Say it's knot so!

May 1, 2013
I sometimes contemplate the number of practicing hygienists who might be afflicted with the malady I'm about to describe – surely it cannot be just poor old me.


I sometimes contemplate the number of practicing hygienists who might be afflicted with the malady I'm about to describe – surely it cannot be just poor old me. I have been practicing clinically for more than a few years but this affliction began to bother me early on, and has stayed with me throughout my entire career. I don't know how to cure it, but I have found a way to respond when it rears its ugly head.

I'm talking about an aggravating tension knot that forms under and around my scapula on my left side. It surfaces adjacent to my left wing area. When I'm stressed (working on difficult patients or falling behind schedule), the knot seems to become far more apparent. I envision it as a moveable, knotty "whine ball" of stress in my back that gnaws at me as I try to do my work, a chronic thorn that has persisted most of my adult life. While I believe that clinical dental hygiene aggravates it, the stress knot is occasionally with me when I do not practice clinically. Go figure.

During treatment, it probably has something to do with how I am turned ever so slightly toward a patient in the 10 o'clock position. As my client rinses, I take advantage of the opportunity to twist my body counterclockwise and hold that pose for a few seconds. When I do this, I can sometimes get my back to crack, which affords relief. But the stress knot is a chronic malady that always seems to return, so I have to believe my physical positioning in dental hygiene contributes.

Wearing my trusty SurgiTel loupes helps because it forces me to keep my body erect. I also practice yoga on a regular basis, and there is a particular pose I use at home that mimics the counter twist that I try to do while the patient is rinsing. I lie on my back on the floor and draw my right knee to my chest, then all the way over across the front of my body until it touches the floor on the opposite side. I try to get my knee as flat to the floor as I possibly can. As I do this, I can feel the pull in the tension knot. I hold that pose for as long as I can. Because the body requires a counter pose for optimum results, I repeat the positioning on the opposite side as well. As I am turning in to each pose, I can usually get a resounding crack out of it. So, so satisfying! I reserve these poses for the home front and my living room.

But what if I get into trouble with my stress knot while I'm at the office? Here is my ultimate go-to solution. I have a pink sock from years past in which I have placed a small, flexible rubber ball in the toe. My lucky sock, so to speak! Let's say my knot acts up during a patient appointment, slowly and maliciously finding its way to knocking at my back's door. When my patient leaves, I grab the sock, sling it over my shoulder, and stand against a wall. With a bit of maneuvering, the ball inside the sock becomes positioned so that it is pushing directly against the tension knot. Incredible relief! I have been told this is a form of acupressure. I picture that spastic knot of fibers being flattened. I then do a quick twist to the opposite side, holding the pose. My back will often crack very easily because I have used the ball to manipulate and relieve that tension.

My sock ball is the most effective solution that I can apply immediately. I have received massages where the therapist uses her elbow to apply acupressure to the knot and it is the same principle.

Clinical dental hygiene is demanding physically, and most who have spent their lives practicing will deal with aches and pains in one form or another. Yet my friend Nancy, who sits in front of a computer all day, has the exact same problem, so I know this is not unique to hygienists. An orthopedic physician told me it is just a little bursitis, and all that I am doing is appropriate and therapeutic. I have to believe things would be far worse if I didn't do my yoga twist poses and employ my special sock and ball. Perhaps it's a solution that can work for you.

Onward we go; it is in our hearts' core! RDH

EILEEN MORRISSEY, RDH, MS, is a practicing clinician, speaker, and writer. She is an adjunct dental hygiene faculty member at Burlington County College. Eileen offers CE forums to doctors, hygienists, and their teams. Reach her at [email protected] or 609-259-8008. Visit her website at

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