Protecting your joints

Many of the day-to-day things you do can place extra stress on your joints, especially when they have already been affected by arthritis. This will lead to increased pain and generally you will tire more easily. There are days or periods of time when your health dictates you should not be undertaking as much as you would normally, or you are not as able as before, because of the effect of arthritis on your life.

This can be frustrating, especially when you have been active before and quite capable of doing everything for yourself. However, there are many things you can do to help yourself in this situation by protecting your joints and conserving energy.

By incorporating the principles of joint protection and work simplification into day-to-day activities, stress on joints can be reduced, so reducing pain, discomfort, tiredness and the possibility of deformity. Poor posture can also contribute to further pain and may lead to deformities of the ankles, knees, hips and spine. Correct posture is important not only in standing and walking but also in sitting, working and resting.

Learn to respect pain

Pain is your body's protective mechanism. If you feel pain during an activity, STOP and rest. If you experience pain for one hour after doing an activity you know that you have done too much. Remember to do less and take rest breaks. The next time you attempt the activity ask yourself if there is some way you can modify the activity to make it less stressful.

Aim for correct positioning

Use each joint in the most stable position and practise good posture.

Standing
Maintain correct posture by keeping the main body segments in alignment. Stand with your feet firmly on the ground, slightly apart to give comfort and stability. Distribute your weight between the heels and the ball of your feet. High-heeled shoes will certainly not help! Keep relaxed, holding your head and chest up. Avoid standing in one place too long as this will tire you.

 Walking
The same principles apply when walking as to standing. In addition, take equal steps with each leg and don't make the steps too long. Use a cane or crutch if it will help you with balance, but make sure it is of the right height.

Lying
When in pain, the most comfortable position for the joints is often bent or flexed. If the joint is constantly held in this position, however, it will become too stiff to straighten out and a fixed flexion deformity will result. Therefore it is important to rest all joints in an extended position whenever possible.

Lie flat on your back, keeping knees and hips straight on a firm surface. Use a low pillow. Never put a pillow under your knees. Change your position frequently to avoid stiffness.

Sitting
Avoid low soft chairs. Use a straight-backed arm chair with a firm seat which will also make it much easier to get out of as well. Keep your feet flat on the floor or use a low foot stool. A working chair should reach up to the middle of your back. Arm rests are generally unhelpful. Your work-station should be high enough to allow you to sit erect with relaxed shoulders and able to be reached without leaning forward or altering your posture.

Protecting your hands

The position of your hands at work and rest is very important.

• Resting
  Position your hand with wrist supported in a slightly raised position and fingers slightly curled.
• Working position
  When using your hands it is important to always move them in the direction of your thumbs and where ever possible, use your hands in a stretched out position. Avoid tight fist grips. Use two hands to work, using a smooth and rhythmic movement. When doing one-handed activities such as turning taps or wiping benches, alternate the use of one hand with another or use them together for extra strength.

Often a physiotherapist will recommend the use of splints to support your hands both in work or at rest. There are also many appliances and aids to assist tasks which put hands under a lot of stress. If you are experiencing considerable pain or some activities are difficult, talk this over with your health advisor - there are many things you can do to help ease pain and make life a lot easier.

Using strongest and largest muscles and joints

• Use the strongest joints and largest muscles available for the activity.
• Bend your hips and knees when lifting, use your shoulders and hips to open doors and your feet to close drawers. Use the heel of your hand to push yourself out of a chair and the muscles of your forearm to carry your handbag. Use palms rather than fingers.
• Avoid lifting and carrying objects such as pots and pans. Use gravity and momentum to your advantage - wring out a cloth by holding it in a perpendicular position. When rising from a chair, rock forward to gather momentum. Use a trolley in the house rather than carry the weight on your hands and a clothes trolley outside. Remember there are many practical devices to assist daily living activities.
• In the garden use long-handled equipment and raised flower beds. There are many changes you can make in your section to enable you to still enjoy gardening - it's a wonderful activity.
• Avoid jarring activities such as hammering and chopping, or digging in the garden. Look for rhythm and repetition in movements.

See also: Arthritis - tips for energy saving

Original material provided by Arthritis New Zealand. Edited by everybody, July 2005.