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{ negative effect on their bodies while paying a high price physi-cally. The concept of caring for our most important instrument, our body, is invaluable yet often ignored. Regular exercise has been shown to improve postural endurance and decrease the cumulative trauma that ultimately results in pain. However, given a busy clinical schedule, how can the clinician incorporate regular exercise into his/ her routine? By adding some exercise as a regular part of your life, can you counteract the ill-effects of the profession on your body? If you are going to invest the time in a regular exercise routine, where should you start? One solution is an exercise ball program designed for the busy dental professional to strengthen those muscular areas that are most stressed and fatigued by the practice of dentistry. The author has worked with Posture Perfect Solutions to develop such a program. Additionally, dentistry for the most part is a “seated profession”; if one must sit to work, why not work to sit? Dynamic sitting on a therapy ball has been shown to improve one’s working posture and spinal alignment, facilitate improved balance and continuous body move-ment and muscle function while working, and increase surface contact of weight bearing structures as well as improving weight distribution while sitting. 18-22 The rationale for use of the ball for sitting is based on the potential for increasing the neuromuscular demand required to maintain sufficient control of the spine and whole body motion. 23 Take out the digital camera at work and take pictures of you and your colleagues working with patients in the operatory. It is often an eye-opening experience. As human beings, we spend a significant amount of time sitting. A 2009 issue of Women’s Health reported the results of a poll conducted by the Institute for Medicine and Public Health. The authors identified that the average American spends a little over 56 hours of the week sitting. 24 Several other studies have shown that prolonged sitting throughout the day may even increase your risk of morbidity and mor-tality. 25 Movement is life and can be a beneficial part of the working day (Yancey). 26 A colleague of mine often says, “motion is lotion.” With sitting as a chosen work position, we often sit in a fixed, frequently slouched posture for any number of hours during the working day. Not sure if you do? Take out the digital camera at work and take pictures of you and your colleagues working with patients in the operatory. It is often an eye-opening experience. There are many seating alternatives available for the dental professional. One of them is dynamic sitting, which provides a unique alternative to typical seated posture. Posture Perfect Solutions’ Evo-lution chair is a dynamic seating product that provides an opportunity to actively “participate” in the act of sitting, and while this may not be a good fit for all practitioners, it is a viable option to consider. Dynamic sitting allows us to avoid the habitual slouched sitting pos-ture that our mothers always warned us about. We are continuously moving, adjusting and repositioning ourselves against the forces of gravity throughout the day, thus counteracting our typical “holding patterns” of poor posture. This certainly allows us to work in a more upright position while exercising our postural and core muscles. It is nearly impossible to sit poorly on such a chair more than once, which may delay the muscle fatigue that normally accompanies our working day. It may delay some of the usual daily discomforts and perhaps save our career from debilitating injury! Efficiency, effectiveness and career longevity may be positively impacted by the fitness of the operator and their choice of seating. So when considering career lon-gevity with the hope of making it to the end of your career in great shape, get on the ball! Note, if pain persists beyond several weeks’ time, seek out professional help. References 1. Seyffarth H, Steen Johnson S. The dentist’s working posture and musculo-skeletal disorders. Tandlaegebladet. 1954; 4:139-59. 2. Eccles JD, Powell M. The health of dentists: A survey in South Wales 1965/1966. Br Dent J. 1967; 379-87. 3. Rundcrantz BL. Pain and discomfort in the musculoskeletal system among dentists. Lund Sweden: Department of Physical Therapy, University of Lund, 1991; 3-59. 4. Kilpatrick H. Work simplification in dental practice: applied time and motion studies. 3rd ed. Philadelphia: W.B. Saunders, 1974. 5. Spratt KF, Lehmann TR, et al. A new approach to the low back physical exami-nation: behavioral assessment of mechanical signs. Spine. 1990; 15: 96-102. 6. Kelsey JL, White AA. Epidemiology and impact of low back pain. Spine. 1980; 5:133-42. 7. Toroptsova N, Benevolenskaya L, et al. “Cross-sectional” study of low back pain among workers at an industrial enterprise in Russia. Spine. 1995; 20:328-32. 8. Croft PR, Macfarlane GJ, et al. Outcome of low back pain in general prac-tice: a prospective study. Br Med J. 1998; 316: 1356-9. 9. Carey TS, Garrett JM, et al. Recurrence and care seeking after acute back pain. results of a long term follow-up study. Medical Care 1999; 37:157-64. 10. van den Hoogen, Koes BW, et al. On the course of low back pain in general practice. a one-year follow up study. Ann Rheumatological Disability.1998; 57:13-19. 11. Oberg T. et al. Musculoskeletal complaints in dental hygiene: a survey from a Swedish country. J Dent Hyg. 1993; 67(5): 257-61. 12. Murphy D (ed.): Ergonomics and the dental care worker. American Public Association, 1998. 13. American Dental Association. ADA News. June 21, 2010. 14. American Dental Association. ADA member survey, 2007. 15. McQuade KJ, Dawson J, Smidt GL. Scapulothoracic muscle fatigue associ-ated with alterations in scapulohumeral rhythm kinematics during maxi-mum resistive shoulder elevation. JOSPT. 1998; 28(2):74–80. 16. Escamilla RF, Yamashiro K, Paulos L, Andrews JR. Shoulder muscle activity and function in common shoulder rehabilitation exercises. J Sports Med. 2009; 39(8): 663-85. 17. Andersson BJ, Ortengren R, Nachemson AL, et al. The sitting posture: an electromyographic and discometric study. Orthopedic Clin North Am. 1975; 6(1):1 05-20. 18. Mayo Clinic. www.mayoclinic.com/health/exercise. 19. Centers for Disease Control and Prevention. www.cdc.gov/physicalactivity/ everyone/health/index.html. 20. Sochaniwskyj AR, Koheil K, Bablich M et al. Dynamic monitoring of sitting posture for children with spastic cerebral palsy. Clin Biomechanics. 1991; 6(3). 21. Dieter Breithecker P. “Ergodynamic” work station design and its effect on physiologically correct body behavior, attention span and concentration at school. Federal working group on the development of posture and exercise V. Matthias-Claudius-Strabe, 14 D-65185 Wiesbaden, Germany, 2007 22. Bauman A. Updating the evidence that physical activity is good for health: an epidemiological review 2000–2003. J Sci Med Sport. 2004; 7(1) Supplement 1. 23. Marshall PWM, Desai I. Electromyographic analysis of upper body, lower body and abdominal muscles during advanced swiss ball exercises. J Strength Conditioning Res. 2010. 24. Women’s Health Magazine. Survey, November 2009. 25. Patel AV, Bernstein L, Deka A et al. Leisure time spent sitting in relation to total mortality in a prospective cohort of US adults. Am J Epidemiol. 2010. 26. Yancey T. Instant recess: building a fit nation 10 minutes at a time. Univer -sity of California Press, 2010. Timothy J. Caruso PT, MBA, MS, Cert. MDT, CEAS is a physical therapist focused on manual therapy and orthopedics. He provides direct patient care at Shriner’s Hospital for Children in Chicago and Com-munity Physical Therapy, a private physi-cal therapy practice. He has worked exten-sively with pediatric and adult populations with orthopedic conditions and is involved in seating and positioning for children and adults with special needs. Cofounder and president of the Kids Equipment Net-work Childrens Charity, he has many publication credits and is a nationally known professional speaker, having worked extensively with dental professions since 1988 in ergonomics, injury prevention, productivity, exercise and wellness. He has an ongoing interest in assessing musculoskeletal pain in dental professionals and creative prevention strategies. 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