Preparing Ourselves For an Injury-free Career in Dentistry

My comment is the sooner you start doing these things and you incorporate stability training and joint articulations and mobility training into your regimen, the better because when you're in your 50s and 60s and even many people in their 40s, you're not likely to get as injured as you would if you had. Welcome to the Phil Klein Dental Podcast. So I think all of us that are listening to this podcast who are dental professionals can agree that we've spent an incredible amount of time and resources in getting our degree and learning our profession so that we could be skillful and be a really top-notch dental professional healthcare provider. And the idea is that we plan to work for many years to take advantage of everything we put in. And as we work, we learn more and become better and better at what we do. But the last thing that you'd want to happen is to have an injury that hampers this. And these injuries can be very devastating. And when this injury occurs, you go to the doctor, you go to a therapist, you might go on medication, but it's always more difficult to manage the injury once it happens. So this episode will focus on prevention. What can we do at home or in a gym to avoid having an injury that could potentially hamper our career or make our life miserable while we're working? And this, of course, will affect our career satisfaction as well as patient care. So with us today is an expert in the field. She's a bodybuilder. She's an author, speaker, educator in the field of ergonomics. We're really happy to have her on the show. Her name is Katrina Klein. She's been a hygienist for 16 years. She has a company called ErgoFit Life. So look her up. And she's very happy to engage with our audience if you have any questions. This is going to be a great episode about what we could do to prevent injuries before they happen so we could really enjoy our profession and provide the best care possible to our patients. We'll be getting to our guests in a second, but first, with countless dental composites on the market today, choosing the right one can be overwhelming. Yet a few products rise above the rest, and VOCO composites lead the way. For over a decade, Grandioso's tooth-like physical properties have remained unmatched by any other restorative material. With its stunning aesthetics, exceptional durability, and superior handling, Grandioso stands out. as the clear choice for all of your composite needs. And if you're looking to simplify posterior restorations with a single-shade solution, check out Admira Fusion Extra. This omni-chromatic nano-hybrid covers all 16 Vita classical shades with a single shade. It achieves this without compromising strength, handling, or radio opacity, providing fast, strong, and aesthetic posterior fillings. Join thousands of dentists who trust VOCO for proven performance, superior aesthetics, and lasting results. Explore VOCO's full range of composite materials and request a sample at voco.dental. So without further ado, let's introduce our guest, Katrina. It's a pleasure to have you on the show. Thank you for having me. Before I ask you the first question, I just want to tell you a quick story about a friend of mine who I met in my first week of dental school, and he had joined the local gym. At that time, it was called Nautilus. I don't know if you're familiar with the term Nautilus. Are they still in business? I don't know if they are or not. They are. Okay. So this was a gym that was early on in its concept where it didn't have many free weights, mostly ergonomically designed stations. where the person would go in and sit down and the weights would only isolate certain muscle groups and provide a controlled workout. So the idea was to minimize the risk of injury. Anyway, I asked him why he worked out there so much. And he told me that he wanted to strengthen all of his muscles so that he could do just about anything in life and not get injured. That's what he talked to me about. It was like my first week of dental school. And I remember him saying, if you are strong, then almost every daily routine task becomes easier and you will dramatically reduce your risk of injury. And it's really amazing that he said that because a lot of people get injured doing very routine things and just in their own home. So anyway. before we get to our first question. So shortly after that conversation, I joined the gym and continued to work out regularly for 35 years. So for me personally, that was one of the best conversations I ever had. The second best was also with him when he told me how I should study for neuroanatomy. He had a great trick on how to understand and memorize neuroanatomy, which was phenomenal, but that's another podcast. But anyway, getting to your first question. about the injury thing. So what are the top three things we can do at home to prepare ourselves for an injury-free career? My first suggestion is to pay attention to your self-care. And by self-care, I don't mean bubble baths. I mean getting enough sleep. It is so important that we allow our bodies the reparative time of sleep. during those REM cycles is when we don't just process information. We do that, but that's not the only thing we do. It's where our muscle fibers become long-term and get memory and things like