Monday, August 10, 2009

What Is Joint Protection for Rheumatoid Arthritis

How can we protect our joints?

As soon as the initial shock of a Rheumatoid Arthritis diagnosis wore off, I began to search for ways to make my life as good as it could be. I was ready to fight. One of the things that we fight off is the deformity that is part of the RA package. We have talked about fighting medically. But I also learned very early in my searching that we can do other things to protect and preserve our joints.

I was so glad that I found an article on the Mayo Clinic’s web site about joint protection techniques. That led me to search for even more on the subject. I was shocked that my doctor had not told me that there were actually things that I could do that might help avoid some deformities caused by Rheumatoid Arthritis.

Many of the things on the list are actually things to avoid doing. I remember my own grandfather’s hands. He also had the RA genes. He is the reason that I understood easily what was meant when I read about “ulnar deviation.” I remember how his fingers all leaned out toward the ulnar / pinky side. What’s more, I even remember him doing some of the motions that are warned against in the articles I read!

When Granddaddy stood up, he pushed off using the backs of his fingers. That is a big no-no! He broke 2 rules at once:

(1) Don’t ever use small joints when you can use large ones. For example, he could use an elbow. Or better yet, a forearm and no joint at all.

(2) Don’t ever use the backs of the fingers to push because it drives them in the ulnar direction, encouraging that deformity.

I get plenty of funny looks, but when I stand up, I push off with my arms and let my fragile little hands and wrists alone.

Another one that has been a life saver for me is this: Never tightly grip anything. Do not pinch or squeeze or twist. Ever. Use a light touch. I use all my fingers together as one, avoiding any twisting motion whenever possible. This might mean I get a tool or get help. Often, it just means I’m slow and funny-looking. Whatever it takes.

Here is another basic principle that you can apply lots of ways: Use the largest joint you can to do any motion or no joint at all if possible. Sometimes, I will also go to a lesser used joint or one that does not hurt. You might use your whole hand or arm instead of fingers to carry something, for example. All of this requires that you think before you move. At first this seems awkward, but you can develop your own joint protecting habits pretty quickly and then it becomes more routine.

Here is one more technique I figured out: In describing ulnar deviation, an article stated that the movement to avoid is the motion that is like turning a key. I determined never to do that. At times, my hand was unable to turn a key anyway, so I had my kids turn the key in the car ignition – big thrill for them. Here is what I did: I got a huge key. (You can also get yours wrapped in rubber bands or tape.)Then, I grasp the key like an overhand baseball grip only more relaxed. I use my whole hand to turn the car key away from me. It does not use my fingers at all.

I recommend that you read the whole Mayo guide to joint protection, and Cleveland Clinic’s joint protection strategies for Rheumatoid Arthritis, too.

PS: If you are a “no pain no gain” advocate or believe in “use it or lose it,” you may be in for a surprise. The Mayo Clinic regards pain as a warning for Rheumatoid Arthritis patients to use caution and protect their joints: “Though you may want to work through your rheumatoid arthritis pain, doing so can aggravate the situation.” Similarly, Cleveland Clinic’s article states: “Respect pain. It is a body signal that is telling you something is wrong. Don't try an activity that puts strain on joints that are already painful or stiff.”

Tomorrow, see me in action doing joint protection 24/7.

1 comment:

mallen said...

Thank you for this post. I have been having a lovely flare for the past few days and it has reminded me that I need to be more careful. There are days when I do stupid stuff. A lot of times I do things I know I shouldn't do because I am single and I figure no one else will do it for me. However, I do have kids who love to help me. I need to stop being so stubborn and ask for help more often.