Muscle Strengthening: A Better ROI than Disability Insurance

When I'm working with dentists or hygienists or even assistants, it's really about getting the strength and the muscular integrity to hold yourself into that neutral posture, maintain good posture while you're in these sometimes compromised positions, and then, of course, learning how to stay out of those compromised positions as often as possible using ergonomic strategies. Welcome to the Phil Klein Dental Podcast. It's no secret that dentistry is a physically demanding profession. We all know this. Long hours, repetitive movements, and awkward postures can take a serious toll on your body. But here's the good news. With the right muscle strengthening strategies and ergonomic equipment, you could prevent pain, improve endurance, and extend your career while working more comfortably every day. In this episode, we'll explore why muscle strength is a game changer for dental professionals, the key muscle groups you need to focus on, and simple exercises to keep you strong, stable, and pain-free. To tell us more about it is our guest, Katrina Klein. Katrina is a registered dental hygienist for 16 years, national speaker, author, competitive bodybuilder and certified personal trainer. She's the founder of ErgoFit Life, where ergonomics and fitness are a lifestyle to prevent, reduce or eliminate pain. Katrina will be joining us in a moment, but first, for the optimal bond between zirconia and your resin cement, check out Bisco's Z-Prime Plus. Rated best in class by thousands of top clinicians, Z-Prime Plus, featuring MDP, creates a strong, reliable bond to zirconia, metal, and alumina substrates. And nothing could be simpler. It comes in a single bottle, and it's 100% compatible with both light-cured and dual-cured resin-luting cements. It's time you get the most out of your zirconia restorations. To learn more about Z Prime Plus and the entire Bisco adhesive product line, visit bisco.com. Katrina, thanks for being on our show. Thanks for having me. Yeah, your other podcast episodes have been doing really well. We really appreciate your input. And it's such an important topic. And this is an interesting episode, muscle development, and we compare it to disability insurance. And I certainly don't think your goal here is to have us cancel our disability insurance and replace that with a diligent workout schedule. So tell us what your thoughts are regarding this whole topic. Well, first of all, most definitely do not cancel your disability insurance at all. That's definitely not what I'm saying. But I think that the ROI for muscle development is significantly better than what you're going to get from your disability insurance. And the reason I say that is because if you think about not having to use your disability insurance in the first place, that's one benefit. But also, if we develop enough musculature that we can remain pain-free, that we can practice without fatigue, that we can have quality of care and execute our procedures with precision and make it so that our patients want to come back to us. that's doing so much more for us, not just in, you know, career longevity and happiness. You don't have to go get surgery. You don't have to do all these things. But the ROI for muscle development and being able to practice in good posture is so multifaceted that it saves your career before you ever need to use your disability insurance. So let me ask you this, Katrina. Do you think that dentists in general are preventive in nature when it comes to their bodies? I know they have so many things to do running a practice. There's just so much responsibility dealing with the patients, the staff, the office. It's a business. With all that, do you think they're focused on preventive measures in the area of physical fitness, knowing that they need to stay in shape in order to prevent an injury? Or with all the things on their plate, do you think they wait to the point where they have a chronic nagging injury and then they reach out for help? started this about eight years ago i would have said then that i would get the 10-year call the gift of desperation uh where you're asking for help because you're dealing with symptoms that are no longer controllable by ice or advil or whatever you've got symptoms you're dealing with pain and you're facing big problems like loss of productivity and disability and whatnot but now I am seeing more and more of this newer generation of dentists that are coming out of school with wellness in their mind as a prevention method. And it's wonderful to see that because we shouldn't be thinking about prevention as an afterthought, right? It's prevention for a reason. And it's just like our patients, you know, sometimes they come in and they're motivated by pain and sometimes they come in and they're motivated by the fear of pain. And others just really want to keep their teeth, right? And they have the education from the beginning. Maybe they had great parents that happened to have the information that, you know, brush your teeth all the time because they're the only set you get. Whatever it is. But I would say there's a shift that's occurring. And wellness in this newer generation of graduating dentists. are truly seeming to want to protect their education investment, first of all. But also, they know they have to practice a lot longer. Retirement doesn't just happen at 55 now. Yeah, absolutely. Yeah. And retirement seems to be very overrated. A lot of my colleagues are still practicing