Good Hand Health Tips
Do you want your hands to feel better?
Of course you do, who wouldn’t? It’s so easy to take our hands for granted. Stop, think about how much you really use your hands. It’s a lot. 77% of massage therapists polled reported pain related to massage work. Of those, 67% had ongoing symptoms. Approximately 20% of us had to reduce our workload or consider leaving the profession all together due to pain.1
Is anyone immune from cumulative stress trauma?
Two years ago Coach Cathy was “delusionally inspired” by an obituary of a 94 year old massage therapist. She was giving four or five treatments a week up to her passing. “Wow, I thought, if she could do that then surely this year I could add an extra day of practice. Wrong! What started off as a minimal, intermittent morning numbness progressed to a constant tenderness, zinging and discomfort over the thenar eminence, fingers 2-4 (not my pinky). The decrease in grip strength was what really made little tasks hard. I saw a hand surgeon and was diagnosed with carpal tunnel syndrome with tenosynovitis2of the long flexor tendons. Given my 25 years of repetitive hand motions combined with force and my overly enthusiast drive to work, is it any wonder I finally damaged my tissues! Here are 5 things we can change…
1. Pacing ourselves– resting in the midst of activity.
Does it look like I can take a coffee break here?
Building in periods of rest is imperative in reducing the sustained exertion we experience during our work day. Even less physically demanding jobs require rest. Changing of your body’s position regularly makes a huge difference!
Massage therapists: Starting today, consider standing for 45 minutes of a one-hour massage and sitting for the other 15 minutes. This ratio allows the larger muscles of the hips and legs to work more and the smaller muscles of the forearms and fingers to relax. Relaxing select muscle groups while performing a massage reduces sustained exertion. 3 Mentally imagine your non-active muscles relaxing all throughout your day. Think of the five point stance where you’re long and limber. An anatomical neutral body is a happy body even if it’s uncomfortable when you first start doing it all the time.
Build-in rest periods
Be it during your work day or at home, rest is very important for our career longevity. As muscles contract (tighten due to anything from holding a pencil, typing to paining or jack hammering), fluid pressure inside your muscles increase. When the contraction is sustained at maximum effort, even for a few seconds, the fluid pressure inside a muscle can be four times higher than the fluid pressure of the surrounding capillaries. It’s speculated that this fluid pressure prevents blood from flowing into the muscle. This results in ischemia. (Ischemia is deficient supply of blood.) Ischemic muscles are more likely to fatigue quicker. This places the muscles and the surrounding structures, like the joints, at risk for injury. Resting your hands by either shaking them out or consciously relaxing them restores muscle tone. Shortly, we will consider movements we do everyday that potentially place our hands at risk too.
2. Perpetuating factors – identifying our risk factors
In the same way heart disease has identifiable risk factors, so too do cumulative stress traumas of our hands and wrists. How would you rate yourself for the following questions? 4
- I use a significant amount of hand force.(pressing, gripping, pinching)
- I am exposed to vibration.
(such as when driving or using power tools)
- I regularly perform repetitive movements.
(particularly activities without a change in movement)
- I exert myself to the point of fatigue.
(and then keep working even thought I feel discomfort)
- My body moves into or repetitively stays in awkward positions.
(sitting slouched, standing twisted or sleeping lopsided)
- My body remains in a stationary position.
(as when watching TV or surfing the net)
- My wrist or hands are in contact with hard surfaces.
(like resting on a desk or pressing a tool)
- I am frequently carrying or lifting heavy objects.
(like a massage table or a baby)
- My feelings around my activities and duties impacts me negatively.
(I am sick of my job, my job hurts my body, and I don’t feel in control of my time…)
I have the following conditions:
(If you can’t pronounce it, you don’t have it!)
- Arthritis of the wrist
- Family history of carpal tunnel syndrome
- History of bone injuries of the forearm, wrist or hand
- Hormonal fluctuations
- Kidney failure and dialysis
- Rheumatoid arthritis, systemic lupus erythematosus, and scleroderma
Scored high? Breathe! Exercise and behavior modifications are the golden standard for prevention and recovery from cumulative stress. However, staying motivated to follow through on self-care can be as difficult for us as it is for our clients. At carpaltunnelcoaching.com we provide a solution by offering step-by-step video tutoring that teaches a proven protocol of yoga-based stretching and strengthening exercises and lifestyle strategies for lasting relief.
