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.
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.
A treatment takes fifteen, twenty minutes. Multiply that by a full day of clients, a working week, a career, and most of your professional life is spent holding one position, low to the ground.
Your muscles do not mind hard work. They mind holding still. A muscle that alternates between contracting and relaxing keeps its own blood supply moving. A muscle that holds one position does not.
Motor units take turns
The same fibres fire continuously
Blood flows with the rhythm
Sustained tension compresses the vessels
Heart rate rises with the effort
Heart rate stays low
Oxygen keeps pace with demand
Delivery stays limited
Waste clears between contractions
Waste accumulates and stays
The result is micro-damage in muscle tissue that never fully repairs. That is the starting point of every musculoskeletal disorder in this profession.
Notice the head, too: to keep the working area in view, the neck is forced far forward and down, an unnatural position relative to the client, held still for the length of every treatment.
A Danish study followed 944 workers for four years, measuring their posture with accelerometers and their sick leave through the national register. Every five extra minutes per day spent bent forward beyond 30 degrees was associated with a 4% higher risk of long-term sick leave. Beyond 60 degrees, 8%.
Those workers averaged 40 minutes a day bent forward. Foot care is not an average job.
Gupta N et al. Does occupational forward bending of the back increase long-term sickness absence risk? Scandinavian Journal of Work, Environment & Health, 2023.
"Static strain is a silent killer. The damage builds slowly and unnoticed.", Hanneke Knibbe, IZZ / ZZP Magazine De Zorg
The largest study of its kind surveyed 948 podiatrists across Australia, New Zealand and the United Kingdom. The findings are hard to read as anything other than a warning.
The second figure is the one that matters most. Nearly half of all injuries happen in the first five years, not at the end of a long career. Three quarters of those affected changed how they work as a result, while only 58% told a manager or colleague. The rest adapted quietly, and carried on.
Williams CM, Penkala S, Smith P, Haines T, Bowles KA. Exploring musculoskeletal injuries in the podiatry profession: an international cross-sectional study. Journal of Foot and Ankle Research, 2017.
Qualified staff are scarce, and the ones you train are the ones most at risk in their first five years. Practices that take ergonomics seriously report higher staff satisfaction and an easier time attracting new people in a market where qualified personnel are hard to find.
Read what practitioners sayThe posture is the problem. So change the posture, not the person.
Everything on this page follows from one thing: the work sits at floor level and you go down to meet it. Reverse that, and the mechanism has nothing to act on. No sustained forward lean. No kneeling. No holding still at the edge of your reach.
A German study measured the postures of twelve nurses during standard care routines. Working standing over a low bed, they spent 87% of the time bent forward. Raising the work to hip height and working seated significantly increased the time spent upright, and the more time they spent upright, the less strenuous they rated the work.
The researchers' conclusion: adjustable working heights and seating let care staff spend considerably more of their time in an ergonomic posture.
Freitag S, Ellegast R, Dulon M, Nienhaus A. The Effect of Working Position on Trunk Posture and Exertion for Routine Nursing Tasks. Annals of Work Exposures and Health, 2014.
There's no obligation, only an open invitation to consider a better way of working.
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