that. So sleeping, hydrating. Another thing would be to stretch frequently. I'm a firm believer that yoga and yoga-like poses are extremely important for dental professionals because they strengthen. or excuse me, they stretch the muscles that are chronically contracted. When we lean, when we perch, when we put our chicken wing out, when we put our head forward, all those things, the body is a kinesthetic chain of muscles and tendons and ligaments and bones that work together. And when one of these elements is chronically tightened, you're going to create dysfunction. You know, I always like to say when we sit with one foot up on a caster wheel of our chair and that hip goes up. Whereas the hip goes, the spine follows. So that means we got to make sure that we're stretching that dominant side out regularly. So stretching is important. And then the third thing by far is going to be strengthening our body. We cannot do this job. We cannot ask our body to do a job that we don't have the musculoskeletal integrity to perform. I would never go to an Olympic race. And try to perform next to Olympic racers because I'm not prepared for it. I don't have what it takes to do that. And for us to go into a dental office and try to be dental athletes, because I believe that's what we all are. Anybody who works in dentistry knows you feel completely exhausted by five o'clock most of the time, mentally, emotionally, physically. And if we just allowed ourselves the opportunity to practice with enough energy, with enough muscle, with enough sleep on board. we could definitely prevent a lot of injury. And I'm glad you brought up sleep, Katrina, because it is so very important to maintain your health without a good night's sleep. And that compounds over time. It's very difficult to stay focused. It could lead to depression. It's shown to increase the rate of dementia as we get older. And of course, there's a ton of chemistry that goes on in your body behind the scenes while we sleep to keep our bodies tuned up and running in an equilibrium state. So getting back to weights, and we now know that Weights are certainly not just for bodybuilders. Weights can be extremely beneficial to every one of us, regardless of our age. So tell us why it's so important to have some sort of regimen that involves lifting weights and practicing with weights in a way that we could strengthen our muscles. And this is particularly relevant to the dental professional who goes to work and deals with a very demanding physical day. I would say it's one of the... But definitely one of the top three things that we should be doing is extremely important because of the awkward positioning. that we find ourselves in with our workplace. I mean, the oral cavity is sitting in front of us down. And even if you're using deflective loops, you still have to be able to maintain that neutral posture. Most of us can't even get our shoulders back and down and hold them there longer than five seconds. And that's because we've just lost that muscular integrity of the posterior chain of our body. I do like what you said in regards to, you know, it's not just bodybuilding, which is why I went from bodybuilding into obstacle course Spartan racing, because I want to be able to run fast and jump high and do epic things, as well as bend down and pick up a paperclip without injuring myself. And that's really where you see the stability exercises that are involved in weight training, if done correctly. They translate directly into... the biomechanics needed for dentistry. So as we do something like we sit down on a chair, we stand up from a chair. If you break that movement down, it looks a whole lot like a squat. And, you know, we talked, I believe in another podcast about, you know, you look at babies and when they're, they sit down, they squat, they stand back up. coming out of a squat, just bodyweight exercises that use the stabilization muscles in our hips and in our shoulders and our spines. You know, the babies keep their chest up when they're standing up. Why aren't we doing that? Why aren't we strengthening those muscles that allow us to practice longer? These are the questions I ask myself daily. Yeah. So you could certainly isolate certain muscle groups with proper weight training and you have to get some guidance on that. You may need a trainer. And I know you do some of that personally when you visit dental offices and so forth. But what do you say to the dentist who says, I walk three miles every other day. Some of the walk includes hills. Is that enough to do vigorous walking either on a daily basis or maybe four times a week? Is that enough to keep their body strengthened so that they could resist some of these injuries that dentists are typically prone to? My answer is, unfortunately, it is not. That's going to help with your cardiovascular health, which is completely different. That does not develop muscle. You need resistance to develop muscle. And so even if you have some hills in there, you're not likely to be getting enough resistance and force, explosive force required to tear the muscle fibers apart, which is what's important, then be fed nutrients via proteins and things like that, and then mend back in multiples. And that's how your muscles. build. If you think about a string, you pull the string apart with force, and