at a very fervent pace. And they're not young kids anymore. And they are still practicing. They still love it. older friends who are in their 70s who still go to work every day. I spoke to a dentist last week, a periodontist who's 81, who actually commutes from Kansas City to Wichita State at a residency program. And he goes in once a week. Yeah, 180 miles. He drives 81 years old because he wants to be around young people and mentor. But let me ask you this. When you're mentoring dentists on muscle development, The first question I want to ask you is, is it specific or more specific and targeted towards dentistry in the way we operate every day in the operatory? Oh, most definitely. I mean, there are certain parts of muscle development that we really need to focus on in dentistry. Things like, you know, your back posture, focusing on developing the lat muscles, the mid-back muscles. strengthening the shoulders you know the hips those are those are things that entire posterior chain is what is oftentimes taxed to the max for dentists and dental professionals so most definitely when I'm when I'm working with dentists or hygienists or even assistants it's really about getting the strength and the muscular integrity to hold yourself into that neutral posture, maintain good posture while you're in these sometimes compromised positions, and then, of course, learning how to stay out of those compromised positions as often as possible using ergonomic strategies. But if we don't have the muscular integrity to hold ourselves upright just standing still, we're already in a world of pain. So it comes down to being able to... gain the muscles that we need specifically and one of the things that i think dentists don't understand is is that their profession is extremely dangerous to the musculoskeletal system right because if they're not doing it correctly so if they don't have the knowledge of good ergonomics from the get-go you're kind of destined to have back problems like you mentioned shoulder problems and then you just have to fight it to keep it from getting worse and then re-strengthen everything so that you can actually extend your career and work in an enjoyable environment where you're not chronically in pain. But the actual profession itself lends itself to these injuries. What would you recommend a young dentist who's just starting a busy career and they don't have a lot of time? What are we looking at? Like a 15 to 20 minute workout a day where they could do that without going to the gym? Absolutely. You know, there's a lot of things that we can do at home. And for that newer dentist that's just graduated from school that perhaps has more. um energy maybe maybe not but we're gonna just presume that's the case um you know utilizing those times where you've got 15 or 20 minutes to do some resistance band training do some dynamic movements like body squats or burpees or things like that that you know, prior injury doesn't prevent. And I think that's going to be the big change between someone who is maybe more seasoned in the profession and maybe already has injury from the profession. You know, you can do a little bit more in agility movements or compound movements or dynamic movements when you're not already facing an injury. But for someone who might be on the other end of it where you're, you know, battling injuries or you know, you don't have that range of motion that you once had because you haven't been stretching for the last 20 years of your career or whatever, you're going to need to start a little smaller and doing some mobility and joint strengthening exercises first. You know, you're not going to go into a full burpee if, you know, just doing a push-up is difficult. So, you know, truly listening to the body, but starting with some more isolated movements as we get older. to strengthen those muscles or those joint systems that are already injured. For example, with a shoulder injury, someone who's had shoulder issues, and I bring that one up because it's so common. If you were to take a resistance band and simply extend that resistance band out to the side with the elbows down at the side. basically gluing it to the body and then bringing the hand in front of you, holding that resistance band and then pulling it out to your side, that's going to strengthen the rotator cuff. And that can be done with a simple resistance band in your office, right? It doesn't take a lot of weight. It doesn't take a lot of pressure. You can do it, you know, just three to three to 10 times. You can do it 15 times, whatever works for you. Integrating just a few strengthening movements into the day can go a long way. And then if you can, you know, alternate maybe one day is strengthening muscles. Another day might be mobility. Another day would be maybe cardiovascular exercise. And then also integrating some stretching. You know, I oftentimes say that teams that stretch together stay together. So if we can integrate stretching, be it on our own or with our teams, you know, we're all benefiting from that. But it doesn't take hours and hours a day. You don't have to live in a gym. You don't even have to do it outside of your office. You can do wall fits. And that's going to develop strength, core strength and leg strength. So all of the things that we need can be done in 15 or 20 minutes a day if we really, truly dedicate ourselves to just that. Yeah. What was the exercise with the wall? You got cut off there a little bit. It's called a wall sit. So when you sit against