Joint Protection of the Hands

Romina Astifidis MS, PT, CHTCurtis National Hand Center at Lutherville

410-823-4263Romina.Astifidis@medstar.net

Goals

• Review basic joint protection techniques• Provide helpful hints

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

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

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

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

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

Joint Protection Principles

• Splinting Purpose– Rest– Position– Immobilize

• Splint types– Thermoplastic– Hybrid– Silver Ring

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

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

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

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

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

Helpful Hints- Websites

• www.pattersonmedical.com• www.AliMed.com• www.lifesolutionsplus.com• www.arthritis.org• www.ncmedical.com• Ebay• Amazon