Stop twisting your spine: Clock positions every clinician should know

Have you ever found yourself working on a patient, only to realize you probably look like a pretzel? If you’re not careful, you end up twisting into all sorts of awkward positions when you provide care. These are often the cause of much of dental hygienists’ pain, fatigue, and even injury. With just a little ergonomic know-how, you can untwist yourself, become much more comfortable chairside, and protect your body for the long term.

Which clock position is best?

This can be a hot topic depending on who you ask, but studies have indicated there are certain clock positions that are better than others, which is the focus of this article. I’ll share my recommendations, and you can also view them in action in my video.

The priority position

The clock position to prioritize is the 11 to 1 o’clock position, which allows you to be behind the patient. I know this is where I’m most comfortable when I’m practicing, and I can be in a neutral posture much of the time. When you’re behind the patient, there is minimal reaching and twisting, and your arms are more balanced with minimal abduction (referred to as the chicken wing position).

In fact, research has shown that this is where someone has the least amount of muscle activity, which is exactly what you want. You don’t want your muscles to work any harder than they have to, and practicing from behind the patient allows for this.

Can you do everything from behind the patient? No, but you likely can do more than you’re doing now. Getting used to practicing in this position will pay dividends on your energy and pain levels.

The side clock positions

Next up is working from the side, in the 9 or 3 o’clock positions. These are acceptable and necessary, but there is one rule to follow—always be sure you’re squared-up. What I mean by this is your head, shoulders, hips, legs, and feet should all be pointed in the same direction, in this case, toward the patient. An ideal stool position will allow you to be in this position, which my video demonstrates.

Last on our list is the 7 or 5 o’clock side sitting position. This typically looks like your legs pointed up toward the head of the patient, while your trunk is twisting toward the patient. This position is very taxing on the musculoskeletal system and causes muscles to contort and strain. However, I occasionally find myself in this scenario in order to access a specific area. Sometimes we just do what we need to do!

Dental hygienists won’t always be perfect, but we must be aware. If you find yourself in this situation, recognize you’re in a dangerous position, do what you need to, then get back into a safer clock position.

I have an 80/20 rule. Try to be as “perfect” as you can about 80% of the time so that when you need to “break neutral” the other 20%, you have a little gas in your tank since you’ve been ergonomically good most of the time.

Practicing dentistry is not easy physically, but little ergonomic tweaks here and there make a big difference. Learn what all you can do from behind the patient, I think you’ll be surprised!