We use our hands everyday in immeasurable ways to complete a huge range of daily tasks. At the latest Sunnybrook Speaker Series, Within Reach: Common Hand Issues and Helpful Solutions, occupational therapist Tiffany Hsieh discussed ways to keep your hands and wrists safe and functional.
Protect
Using protective strategies can help prevent cuts and fractures, decrease wear and tear on the joints, decrease strain on muscles and tendons and reduce pain. The key is incorporating these suggestions into daily tasks as you do them.
If you have to do tasks that require repetitive movements, your tendons and joints may suffer some trauma, possibly leading to repetitive strain injury. Take frequent breaks, or modify how you are doing a certain task. For example, alternate between various fingers when using a computer mouse. Also try to avoid static holds, such as holding a phone to your ear for prolonged periods of time with one hand. Switch hands, or look for hand-free alternatives.
Avoid putting excessive pressure on your hands and wrists. When using a tool, you should be able to naturally overlap your thumb over your pointer finger. If a tool is too large or small, you’ll have to exert more force to get the job done. There are many foam or plastic devices available that can modify the shape of handles on things like cutlery and tools. Try using levers to do tasks like opening doorknobs, which can reduce the pressure on small muscles in your hands and fingers. Using larger joints is another a good option. For example, when carrying heavy groceries, use your elbow joint and not just your fingers, and split the weight over both sides of your body.
Sometimes doing a task in a new way can help prevent injury. When hammering a nail, why not hold it in place with a clothespin or pliers rather than your fingers? When using a knife, ensure the blade is sharp as that’s easier to control, and work with the blade away from your body. Whatever the task, avoid rushing which can lead to injuries and mistakes. Slowing down can also prevent falls, which are one of the top causes of wrist fractures.
Whenever possible, keep your hands and wrists in a neutral, or natural, position. Angling them too far up, down or sideways can lead to pain and injury over time. Maintaining good posture is key, as there is a close connection between posture and upper extremity function. When using your hands for precision, they will work better if your posture is straight and your shoulders are pulled back.
If you experience pain, don’t ignore it and avoid any activities that cause excessive discomfort. Generally, a task is likely too stressful on your joints and muscles if you still feel pain more than one hour after completing it. Making note of what causes your pain in a journal can be helpful in tracking patterns. If an activity is a trigger for pain, modify those movements, take breaks or allocate them to someone else to do.
Use aids
Local medical supply stores have many device options to help protect your wrists and hands while doing daily tasks. Well-fitting gloves can offer grip and friction, and may also protect your hands from cuts, burns, cold and vibration. If you have arthritis, there are specially designed gloves that offer slight compression and may provide relief from symptoms like pain and swelling.
Hand and wrist braces or splints can provide joint stability, and allow certain joints to rest and recover. It’s important to see a health professional to ensure you wear one that’s right for you.
General management
Exercise is key to maintaining hand mobility and strength. If you have a specific condition, you’ll want to consult with your physiotherapist or occupational therapist to ensure the exercises you do are right for you.
If you feel stiffness in your hands, range of motion exercises may work well for you:
- Finger opposition: Keep your thumb bent and touch each finger to the tip of your thumb. You can add speed to improve your coordination and reverse the order of your fingers as you work through the exercise. Moving forward and then reversing is considered one repetition. Start with 6-8 reps as many times throughout the day.
- Wrist movements: Do as often as you can, reverse the direction after a few rotations and move them up and down. For each movement try 10 repetitions, at least three times a day.
- Hand circuit: Start with your hand straight, then transition into a hook (four fingers curled down and pressed together and the thumb in a neutral position), then make a duck bill, move into a fist and finish with a table top (four fingers pressed into your palm with your thumb out). Start with three to four cycles, rest and repeat. Do this at least three times a day.
- Stretch: The point isn’t to feel pain, but rather to feel tension. Hold each stretch for at least 30 seconds. With the palm down, pull each finger up gently in the opposite position of the way it bends. For your wrist, you can stretch it against the edge of a table. Stretch each area for three to six repetitions as often as you feel you need to during the day.
- Strengthening: If appropriate for you, you can strengthen your fingers by squeezing a small stress ball or rolled up towel to practice your grip. Try squeezing 10 repetitions, hold for three seconds, rest and repeat at least two to three times a day. Pinching putty between your fingers also works. Pinch each finger six to eight times, at least two to three times a day. Or, take an elastic band and wrap it around your fingers and thumb, and then open and close your fingers to push against the tension of the rubber. Try eight to 10 repetitions, rest and repeat at least two to three times a day.
For general management, heat can help relax muscles before movement. Cold can reduce inflammation. For either approach, be sure to wrap the pack in a towel and avoid putting these into direct contact with your skin.
