Arthritis is a disease that affects the joints of your body. Deformity will occur if stress is placed on these joints, especially over a prolonged period of time. Therefore, it is very important to understand that damage can be done to your joints when the disease is in its active and inactive phase. You can prevent unnecessary joint damage and minimize pain due to unnecessary stress by assessing your daily activities and modifying your habits, as well as following a number of exercises that will help you increase joint motion and flexibility.

PROTECT YOUR JOINTS: joints tend to deform in a flexed of bend position. Arthritic joints are vulnerable to pressure that decreases space and circulation.

1. Knees: Do not sleep with a pillow under your knees at night
2. Hips: try to keep your hips straight. Lay over your stomach up to ½ an hour every day
3. Elbows: do not lean over your elbows while seating. Relax your elbows over a pillow, resting them at 30 degrees flexed.
4. Hands: Avoid pushing yourself up from a sitting position, avoid resting your head over your knuckles (try over the palm of your hand), avoid excessive use of the thumbs for lateral pinch and to pick up heavy objects( use your bigger body areas such as your forearms).

AVOID HOLDING JOINTS OR USING MUSCLES IN ONE POSITION FOR A LONG TIME

Maintaining a grasp or one position for a long period of time causes muscles to fatigue quickly. Tired muscles do not give the support that your joints need.

1. Do not stand for long periods, especially in the kitchen. A high stool may be useful to use at the sink, etc. If your job requires more than 10 min standing, try to take sitting breaks.
2. At the same time, if your job requires sitting for a long period of time, use a footstool to rest your feet and take stretching breaks.
3. Avoid holding a book or paper while reading. Support the reading material on a book rest or a cushion leaving your hands free.
4. Sometimes typing is better than writing. You can also change the way you hold a pen using it between your index and long finger, or building up the diameter.
5. If sustained grip is necessary in an n activity, stop and allow the finger to stretch in the opposite direction.

USE THE STRONGEST JOINTS AVAILABLE FOR AN ACTIVITY.

1. Carry your pocket book, laptop or grocery bag on your forearm evading using your fingers.
2. Use your knees, not your back, when lifting objects
3. When carrying objects, use the palm of your hand
4. When pushing an object try leaning over it. Consider using your foot or hip.

DO NOT START ONACTIVITIES YOU CAN NOT STOP IF NECESSARY

1. Subdivide articles in smaller groups instead of lifting all of them if you feel that you might not be able to maintain a comfortable grip
2. Evaluate your endurance level before starting an ambitious task such as preparing a meal or shopping. Energy conservation is the key.
3. Plan your activities before starting

RESPECT PAIN

1. Your body will give you danger signals if you are putting your joints under stress. Harmful pain last more than two hours after doing an activity rather than discomfort.
2. Follow a range of motion exercise program using deep moist heat previously to condition the joint.
3. Use static splints for the thumb and wrist to stop overusing the small joints of the hand and to promote muscle rest and decrease inflammation.
4. Adequate general body rest is essential. You will have a better sleeping posture if you use a firm mattress, with a small pillow under your head.

Kitchen tips:

1. Holding a knife: hold it like a dagger and use pulling action to cut
2. Lifting plates, bowls, etc.: slip your palms of both hands under the plate and use your wrist muscles to lift.
3. Lifting saucepans: Place one and on top of the handle and grip it parallel to the knuckle, support the other side of the pan with the palm safely inside the oven mitt.
4. Scouring saucepans with ordinary scourers cause harmful pressure on the fingers. Use a wire brush scourer with a handle, and Teflon pans and pots to eliminate scouring all together.
5. Opening screw-lids: press down on the lid with the palm of your hand and use shoulder motion to open the lid. Keep jar lid screwed on loosely. An electric jar opener should be considered.
6. Use lightweight objects and containers.
7. Rearrange shelves with lightweight objects on the top
8. Holding a cup by the handle: muse a cup with a large handle through which you can slip all your fingers. Otherwise use an insulated mug and hold it with both fingers.
9. Use a spike board to hold vegetables while preparing them. A spike board can be easily made by using stainless steel or aluminum nails through a wooden cutting board. Also consider using a rocking knife.

HOUSEHOLD TIPS

1. Turning doorknobs: position your body sideway to the door and use wrist motion. A door knob extension might be useful for the round knobs that are difficult to grip.
2. Open windows using the palm of the hand
3. Push a drawer shut with the palm of your hand or hip
4. Consider buying electric scissors or spring wire scissors.
5. Electrical equipment (e.g. food processors/mixers, electric can opener, washer/dryer, lightweight vacuum cleaner) should be regarded as essential if financially possible
6. Long handle brush makes it easier to clean the tubs

“He who treats the site of the pain is lost.”- Carel Lewitt, M.D.

This is very true especially of the shoulder. Most people complain of pain in front and tip of the shoulder. However this pain might be arising due to faulty mechanics of the shoulder blade, muscle imbalances, and/or tightness of the shoulder capsule (joint). This is further complicated by the fact that the “ball and socket” joint of the shoulder is more of a “golf ball on a tee”. Maintaining the head of the humerus (ball) in the center of the glenoid (socket) requires flexibility and muscle balance between opposing muscles of the shoulder. In addition to this decreased upper thoracic (back) mobility, weakness of the hips and trunk can add to shoulder problems. Consider the following

• By age 60, 60% of adults have rotator cuff pathology (Hijioka et al 1993)
• 36% scapula winging and scapulohumeral (shoulder blade) abnormal mechanics in shoulder instability. Tightness of pectoralis minor (muscle in anterior chest wall) adds to this abnormal mechanics. (Kibler 2000, Borstad 2005, Warner 1992, Sahrmann 2002)
• 34% more rotational stress to the glenohumeral (shoulder) joint when there is a 20% loss of trunk power (Kibler 2001)
• 49% scope proven labral injuries with positive Trendlenburg ( a test for hip weakness), and tight hips (Burkhart 2000)
• 23.6% loss of elevation motion and 16% loss of strength with thoracic spine (upper back) kyphosis (Kebaetse et al 1999)

Traditional physical therapy techniques of ultrasound, electrical stimulation and exercises (general strengthening) might help relieve shoulder pain temporarily but does not help the faulty mechanics that caused you to have the pain in the first place. If you have pain in the shoulder, have your physician or physical therapist perform a comprehensive evaluation of your shoulder to identify the cause of the pain and provide an individualized treatment program.

Summer is a wonderful time for outdoor sports activities. The weekend warrior deep inside us mostly desk bound athletes inspires us to participate in all recreational activities. These might result in pain and discomfort to the shoulder joint. Make sure you review common stretching and strengthening exercises for the shoulder with your physician or physical therapist to prevent shoulder injuries.

Here are some general tips to avoid shoulder injury:
• Do not work overhead for more than a few minutes at a time
• Do not lift heavy loads
• Do not reach with the palm down
• Do not support yourself on the painful shoulder
• Do not carry your purse, backpack or other items over one shoulder
• Do not sit in a poor posture while working on desk/computer.
• Do not sleep on the painful shoulder
• Do not reach into the backseat of your car
• Use foot stool or ladder to reach overhead or perform overhead activities.
• Perform posture exercises to improve shoulder blade strength