Maintaining optimal ergonomic positions can help clinicians to achieve optimal performance with minimal physical burden or fatigue. For every articulating joint, there is a neutral zone of movement that does not require high muscle force. Musculoskeletal problems or injury may develop with awkward or deviated working postures in repetitions or a sustained period of time outside the neutral posture.

It is more efficient to maintain a neutral and basic operating posture which permits balance between muscle activity and relaxation. This can be achieved by better positioning of both the operator and patient. Better sitting posture can be adopted, such as adjusting to an appropriate chair height with and having the back supported to ease load on musculoskeletal structures. Suitable instruments and gripping technique should be utilised to maximise force production efficiency, vision and ultimately help with physical demands from work.  

Dental practitioners experiencing pain or deviation from normal movement in practice should seek advice and care from qualified health practitioners. Dental practitioners should aim to prevent musculoskeletal injury, however the diagnosis and management of injuries will require professional intervention.  

Dental practitioners should take breaks whenever possible, such as between appointments, to mobilise the different joints through range and stretch muscles that are shortened or tight. This would help practitioners maintain adequate flexibility, which is the ability of a joint to move freely. Enhanced joint flexibility may improve muscle balance and function, improve posture, reduce injury risk, and reduce the incidence of low back pain.^[1]

Active lifestyle (regular physical activity and aerobic exercise) and strengthening exercises should be performed to increase the capacity to load and work demands so that injury risk can be reduced. Holding a static stretch to the point of feeling tightness or slight discomfort for 10-30s is recommended for each of the stretch. Each of the stretch should be repeated three times on both sides. Ballistic or jerky stretching movements should be avoided.  

Neck flexion, extension, lateral flexion, rotation 

1. Turn the neck slowly into flexion, extension, rotation and hold.
2. For lateral flexion, slight additional force can be added with the hand.

1. Hold the right arm in front of the chest across the body.
2. Bend the left elbow and slowly pull the right arm to the direction of the left shoulder.

1. Start the exercise with the palm of the hand facing downward, extending the right arm.
2. Put the left thumb over the dorsal side of the fingers and the other four fingers over the palm side of the fingers for support.
3. Stretch the flexor muscle group pulling the fingers backward (dorsal flexion).

1. Sit at the edge of the chair and maintain a upright back spinal posture throughout the stretch.
2. Then extend your left leg out and slowly lean forward by folding at the hips while maintaining the spine neutral.

Standing wall calf stretch

Stretching the plantar flexors.

1. Face the wall and step one leg back and the other bends at the knee.
2. Extend the back leg and lower the heel to the floor.

Arms above head stretch

Stretches the upper back muscles.

1. Stretch the arms in front of the torso and interlock fingers with the palms facing out.
2. Straighten arms above the head and reach upwards and back. Hold the position.

Practical application to the dental environment