A few years back I wrote a book for people with rheumatoid arthritis. In the book, I had a chapter entitled , Keeping Joints Strong And Stable. I named it that for a reason; I’d always held a secret grudge. The grudge I had was about the term “joint protection,” something you learn about as an RA patient if you go to occupational therapy. Joint protection is a term that describes techniques you can use in order to maintain the integrity of your joints even when they are extremely weakened and impaired from inflammation and/or pain. Joint protection techniques are literal life-savers; when I was a new therapist one of my first patients was a woman who could no longer function because of severely deformed hands. She had spent twenty years of her life raising seven children with RA with no training about how to avoid the deformities she was now facing.
I love joint protection techniques; I just hate the name. I hate it because I hate the idea that my joints need protecting. Living with a chronic disease my whole life has made me sensitive to anything that makes me feel frail or needing protection. So I re-named the concept- I now call it keeping joints strong and stable. Keeping joints strong and stable is one of the most important things you can do for yourself when you have arthritis of any kind.
These strategies involve understanding how to move differently in order to avoid damaging your joints when they are chronically inflamed. Inflammation changes the joint structure and that puts tendons and muscles at a disadvantage when they are working. Anytime you put sustained pressure on an inflamed joint you are stretching and pulling on already overstretched tendons and ligaments and over time this can lead to the classic deformities that people think of when they picture arthritic hands.
So, with that long and winding preamble, let’s dig into some specifics about how to keep your joints healthy….
- Use Larger, Stronger Joints For Activities, Some ideas for this would be to carry shopping bags with your forearms instead of your hands, closing doors with your hips instead of your hands, and lifting items with both hands to distribute the weight.
- Avoid tightly grasping and sustained pressure on the side of the fingers (especially when they are being pushed toward your pinky) I use cylindrical foam on my toothbrush handles and pens, which increases the diameter, allowing me to loosen my grip.
- Try Not to start any activity that can’t be stopped if need be. I think everyone has been in the situation where halfway through you realize you’ve bitten off more than you can chew. I’ve been in this pickle more times than I care to admit and it rarely ends well! So now, I try to avoid doing things that may get me in trouble without a back-up person who can take over if things get too tough. I may have a few less stories to tell about my misadventures, but my life is much more comfortable!
- Move your joints through their full range of motion every day and stay active. I use the motto for myself that I will move my body every day, which tells me that I will do my best with the body I wake up with. Some days this is a four-mile hike and others it is standing in a pool and moving each joint in a gentle, less painful, way. It is a good idea to consult a physical or occupational therapist who can guide you through a specific range of motion program that fits your needs.
- Avoid staying in one position for long periods of time. One idea for this is learning to fidget while sitting. You can do ankle circles or roll your shoulders back ten times- this will keep your joints more supple and less stiff. Another possibility would be to alternate sitting and standing, by setting a timer when you are sitting and every twenty minutes taking a stretch or standing break.
- Maintain Or Use Your Joints In Good Alignment. If you haven’t heard of body mechanics, now is the time to find out. This is another area that your physical/occupational therapist will come in handy. Not slouching, twisting, or doing other things that put joints under strain is the idea, and if you follow the basics you will end up in less pain and with more energy, on top of taking care of your joints.
- And finally, Respect your pain. Pushing through it may be necessary at times, but don’t make it a habit. I always think of my patient and her barely functional hands when I think of pushing too hard. She ruefully said to me one day, “I guess wringing out thousands of diapers over the years did more harm than I thought.” I hated to tell her she was exactly right.