lengthening/stretching at the back of the neck. If you're performing this correctly, you should have 2-3 'double chins'!  Hold 1 breath cycle, and repeat 10 times.  If you have discomfort with this exercise, try supporting the back of your neck with interlaced fingers, then perform the exercise.

5. Use arm support & 12:00 position.

Simply the weight of the arms hanging dependently can be enough to set off neck pain for some dental professionals.  In consultations, I perform a test to determine if, indeed, armrests would be beneficial to team members. In the 12:00 position, you are not reaching over a chest or a forehead, so the most neutral working posture can be attained.  Make sure that the occlusal plane of the upper arch is angled at least 10-20 degrees backward if you are working on the maxillary arch. Otherwise, you will be craning your head forward to visualize the work area--even with good loupes!  

�2011 Posturedontics, LLC