Monday, November 17, 2008

Dealing with hand problems, part two.

There were actually some questions in the comments, and it is something I kind of know about (I had lessons on what to look for in activities from a physical therapist who knew I'd need to do lifetime, continuing PT). And there are some other suggestions and ideas I have for dealing with issues, so... here we are.

In the fiber arts, I would have to say that the best general good-for-you actifity isn't knitting. It's spinning. I was working with the carbon fiber yesterday and really paying attention to what I was doing, and if you get an easy-to-work-with fiber (like merino wool or S American mystery sheep from Colonial Wools) and spin a reasonable weight like worsted or DK, it is probably the best of the fiber arts for physical therapy. It uses both hands, but gently. (At least until you spin for like eight hours straight, and I'm pretty sure NOTHING is good for you at eight-hour stretches, except maybe sleep.) The act of pre-drafting the fiber, of smoothing it out, and holding it in your hand, is both soothing and reasonably easy. I've improved my grip and pinch strength, with little or no bad side effects, even after marathon eight-hour sessions that I knew better than to do. I poked around in the archives for some photos of my hands, spinning, and here are a few to give you an idea. In most of those photos my right hand is taking the photo, but usually it is used to either support the roving or mirror what the left hand is doing.




It's easy on the hands compared to knitting, where there's a good bit of stress on the knuckles to pull the yarn where you need it. (These things are, of course, relative.)

Knitting is, of course, good physical therapy and helps the strength and motion. Some things are harder to do than others. Some of that depends on you, specifically, and what you've got problems with. I find that fine gauge is easier on the hands because there's less weight, but it requires more fine-motor skill to accomplish. Wool and other animal fibers are generally easier to knit with than plant fibers (and less obviously, woolen-spun yarns are easier to knit than worsted-spun, but I doubt most people would even notice). The object in knitting is to make something that doesn't unravel. So however you get the yarn around the needle, is the right way. Though for normal hands, Continental (yarn in the left hand, 'work' done with the right hand needle) is easier on the hands. If your hands aren't normal, do whatever works. Again, there's no wrong way.

Sewing - hand sewing - though I mostly hate it, is really good for fine motor skills, and again is relatively easy on the hands. Mind you, you can make it insensible by sewing four layers of denim, or quilting through umpteen fabric layers, or whatever. One reason I like my antique-style ribbon work is I usually don't sew through many layers, and the weight of the ribbons isn't much, so it's easy to haul around. I do know a quilter who had to quit after half a lifetime of twelve hour days of hand-quilting for pay. Again, the body isn't meant to do ANYTHING for twelve hours straight.

Remember, if it starts to hurt, you need to knock it off. Usually a fifteen minute break is enough, but if you're still hurting at the end of your fifteen minute break, listen to your hands. TAKING PAINKILLERS AND THEN GOING BACK TO THE ACTIVITY THAT MADE YOU HURT IS DUMBASS. (Yeah, I do it, but for me it's the chronic pain thing. And even so, I get sent out to a specialist every couple years to make sure I'm not ignoring something important. Even then it's kind of dumbass.) Options for the ol' hands include heat, ice, anti-inflammatories (Tyelenol or whatever), massage (a good hand massage is as good as chocolate), TAKING A BREAK, simple exercises, and plain old doing something else. One way I manage to knit for days at a time is, I'm really not. I play my strategy games. So I knit for a minute, game for a minute, knit for a minute... It's a bunch of short breaks and I manage to get a lot more knitting done that way than if I were to sit down and JUST KNIT. Though of course it does take longer.


Something else most of us do, that I feel compelled to mention in the hand category: cooking and the kitchen. You can have major problems in the kitchen, especially when you add in nerve damage and trouble hanging on to things. Some thoughts:

-It's actually good for your hands to do dishes. The nice warm water increases the circulation and the wide range of non-repeated motions are good exercise. (I hate it, but it's true. Sorry.) If you drop a dish, do NOT try to catch it. You'll wind up either cut, or otherwise smashed. Better to break the plate than slice yourself. Really.

-Keep your knives sharp - you need less effort to use a sharp knife - and learn knife skills. "Knife Skills" is the collective term for all that textbook stuff used in restaurants to cut stuff up. They've got specific methods for chopping and slicing and scoring and blah blah blah. I learned them while working at a restaurant (as the bookkeeper) during my second orthopedic surgery. The chef saw I had hand problems, knew I liked to cook, and immediately said 'You need to learn knife skills.' I thought he was just looking for cheap labor, but you know what? Since I learned, I can't think of the last time I cut myself. And before that? When my hands were GOOD? I cut myself all the time. There's a reason restaurants use these methods; they're efficient. Having the help cut themselves up isn't efficient.

