The discussion

A capable core

OT  speaks to Ten Health & Fitness physiotherapist and pilates instructor, Kendall Scales, about how good posture can help ward off unwanted injury


In a role that requires you to bend, reach, stretch and twist regularly during the eye examination, it is common for optometrists to experience pain or injury during their career, particularly in the lower back and neck.

Many of the aches and niggles that optometrists experience from time to time can be classified as repetitive strain injury. “Repetitive strain is very much a workplace notion that comes from doing something constantly,” physiotherapist and pilates instructor at Ten Health & Fitness, Kendall Scales, told OT.

Injury in the workplace generally stems from a prolonged posture, Ms Scales said, explaining: “If you regularly do something in a position that is not good for your body, it starts to wear down and can eventually cause injury. This is completely normal.”

However, just because this is normal, it does not mean that optometrists have to accept it as a consequence of the vocation they work in. In fact, there are exercises that clinicians can do to help protect their body and prevent injury, Ms Scales highlights.

These exercises can be broken down into two categories: maintenance and core.

If you regularly do something in a position that is not good for your body, it starts to wear down and can eventually cause injury


Maintenance matters

Maintenance exercises are designed to be simple but effective and can be done at a desk throughout the day. They are also designed to keep you moving and promote good posture, with emphasis placed on ensuring a strong, mobile thoracic spine.

A strong mobile thoracic spine is important because it plays a key role in the quality of your posture and good posture can help prevent injury, Ms Scales explained.

“Our spine is the powerhouse for our body, it’s where the lower back stems from, the neck sits on and where our peripherals come from. If we are stiff and stuck, we are not really able to move through our body, so we overload somewhere. This is what can lead to pain and injury,” she said.

The maintenance exercises that Ms Scales recommends include four simple moves: shoulder rolls, spinal rotation, pectoral stretches and pelvis tilts.

She advises people who spend upwards of seven hours a day in a sedentary role to repeat these exercises up to three or four times daily, where time permits, with each cycle taking around 10 minutes to complete.

“Being realistic, not everyone will have the time to repeat these exercises multiple times during the working day, but I would encourage them to complete them at least daily to help them maintain good posture and minimise potential injury,” Ms Scales said.

Core capabilities

Many people working in sedentary roles will become ‘weekend warriors,’ Ms Scales explained, completing high intensity cardio sessions in a bid to counteract their stagnant activity in the week. And while Ms Scales endorses regular exercise, she highlights that cardio sessions such as running or cycling will not bring the same benefits as the maintenance and core exercises that she suggests.

‘Weekend warriors’ should know that having a good core will support them in their cardio exercise, she highlighted.

When it comes to core exercises, Ms Scales recommends adopting a 20-minute routine twice a week that focuses on strengthening the upper and lower back. These exercises include: the thoracic extension towel stretch and “thread the needle” for improved mobility through the upper back; the prone scapular setting to strengthen the back of the shoulders; as well as hip flexor stretches, gluteal bridges, clamshells and side lying leg lifts, which each strengthen the gluteal and offload the lower back, she explained.

Once awareness has been raised, we can look at what good posture is when sitting and standing, as well as how to get it and how to maintain it


Being aware

For Ms Scales, awareness is key when it comes to injury prevention. “Despite moving around to reach for different pieces of equipment during the test, being an optometrist is quite a sedentary job,” she emphasised. “Most people are simply not aware that they have just being largely sitting down for the last three hours,” she said.

As a physiotherapist, when Ms Scales sees a patient for the first time, awareness is the first major bridge that must be crossed. “Once awareness has been raised, we can look at what good posture is when sitting and standing, as well as how to get it and how to maintain it,” she said.

In order to find the ‘perfect’ posture, Ms Scales recommends placing your hands on your hips when sitting and rolling forwards onto your sitting bones and back again – moving your body between full flexion and extension. “Your best posture is when you work out where your half way point is. Then wrap your shoulders back,” she advised.

In order to prevent injury, optometrists should also think about optimising their work space to ensure they maintain regular movement throughout the day.

Flexible standing/sitting desks, which have been appearing in offices recently, could work in the testing room too, Ms Scales highlighted.

“Even though optometrists may have to sit down for particular tests with patients, perhaps the desk that they write notes from could be standing,” she said.

“This means that while they are sitting down for some of the testing and image taking, they can stand up to write notes before and after. This is a really good way to make sure that you are moving,” she added.

A ‘good’ chair is also important, with Ms Scales highlighting that mobile stools work well, much to some people’s surprise.

Explaining why, Ms Scales said: “Stools are fantastic because you are then not slumping through your lumber spine. They give you more mobility. You can also stay more mobile on them as they are easier to push around.”

However, she warns that for those with a weak core that is contributing to poor posture, a stool is not always the right solution. “If you don’t have good core strength you may not be able to hold yourself up properly. You may start the day correct, but with fatigue, holding the correct or prolonged posture will start to drift,” she said.

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