Joint Protection of the Hands

1. Joint Protection of the Hands RominaAstifidis MS, PT, CHT Curtis National Hand Center at Lutherville 410-823-4263 Romina.Astifidis@medstar.net

2. Goals • Review basic joint protection techniques • Provide helpful hints

3. Basic Anatomy • Hands and wrists rely almost exclusively on ligaments to maintain stability • Loose ligaments allow joints to sublux/dislocate which will cause weakness and pain and further injure the tissues • Cannot strengthen these joints to prevent problems

4. Joint Protection Principles • Respect pain • Pain is body’s method of letting you know that damage may be occurring • Signs of pain include fatigue, weakness, stiffness, swelling, aching at night • Pain is good guideline that you are doing too much and need to take a break • Pain may occur after and not during the activity

5. Joint Protection Principles • Avoid tight, excessive and/or prolonged grip or pinch • Avoid using more force than is actually needed • Choose tools that decrease need for tight grip or pinch • Choose whole hand grip instead of pinch whenever possible • Choose tools that fit your hand • Choose tools that minimize grip needed

6. Joint Protection Principles • Use two hands, larger joints and muscles whenever possible • Avoid carrying heavy items • Lift objects with both hands close to body • Push objects using weight of body rather than pulling with your fingers • Carry objects using back to shoulders to distribute the weight

7. Joint Protection Principles • Balance rest and activity • Organize activities to reduce work efforts • Use splints or other devices to rest joints when there is a flare-up • Prioritize activities based on the amount of energy or pain you have • Break down tasks into manageable segments, resting or changing activities as needed

8. Joint Protection Principles • Splinting Purpose • Rest • Position • Immobilize • Splint types • Thermoplastic • Hybrid • Silver Ring

9. Helpful Hints Cooking • Use electric whenever possible for opening cans or jars, mixing, blending, chopping • Use built up kitchen tools • Use paper towels to avoid having to wring; or press sponge with palm rather than squeezing • Use an ‘L’ shaped knife or pizza cutting wheel • Put dycem or wet dishrag under bowls when stirring • Drag pots filled with liquid to sink or stove. Use extensible kitchen faucet to fill pots • Use stainless steel colander in pots to avoid having to tip out liquid • Buy lightweight pots/containers • Use spring loaded scissors to cut open bags or to cut food • Use ‘zipper’ style baggies • Buy reusable containers that are easy to open/close • Buy food pre-chopped or use a spiked cutting board • Use large well sharpened knives and the right knife for the job • Use oven mitts to help you carry heavy pots/pans with 2 hands • Use tongs to lift foods instead of forks • Put groceries in paper bags for 2 hand carry, or in reusable bags for carrying over shoulder or pack light and carry over forearms • Use plastic cups and plates

12. Helpful Hints- Dressing/hygiene • Use pump soap/shampoo/toothpaste to avoid pinching • Use elastic shoelaces with shoehorn to limit tight pinch • Buy a brush with a big handle or build up handle and a travel sized hair dryer • Use ergonomic/modified nail clippers and tweezers that use hand vs fingers • Leave shirts partially buttoned when washing to avoid having to re-button • Use a button/zipper aid to limit painful pinch • Use electric toothbrush

14. Helpful Hints- Work • Use large pens with good easy glide ink, or build up pens with foam • Use scissors to open packages • Use light touch keyboards and alternate mouse types to avoid pressure in one area • Use templates for frequently used documentation • Use a head set to talk on phone and use voice activated features/software as much as possible • Carry equipment on carts or backpacks • Use book stands to hold material open for reading

15. Helpful Hints-Home/Yard • Use body to help push vacuum • Use ergonomic garden tools- add handles to rakes/brooms for ergonomic 2 handed grasp • Throw laundry down in bag and bring up in smaller hamper or backpack • Switch to lever door handles • Use travel iron to decrease weight

17. Helpful Hints- Driving • Add textured wheel cover to steering wheel to increase diameter and allow better grip • Use key adaptor • Pull seatbelt from bottom or attach loop to make easier to pull • Use 2 hands to change gears or behind wheel shifter • Use pliers or other tools open and close gas cap

19. Helpful Hints- Websites • www.pattersonmedical.com • www.AliMed.com • www.lifesolutionsplus.com • www.arthritis.org • www.ncmedical.com • Ebay • Amazon