Alton Brown has an entire episode of Good Eats about knife skills... I'm betting it's available on a lot of the gray-area download sites. Wait. Found him on YouTube. Part One, and Part Two. Even if you can't get your fingers to do all the things his do, you can get the idea and even applying HALF the stuff makes you safer. I strongly suggest using the 'new school' onion dicing method. (Anyone got an idea how I can tactfully teach this stuff to my mother-in-law who traditionally winds up with stitches every year or two at the holidays? And bleeds at almost every big dinner she cooks?) Oh, and bottom line? Get a good knife. At least one.

Honestly, I think everyone's better off with knife skills. The husbeast has picked them up from me, and from watching Good Eats with me. The last time he volunteered at a charity cookout he was showing everyone else how to cut things up properly. Everyone was vastly impressed. (Plus it went faster and no one bled.)

Otherwise, if you have a bias against kitchen gadgets, get over it. I do; I'm one of those maniacs who used to juice a lemon with a fork. I blame "Great Chefs of the World", an old PBS series where they did just what it says: went into great restaurants and showed famous chefs preparing the dishes they were famous for. And these chefs were making amazing gourmet, world-famous, got-them-on-TV food with one beat-up pan, a dinner fork, and a chef's knife. I still fall back on that attitude. But you know what? With my hand problems, I need to get over it. For example. I think egg separators (doohickies of several designs that separate yolks from whites) are the silliest things in the world because you can use your hands/fingers to separate eggs perfectly well. But cold egg hitting my fingers feels like someone hit my knuckles with a hammer. I need to get over it and buy the damn gadget. (Preferably before I dig into the holiday baking.) You certainly don't need EVERY gadget on the market (who could afford them all?) but if there is a gadget for a certain thing you do a lot, that bothers your hands, buy it already.



Otherwise, stick with the obvious: If it hurts, don't do it. Ongoing physical therapy shouldn't hurt, or not much. The original get-it-working is brutal, but keep-it-working should be fairly painless or you're doing it wrong.

Anyone interested in video of my range-of-motion exercises I had drilled into me during three months of hard time in the physical therapy department?

15 comments:

Bunny Queen said...

I've never used an egg separator, but I've also never used my hands to separate the egg. :) I was taught to somewhat carefully pass the egg back and forth between the two halves of the shell. The vast majority of the whites will drip out into the container that you have put under the egg and the yolk stays in the shell with a bit of white. When I first started this, I used to leave what I thought of as "a lot" of white behind, but now I probably do as well as the egg separator. I don't know if that will work with your hand issues, but it is at least a free option if you want to give it a try.

Julie said...

Thanks for the tip, but I can't do it. I'm hell on eggs and regularly wind up straining them to get the shell out. Not enough fine motor skill - I either don't hit it hard enough to crack it, or smash it into a zillion pieces. Or both. Tap tap, tap tap, CRUNCH.

And I don't want to sound like the CDC or anything, but I've heard that method is a good way to get any salmonella germs on the OUTSIDE of the egg into your food. Though I've seen full-on, formally trained CHEFS use the method.

Sarah said...

I do the same thing as bunny queen to separate eggs - of course, it requires practice as you've got to split the shell more-or-less in half along the "equator" (which my husband is apparantly incapable of doing).

In preparation for a dinner party this weekend, I broke down and bought an apple corer/slicer. Really, my prep time for making an apple pie went from 1 hour to 35 minutes. I've inherited my mother's distaste for kitchen gadgets (what Alton Browne calls "unitools"), but like Browne says, an apple slicer can also be used to slice small pears :)

Sarah said...

More on eggs - my husband is also a fan of the "crunch and strain" method of cracking eggs. In his words: "The yolk mostly reforms if you give it a good shake!"

(Note: my husband is a much better cook than I am; although I am a student of kitchen techniques my final product generally leaves something to be desired)

historicstitcher said...

I'm a pass-it egg separator, too. Always have been. But then, I also worked in a kitchen, as a breakfast cook, and used to crack an egg in each hand and not get shells into it or break the yolk! Never learned proper knife skills, though I do own one good knife and keep it very sharp. Went out and bought a Wusthof chef's knife about 10 years ago. My ex- tried to claim it in the divorce. Never try to steal a woman's knife! (I still have it)

And yes, please, show some hand PT. I could teach knee PT, but my hands are in sorry shape. Actually they hurt and are bleeding right now just from being dry and from washing down laboratories all day. My skin splits open. Not that PT is going to help with that...

