Polio Place

JOINT PROTECTION
Joint protection really means joint preservation. If a joint is surrounded by weak muscles or an imbalance exists between weak and strong muscles, the strain can cause ligaments around the joint to stretch, giving less protection to the joint. Stabilizing a wobbly joint takes more work and, therefore, more energy. Eventually, joints may be pulled out of normal alignment by everyday use, causing degenerative arthritis, deformity and pain. Once joints are damaged, they will not be able to regain their original strength.

Joint protection is a variety of techniques designed to reduce external stress on joints. These techniques include using external supports, splints and bracing to protect weak joints, using adaptive equipment, changing the way you use your hands or position your body, and applying energy conservation methods.

Use the largest/strongest joints available for a task.
The joints closest to the trunk are the largest and strongest. The smallest and weakest joints are those that are farthest from the trunk. Protect your joints and save energy by employing the largest joints possible. Carry heavy objects on your forearms with your palms up so the weight is distributed between the wrists and elbows; open heavy doors by pushing with the forearm rather than your hand; carry grocery bags on the forearm instead of the hand.

Prevent pressure on the thumb side of the fingers.
We often carry heavy items in our hands so that the fingers are pushed away from the thumb. This can cause a deformity called “ulnar deviation,” meaning that the fingers veer away from the thumb and your grip is less efficient. Try the following suggestions to prevent your fingers from developing this deformity.

• Carry purses, grocery bags and totes on your forearm, not with your hand. Choose purses with a long shoulder strap that can be worn diagonally across the body.

• Carry books, folders and packages with both hands, palms up.

• Carry garments on your forearm instead of holding clothes hangers with your fingers.

• Push drawers closed with your palm, not the fingers.

• Use a stick or the eraser end of a pencil for dialing telephones.

• Squeeze wet clothing instead of wringing the garments.

• Hold a cup or mug between both palms. Lifting a cup of liquid by the handle pushes the fingers into ulnar deviation.

• Pour from milk or juice cartons by holding them with all the fingers of both hands.

• Use both hands to lift pots and pans. Wear oven mitts and grip the pot handle with one hand, palm down, while the other hand holds the side of the pot.

• When carrying casserole dishes, wear oven mitts and place your palms under the dish instead of lifting with your fingers.

• Stir towards the thumb side rather than towards the little finger. A wire whisk held in the palm instead of fingers can be used for stirring or beating.

• Avoid pushing in the tops of cereal or cake mix boxes with your fingers. Hold a serrated knife like a dagger to cut the box open.

• When peeling or scraping vegetables, move the peeler towards your body.

• Open jars with a stationary opener which mounts to a wall or the underside of a cabinet. Wedge the lid as far as it will go and use both hands to turn the jar clockwise.

Change positions frequently
Holding muscles and joints in one position for prolonged periods of time causes muscles to fatigue, placing more stress on the joints. Try not to hold onto objects for prolonged periods of time. Change positions every fifteen minutes or so, and put objects down when you are not using them.

• When watching television, change your position often and do stretching exercises.

• Use a typewriter or computer instead of writing by hand, but stop often and do stretching exercises for the hands, arms, and trunk.

• For card games use a plastic or wooden card rack instead of gripping a fistful of cards.

• Wear a telephone headset. They free your hands from prolonged holding and the portable models provide mobility if you clip the base to your belt or carry it in a fanny pack. Newer Bluetooth earpieces paired with a cell phone are not only portable but lightweight.

• Use a book holder. You can fabricate one for your lap by filling a trash can-size plastic bag with packing foam popcorn and taping or tying the top. It is lightweight and the book can be cradled at any angle. Place it inside a pillowcase so the popcorn won’t spill out if the bag should tear. Many commercial models are also available, including a Bed Reader which allows you to read while reclining.

• Use a cutting board with nails to hold the food being cut.

• When stirring, keep bowl stabilized on Dycem or other non-slip material, or place the bowl between knees or in an open drawer, or brace it against your body with assisting arm.

Reduce abnormal forces on the joints.
Use built-up handles on pens, combs, toothbrushes, and eating utensils to reduce the force of a tight grip round a small object. Even a rubber band wrapped several times around a pen can ease the grip.

Storing food leftovers.
Opening tight lids on plastic food keepers has become a nightmare for many of us. The most famous brands tout the “air-tight” quality of their products but are very difficult to open and cause stress to the small finger and thumb joints. Anchor-Hocking Corporation makes food storage containers with lids which are easier to open and close. 

Minimize carrying.
Slide anything that will slide and put everything possible on wheels. Slide pots and pans from sink to stove. Use wheeled carts to move things from place to place.

Use ergonomically correct implements.
Tools which keep joints in a neutral position use less energy and help prevent deformities. For example, ergonomic knives have a handle which is at a ninety-degree angle to the blade. You grip the handle with all the fingers and the wrist stays in a neutral position while the whole arm does the cutting.

Use built up handles so you don’t have to keep a tight grip on small objects. A brand of kitchen utensils called “Good Grips” has enlarged handles with finger indentations for a secure, non-slip grip. Foam hair curlers are an inexpensive way to build up handles on forks, spoons, pens, pencils, combs and toothbrushes. Cylindrical foam and plastizote tubing are available from vendors listed in “Resources”. You have a choice of outside diameters and inside hole sizes and a choice of round or rectangular inside holes to accommodate various implements.

© 2000-2008 Grace R. Young 
Courtesy of Sharon Lark