Nancy Kramer
January 22, 1998
Philosophy
Awareness is your key to recovery. Now is the time for you to concentrate on what your
body is telling you, even though it is hurting. Especially because it is hurting. Your
body is going to speak louder and louder until you listen. With increased awareness,
you'll be able to do more, with less pain, because you'll do it smarter and with less
impact on your body. Intrigued? Read on!
Conserve your hand strength and activity as if it was money, something to budget. It
requires more planning of your time and activities, but if you plan what the activities
are, what they cost in terms of hand usage, and how much time you need to have between
them, you’ll find that you have more options.
Take breaks - often. That could mean every 15 minutes if you are hurting. Breaks don't
need to be long, but you want to release yourself from the static nature of what you are
doing. Variety is extremely beneficial. Stand up, walk across the room and back. That's
enough if you do it every 10 minutes of a taxing activity. Yawn a few times - or take a
few deep breaths if you don't yawn on cue.
Use your body gently. Experiment to find the minimum force required to do any task,
whether it is writing, driving, or holding a paper. Use the loosest grip possible. Put
things down whenever possible. If you are standing around talking with someone and holding
something, find a way to rest the weight of it on a surface or lean it against your body.
Move the burden of tasks to larger muscles. For example, instead of gripping the
handles of a bag with your fingertips, rest the handles over your forearm. This uses your
arm muscles, which are much stronger than those in your fingers. Another example is to
push doors open with your foot - only turn the handle with your hand.
For thoracic outlet issues, avoid neck strain. Rather than a shoulderbag, knapsack or
briefcase, use something carried in front of the body in your arms. Waistpacks are very
good for all RSI folks, and are by far the best solution for carrying small amounts of
stuff. As a rule, carry as little as possible.
Use two hands instead of one whenever possible, to distribute the burden and balance
the weight on your body. This is true for carrying your dinner to the table, moving a
book, or any other activity that requires a firm grip.
Circulation is a good thing - tendinitis begins when muscles don't relax, which reduces
the circulation, allowing toxins and swelling to increase. Some people benefit from
biofeedback sessions which give them information about how successful the are at relaxing
their muscles. You can try the at-home method.
Sit or lie down in a quiet space, without a lot of distraction. Concentrate on an area
of the body where you have a lot of tactile nerves, such as the tip of your index finger
or your lips. Focus on feeling the pulse in that area. It will be difficult to feel if the
circulation is limited, and easier to feel as you relax. The stronger you feel your pulse,
the more blood flow you have and the more healing can take place. Try picking different
spots or several at once (a real challenge!). When you are able to attend to the pulse,
that body part will feel warmed and pain will decrease. This is a good way to relax
yourself for sleep. Lie down on your back, hands at your sides, and start feeling the
pulse in just a finger tip, then in the front half of that finger, then the back half,
then the whole finger, then different parts of the other hand. Just play with it - it
feels really good.
Find ways to keep doing the things you have always liked to do, even if it is only for
10 minutes twice a week. Give yourself treats of varying sorts, whether that means eating
dinner out, reading a junky book, calling a friend, or walking in the park. Be kind and
reverent towards yourself - you are worth it.
Daily Tasks
COOKING
Use utensils that have large handles, such as Good Grips brand. Eat foods that don't
require as much preparation work or eat them in larger chunks. Soups are good, since you
get a lot of meals at once and chunks can be large. Eat a lot of fruit, sandwiches, peas,
corn, and whole carrots! Helpful cooking ideas:
- Use containers that are easy to open.
- Get a good bottle/jar opener.
- Use an electric can opener.
- Use small bottles of oil, etc., so they are lighter.
- Rest your pot on the sink when draining it.
- Don't carry the full pot if it is too much - fill it a cup at a time.
- Plastic is lighter than glass - use it for cups, mixing bowls, even utensils.
CLEANING
Clean the floor with a washcloth, not a mop. Move the cloth around the floor with your
feet! Scrub the tub by standing in it and scrubbing with your feet as well. Do touch-up
with your hands as needed, but the bulk of the work is done by your strong leg muscles.
Other cleaning ideas:
- Use small bottles of shampoo, dish soap, laundry soap, etc. They are lighter.
- Use a wire scrubber rather than a sponge to clean stuck-on food.
- Let dishes soak for a few minutes to make the job easier.
- Get someone else to do some work if you can.
- Clean a little bit at a time.