or you stand against a wall and you slide down so that you're in what would look like you're sitting in a chair up against the wall, but you really just have your back flat against it. The legs are parallel to the ground. at the thighs, and then your feet are on the floor. So you're replicating a chair, and you just sit there, and you would be surprised at how hard that can actually be, how much strength that requires. I do that as well in my routine to help prevent having another herniated disc, just to strengthen the core. Absolutely. Yeah, that helps with all sorts of things. Anytime we strengthen the core, it's going to help with our spinal cord because the core and the back muscles work together to support the spinal system. Yeah. So do you think that it should be a culture in the office? If a dental practice owner has these meetings once a month with the staff, should that be part of it? Because I know the... Most likely response of a dentist who has a very busy practice is he's going to say, I don't have 15 or 20 minutes for our staff to stretch. Katrina will be right back in a moment. But first, as a dental healthcare professional, you might already know that 3M Healthcare is now solventum. And one of its next generation products is 3M ClinPro Clear Fluoride Treatment, available in a new rosin-free water-based formula with soluble fluoride ions immediately available to deposit on the tooth. ClinPro Clear Fluoride treatment needs only 15 minutes of contact time. Plus, with less waiting time to eat or drink after application, it's even easier for your patients to say yes. Its uniquely designed LPOP delivery system ensures a smooth and professional application process. In clinical studies, hygienists found it fast and easy to apply. And patients rated their experience an impressive 98 out of 100. So if you're looking for effective fluoride uptake in a rosin-free, water-based formula, try 3M ClinPro Clear Fluoride Treatment from Solventum. To learn more, visit solventum.com. I think that 100%, you know, the culture that you create is what keeps your team together or doesn't. And if you have a... culture of wellness at the heart of things, you're not just preaching to your patients, but that's something that you wholeheartedly share as a mission statement, that wellness is part of what we do here. And you're no longer just focusing on, you know, we're going to strengthen together, but we're also looking at each other in our overall health. So if they're talking about time and limitations on that, If you do a morning huddle and everybody does one stretch a day for 60 seconds, that's four stretches a week. And maybe in between on their lunch hour, you know, the staff gets together and does a stretch together or they go for a walk on their lunch hour or, you know, we do an end of the day, you know, high five and a stretch and a, you know, hey, we survived the day or whatever it is. Or we incorporate, you know, drinking water or whatever the case may be. And starting the day off with stretching is always going to help, even if it's just one stretch a day. And the staff that gets into it, you know, we enjoy it. So let me ask you this, Katrina. Do you think it's important for a dental office to have someone with expertise, someone like yourself, come into an office and train the staff, the doctors, the whole team on... Good exercises, really important exercises that can be done efficiently in a short period of time, not necessarily at a gym, like you mentioned, that will support the muscles and strengthen the muscles that we use every day in our practice. And also obviously observe the team members, the dentists, as they work and identify ergonomic mistakes that are being made that are feeding into these injuries. You know, we have people come in that teach us how to do CPR once a year. I think that's what the regimen is. and how to use an AED and, you know, those kinds of things. Infection control, people might come in to check the office for OSHA. Why not have someone come in that does the kind of things that you do? And I know, of course, you're going to be a proponent of this because that's what you do for a living, but I still want your take on it. Well, most certainly I... and biased in that I believe we should be getting some sort of help. Now, if you're practicing with ergonomics already and things are wonderful and everyone has energy and no one's having pain and the fatigue is not there, then maybe you don't need it. But the reality is that's just not most of us. The studies show between 74% and 96% of dental professionals report body pain. So I would say the majority of people do need it. Whether you're getting in-person education or you're getting something online or you go to my website and just print out the stretch sheet and pick one stretch every day, doing something is always better than nothing. Right. And so, yes, that should be done. I think that visiting ergonomics once a year as a refresher, even if it's just in an online one hour on demand study type course, you know, I've got one on my website. There's many, you know, there's a few other people that have them. Something to just remind you to be mindful about these things, being consistent with it. You know what we. What we want to see repeated are things that we want to focus on, right? So like any other protocol in the office, say we're talking about Invisalign, and the doctor wants to move towards that sort of procedure on a regular basis, you're not going to say one