Issue link: https://www.massageandbodyworkdigital.com/i/81195
@WORK 5 The supraspinatus is susceptible to compression in the subacromial region. 3D anatomy images. Copyright of Primal Pictures Ltd. www. primalpictures.com. Frequently altering positions (as supraspinatus and neck complaints, it is likely that tension patterns exist in the extremities as well. In many cases, it is cumulative trauma throughout the entire kinetic chain that leads to wrist or hand injury, so it is crucial to address the full upper body when treating dental workers. key Treatment Strategies. It is usually the flexor and extensor tendons of the wrist and hand that experience the most overuse dysfunction. Active engagement methods that focus on longitudinal stripping techniques performed while the muscle is actively shortening or lengthening are particularly valuable for addressing the chronic overuse problems that dental workers develop. Active engagement methods also help encourage tissue pliability and freedom of movement with adjacent structures. Overuse problems lie primarily in the tendon sheaths of the flexor and extensor tendons. This is true in tenosynovitis, where adhesions develop between the tendon and surrounding synovial sheath. Deep friction applied to the affected area is helpful for this situation and should be followed with full-range motions and stretching of the wrist and hand to maintain ideal freedom of movement. OTHER TREATMENT PROTOCOLS In addition to soft-tissue treatments, another very important factor to address with the dental worker is workplace ergonomics. While it may not be easy or even possible for clients to change their working positions with patients, it is still very important to encourage them to consider this element and to make sure they are using the most ergonomic positions possible. much as possible) and taking stretching breaks will go a long way toward decreasing cumulative muscular stress. Stretching should emphasize forward and lateral flexion of the neck, combined with upper extremity extensions to maximize stretching of the entire kinetic chain. Clients can do this stretch also by placing a hand on a wall and rotating their torso in the opposite direction. Similarly, stretching the low back in forward and lateral flexion can reduce low-back muscle tightness. Including lower extremity (hip) flexion during low-back stretches also helps stretch the entire lower extremity myofascial chain. These key stretches, along with others, are good self-care options to recommend, if this is within your state's scope of practice. While it may not initially seem that the dental work environment is high- stress, practitioners in this field report significant physical and psychological stresses associated with their jobs that lead to numerous musculoskeletal complaints. Psychological factors further aggravate patterns of chronic muscle tightness, particularly in the upper-back and neck regions. Be sure to encourage your client to adopt and learn stress reduction practices at home that are proven to reduce this type of work-related strain. Massage therapy is an excellent intervention for these individuals and can greatly reduce the occupational disorders they experience. Massage is of value not only as a treatment for specific problems, but should be strongly encouraged as a preventive measure and for stress reduction. Whitney Lowe is the author of Orthopedic Assessment in Therapy and Orthopedic Massage: Theory and Technique (Churchill Livingstone, 2009). He teaches advanced clinical massage in seminars, online courses, books, and DVDs. Contact him at www.omeri.com. Celebrate ABMP's 25th anniversary and you may win a refund on your membership. ABMP.com. 109