WRITING
Wider is better - the fatter than handle, the easier it is to grip. Also, try holding
the pen/pencil differently. You can rest it between your first and second fingers, while
controlling the tip with your thumb and first two fingers.
Write on a slant board to help keep the carpal tunnel open during the activity. The
goal is to have your hands in the position of your palms facing each other. Slant boards
are for sale from medical supply companies, but you can fake one by writing on a closed
loose leaf binder in your lap. If you are right handed, put the 4" binder in your lap
with the binder rings on the left, so the slope is down to the right. This position
relaxes your shoulders and keeps your wrists positioned to reduce pressure on the carpal
nerve. If you are left handed, put the binder rings on the right.
SLEEPING
Position is important. Sleeping with your hands curled up under your chin doesn’t
allow for as much healing as other positions. It’s cozy, but it isn’t helpful. I
recommend wearing splints on both hands for a few weeks and then alternating hands after
that, until you’ve trained yourself to sleep in a position that allows for good
circulation. The most healthful arrangement for most people will be flat on your back,
hands straight at your sides. Boring, but healthful. For those with low back pain, put a
pillow under your knees. If you have traditionally slept on your side, try using a body
pillow next to you.
Do get enough sleep. A tremendous amount of repair happens during sleep, so give
yourself every opportunity to let your body fix itself. Find out how much sleep you need
by going to bed earlier and earlier until you wake when your alarm goes off. If you don't
need an alarm, so much the better. Let your body decide how much sleep it needs.
GET HELP
If you have family or friends that can help you by carrying groceries or doing what you
need done, now is the time to ask for their help. Paying for someone to clean the house
may not be an option for many injured workers, but if it is possible for you, do it.
Perhaps you feel uncomfortable about getting assistance from others, and this is common.
One way to feel better about it is to try to make a trade. For example, make a deal that
you help your neighbor’s kids with their homework if their parents will do your
laundry. Alternate nights cooking dinner with a friend, that sort of thing. Now is the
time to find creative ways to meet your needs.
Emotional Impact
It is crucial that you develop a network of supportive friends and/or family. Physical
limitations can lead to feelings of frustration, alienation, and lowered self worth. The
good news is that you don’t have to feel that way. Take charge of the treatments for
your injury and plans for your future. You are your own best ally!
Asking for help is difficult for many of us, especially when it is help for something
we used to be able to do. Just think of it as temporary - people do recover from RSI.
People are able to heal so that they are not in pain, so they are able to do the things
they have always enjoyed. You may have to do them differently, plan them more, or do them
for less time for a while, but remain hopeful that you will feel good and entirely capable
again.
Tools
Speakerphone
These are available from Pacific Bell’s Disability office for free. Your physician
will need to sign a form.
Bookstand
Don't hold that book open! Bookstands are available at stationery stores for less than
$10.
Gloves
Keep your hands warm, especially when driving.
Foam tubing
Use this to increase the diameter of whatever you hold. Put it around writing implements,
cooking utensils, steering wheels, your toothbrush, or any other object that you hold.
Splints
Wrist splints are good at first, as training tools. They help you remember to pursue
activities with your wrists straight so that you have better circulation in your hands. Be
aware that there is such a thing as wearing them too much/long though. Muscles can atrophy
and then you will need a strengthening program of exercises.
Tennis ball/MA Roller
Massage your upper back with these tools or against a door jam. Get to those tight muscles
along the top of your spine and by lying down on the floor on top of the tennis ball or
roller and gently massaging your upper back. This may hurt since there is tenderness and
swelling, so it is crucial to keep breathing. Breathing deeply will help you release the
muscle during a massage. Put a towel over the ball if you need to, to reduce the pressure.
Headset
Whatever you do, don't cradle the phone between your shoulder and neck. Use this or a
speakerphone.
Using Computers
The guidelines for all activities apply here, plus some specific ones:
- take frequent breaks, using a kitchen timer if needed
- relax your shoulders and neck
- keep moving
- adjust your equipment so that the least possible strain occurs
- keep your feet flat on the floor
- align the top of your monitor so that it is just above eye level
(Editor's note: guideline intended for large monitors - smaller monitors should
generally be placed lower than eye level)
- experiment with touchpads, footmice, reminder software and other adaptive equipment
- think before you type
- set up and use macros/templates/text styles
- think about ways to reuse previous text or formatting
- make sure text is large enough to read without squinting/straining
- get up a lot
About the Author:
Nancy Kramer is a Technical Writer in the San Francisco area
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