Joint Protection Techniques

Inflammation of a joint or joints is the body’s reaction to a disease process, such as arthritis, that can cause swelling, redness, pain, and loss of motion to the affected area. This inflammation can damage healthy structures, which in turn, can impact the function of your joints.

We only get one set of joints. How do we best protect them from damage, especially following a diagnosis like arthritis or any other disease and/or reaction to medication that can cause inflammation to the joints? The answer, joint protection techniques.

Joint protection techniques consist of recommended ways to perform your activities of daily living with minimal amount of stress to your involved joints so that, pain is reduced, joint structures are preserved and energy is conserved.

1. Respect pain: Try to stop an activity or exercise when you begin to feel fatigued or discomfort, before you feel pain. If you feel pain for more than one hour after discontinuing an activity, next time try to reduce the time or effort you spent on the activity.

2. Strive for a balance between work and rest: Enough rest is vital for people with chronic pain and systemic disease. Resting before becoming overly tired will increase your endurance for an activity.

3. Maintain muscle strength and joint range of motion: Your daily activities may be sufficient to do this, or you may have an exercise program provided by your doctor or therapist. An isometric exercise program (muscle contraction without movement) can be effective.

4. Reduce the effort needed to do a job: This will cause less stress and pain in your joints and help conserve your energy. For example:

• Sit to work when possible
• Save steps by storing items where used, gather all items in advance
• Eliminate unnecessary tasks
• Delegate tasks when possible
• Used a wheeled cart to transport items
• Reduce size of loads you carry (e.g. grocery bags, laundry basket)

5. Avoid positions of deformity:

• Maintain good posture at all times
• Avoid a tight grasp, as this produces deforming stresses in the hand (build up the handles of utensils, tools)
• Avoid leaning your hand on your knuckles (use open palm instead)
• Avoid ulnar deviation of your fingers during grasp (e.g. hold utensils with handle parallel to knuckles, use jar opener or your palm to open jar lids, grasp door knobs from the side, press water out of sponge with flat hand stead of wringing)

6. Use larger/stronger joints: they tolerate stress better. For example:

• Use your hip to push door open, close door
• Use your feet to close a low drawer
• Use your palms (instead of fingers) to push, lift
• Use your forearms to lift, carry (e.g. purse over forearm or shoulder)
• Use of both hands distributes the stress. If you can, slide or glide an item instead of lifting.

7. Use each joint in its most stable anatomic and functional plane. This will avoid excessive stretch on joint ligaments and make the best use of your muscle power:

• When rising from a chair, slide forward in the chair, keep your feet under your body, lean forward and push up with your forearms. Do not turn your body until you are standing upright.
• When lifting, get close to the load and lift with your knees, not your back.

8. Avoid staying in one position for a prolonged time. This can cause muscle fatigue, joint stiffness and pain. A general recommendation is to change your position or stretch every 15-20 minutes.

• When writing, typing, or knitting, stop frequently to rest your hands and extend your fingers.
• When reading, propping your book on a pillow or a book rest avoids prolonged holding and a flexed neck.

9. Avoid activities that cannot be stopped if you feel stress and/or pain. Examples of some helpful items are a wheeled cart for transporting items or a shower chair to allow you to sit during bathing.

By incorporating some of these simple techniques into your ADL routine, you can reduce the rate of damage to your joints.