Joint, Tendon & Nerve Protection Suggestions

• General Suggestions
  • Respect Pain
  • Posture
  • Use Larger, Stronger Muscles
  • Use Ergonomically Designed Tools
  • Use Leverage
  • Plan Activities Ahead
  • Exercise
  • Use of Splints & Braces
• Suggestions for Specific Activities
  • Writing
  • In the Kitchen
  • Housework
  • Miscellaneous Activity
  • Leisure Activity
  • Driving
  • Lifting
  • Self-Care

General Suggestions for Protecting Joints & Tendons from Overuse

Whether you have arthritic joint changes or hand and arm pain from repetitive strain injury, the following general suggestions can be helpful in relieving joint stressors and reducing pain during activity.

Respect pain.

• If an activity hurts, find a way to modify it to take the stress off of your tendons and joints.

Be aware posture when performing activity.

• Posture is fluid, not stiff.
• Your position of good posture is the base from which all other movements flow.
• It’s good for the body to move, but remember to return to your base.

Use the largest, strongest muscle.

• Instead of using a pinch, use a grip (for example, using a key holder)
• Instead of positioning the arm by moving from the wrist, move from the elbow or shoulder.
• Instead of pulling, push with your body weight.
• Instead of lifting objects, slide them if able.
• When lifting, keep the object close to the body and use the strength of the legs.
• Instead of isolating wrist movement, move from the shoulder.

Use the appropriate tool for the job.

• Don’t use the base of your hand as a “hammer”.
• Use power tools whenever possible.
• Keep tools in good shape and, if a cutting tool, keep edges sharpened.
• If you buy items in the larger economy size packages, transfer items into smaller, easier to hold containers.

Avoid awkward or repetitive posture & activity – tight grip, bending, reaching, twisting.

• Use the lightest force necessary for each activity.
• Keep objects you use frequently in an easy reach zone (between hip and eye level and within an arm’s length reach).
• Face objects that you are lifting. Use two hands rather than one. Scoop items with the forearms neutral or palm up.
• Hold objects only as tightly as needed to let you control the object.
• Take frequent breaks.
• Carry items using larger muscles (for example, use the shoulder strap on a purse rather than gripping with the handle).

Use ergonomically designed tools to reduce awkward positioning, repetition, or forceful activity.

• Use pens with a larger grip, hammers or pliers with curved handles that fit in the palm and help position the wrist in a neutral position, or a split keyboard.
• Use pliers to help remove bottle tops or pull plugs from the electrical circuit.
• Look for adaptive aids that help make daily life easier.

Use leverage when possible.

• Use a butter knife to help pop open a tab on a can.
• Modify door knobs to open with leverage rather than with a grip.
• Install sink and bathtub faucets that operate with leverage rather than with grip.

Plan your activities.

• Spread hand intensive activity throughout the day with rests between.
• Spread stressful activity throughout the week. For example, don’t do all the housecleaning on one day, especially if you have been working that day.
• Don’t wait until you are tired or painful to stop and rest.

Exercise

• A fit body tolerates activity better.

Use of splints and braces

• Use splints and braces to provide support to your joints during activities that would typically cause pain.

Suggestions for Specific Activities

Writing

• Use larger, lightweight pens such as the “Dr. Grip” pen. There are many versions now on the market. Choose one that feels comfortable.
• Use the lightest grip possible while holding the pen. Do not bend the thumb tip excessively or hyperextend the index finger tip.
• Try an ergonomic pen that eliminates pinch activity altogether. Or modify writing technique by holding the pen between the index finger and the middle finger.
• Roller ball pens flow easily, but be careful of the ink smearing. Ball point pens require more force for writing.
• Avoid writing through duplicate copies if possible.
• Do not use pens with a smooth barrel – more force is required to grip the pen.
• Keep a neutral wrist during writing activity. Don’t isolate finger movements by planting the wrist down on the table. Movement should come from the larger muscles of the forearm to reduce fatigue.
• Place a binder in your lap as a writing surface to help reduce shoulder tension.
• Use a 3-ring binder with the wider edge by your hand and the narrow edge by the elbow to position the forearm is in a more neutral position and reduce writing stress.
• Take frequent stretch breaks.

