Quick Links: Activities List for Table 2



                                  Self Care: Holding small handles

                          Kitchen Tasks: Cutting food with knife
                                                 Using a can opener
                                                 Opening jars or bottle caps
                                                 Stirring food with ladle

                     Household Tasks: Turning door knobs
                                                Carrying grocery bags
                                                Carrying bags/luggage
                                                Using pair of scissors

                         Leisure Tasks: Reading a book
                                                Holding a phone
                                                Gardening

 
 
 
            
                          TABLE 2: Activities which aggravate the
                                                 Ulnar Drift Deformity
                                                      of the fingers


The following activities accentuate the swaying of the index,
middle, ring, and small fingers towards the small finger side (ulnar drift).
This side swaying deformity occurs on knuckles that are affected
by arthritis frequently seen on the index and middle fingers.
Activities Joint Protection Techniques Assistive Device Recommendation

Self- Care Tasks:

Holding small handles of items such as spoon, fork or toothbrush.

Reminder: Holding smaller handles require more pressure on the finger joints than holding bigger, wider handles. Try to see how your finger joints feel making a closed fist as opposed to a partially open fist (as if holding a bigger handle). The finger joints feel more relaxed if not bent completely.

 

Technique 1: Make the handles of frequently used items such as a spoon, fork or toothbrush bigger by using cylindrical foam inserts.  

Technique 2: Avoid swaying your fingers to the side and keep them straight and properly aligned with the wrist when gripping these items. Position the end side of these items consistently on the side of the hand and forearm (instead of in front) when using them to avoid the side swaying of the wrist and fingers.


 

1. Spoon and fork with built up handle.
2. Cylindrical foam inserts.

Kitchen Tasks:

1. Cutting food with knife.

 

Technique 1: You can keep your wrist and fingers straight when using a knife by learning how to cut sideways. If you are using your right hand this would mean that the blade of the knife would be sticking out towards the left side or thumb side. Position the food on the left side of your right hand and not in front. Use side to side movements of the elbow and forearm for the cutting motion (instead of front- back movements).

Technique 2: Use sharp knives to minimize force of cutting.

Technique 3: Use automated appliances such as an electric knife, food processor, or blender for prolonged cutting tasks.

Technique 4: Use pre-cut food items for cooking to minimize manual work.

Technique 5: Use cooking methods that make food items softer such as braising or stewing.

Technique 6: Use right angle knives that maintain proper alignment of your wrist and fingers when cutting. Holding the handles of regular knives accentuate the side swaying of the fingers.

 

1. Right angle knives.
2. Rocker knives.
3. Electric knives.**
4. Food Processor.
5. Blender.
6. The chopper.**

2. Using a can opener.
Technique 1: It is best to use an electric can opener to prevent placing pressure on finger joints.

Technique 2: When using a manual can opener, make sure it is efficient. It should be sharp, easy to twist and with large wide knobs or handles.

Technique 3: Do not twist the can opener using isolated finger movements. Hold the can opener knob with your thumb and side of the index finger and use rotating forearm movements while keeping your wrist straight.

1. Electric can opener.
2. OXO can opener (manual.***
3. Opening jars or bottle caps.
Technique 1: When opening a pressurized food jar for the first time, lift off the edge or lip of the cap by using a bottle cap opener to release the pressure inside the jar. It is easier to twist the cap open once the pressure inside the jar has been released.

Technique 2: Instead of using your fingers, place your palm on the cap, press and twist it open using shoulder and forearm movements while keeping your wrist straight.

Technique 3:  Do not over tighten bottle caps to make it easier to re-open them.

Technique 4:  Use an assistive jar opener which allows you to push a lever with your palm thereby protecting your finger joints.

1. Jar pressure release.
2. Jar Opener.
3. OXO Products.***
4. Stirring food with ladle.
Technique 1: Hold the ladle with its end out on the small finger side (instead of thumb side). While keeping your wrist straight, use gross movements of the elbow and shoulder when stirring food.

Technique 2: Use cooking ladles with large wide handles. You can make their handles bigger by using cylindrical foam inserts.

Technique 3:  Use right angle cooking utensils (spatula, turners)which help maintain proper alignment of the fingers, wrist and forearm when cooking.