time, okay, guys, let's really start. talking to people about aligning their teeth correctly. You're going to revisit that every once in a while to kind of get everybody back on the right page and reminding them that the importance of looking at people's alignment in the first place. So ergonomic training would go in the same way, whether it's in person. Now, ideally, in person, I would say is the best because we are so individualized with our struggles. both with our own bodies, with our own operatories, with our own patients, how we practice with people. As many assessments that I have done where I've worked one-on-one with people, they're all different. We all do different things. And so having someone work with a clinician one-on-one to determine exactly what their issue is might be a career-saving thing for them. It might be something that they can, if they're aware of it, correct on their own, but they need to have the knowledge to do that. So when a dental office invites you to do the things you do at that office, observe, make recommendations, train, mentor, and you notice equipment that is not conducive toward good ergonomic positioning, for instance, just the chair that the operator sits in. I know the saddle seat is what you prefer, and you can go into that in a second. But is that a little touchy, like for you to go to the dental practice owner and say, hey, you know, I've observed this. We've had great conversations with your staff about how they're going to improve their ergonomic positioning and the way they do things in the office, in the operatory. But they're at a disadvantage because they're working with chairs or certain equipment setup that is not conducive to good ergonomic positioning. And this is going to be a battle going forward to prevent injuries if you don't make these equipment changes. Is that something you present to the dental practice owner? Absolutely. I mean, that's kind of the difference between, say, your good, better, and best type of ergonomic training. You know, you can do an on-demand training type of a situation, or you can have someone come in and actually look at what's going on in your practice, what's going on with your body, how are you practicing with your patients, and if you are getting, you know, what did we find today? What did we find today? What did we do today? What corrections did we make today? And then what recommendations do we make for the future? Whether it be to focus on this particular ergonomic strategy, say the chicken wing, or let's focus on getting this type of equipment, or whatever the action items are that you are left with. That kind of a comprehensive visit is truly going to be where you're going to get your best training. If you get someone that's going to follow up with you in a month and say, how are things going? Do you have any new problems that are arising? Because when you get a CE, when you go to a CE or you get some in-person training or whatever it is, you're only going to retain so much of it. Having something written out for you so that you have action items later is so key. in order to be able to say, okay, I've finally mastered the chicken wing. What else was she telling me about? And then you have to hopefully remember, or do you have a list there? Do you have a written report there? So getting that... Tell us what the chicken wing is. For those of us who don't know, what's the... The chicken wing is when you got your elbow up. I figured that's what it was. Yeah. So let me ask you... And so many of us do it. Yeah, let me ask you this, Katrina. So you've been in this business a little while. You've been around the block when it comes to ergonomics. You have a great website, ErgoFit. What is it? ErgoFit.com? ErgoFitLife.com. ErgoFitLife.com. So you've done so much stuff in this area. So what would you say are the top five egregious mistakes a dentist is making? Let's start with the dentist. So the first thing I would say is it's really just a distinction between The operator, whether it's a dentist or a hygienist, we typically do some pretty similar things. An assistant has different problems only because they're not the main deliverer of the care. And so they're more subject to the whims of what the doctor is doing. So as a provider, the things that we would, I say the number one, we don't lean our patients back all the way. um that is the first thing we we want to try and keep them as upright as possible because we want them to be comfortable what we don't realize of course is that when they're not lying back and we're not able to instrument properly that makes them more uncomfortable so and it because it takes us longer we can't see you know all those things So that would be the first thing. And that's oftentimes remedied just by tilting the headrest back on the patient chair. You can get so much farther by just tilting that patient headrest back. And then the patient doesn't actually have to be completely supine. So that's the first thing. The second thing is the chicken wing. We've always got our arms up in the air rather than pivoting the elbow down, moving our retraction hand into a different position, using our indirect. division. And that is a major, major player because we're battling against a lip, a tongue or a cheek, whatever it is. And that is where our shoulder problems come from almost every time. The next thing I would say is that we tend to lean forward and tilt our head to the side. Again, that's an indirect division issue. Every time we have got to learn to use