then you glue each one of those little fibers back together in that string, it's going to look bigger and bulkier. That's exactly what happens with muscle tissue. It's just fibers in the body. And so no, unfortunately, we do have to do some resistance training. It doesn't have to be 300 pound deadlifts, but we've got to do something. And I joked before about go and get a bottle of shampoo. That's Depending on the size of if you're going to Costco, that could be a 64 ounce weight in your hand. If you have a baby at home, I hear a lot of dentists with young babies at home or they've got a toddler. You know, you're taking that baby and you raise that baby into the air. That's a 16 pound weight. Use what's around you. Those dynamic movements for balance and strengthening the muscles that way. Doing a plank. Oh, my goodness. That is there's no minute like a plank minute. And if you don't have any time. That's a good thing to be doing. Yeah, describe to our audience what that is. So in a plank, you have your body parallel to the ground or slightly parallel with your feet down and your arms extended out, possibly onto your forearms. I recommend for dental professionals to do it on their forearms so that they don't overextend their potentially injured wrists. And you contract the belly button towards the spine, contract every part of your body so that your body is completely straight and in a... It's a straight line and you hold it and you hold it until you're shaking and you keep holding it until you fail. It is a powerful way to strengthen your core. Now, is that impact? No, it's an isometric movement, but boy, it's powerful. It's something you can do. You can incorporate other movements into it. There's plenty of body weight exercises that you can use your own body weight for in your own house, in the privacy of your space, or if you want to go to the gym. That's fine too, but definitely get help with form. I see a lot of folks doing some things that are injury potentially bad for dental professionals like shrugs and things that work the upper traps. We shouldn't be doing those things. I do, as you said, I do personal training for dentists and dental professionals privately. It's virtual, but it's private. So it's custom made to them. And there are some staple moves that are there and there are some moves that are specifically not there. Because we need to work on certain things because of the nature of dentistry. We'll be getting right back to our guest in a second. But first, when it comes to digital workflow equipment, it's important to partner with companies that provide premium products with unparalleled service. all at an affordable price. That's why you should check out Shining 3D Dental, a company that offers a complete and integrated suite of high-quality and easy-to-use digital dental equipment. Their local offices are based in California and Florida, so you get in-time comprehensive support. In fact, Shining 3D Dental can furnish your office with an entire suite of digital equipment for under $27,000. This includes their AoralScan 3 wireless intraoral scanner, Metasmile 3D facial scanner, and the AccuFab 3D printer with its post-processing equipment. Plus, the Shining 3D Dental digital workflow solution includes cloud storage, synchronization, and software for consultation, analysis, and design. So whether you're taking your first step into digital dentistry or you're looking to add additional equipment, check out Shining 3D Dental's complete digital dental portfolio. To learn more, visit shining3ddental.com. So that's a great point, Katrina. It's important for us to be aware that exercising is great, but certain exercises can actually be deleterious to our muscle structure related to the fact that it has a negative effect on what we do in the dental operatory. So this is something to be top of mind when exercising and it certainly emphasizes the need for a trainer, at least in the beginning, that possibly has an understanding of what is going on in the dental operatory. Yeah, I mentioned shrugs, for example, where we're taking heavy weight and we're just lifting our shoulders. And you can see me, the audience can't, but imagine your shoulders are going up to your ears. Well, doesn't that look a lot like what we spend our day doing? Those muscles are already being overworked throughout the day. We don't need to stimulate them any further. Now, unless you're going to go do a bodybuilding show, that's really not going to benefit you. Those muscles are strong. I also don't recommend doing CrossFit for dentists and dental professionals because you're working with high inertia and speed and weight all at the same time. You're going for your max number of reps per cycle. And there's so much injury risk potential in the shoulder area in particular. The shoulder girdle is made up of four very small muscles. And when you're throwing your body into the air or throwing weight into the air, that injury risk is really high. And our shoulders are already taxed because they're elevated, internally rotated, and then leaned forward. We're protracting those shoulders in such a terrible way as it is. It's just not the risk benefit analysis doesn't matter for me. So based on what you're saying, Katrina, is you're encouraging everybody to get into weightlifting to some extent. You can