The next ergonomic revolution

Dentistry changed decades ago.Foot care is next.

Dentistry redesigned the treatment environment around the practitioner, bringing the patient into a better working position instead of asking the dentist to keep adapting their body.

A dentist in the mid twentieth century standing and bending forward over a patient who is lying back in a dental chair, adapting his own body to reach the patient's mouth. A dental practitioner sitting upright on a stool beside a modern dental chair, with the patient reclined and brought up to her working height. A foot care specialist sitting upright on a stool with her knees under the raised footplate of an Orthostand, examining the loaded foot of a client who stands on the lift holding the handrail.

Before 1958: the dentist stands, bent forward over the patient.

Dentistry today: the dentist sits, with the legs under the patient.

The client stands on the lift. You sit, with your legs under the work.

Dentistry moved the patient.
Foot care still moves the practitioner.

How dentistry changed

Legs under the patient. That is what changed dentistry.

In 1958 a dental chair was shaped so that the seated dentist's legs fit underneath the patient. Within a generation the whole profession sat down. The Orthostand is built on exactly the same idea.

  1. A mid twentieth century dentist standing and bending forward over his patient.
    Before 1958

    The standing dentist

    The chair leaves no room for a seated dentist's legs. So the dentist stands beside it all day, bent forward and twisted to one side, over a patient who cannot be moved.

  2. 1958
    The turning point

    The legs go under the patient

    In Iowa, inventor John Naughton starts selling a contour chair with a break in the backrest. The patient lies back and the mouth comes to rest above the dentist's lap. The dentist sits on a stool and slides the legs under the patient. By the late 1970s this is the standard worldwide.

  3. A specialist bent forward on a stool, reaching down to the foot of a client standing on the floor.
    Foot care so far

    Half the answer

    Treatment chairs raise the foot, but only unloaded, with the client sitting or lying. To measure or treat the loaded foot, the client stands on the floor. You kneel on one or both knees, bent forward, or improvise your own floor acrobatics. Half the treatment still happens at floor level.

  4. A client standing on the raised Orthostand lift while the specialist sits upright with his knees under the footplate.
    Today

    The client stands, you sit

    The Orthostand was developed on the dentist's principle. The motorised lift raises the standing client, safely and steadily. You stay seated on your stool with your legs fully under the work, just like working at a desk. And if the client needs to sit, that happens on the same lift.

Why legs under the work changes everything

  • Lower backYou sit close without leaning forward. The pelvis stays neutral, the lower back keeps its natural S-curve and the pressure on the discs drops.
  • NeckThe foot moves into your natural line of sight. The neck no longer has to bend as far, so head and shoulder muscles can relax.
  • KneesYour legs rest under the footplate at a relaxed angle. No more twisted, asymmetric knee positions, and no more kneeling in front of the client.

Sources: Pacific Dental Museum, DrBicuspid, UAB School of Dentistry.

Before we get to the science

Is this you?

You stretch your back between clients without thinking about it. You kneel without deciding to kneel, because it is just how you reach the foot. And somewhere along the way you told yourself it comes with the job.

Almost every specialist recognises this. Almost none of them call it a problem.

The ergonomic change

It's not the work. It's your workstation.

In foot care, a significant part of every day is spent forward-bent and still, low to the ground. The effort isn't the problem, the stillness is. Here's what it does, and why it's worth changing.

Left: a specialist bent forward and kneeling to reach a standing client's feet, spine curved under strain. Right: the same specialist sitting fully upright while the client is raised on the Orthostand.
The physical toll

Where static strain adds up.

  • A specialist kneeling and bent forward over a standing client's foot, with the neck highlighted as a point of strain
  • A specialist kneeling and bent forward over a standing client's foot, with the shoulder highlighted as a point of strain
  • A specialist kneeling and bent forward over a standing client's foot, with the lower back highlighted as a point of strain
  • A specialist kneeling and bent forward over a standing client's foot, with the rear knee highlighted as a point of strain

    04 Knees Kneeling adds direct pressure while the body continues to lean and work around the joint.

    The rear knee, in detail

    When you work with one knee on the ground and the other leg forward, the rear knee bears nearly twice the load:

    1. Weight. Your bodyweight travels straight down through the femur into the knee joint, creating significant load on one knee.
    2. Compression force. The kneecap, bursa and soft tissues of the rear knee are crushed between bone and hard floor, this is why kneeling bursitis is endemic in foot-care work.
    3. Shear force. The forward lean over the patient's foot turns the knee into a pivot point, pushing and pulling the joint internally. Cartilage and meniscus absorb it day after day, wearing down faster.

    Over the years this cumulative load damages cartilage, menisci and the bursa, leading to osteoarthritis, bursitis and chronic knee complaints.

    Side view of a kneeling leg with the bones drawn in, showing three arrows at the rear knee: bodyweight pressing down through the thigh bone, compression force pushing the joint against the floor, and shear force pulling the joint sideways.
Static strain

The effort isn't the problem.The stillness is.

Holding the same working posture keeps the same muscles active for extended periods, with fewer opportunities to relax and recover.

45%

of reported injuries occurred within the first five years of practice.

Williams et al., Journal of Foot and Ankle Research, 2017.

The alternative

Move the work.Not your body.

Traditional foot and lower-limb care asks the practitioner to move down to the work. But the relationship can be reversed.

The solution

One workstation.No more floor acrobatics.

The Orthostand M30 raises the client, seated or standing, to the height where you work best.

The Orthostand M30 height-adjustable workstation, seen from the front with the seat mounted above the wooden platform
Ergonomic Database Explore the research behind the problem. Explore