Arianne said...

This has been really helpful...I get pretty bad RSI in my hands from typing, but when it flares up it stops me doing a lot. Nowhere near as bad as your hand problems but enough to bother me...

I'd like to see a video of your hand exercises.

Mandy said...

I'm a pass-it egg separator, too, although I do sometimes wash the eggs first just because I'm a freak about all those germs on the outside - just like washing melons before you slice into them (who knows WHAT got all over them before they went to the market? eewww!).

I'd love to see some hand pt vids also. I have chronic stiffness and pain in my right hand, and it isn't bad enough yet to get a doctor's attention. Knitting and spinning do help, although using the computer mouse makes it worse (not least because it is so frickin' cold in my home office in the winter!) I really need to make myself a pair of fingerless gloves or mitts that I can wear while I work on the computer - why not? I've made them for everyone else, right? But the cobbler's children go barefoot around here.

Amy Lane said...

Good advice, all of it--although I will always be one of those dumbasses who takes pain meds to go and do shit that still hurts me!!! As for knife skills--ah, if only. I tried to learn when I was prep-cooking at Friday's, but I scared people--they put me on the expo line instead...

Bells said...

Knife skills are so good to have. I've developed good ones over the years, learning from friends who are trained. I get frustrated watching Sean with his very basic skills - it's so much more efficient to chop well. I cut myself a lot in the early days, but not so much now.

Cam-ee said...

I have a connective tissue disorder that affects all connective tissue. I can't write terribly well, my handwriting as been described as looking like a drunk spider stumbled across the page. However, I can knit for up to 8 hours at a time and spin for a similar length of time.

Practice is essential. I don't write much, I get writers cramp with 3 minutes and nothing I do will extend that time frame. But the knitting lace and spinning will keep my hands in shape :)

NeedleTart said...

if you must use an egg separator find the moose egg separator (ask google) and prepare to giggle. Best kitchen thingee I ever saw.
As for the hand PT, absolutely, don't go over your time limit. Two (two!!) years ago The Husband had surgery that didn't go so well and I spent 12-16 hours a day next to his bed doing fine hand sewing. My right hand has almost recovered so long as I stay away from lengthy hand embroidery. I haven't hand quilted since. Maybe by next summer...

ellen in indy said...

video?, yes, please. and if a video of right hand's role in basic spinning turned up sometime, i'd definitely watch it.

meanwhile, i'm thinking of seeing if there's a video of continental-for-lefties, in which the right hand does the heavy lifting. i taught myself to mouse lefthanded on pc and righthanded on mouse, so maybe i could learn to knit "wrong-handed" and rehab my right thumb.

having had a knee replacement, i'm not thrilled by my rheumatologist pointing out that there are thumb-joint replacements. thanks, but i'd rather just work on the damn thing until i get as close to normal as possible.

MLJ1954 said...

My Mom swore that knitting and hand quilting kept her arthritis at bay. Also my piano teacher (when I was older and paying for it myself) was the tiny little old lady (she was 83 when I quit). She could barely walk but had played the piano when she very young and then took it up again in her 40s. She was fabulous and she said that the only thing that didn't hurt were her hands (and they were lovely things, limber and strong). Unfortunately, when she sat too long at the piano, she could barely walk.

Knife skills -- absolutely!!! I have been cutting onions like Alton for years but not because I had thought of it as a better way, but started doing it to keep the ends together without the silly thing falling apart before I was done. Silly me, never though about doing it with garlic.

Also, there is much to be said for really good knives. Another thing don't put your knives in the dishwasher. I had a friend that bought me a couple of really good knives. I have bought others since but always go back to the good ones.

I only use egg separators if I have a lot of eggs to separate. Otherwise, I do the shell thing. Egg separators are really a good tool and make it so easy. Especially if you really need to keep yolk out of the white . . . or your hands start doing the pounding thingee.

Oops, sorry I went on and on.

Roxie said...

Video? Yes please.

As for seperating my eggs, I usually just put them in different pockets in the cardboard carton. Oh, you mean to seperate the white from the yolk? Maybe it would be easier if you cook them first?

Emily said...

Re pain management...a nurse friend suggests going outside the military to another hospital...she mentions CHAMPUS, which I vaguely recall from my army-wife days...
and finding an anaesthesiologist who specializes in pain management. (This friend recently had a run-in with a stupid doctor while she was in the hospital awaiting surgery; I thought of you with the judgemental idiots who didn't bother reading your file, plus the doctor decades ago in the army who would have killed me. I don't think the military excels in civilian medicine, generally.)