do this at home. You can do it at a gym. You can get a trainer. But the idea is to make sure that you're not just watching an Instagram or YouTube video and copying what you're seeing because it looks like something you want to do because there is a chance that it could be detrimental to the muscle group that you actually are overworking at the office. And this could apply to a dentist, a dental assistant, a dental hygienist. So it wouldn't be a bad idea to get some consulting beforehand from someone that has an idea of how to isolate muscle groups. So you're strengthening the ones that you need that are going to help you prevent injuries in the operatory and protect those that you're overworking in the operatory as well. So all good stuff. Let me ask you this question. Let's say we have someone in their mid-50s, a dentist, listening to this podcast, and they haven't worked out in many years or maybe not at all. They've been developing some problems with their back, their shoulders, their neck. Is it... Too late to start working out at any time. Or you mentioned you started working out after you were 35, which is still considered young in my eyes. Maybe not to a 20-year-old, but for me, 35 is a very young person. But someone who's in their mid-50s, when is it too late to start doing these things where the risk of actually injuring yourself working out is more than just not doing it at all? It is absolutely never too late, but it has to be done correctly. With my personal training clients, I have them take videos of them doing different movements so that I can determine what is safe and not safe for them to be doing. And if you don't have a trainer looking at your body with their eyeballs, it doesn't have to be in person, but at least evaluating you, it's so dangerous because someone who has, say, anterior pelvic tilt or hypermobility or forward head posture, there's a lot of things that go into exercise science that... are beyond an Instagram post that looks really cool. So with someone that is in their, say their 50s or 60s or 70s, my focus for them, depending on their fitness level, is going to be a lot more balance oriented. It's going to be making sure that they have a range of motion in their shoulders and their hips and that they can achieve. um abdominal and spinal flexion and extension basic moves like just sitting into a chair and standing it seems like it's really trivial and small and not effective but if you can't go to a sitting and standing position without having to lean forward and gain your balance from an external object we got to do there first you got to crawl before you walk And that's true for exercise too. And these are valuable things. Imagine you're in your 70s or 80s and you're facing the potential of going into a facility where there's nothing wrong with your health. You're simply a danger to yourself because you can't be alone because of your fall risk. You mentioned falling earlier and falling is the most, like literally the number one thing that we worry about with our senior citizens. And imagine if someone had just given you instructions on how to maintain the stability. You don't fall. You're not a fall risk. Yeah. And some of the other things involved with falling, which is loss of muscle mass, not only from not working out, but also the medications that some of these patients are taking, they eat away the muscle, which is, I believe, you know, a lot of this cholesterol medication does that, which is really too bad because they're kind of stuck between a rock and a hard place when it comes to taking the medication, which is essential to bring their cholesterol down. And losing muscle mass, which is also very, very dangerous as you age. Because you typically lose a certain amount of muscle mass every 10 years after 40. I think about 8%. Is that correct? It's about. And that's with working out or without working out or either? Could you stop that process? You can slow it. So if you work on it, you can even, I don't want to say stop it, but you can grow muscle. It's not that you can't do that. It's something you have to work harder at, you know, at a certain point for sure. Yeah. And I'm not going to tell everybody how old I am, but I still feel great and young. But my colleagues often tell me that they stopped working out because they started to get injuries in the gym. So what I think they were doing was their regimen was very similar to what their regimen was in their 30s. and they've driven it all the way through their 40s and now they're 61 and they're still doing the same thing but the body is not the same thing so what do you what's your comment on that so here here's the thing when you're 20 years old all you're focused on is the mirror muscles you want to get big and bulky and you want to look hot in that nice shirt and pair of jeans and in your 20s you ignore the not sexy moves like stability movements and stability exercises and doing one-legged body you know deadlifts and things like this that are muscles you don't see and so you spend your whole life ignoring these things and then by the time you know you're in your 40s the stability muscles have atrophied and you start occurring incurring injuries and so my comment is the sooner you start doing these things and you incorporate stability training and joint articulations and