Following is a discussion on joint protection techniques that you can apply to specific, highly deforming tasks. Tasks are grouped into three tables, according to the type of arthritic deformity they accentuate. Several joint protection alternatives are given for a particular task. Choose a technique which is easier for you to apply. The use of assistive devices is highly recommended. Aside from protecting involved joints, assistive devices help improve the function of hands with limited strength and movement.

     Do not wait until your symptoms get worse. By following these guidelines immediately and making them part of your daily lifestyle, you can prevent advancement of your joint pain and deformities. Consistency of implementation is the key to long term symptom management.

   
   
 
                        Quick Links: Activities List for Table 1



                      Self Care: Brushing teeth
                                     Bathing/washing hair and face
                                     Drying and brushing hair
                                     Shaving
                                     Manipulating undergarment (bra) fasteners

                         Dining: Using spoon and fork
                                    Pouring from kettle or pitcher
                                    Drinking from a glass or cup

        Other Daily Tasks: Turning faucet on
                                    Wiping or cleaning tasks
                                    Pushing a grocery cart
                                   
Driving, holding a steering wheel

 
 
 
                                         TABLE 1: Activities which aggravate the
                                            Radial Deviation Deformity
                                                         of the wrist.


The following activities accentuate side to side movements of the
wrist particularly towards the thumb side. This can aggravate the
radial deviation deformity which is common to arthritic wrists.
Activities Joint Protection Techniques Assistive Device Recommendation

Self- Care Tasks:

1. Brushing your teeth.

 

Technique 1: Keep your wrist straight when holding the toothbrush. Avoid isolated wrist movements by using forearm and elbow movements when brushing your teeth.  

Technique 2: Make the handle of your toothbrush bigger by using cylindrical foam inserts.

Technique 3:  Using an electric toothbrush is highly recommended because it eliminates the need for repetitive wrist movements. These devices have a wider handle and would require less pressure on the finger joints on prolonged grasping.


 

1. Cylindrical foam insert for regular toothbrush handle.
2. Electric toothbrush.

2. Bathing, washing hair and face.
Technique 1: Keep your wrist straight when holding the sponge or soap. Avoid isolated wrist movements by using combined elbow and shoulder movements when scrubbing.

Technique 2: Use a strap-on bath mitt or a glove bath mitt to avoid prolonged resistive grasping with your fingers. The pressure of the scrubbing motion should be placed on the more stable palm instead of the fingers.

1. Bath Mitt (glove).
2. Terry Cloth Wash Mitts (glove with soap pocket).
3. Sponge Wash Mitt (glove).
3. Drying and brushing hair.
Technique 1: Keep your wrist straight when holding the hair brush or electric hair dryer. Avoid isolated wrist movements by using combined elbow and shoulder movements when using the hair brush or dryer.

Technique 2: Make the handle of your hair brush bigger by using cylindrical foam inserts.

1. Cylindrical foam insert for regular hair brush handle.
2. Hands free hair dryer.
4. Shaving.
Technique 1: Keep your wrist straight when holding the razor. Avoid isolated wrist movements by using combined shoulder and elbow movements when shaving.

Technique 2: Use a shaving gel to soften hair and minimize force of grip when shaving.

Technique 3:  Make the handle of your razor bigger by using cylindrical foam inserts.

Technique 4:  Using an electric razor is highly recommended because it eliminates the need for repetitive wrist movements. Electric razors have a wider handle and would require less pressure on the finger joints on prolonged grasping.

1. Cylindrical foam insert for regular razor handle.
2. Electric Razor.
3. Universal electric razor holder.
5. Manipulating undergarment (bra) fasteners.
Technique 1: Avoid reaching towards your back to hook or unhook undergarment (bra) fasteners. This would require extreme wrist radial deviation positioning. Hook the fasteners in front and then rotate to backside afterwards.

Technique 2: Keep your wrists straight and avoid side to side swaying of the wrists while manipulating bra fasteners.

Technique 3:  Use bras that come with front hooks.

Bras with large, front hooks.
Dining:

1. Using spoon and fork.

 

Technique 1: Keep your wrist straight when holding the spoon and fork. Avoid isolated wrist movements by using gross movements of the elbow and forearm when eating. Avoid the tendency to sway your wrist towards the thumb side as you place food in your mouth.

Technique 2: Make the handle of a regular spoon and fork bigger by using cylindrical foam inserts.

Technique 3: Use assistive devices such as curved utensils.

 

1. Cylindrical foam inserts for regular spoon and fork handles.
2. Feeding utensils with built up handles.
3.Curved feeding utensils.

