Protect Your Hands-You Only Get Two!

February 21, 2020

The saying goes “work smarter, not harder.” These are words to live by when protecting the fragile joints of your wrists and hands, especially if you have arthritis. There are many techniques you can learn to get through your day without injuring yourself further.

Remember to be proactive. Balance work and rest, making sure you rest before you’re tired and before pain starts. Prioritize what’s important for the day, setting realistic goals and completing more difficult activities when you feel strongest. For some the morning is best, for others the afternoon is better when they’ve loosened up.

When you’re in the middle of your task, try to maintain proper posture, use both hands when possible and avoid a tight grip, using the palms of your hands for lifting and pushing instead.

When working in the kitchen there are many cooking tips and gadgets to make it easier on your hands. Setting a bowl on a sponge or washcloth can prevent bowls from turning, so you don’t have to hold them. Large culinary scissors can be used to open plastic bags and cut up vegetables. Use tongs instead of forks to turn or lift foods, and if you have a spiked cutting board, your steak will stay put. Electric can openers and jar openers do most of the work for you. Keep knives sharp so you can use your other hand to provide pressure on top of the knife to cut items. Carry groceries in your arms, close to your body. By doing this, bag handles won’t cut into your hands and fingers, and your back will thank you, too.

There are many things we do every day not realizing how much strain we are putting on our fingers. When you’re

done with the dishes, press water out of sponges with your palm, not by squeezing. Drip dry your hands or pat them, instead of wringing them in a towel. Slip foam over a pencil or use the eraser end to dial the phone, holding the pencil like an ice pick. When inserting tacks don’t put all that pressure on your thumb; use a small hammer. Place extensions or grippers on door knobs or water faucets. Many of these items can be found at your local hardware or dollar store.

Hopefully these aforementioned tricks will help. Just remember, that if your hands are already fragile or injured, these are good guidelines to follow. If preserving hand strength is your goal, talk to your Pemi-Baker Physical or Occupational therapist for strengthening exercises.

~by Pam Hixon, OT

Heart Health and Shoveling Snow

December 18, 2019

Now that the first snow of the year has fallen, it’s a good time to think about safety with snow shoveling and using a snow blower. This is especially important for Senior citizens as well as those with a history of heart disease and/or heart related health conditions. Those of us living in and around the Plymouth, NH area will get plenty of chances to practice snow removal, since we average around 73 inches total snowfall annually. That’s over 6 feet of snow!
What are the health risks related to shoveling? A recent report from Harvard Medical School found the following:

Most heart related health issues due to shoveling were noted in men. Studies have not found a link between heart attack and snow shoveling for women.
The deeper the snow, the more men were admitted to hospitals due to near attack. If snowfall totals were 8” or more, there was a 16% increase in hospital admission from heart attack compared to days with no snow.
Fatal heart attacks were 34% more common after snowfall of at least 8”. Also, the longer it snowed, the higher the rate of heart attack.
These findings were not strictly limited to heart attacks from shoveling the snow-there may be other factors related to heavy snowfall that trigger heart issues, such as trying to walk thru deep snow, or pushing a car stuck in snow.

What is it about snow shoveling, or even pushing a large snow blower that creates these risks? Doctors who have investigated the problem have identified several factors:

Snow shoveling requires forceful use of arm muscles. Many people are not used to using their arms so aggressively, and this creates strain on their circulatory system.
This type of activity is known to cause rapid increase in pulse rate (how fast the heart beats) and blood pressure. For people with heart disease, their system may be unable to cope with sudden increases of that nature.
Working outdoors in cold weather may cause blood vessels to constrict (tighten up), depriving blood flow to the tissues and forcing the heart to work even harder to keep up with the demand of lifting heavy shovelfuls of snow.
In most cases, people do not take the time to warmup their muscles, as you would prior to working out. Typically, we just grab the shovel, head out the door and start flinging snow. The heart and lungs have no chance to prepare for the workload.

So what can people do to prevent a problem with winter snow removal? The American Heart Association and the Harvard Medical School list the following safety guidelines:

Pace yourself! If you start to tire or become short of breath, take a rest break. If you were exercising and started to fatigue, you would rest before continuing-why not do the same with snow shoveling?
Avoid eating a large, heavy meal right before going out to clear the driveway-the stomach and GI tract require extra blood flow to digest that meal. Shoveling lots of snow in addition can add stress to the heart muscle.
If you smoke, please do not smoke while shoveling, it will deprive your muscles of needed oxygen.
Push snow rather than throw or lift it whenever possible.
Avoid shoveling heavy wet snow. While a cubic foot of fluffy snow may weigh as little as 5.2 lbs., a cubic foot of wet snow can weigh over 12 lbs.
Take smaller shovelfuls and avoid using large shovels-a large shovel might seem attractive (I’ll get done quicker) but you’ll be lifting a lot more weight with each shovelful.
Make sure to dress warmly enough to avoid hypothermia. When he was in high school, my son used to shovel our driveway in shorts and a t-shirt. Being a bit older, I would never try that! Also some people find inhaling lungful’s of cold air very hard on their breathing. Wear a kerchief or snow mask to help warm the air you breathe while shoveling.
For folks who have had a prior heart attack, known heart disease, or multiple risk factors for heart disease, one simple recommendation is – don’t shovel the snow! These folks may best reduce the chances of a problem by getting a snow blower, hiring a plow truck or a neighborhood kid to do it for them.

Regardless of how much snow we get this year, we at Pemi Baker Community Health hope all the people living in our part of NH have a healthy and safe winter.

~by Ernie Roy, DPT

Pemi-Baker Physical Therapist, Matt Scagliarini Explains Taping

October 22, 2019

October is National Physical Therapy month and one of the most common questions we here from our patients is ‘what does taping do and can it help my injury?’ There are many kinds of tape used in the world of physical therapy. Some tape is applied to limit motion such as athletic taping but, in physical therapy we use tape to limit motion, increase motion and decrease swelling depending on its application technique. You may have seen tape applied to professional athletes or Olympians over the years and wondered what does that do? How could it possibly work?

Over the course of years as a physical therapist performing both manual therapy and exercise therapy interventions, it has become apparent to me that a great deal of what I do is targeting the nervous system, whether intended or not! I believe tape placed on a patient’s skin is just that, mostly a neurological input.
For years I think healthcare practitioners hoped and believed that taping techniques changed the way muscles move by pulling on them through the skin. If we think about this it really seems unfathomable that tape could create force changes in muscle tissue. So, I often half-jokingly tell my patients that “tape is tape on the brain. It can change your nervous system’s input to the brain about pain, swelling, muscle or joint position and allow it to respond with improved movement in that area.” I stop short of making claims that tape could actually pull hard enough to physically change a muscles ability to contract or markedly change joint position.

One thing I have positively seen with taping (as in the crisscross pattern) is reduction in swelling when applied to the affected area. So much so that visible changes in edema and bruising can be seen easily. In this case, the tape must be lifting the skin enough to allow the lymphatic system to drain more effectively or so it is believed.

The best part about taping is that it can be left on for up to 5 days helping to retain any affect your therapist is trying to achieve, it is inexpensive, it can be applied by the patient at home and very few patients ever report a negative side effect from its application. Ask your therapist if this could be beneficial to your treatment here at Pemi-Baker Community Health!

~By Matt Scagliarini, PT, DPT