mobility training into your regimen, the better because when you're in your 50s and 60s and even many people in their 40s, you're not likely to get as injured as you would if you had. So if you haven't started exercising or you've been getting injured, I would say back off of the heavy weights for a while and work on stability. still weight train continue to weight train please just don't try to live so heavy while you're also trying to strengthen your joints because without a knee and without a hip your squat means nothing it's a very good point and there's no question my son is 28 and yeah he's always it's upper body he does some squats but it's mostly upper body there's no question about it because that's what people see and that is so true um so in wrapping up we do have a few more minutes and i want to touch upon The fact that many people are very, very busy and don't have a lot of time. So for those that cannot go to the gym right now, and I know you can always prioritize your life and you can always make time. We rationalize a little bit saying that we don't have the time, but we have the time for what we want to do. But let's say they have five minutes or less. What can someone do at home in five minutes or less where they would get the most out of that time? Well, first of all, I always recommend you must stretch before you exercise. um so so a few stretches you know at least 90 seconds of stretches you can do burpees you can do you know compound exercises like body squats um whether you have a dumbbell in your hand or you grab your shampoo out of the out of the bathroom some body squats are really good and lunges front lunges side lunges back lunges whatever i'm doing planks using alternate arms on your planks there's a lot of dynamic exercises that you can incorporate for just five minutes whether you're focusing on trying to build muscle during that time or you want to do jumping jacks for five minutes whatever it is we don't want to neglect any one area of training and i think that that's what i'm trying to get at is if you have a charcuterie board of exercise for dental professionals it's stretching it's strength training it's cardiovascular activity and and also mobility, stability exercises. You can't ignore that one. And so take a little bit of each. You got five minutes a day, one day you work on stretching, one day you work on mobility, and so on. So not limiting yourself to one exercise because the body adapts to that one exercise really, really well. You may be fantastic at squats, but because you haven't strengthened anything else in the body, you can't do five burpees without being winded. Yeah, and that's very typical of human nature is to focus on what you do well and the things that you're suffering with, you kind of push to the side and say, I'll get to that later. Do you have a video that covers some of the things you just mentioned in those five minutes? You mentioned the names of these different kinds of activities. Some of us know what they are. Some of us that are not that familiar with them may not. Do you have something somewhere our audience can get in touch with you online to see what those look like? Yeah, I mean, you can go onto my Instagram anytime. I've got tons of videos there, posture exercises, specifics on say you just have one course. core strength or you are having a low back tightness or, you know, specific things, but also just generalized things, ergonomic information, even, you know, nutritional health for those that like it, different stretches that your neck is bothering you. You want to stretch it just for your neck. There's tons of stuff on Instagram. There's tons of stuff on Facebook. You can go to my website and go there as well. I'm also available to come to the office and do a team training or you want to have just a conversation with me over the phone. I'm up for that too. Yeah, you can look up Katrina Klein, K-L-E-I-N and ErgoFit, right? That's ErgoFit. What's the exact email address? It's ErgoFitLife at gmail.com. Okay. The website is ErgoFitLife.com. Very good. So are there things that you recommend dentists and team members do in the office during the workday? Or is that something you think they should just be sitting in the break room having a cup of tea? Oh, my goodness. No, no. Stay out of the commiseration station. I actually have, if they reach out for me or out to me to my email address or on my website, I have a QR code for a stretch card. And there are 10 different stretches. I highly recommend stretching together as a team, either in morning huddle or if you don't huddle, just do it as a team. I always say that the team that stretches together stays together. And whether you're doing those stretches in between patients, in the morning, at the end of the day, you can pick one for the week. I don't care. Pick one. Do it. It feels good. Everybody's having a good time. And it really makes a difference. Getting out of the office on your lunch hour and just stretching a little bit can make the difference between having to have a pep talk with yourself to come back from lunch or coming back from lunch and wanting to really battle out some dental disease. Yeah, there's no question stretching offers tremendous benefits to the human body, both physically and mentally. In fact, I know some individuals that were very