2. Pouring from kettle or pitcher.
 
Technique 1: Keep your wrist and fingers straight when gripping on the handle of the pitcher or kettle. This can be done by positioning the spout on the side and not in front of the carrying hand. Avoid isolated wrist movements by using rotating forearm movements when pouring from the pitcher.

Technique 2: Do not fill the pitcher completely to avoid lifting heavy weight.

Technique 3: Instead of completely lifting the pitcher, rest it close to the edge of the table on a non slip mat and tilt it slowly. Let the table carry its weight.

Technique 4: Avoid using glass or steel pitchers that are already heavy in the first place. Use plastic pitchers that are lighter, and with wide round handles. (offer product listing).
Technique 5:  Use assistive devices such as a pitcher or kettle tipper.

1. Kettle/Pot Tipper.
2. Oxo Pitcher.
3. Dicem non-slip mat.
3. Drinking from a glass or cup.
Technique 1: Keep your wrist straight by holding the glass or cup on the side and not in front.

Technique 2: Avoid isolated wrist movements by using gross movements of the elbow and shoulder when bringing the glass up to your mouth when drinking.

Technique 3: Use glasses or cups that are lightweight.

Technique 4: Use drinking straws to free hand use.

1. Clear Caring Mug/Two Handle Snorkel Cup.
2. Sip-Tip Drinking Cup.
3. One-way straws.
4. Reusable Drinking Straws.
5. Drinking Straw Holder.
Household Tasks:

1. Turning faucet on.

 

Technique 1: Hold the faucet knob with your thumb and the side of the index finger. While keeping your wrist straight use gross movements of the elbows and shoulder to turn the faucet on.

Technique 2:  Do not over tighten faucet knobs to avoid using excessive grip pressure when using the faucet.
 
Technique 3:  Replace old faucet fixtures as they require more grip pressure to operate.

Technique 4:  Use lever type faucet handles instead of regular faucet knobs. This way you can protect the weaker finger joints by avoiding pinching and twisting movements. You can operate faucet lever handles by pushing them with your stronger palm instead.

Technique 5: Use an assistive device such as an automatic faucet control or grip devices such as the Uni-turner, to avoid resistive pinching and twisting of the fingers by using a more stable grip instead.

 

1.  Automatic Faucet Control.
2. Uni-turner grip assist.
3. Good Grips - Attachable faucet knob levers.
4. Lever type faucet fixtures.
5. Automatic infrared faucet fixtures.

2. Cleaning tasks such as dish washing, wiping or cleaning countertops or tables.
 
Technique 1: Press your palm on the wash cloth instead of gripping it forcefully with your fingers. When wiping, avoid isolated wrist movements by keeping your wrist straight and using combined movements of the elbow and shoulder. To avoid movement on the wrist, tense your forearm to make the wrist more stable.

Technique 2:  Pre-soak countertop surfaces or dishes with warm water and detergent for easier wiping or cleaning.

Technique 3: Avoid wringing towels with your hands. Twisting movements like this can be highly deforming to your wrist and finger joints. Instead of using regular cleaning towels, use sponges which can be rinsed easily by pressing them against your palm.

Technique 4: Use automated equipment such as a dishwasher as much as possible.

1. Sponge wash mitt.
2. Dishwasher.
3. Pushing a grocery cart.
Technique 1: Choose a grocery cart that easily rolls and have well functioning wheels.

Technique 2: Keep your wrist straight when grasping the handles of the grocery cart.

Technique 3: When holding the cart handle, do not position your hands too far apart which can accentuate the radial deviation deformity of the wrist. Keep your elbows close to the side of your body. This will help keep your wrist straight and properly aligned to your forearm.

Technique 4: Or, straddle the sides of the cart with your forearms and push the cart handle with your torso, taking off the pressure on your wrists.

None
4. Driving, holding the steering wheel
Technique 1: Keep your wrist straight when grasping the steering wheel. Avoid isolated wrist movements when turning by using gross movements of the elbow and shoulder.

Technique 2: When turning the steering wheel, make sure car is moving (not on dead stop). This makes the steering wheel turn lighter.

Technique 3:  Steering wheels that are thicker and well padded are more "joint friendly".

Technique 4: Use cars with power steering.

Steering wheel pads/covers (available at auto accessory shops).
 
   
  >> Back to Activities List for Table I
  Note: At this point, you can begin to understand that certain activities involve movement components that accentuate deformity patterns associated with arthritis. Through repetitive stress these joints can easily give way to these deforming movements. On the next page I will discuss alternate ways of doing tasks which accentuate the ulnar deviation deformity of the knuckles. >>next page
   

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