What more can we do now to reduce the strain on our hands?
3. Minimizing stress – changing hand movements
Let’s consider everyday movements restricting the soft tissue of our forearms. Can you identify with any of the following?
- Prolonged strong gripping with vibrational force such as when gripping a power tool, a steering wheel, a tennis racquet or golf club.
- Repetitive strenuous pulling and twisting movements with the fingers like when weeding, pulling on ropes or wringing a rag.
- Forceful gripping such as required when using small tools like scissors or a needle.
- Forceful compression on the fingertips like when giving a massage or manipulating machinery.
- Contact compression over the carpal tunnel like when resting the front of the wrists on a hard surface like a keyboard.
- Clenching the fists and flexing the wrist while sleeping.
I love puttering in my garden, being on my computer and doing my own handy work around my home. As my hands began to fail me, these were the things I had to give up first. If you find yourself in this situation too, you are not alone. Hand and wrist problems are the second most common reason people miss work in the United States, an average of 25 days a year. 5 According to the National Institutes of Health, early diagnosis and treatment is important to avoid more permanent damage to the hands. Reducing our workload usually requires asking for help.
4. Finding support – asking for help
Doing less with our hands means making some changes. Here are some things we can practice starting today:
- Say no when you are overbooked.
- Book a massage for yourself.
- Get a diagnosis if you have pain.
- Delegate your responsibilities.
- Wear a wrist brace at night to keep the wrist in a neutral position.
- Ask for help.
5. Honoring recovery –physical and emotional stages
Finally, when we have been experiencing discomfort, we need to honor the recovery process. Think positive to create positive effects. Your physical abilities will return at their own pace. Just keep returning to the basics. Follow our stretching routine. Come back here as often as desired to remind yourself of small things to care of yourself. Get a supportive network, you are not alone.
The 5 Rs of Physical Recovery
- Relieving Pain
First, getting out of pain is important. Again, resting and pacing are the keys to relieving pain.
- Reducing Inflammation
Once pain is reduced, and inflammation has receded, you are safe to move.
- Realizing Risk Factors
Once you are moving, you are less likely to re-injury yourself if you commit to changing your risk factors.
- Restoring range of motion and function
You will need to continue exercising every day to keep your muscles and joints pliable and strong.
- Returning of endurance
Endurance comes last because this takes the most time to re-build. Even if you feel good, don’t overdo it, as you will not feel the strain until the next day.The mental/emotional road to recovery can also have five stages. However, these may not happen sequentially as with the physical body. Feeling this range of emotions is part of the healing process.
The 5 stages of emotional recovery
At first there is often denial, as in “I feel fine, I can work through this.” or “This can’t be happening to me.”
Another is anger, even rage, “Why me?” or “This is ruining my life.”
There can also be shame or blame, “I can’t provide for my family anymore.”
A sense of loss can also be felt. “I will never be able to button my own shirt.”
Accepting the dysfunction of your hands and how it’s affecting your life is the emotional goal. You know you have arrived when you can say, “I can change my habits to help my hands and wrists.”
The physical, mental and emotional stages of recovery take time. You will cycle through each in your own manner.
If the Carpal Tunnel Coaching Team can support you in any other manner, please feel free to contact us with your questions or to share your personal stories. Facebook is the best way to stay in contact. Wishing you continued success in caring for your hands.
Cathy Cohen, LMT, is the founder of Beyond Trigger Points Seminars and the content creator and coach for Carpal Tunnel Coaching. For more information on caring for your hands and wrists, go here: carpaltunnelcoaching.com. For more information on treating myofascial pain due to trigger points, go here: beyondtriggerpoints.com.
- Survey Results Musculoskeletal and Injuries among Experienced Massage and Bodywork Professionals. Massage & Bodywork, Dec/ Jan 2006
- Tenosynovitis is inflammation of a tendon sheath. Merriam Webster online medical dictionary
- Greene L, Goggins R: Save Your Hands! The Complete Guide to Injury Prevention and Ergonomics for Manual Therapists. Coconut Creek, FL, Body of Work Books, pp. 31-36
- This survey has been modified from the book Save Your Hands! The Complete Guide to Injury Prevention and Ergonomics for Manual Therapists, ibid, pp. 300-303
- Bureau of Labor Statistics, U.S. Department of Labor, November 12, 2009