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The Core of Ergonomic Practice

Practicing Pilates to develop and maintain strong core muscles.

The work of dental hygienists contributes to an identifiable pattern of musculoskeletal strain.1 Unsupported postures, repetitive motion, excessive movements, and poor workplace design are just a few of the contributing factors to ergonomic injuries in the profession.2 Maintaining the body’s neutral position is the key to preserving musculoskeletal health. Achieving this neutral position requires the practitioner to develop and maintain strong core muscles. The neutral torso position is based on evenly balancing the practitioner’s weight on the chair seat with elbows close to the sides of the body and no less then 20° away from the body.

The practice of Pilates is an effective strategy for strengthening those important core muscles.


Joseph Pilates, a nurse and physical trainer, developed Pilates in the 1920s.4 Initially designed as a system of rehabilitation, Joseph Pilates’ first clients were dancers and soldiers who were returning home from the battlefields of World War I.

The method of Pilates exercise can help develop core control in addition to flexibility, agility, and economy of motion. Pilates practice today includes using resistance devices while performing the exercises to substantially increase the workload. This resistance works multiple muscle groups simultaneously and thus provides a more efficient workout than commercial weight lifting equipment. Pilates also restricts adverse movement at the joints, making exercise safer and smoother.

Joseph Pilates originally called Pilates exercise “controlology.” His body/mind/spirit approach to movement was founded on integrative principles such as centering, concentration, control, precision, breath, and flow.5 These principles help practitioners maintain a neutral, balanced posture throughout their daily routines.


Mobility exercises that target weaker muscle groups are essential to improving body alignment during dental hygiene practice.2 Practitioners need to focus on exercises that focus on core stability. Core stability or core strength is the balanced development of the deep and superficial muscles that stabilize, align, and move the trunk of the body, especially the abdominals and muscles of the back. Core strength goes beyond the surface muscles to use deep internal muscles to maintain stability while the body is in motion. Abdominal muscles are the front part of the torso. The major muscle groups that compose the abdomen are the transverses abdominis, rectus abdominis, external obliques, and internal obliques.6


Pilates exercises emphasize the strengthening of the core. In Pilates, the abdominals are pulled in or scooped and balanced throughout the length and width of the spine. Proper breathing is an essential element of Pilates exercise. Ribs expand sideways and the breath moves all the way down into the lower abdominals for maximum lung capacity.

The warm up to Pilates exercise begins with imprinting the pelvis and letting the spine anchor to the mat while the ribcage is relaxed down into the floor. This classic “roll up” exercise uses breathing and fluidity while the upper body curls forward with a scoop of the abdominals (or navel to spine) and arms reaching forward parallel along the length of the legs (see Figures 1-4).

The exercise is continued by inhaling with a deep pull in of the lower abdominals to roll back down and then exhaling to complete the roll down one vertebra at a time.5

An exercise regimen of eight to 10 Pilates mat exercises performed diligently each day can help improve the musculoskeletal health of dental hygienists. The key to performing Pilates exercises effectively is to do the exercises correctly. Pilates requires a rethinking of exercise and taking note of the simplicity of just breathing and keeping the movement fluid, which allows for control over the movement. Each exercise needs to be infused with intention and fullness of expression. Each exercise should be mastered before moving on to a new one. As Joseph Pilates noted, “It is better to perform fewer repetitions correctly than to perform dozens the wrong way.”5

The practice of Pilates and its body/mind/spirit approach are well-suited for dental hygienists whose work can be challenging both mentally and physically. When beginning any new exercise routine, a consultation with a physician is advised. The United States Pilates Association provides a search engine on its website at www.united states pilates associa to help locate certified instructors by state.


  1. Pollack-Simon R. All the Right Moves. Tulsa, Okla: Penn Well; 2002.
  2. Murphy DC. Ergonomics and the Dental Care Worker. 1st ed. Washington, DC: American Public Health Association; 1998.
  3. Dylla J, Forrest J. Stretching and strengthening for balance and stability: part III. Access. 2007;5:37-42.
  4. Who Was Joseph Pilates? United States Pilates Association. Available at: Accessed December 16, 2009.
  5. Pilates JH, Miller WJ. Pilates’ return to life through controlology. Paper presented at: Presentation Dynamics; Incline Village, Nev: 1998.
  6. Jarmey C. The Concise Book of Muscles. 2nd ed. Chichester, UK: Lotus; 2008.

From Dimensions of Dental Hygiene. January 2010; 8(1): 36-37.

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