our indirect. The next thing that I would say on that top five list is that we're not using good equipment. We're trying to just do something real quick. And if you think about it, everything that we do is just real quick. Taking time to use your indirect vision and readjusting the body when we find ourselves in this awkward position where we're leaned forward at the hip. Evaluate the equipment because if you're using a saddle stool, for example, that's going to prevent you from leaning forward in that way. And so I know that, you know, we want to invest in something that we feel has an ROI. to it we want to invest in say you know that new serica machine or what have you but if that saddle stool provides you with the body positioning to avoid injury in order to do better dentistry without having pain and then spending money with the chiropractor and the massage therapist and all of the things and where we're not having to slow down buying that equipment is just that makes so much more sense you know the math math's better using ergonomic loops I mean now that we have them and the studies across the board show how much more effective they are in pain reduction I mean, it's 2025, you know, when you know better, do better. Yeah. I mean, what is the cost of a pair of loops? What's really interesting is you talk a lot about that saddle stool. Is that one of the, in European, one of the big deals as far as maintaining ergonomic, correct ergonomic positioning? I mean, the saddle stool versus the chairs, the seats you get for free when you buy the patient chair, you get that free seat. What do you do with those free seats? Just put them in storage or sell them on eBay? Well, or you just ask them to maybe apply that credit towards a saddle stool, you know, to say, hey, listen, if you're going to give me this chair, why don't you apply something towards a saddle stool instead? Because most of the manufacturers have access to a saddle stool distributor. And so they have relationships in them. It doesn't make them as much money, but on the back end, it's not about just that. safe. And so, yeah, I mean, I definitely believe that a saddle stool in combination with practicing with standing dentistry, you know, there was a thing, you know, we switched from standing to sitting and, but we also made a change where we put the patient from sitting to lying down. We made two changes rather than one. And if we would have simply just had the patient lie back. We wouldn't have needed to incorporate a chair except that our feet get tired. So really, if we incorporate some standing in with our saddle stool usage, we would find that there's a much less propensity for joint compression, which is where we find that injury through oxygen innervation and blood supply deprivation. And that's where we have problems. So if we could just vary up our posture a little bit, you'd be surprised at how much less injury we'd have. But we don't want to invest in the saddle school and we don't want to try standing. Right. Well, we will after this episode, hopefully. Yes, sir. So do you recommend half the time to stand and half the time to sit? You know, I'm a big proponent of 50-50, but I always say for dentists, start off just doing your hygiene checks standing and you'll find that they... are faster it's easier if that hygienist already has the patient chair up at your standing height you're not having to go in and wait for the hygienist to get out of the chair and then take that journey with the patient and bring them back into supine again it's much more efficient and you can get a variation in your posture so you walk in you're standing you do your exam you have your conversation and then you go that's going to lend to that so you might start with just that and eventually you're going to end up doing more things that way because it feels good so that's a good start yeah so the hygienist prepares that chair position obviously knowing the dentist is going to come in and do that hygiene check right so they come in and it's the the patient is now elevated but still in the supine position correct correct okay so they're just raised up yeah it's just a straight upward upward vertical motion of the chair and hopefully the chair will go high enough to accommodate the dentist who's coming in if the dentist is like six foot eight then you got a problem but there aren't too many of those out there yeah yeah so let's not worry about that i'm six people i've got solutions there are two there are patient chairs out there that go up to 36 and a half inches high for those dentists that might be an investment they might want to make because imagine And how much more, I mean, I hate to say it, but how much more money can you make if you can do things more efficiently? Yeah, without a doubt, Katrina. I think there was a lot of take-homes in this episode. Definitely a good discussion. I think that you've emphasized very clearly how important it is to live a preventive life when it comes to strengthening your muscles to support what we do in the operatory every day and what we do in the practice. And of course, many other things you discussed. worth listening to. Remember to our listeners, ergofitlife.com. That's ergofitlife.com is Katrina's website where you can get ahold of her. Feel free to visit that website. There's lots of videos and documents that you can download that coincide with a lot of things that we talked about today. Katrina, thank you very much for your time and I appreciate it. Thank you so much.