Physiotherapy - Joint Protection Advice

This leaflet has been developed to provide information for people with a variety of conditions and is not intended as an individual recommendation.

The connection between two or more bones in the body is referred to as a joint.

Most joints allow movement in certain directions allowing bending, turning, stretching and twisting.

Joint protection is about changing the way you do activities and making them less straining in order to help you to continue to complete your activities of daily living.
 
If an activity is causing you increased pain, consider the way you are using your hands during this activity to see if you can change how you are doing it to reduce the amount of pain caused.

The following advice may be useful to relieve pain and difficulty when completing activities of daily living.

Principles of Joint Protection:

• Use as large a grip as possible - use all of the joints of the hand and avoid prolonged pinching where possible
• Avoid long periods of repetitive movements - pace activities with rest breaks
• Take notice of pain – avoid painful movements if possible
• Avoid lifting heavy objects - find another way of moving them and/or wear a splint for support and/or ask for help
• Recognise if you need assistance either from another person or from an assistive device

Joint protection techniques

Drinking

Try using a lightweight heat resistant mug with a large handle so all fingers can wrap around the handle and support the cup underneath with your other hand.

Opening jar/bottles

Try using non-slip mats. Assistive devices are also available for purchase, for example electric jar openers/on-slip jar and bottle openers.

Wringing cloths

Use sponges instead of a cloth. Squeeze water out of sponges by placing on the draining board and with a flat hand compressing the sponge to release all of the water.

Alternatively, if using a cloth, place the cloth over a tap to allow it to drain and air dry therefore avoiding wringing.

Fastenings

Try increasing the gripping surface of zips with tape or a keyring, or use an assistive device such as a Button Hook/Zip Aid.  Investigate easy fastening clothes when considering future purchases. Leave buttons fastened if possible when removing clothing to allow easier application next time.

Scissors

Consider investing in spring loaded scissors.

Lifting plates

Carry plates on flat palms with fingers and thumbs straight.

Kitchen tasks

Opening tins

Try levering up ring pulls with a spoon or use a ring pull opener assistive device. Electric tin openers and one-touch design tin openers which are easily positioned on top of a tin and open at the touch of a button are available for purchase. These are also available for jars.

Taps

Try using non-slip mats and your palms to operate crystal handled taps. Tap turners are available for purchase. Fitting lever tap handles may be a long-term solution.

Kettle

Try filling a kettle using a lightweight jug with only the amount of water you need for the number of hot drinks you are making. Try lifting the kettle with two hands using an oven glove to protect from heat or carefully slide the kettle across the work surface. Mini lightweight/travel kettles, kettle tipper assistive devices or hot water dispensers are also available for purchase.

Vegetable preparation

Try reducing the amount of peeling by boiling vegetables in their skins. Consider using ready prepared/frozen vegetables. Prior to roasting, partially boil potatoes so they soften before chopping them.

Cooking vegetables

Try using lightweight two handled pans. Try pouring the water into pans with a lightweight jug. Remove vegetables with a strainer spoon or boil vegetables in a wire cooking basket. Try alternative ways of cooking i.e. steaming/microwave/roasting.

Opening cartons

Use a knife to cut around foil tops if safe to do so. Investigate different types of carton. Assistive devices are available for purchase, for example a pierce carton pourer.

Washing up

Support heavy items on a dishcloth/drying mat on the draining board. Use a brush with an enlarged grip. Try leaving dishes to air dry.

Other daily activities

Eating

Try using a steak knife and enlarging handles of cutlery/utensils with tape or foam grips. Specialist cutlery is also available for purchase. You could try putting a non-slip matt under the plate to provide a grip for the plate enabling easier cutting.

Door knobs

Try applying a wide elastic band or non-slip material around the door knob to add a non-slip surface for a better grip. Fitting lever handles could be a long term solution.

Plugs

Packs of plug pulls are available for purchase and help as the force required to pull the plug out of the wall is spread through all fingers when using this device.

Vacuuming

Try wearing splints/supports for heavier tasks like vacuuming to support your joints. Pace this activity by taking regular breaks.  Investigate a lightweight vacuum cleaner when considering future purchases. Cordless vacuum cleaners avoid unnecessary plugging and unplugging between rooms.

Laundry

Avoid hand washing laundry altogether. Try loading and unloading the washing machine in small amounts using both hands. Ensure clothes are not inside out before loading into the machine as it is more strenuous on joints to turn them back when they are wet. Try pegging out washing to dry using plastic pegs without springs. Try using a trolley to transport heavy clothes baskets.

Ironing

Minimise ironing if possible. Investigate a lightweight iron and non-iron clothes when considering future purchases. If you have a tumble dryer, hanging up clothes when still warm having been tumble dried can also minimise ironing. Use non-slip material around the handle of the iron to enable a better grip. Use splints/ supports for heavier tasks like ironing to support joints.

Shoes

Try using a shoehorn and Velcro fastenings. Consider pre-tied elasticated laces.

Brushing teeth

Try pumping toothpaste out of a dispenser using your palm instead of squeezing out of a tube with your fingers. Gadgets to roll up the toothpaste tube are also available. Investigate an electric toothbrush with an enlarged handle when considering future purchases.

Drying hair

Try resting elbows on a shelf or placing the hair dryer on a hook when towel drying/blow drying hair to reduce strain on your shoulders. Consider using a lightweight/travel hairdryer.

Shaving

Try wrapping tape/non-slip material around razor handles for an easier grip. Electric razors can be less strenuous on joints

Keys

Use a key turner assistive device or add non-slip material grips on individual keys to create an easier grip.

Writing

Use an ink gel pen rather than a biro as less pressure is required. Use a wid grip pen with a non-slip grip or build up existing pens with tape/non-slip material. Type or use voice recognition technology where possible.

Reading/using tablet computer/mobile phone

Rest the device on a table or lap with a cushion or lap tray or purchase a stand. Use a stylus with a wide grip. Avoid gripping by pinching with fingers and thumb instead use open palms. Add a stick-on grip aid to your mobile phone and hold the device with your fingers straight. Avoid prolonged/repetitive movements.  Arrange a workstation assessment for computer use and use a keyboard support or adapted mouse if appropriate.

Handling money

Shaking coins into the lid of a pouch purse enables easier handling. Storing your bank card in the coin section of a purse or wallet can be easier than using a card holder.

Shopping

Consider investing in a shopping trolley or rucksack. Carry lighter loads/bags on forearms with elbows bent, if using a rucksack place straps on both shoulders to spread the load. Consider asking for help when packing items or loading into a car.  Arranging home delivery through internet shopping can be useful for heavy items.

Driving

If buying a new car consider an automatic gear box and/or a push button start instead of a key. Many car adaptations are available for purchase; there are driving centres that can assess and advise you regarding modifications.

DIY

To widen the grip of tools pad the handles if safe to do so. Lightweight power assisted tools may be also beneficial.