1. Right angle utensils.
2. Cylindrical foam inserts for handles of regular cooking ladles/utensils.
Household Tasks:

1. Turning door knobs.

 

Technique 1: Hold the door knob from the side and not from the front so you can keep your wrist and fingers straight. Turn the door knob by pushing your forearm and elbow down. This way you can avoid twisting movements of the wrist and fingers. Use the palm of your other hand to pull or push the door open.

Technique 2: Use lever type instead of regular round door knobs. By pushing the lever down with your palm you can prevent twisting movements of the wrist and fingers.

Technique 3: Avoid using heavy gauge doors in your house since they are heavy and require more force to open.

 

Attachable door knob levers.

2. Carrying grocery bags.
Technique 1: Use multiple grocery bags to distribute load.

Technique 2: Do not carry grocery bags using your fingers. Instead sling the bags on your stronger palm or forearm.

Technique 3: Do not carry all your grocery bags at one time. Make multiple trips to unload them from your car if necessary.

Technique 4: Use a utility cart to avoid carrying at long distances.

Technique 5: Use assistive handles. They are designed to hook on to plastic grocery bags providing a wide, sturdy handle for grip. Carrying straps allow you to use your stronger shoulder instead.

1. Grip it Multi-Purpose Tool.
2. Carrying Strap.
3. Utility Carts.
3. Carrying bags/ luggage.
Technique 1: Use bags with shoulder straps to minimize carrying with your hand and fingers. Back packs are very convenient to use.

Technique 2: Sling bag handles on your forearm to protect your hands and fingers.

Technique 3: Use bags with roller casters.

Technique 4: Break the habit of overloading your bag with personal items. Lighten up the load by bringing only the absolute necessities.

Technique 5: If you have no other choice but to use the grip handle on your bag, build up the handle by using a wrap around padded support.

1. Roller bags
2. Back packs
3. Wrap around handle pads.
4. Bag dolleys?
****Carry bags/accessories?
4. Using a pair of scissors.

Technique 1: Use spring loaded or self-opening scissors to decrease amount of work on your fingers. Choose a handle which is wide enough to accommodate all fingers.

Technique 2:  Avoid bending your wrist and fingers down to the side when using the scissors. Keep your wrist and fingers straight and properly aligned. It helps to position the materials to be cut at the side of the hand/forearm, instead of in front, to avoid the downward swaying of the wrist and fingers.
 
Technique 3:  Use scissors that are efficient. Keep them sharp and well oiled. Scissor sharpeners are easy to use and make cutting a lot easier.

Technique 4:  Cut materials one at a time. Avoid lumping them together to minimize force of cutting.

1. Self-opening scissors.
2. Scissor sharpener.

Leisure Tasks:

1. Reading a book.

 

Technique 1: Instead of grasping the book with your fingers, rest the book on your palms while keeping your wrist and fingers straight.

Technique 2:  Rest the book on a table. Improve the reading angle by placing items under the top end of the book.

Technique 3: Use a portable book stand for prolonged reading tasks or when using heavy books. Using a book stand will also correct your neck and shoulder posture.

 

1. Portable book holders.
2. Book clip light.***

2. Holding a phone.
Technique 1: Keep your fingers straight and hold the phone by cupping it on your palm.

Technique 2: Use phones with a speaker phone feature to avoid grasping the phone handle for long periods.

Technique 3: Use assistive devices such as telephone headset or a phone stand for hands-free use.

1. Phone holder/stand.
2. Phone Flipper.
3. Telephone Headset.***
3. Gardening.
Technique 1: When using regular garden tools, keep your wrist and finger straight by holding the tools end-side down.

Technique 2: Avoid isolated wrist movements by using gross movements of the shoulders and elbows when working with garden tools while keeping your wrist straight.

Technique 3:  Using right angled garden tools is highly recommended as it allows proper alignment of the forearm, wrist and fingers.

Technique 4: Avoid kneeling on hard surfaces. Use padded knee supports or a low stool for sitting to avoid placing excessive pressure on arthritic knees.

1. Right angled garden tools.
2. Padded knee support.
3. Low work stool.
Consider Birkenstock products.

 
   
  >> Back to Activities List for TABLE 2
  Note: Joint protection is important for tasks which require twisting or swaying movements of the wrist and fingers. These tasks accentuate the deviation deformities of arthritis. On the next page, I will discuss joint protection techniques for tasks which aggravate the zigzag or collapse deformities of the fingers.>>next page
   

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