much into weightlifting that kind of transitioned out of that into yoga. And they're now doing yoga as their main activity. And they believe they're getting the strengthening, the muscle strengthening they need along with the stretching at the same time. What's your feeling on that? Yes and no. So the yoga that most people do, no. Most people are not doing aerial acrobatic type yoga that builds strength. Most people are doing like therapeutic Zen yoga that is relaxing and stretches muscles. So it depends on what kind of yoga you're doing. And I would say that the reason why we see so many bodybuilders getting injured and um moving from bodybuilding into something like like yoga and things like that is because they were not implementing the stretching to begin with um when i say you know it's like a charcuterie board it is literally that way variety is the spice of life and if all you're doing is lifting heavy iron in in compound movements or dynamic movements that are just isolated to your quads and you're doing nothing else you're going to get injured And so we have to stretch. We have to be able to run fast and jump high and pick up a paperclip. And that requires more than just lifting weights. You got to be able to touch the floor, folks. Yeah, that's one way to put it. That is one way to put it. So in closing, and I keep saying that, but we are going to close, ladies and gentlemen. The time is getting close. What are the top three strength training exercises for a dentist? And can those exercises be tailored to the individual? All exercises can most definitely be tailored to the individual and should be. Not everybody is the same and everybody is going to need different things. So I mean, everybody also has a different history. If you've got herniated discs, you're going to handle your body a little differently. So there's that definitely tailored to you. And the top exercises, I would say, are going to be like a squat. so that you are using a compound movement that incorporates hip, posterior chain involvement of the glutes, the hips, the quads and hamstrings, as well as the core and even the back muscles. The next would be any kind of a row, whether it be a bent over dumbbell row, a cable row, a row machine that's set on a high resistance. Rowing strengthens the back muscles. When you bring weight to the body, either in front of you or from above down, That's going to strengthen the back. That is where your posture muscles are going to come from to hold your shoulders back. And then the last one is going to be deadlifts. If I'm talking weight training only, deadlifts are so important to us. The hinge of the body is the hips at the lumbar spine. Where do we have all of our problems? The hips and the lumbar spine. So if we are deadlifting correctly, we're going to strengthen the hamstrings, the hip complex, the back, the low back. as well as the lats and things like that that allow us to use our hinge, which is our hip and lumbo pelvic hip complex, appropriately, holding our pelvis into the right place so that we don't get that crazy sway back going and really strengthen the way we need it. Those are my top three, hands down. Amazing. It's amazing how much knowledge you have on this subject and how well you articulate it. And you have so many things online that are free. to the audience to take advantage of. So I really do encourage people to Google Katrina Klein, K-L-E-I-N. Katrina starts with a K. Look her up, check out her free stuff. And as she mentioned, she has a QR code that you could scan and you can get a free download of whatever she said she has there. What was the free download for? It's the morning huddle stretch card. Yeah, the morning huddle stretch card. Yeah. So there's so much to think about in dentistry. There's infection control. There's HIPAA compliance. There's inventory. And then there's a million different procedures. And then there's dealing with insurance companies and running a business. It's got to be one of the most complex careers you can possibly, and then it's physically demanding. So putting all that together, being one of the most complex careers, it's amazing that dentists can actually go through a full career and retire. at the typical retirement age. And some dentists are working well into their late 60s, early 70s. I have a friend that actually moved to Florida with his wife into an area, Boca Raton area, and she loved it. And he was like, oh my God, I'm just waiting to die here. And he flipped out and he went back to Pennsylvania and literally went into the office that he sold to this other person and said, I will work part-time or whatever. And he took a small apartment. Because they had sold their house. He took a small apartment to get back into dentistry. And I think he's 76. And he just refused to stay there and not be active. So talk about a long career. So this is, you know, it's the individual. If you love dentistry, there's so many great things about it. Minimize the injuries. Take the advice of someone who knows all about it, which is Katrina. And good luck to all you people out there and start stretching at your morning huddle. That's my advice for the day. Katrina, thank you so much. We really enjoyed this discussion. It was very, very good. Thank you. Thank you so much. I really appreciate the opportunity. Pleasure.