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Joint protection and energy conservation

Joint protection principles require the use of a series of positive techniques that can help to preserve your joints and reduce pain. It is a “style of life” that once learned becomes second nature. It is not designed to make life complicated. It is designed to encourage independence.

The main methods of joint protection

  • Use joints in a good position.
  • Avoid activities that do not allow for a change in position.
  • Respect pain.
  • Avoid tight grips or gripping for long periods.
  • Avoid actions that may lead to joint deformity.
  • Use one large joint or many joints.

Use joints in a good position

  • Joints work best in certain positions. When they are used in the wrong position, such as twisting, extra force is placed through the joint and the muscles are unable to work as well, eventually causing pain and deformity.

Avoid activities that do not let you change the position of your hand

  • When you are in a position for a long time your muscles get stiff and pull the joint into a bad position. The muscles also get tired quickly and so the force is taken up by the joint and not the muscles leading to pain and damage.

Respect pain

  • The nature of arthritis means that you may always have pain. If pain continues for hours after an activity has stopped, this means that the activity was too much and should have been changed or stopped sooner. Your therapist will talk to you about the many ways of dealing with pain, such as the use of splints, saving energy, learning relaxation methods, planning the day ahead or using equipment or gadgets to help you with certain activities.

Avoid tight grips or gripping for long periods 

  • Gripping tightly will increase your pain and may damage your joints further. It is better to avoid it. Your therapist will discuss ways with you such as:
  • Using thicker or padded pens for writing.
  • Resting books on a table or book rest.
  • Using a chopping board with spikes to hold vegetables.
  • Using non-slip mats under bowls to hold them.
  • Allowing hand washing to drip-dry rather than wringing it out.
  • Relaxing your hands regularly during activities such as knitting or writing.

Avoid activities that could lead to deformity

  • Damage to your joints could lead to deformities in your hand, such as your fingers appearing to drift in the direction of your little finger (ulnar deviation) or your individual fingers bending or straightening in unusual positions (swan neck deformity). Activities can be changed to avoid these.
  • When turning taps or opening and closing jars, use the palm of your hand and use one hand to open and the other to close. Remind others not to close them too tightly.
  • Use a flat hand where possible such as when dusting or wiping.
  • Try to use lightweight mugs with large handles rather than small teacups so pressure is not put on just one or two fingers.

Use one large joint or many joints

  • Stronger muscles protect large joints so it is better to use large joints where possible, or try to spread the force over many joints.
  • Use the palms of your hands and not your fingers when you carry plates or dishes.
  • When standing up from a chair, try to rock gently forward and use your leg muscles to stand up rather than pushing from your knuckles or wrists.
  • Carry light bags from a strap on your shoulder rather than your hands.
  • Use your bottom or hips to close drawers or move light chairs.
  • Use your forearms to take the weight of objects when carrying, not your hands.

The main methods of energy conservation

  • Balance rest and activity.
  • Organise and arrange space.
  • Stop activities or parts of them.
  • Reduce the amount of weight you take through your joints.
  • Use equipment that saves energy.

Balance rest and activity

  • It is important to balance your rest and activity to allow your joints to rest and repair. Stop before you feel tired or are in pain and avoid activities that you can’t stop when you need to.
  • Try to plan ahead. Write a weekly or daily diary with activities in red and rest times in blue. Think about what you need to do and space the harder activities out over time.
  • Activities such as vacuuming, ironing and cleaning windows mean that you are doing the same movements lots of times and keeping the hand in the same position for long periods of time. Try to do them for very short periods, or where possible get someone else to do them for you.

Organise and arrange space

  • Prepare your work areas so that everything you need for that activity is there. Store items you use often in places that are easy to reach and keep things in small refillable containers, rather than large, heavy jars.

Stop activities or parts of them

  • Use clothes that are easy to care for
  • Make the bed on one side and then the other.
  • Soak dishes before washing them and let them drip dry.
  • Where possible use tinned, frozen or prepared foods.
  • Hang items within easy reach.
  • Where possible get someone else to help with activities.

Reduce the amount of weight you take through your joints

  • Consider wheeled trolleys rather than carrying things.
  • Slide pans where possible and use a wire basket or slotted spoon to drain vegetables
  • When you buy new equipment, make sure it is lightweight.
  • Use a teapot and/or kettle tipper and fill the kettle with a lightweight jug.

Use equipment that saves energy

  • Your therapist will discuss with you some of the things that are available to buy.
  • Automatic washing machines, frost free freezers and food processors are all energy saving devices however and simple things such as sharp knives use less pressure and so less energy.

Should I exercise my hands?

  • It is important to maintain the amount of movement you have in your joints so that you are able to use your hands as much as possible. You may find that without regular exercise your hands feel weak and activities become more difficult.
  • Exercise can help to relieve pain, keep bones and muscles strong and keep your joints moving. Strong muscles around your joints can help keep them in a good position, but do not overdo your exercises or use weights or resistance as this may harm your joints.

Do I need to wear a splint? 

  • Your therapist will talk to you about wearing a splint. They can be used to rest a joint and allow the muscles around it to relax. This can help reduce swelling and pain. Splints can also be used to prevent deformities around the joint or stop existing deformities from worsening. It is often advisable to wear one during activity to support a joint and restrict movement.
  • There are various types of splint and your therapist may provide you with more than one.
  • A thermoplastic resting splint can be made, which due to its strength can also be used during activity to restrict movement around the joint. Softer splints made from neoprene are also available that will allow more movement.
  • Other therapy tools that people have found useful are Lycra gloves worn at night and hot or cold gel packs. Your therapist will talk about your symptoms and your daily activities.

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