In The Kitchen

• Use an electric can opener, especially if you have any thumb pain!
• Use a “jar popper”, a jar opener, or an electric jar opener. Or use rubber disks to help reduce the force of opening jars.
• Use a “tab grabber” or a butter knife to open soda cans.
• Choose silverware that is lightweight and that has comfortable handles to grip.
• Place rubber bands around glasses and and cups to improve traction and reduce the grip strength needed to lift.
• Use kitchen utensils with large and comfortable handles such as the “Good Grips” brand.
• Use a blender or food processor to assist with chopping and slicing.
• Purchase pre-chopped vegetables.
• Use a lightweight electric mixer rather than stirring by hand.
• When you do need to stir, keep the wrist in a neutral position, grasp the spoon as lightly as possible, and use the entire arm to stir.
• Work at lower surfaces such as the table rather than the countertop to reduce shoulder tension.
• Slide pots and pans along the counter (using a potholder underneath).
• When pouring, use two hands with one hand supporting the object underneath. Or use a ladle. Or rest the pot on the side of the sink and tilt it to pour into another container.
• Use non-stick pans to reduce scrubbing activity.
• When opening cabinets, drawers, the refrigerator, etc., slide your fingers through the handles and pull. This distributes the force of the movement through the palm and uses the larger elbow and shoulder muscles. Don’t grip and pull the handles using the fingers.

Housework

• Use self-propelled or easy to push vacuum cleaners.
• Use your whole body to push and pull the vacuum, broom or mop rather than the arm.
• Use cleaning products that “self-clean” to reduce the need to scrub.
• Use battery operated scrubbers and cleaners.
• Avoid wringing movements. Let clothes drip-dry, spin in washer, or wrap with a towel and press down to remove excess moisture. Place sponges or washcloths in the sink and press down on them with the palm of the hand.
• Change hands often or take breaks frequently when using spray bottles for cleaning.

Miscellaneous Activity

• When cutting with scissors, hold the item being cut lower or stand up to prevent awkward wrist movements.
• Use electric scissors, self-opening scissors (loop handle or spring-loaded), or rolling scissors.
• If you need to use a stapler often, use an electric stapler. If you use a stapler infrequently, find a style (such as the vertical hand held stapler) that fits comfortably in the hand and closes easily.
• Use power tools whenever possible instead of manual tools.
• Use a headset or speaker phone if you speak frequently or for long periods of time on the phone.
• When opening doors, push the door open with your shoulder and body weight by leaning into it instead of pushing with the hand.
• If painting, use a roller rather than a brush. Use as light a grip as possible for the activity. Take frequent breaks.
• Use a key-holder to reduce forceful pinch when turning keys.
• Hold the iron lightly. Slide rather than lift. Buy wrinkle-free clothes if possible so you do not need to iron.

Leisure Activity

• Use book holders or weighted book cuffs to hold pages open.
• Rest books or the newspaper flat on a table, pillow or lap desk and hold open with the palm of the hand. Use good posture, especially if reading in bed.
• If knitting or crocheting, take frequent breaks and stretch the thumb out often. If possible, use larger needles or build-up the handles to make them easier to grip. Limit your time to 10-15 minutes.
• Use an electric sewing machine if possible.

Driving

• If on a long trip, take frequent breaks.
• Hold the steering wheel comfortably with only the amount of force needed to drive safely.
• If you are tense while in traffic, make sure you do not squeeze the steering wheel tightly. Listen to calming music. Try some deep breathing.
• The steering wheel should not be slippery or smooth. More traction will allow you to hold the wheel less tightly.
• Minimize steering wheel vibration by keeping your car mechanically sound with the wheels in good alignment and balance tires.
• The arms are more relaxed if you can sit closer to the steering wheel. However, air bag safety encourages a greater distance between your body and the wheel. Find a comfortable distance for you. Do not sit so close that the elbows are bent past 90 degrees.
• Hold the steering wheel at the 4 o’clock and 8 o’clock positions.

Lifting

• Keep objects in close to the body.
• Don’t lift with a straight elbow.
• Use two hands to share the weight.
• Lift with the strength of the legs.
• Slide items if possible.
• Don’t lift with the palm down but support the object from underneath with the palm up.
• Get assistance.

Self-Care

• Use an electric toothbrush or razor.
• Push toothpaste or lotions out of squeeze tubes by placing the tube flat on the counter and using the palm of the hand. Do not squeeze with the fingers
• Transfer items such as shampoo or lotions into pump bottles that can be activated with the palm of the hand. Try to avoid spray bottles that are activated by the finger or modify with an extension.