RSI recovery info
May. 7th, 2008 11:51 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
paperclippySince I've been going to this new occupational therapist, I have learned a lot of exercises, stretches, and techniques that really seem to help with my wrist pain, so I thought I should share them with you. If you don't have RSI, some of these will help you avoid getting it in the future.
My absolute favorite technique:
Take some lotion and put it on your wrist/forearm (is that seriously how you spell forearm?), particularly on areas that hurt. It can be on the top or bottom of your arm/wrist, wherever you have a problem, or even where nothing hurts. Take a plastic object with a straight but rounded edge -- I use a pen that doesn't have any grippers or anything on it. Hold the pen so that it is oriented horizontally, so for example the cap would be on the thumb side of your wrist and the end would be on the pinky side of your wrist. Using the lotion for smooth gliding, rub the pen up and down your wrist/arm/hand. You don't have to press really hard, just enough to feel it -- it will hurt on the problem areas, but after completing the technique you should not be any more achy than you were to start with. As you go back and forth, you might notice some areas where it feels kind of crunchy. These are areas to focus on (i.e. rub them more). Your skin will start to turn red in patchy blotches. This is because you are increasing the circulation in that area. The problem areas will have darker red, more focused blotches. Just rub for a couple minutes, then wipe off the lotion, you're done. What I like best about this technique is that you can actually visualize your progress. As your tissues heal (and become less crunchy), the areas will not turn as red as before. So if the first time you do it you have a big red spot on your wrist, then a couple weeks later that red spot doesn't show up, you have probably made a big improvement there. The official goal of this technique is tissue mobilization (breaking up scar tissue and places the tissue is stuck together) and increased circulation. Increased circulation = more healing!
Technique that has to be done by a professional but appears to be very helpful: ultrasound. They set the machine so that the ultrasound waves are penetrating about a centimeter deep, and rub it over the problem areas. This also results in tissue mobilization and increased circulation. I had one session the other day where before the ultrasound I could not stretch my wrist without pain and "crunching," and after the ultrasound I could do the same stretch with no problems.
Stretches and exercises -- I found this website which lists a lot of them, so I'll give you a list of the ones that have helped me the most referring to the names on their site. Obviously you need to use different stretches for different problems.
My OT also has me doing "fours and fives." Basically, you alternate between folding your four fingers, and folding all five down, in varying patterns. The idea is that there is a point where I have some pain where the tendons from the index finger and the tendons from the thumb cross, and due to the pattern of typing they are getting stuck together. You try to use a different sort of pattern to loosen them up. Another similar exercise is to straighten either your thumb or your fingers (but not both at the same time) and just wiggle your wrist around, then switch.
Ice can be helpful in the middle of the work day, to sort of calm down your tissues. I find that it mostly provides about 15 minutes of numbing, which relieves the pain some, but no really lasting effects.
I think the general idea is to do these stretches and such so that you never have more pain after doing them than you did before. These are all supposed to reduce your pain, not increase it! If you have increased pain, either you're doing it too hard or you're doing it wrong, or in the case of strengthening, you tried to do too much, too quickly, and you may not be ready for strengthening at all.
My absolute favorite technique:
Take some lotion and put it on your wrist/forearm (is that seriously how you spell forearm?), particularly on areas that hurt. It can be on the top or bottom of your arm/wrist, wherever you have a problem, or even where nothing hurts. Take a plastic object with a straight but rounded edge -- I use a pen that doesn't have any grippers or anything on it. Hold the pen so that it is oriented horizontally, so for example the cap would be on the thumb side of your wrist and the end would be on the pinky side of your wrist. Using the lotion for smooth gliding, rub the pen up and down your wrist/arm/hand. You don't have to press really hard, just enough to feel it -- it will hurt on the problem areas, but after completing the technique you should not be any more achy than you were to start with. As you go back and forth, you might notice some areas where it feels kind of crunchy. These are areas to focus on (i.e. rub them more). Your skin will start to turn red in patchy blotches. This is because you are increasing the circulation in that area. The problem areas will have darker red, more focused blotches. Just rub for a couple minutes, then wipe off the lotion, you're done. What I like best about this technique is that you can actually visualize your progress. As your tissues heal (and become less crunchy), the areas will not turn as red as before. So if the first time you do it you have a big red spot on your wrist, then a couple weeks later that red spot doesn't show up, you have probably made a big improvement there. The official goal of this technique is tissue mobilization (breaking up scar tissue and places the tissue is stuck together) and increased circulation. Increased circulation = more healing!
Technique that has to be done by a professional but appears to be very helpful: ultrasound. They set the machine so that the ultrasound waves are penetrating about a centimeter deep, and rub it over the problem areas. This also results in tissue mobilization and increased circulation. I had one session the other day where before the ultrasound I could not stretch my wrist without pain and "crunching," and after the ultrasound I could do the same stretch with no problems.
Stretches and exercises -- I found this website which lists a lot of them, so I'll give you a list of the ones that have helped me the most referring to the names on their site. Obviously you need to use different stretches for different problems.
- Nerve glides: medial and ulnar. I haven't tried the radial ones but I might. I was given slightly different methods for these. For medial, I either do the kind with your hands out, palm up (the one on that site), or a method using the wall. Stand perpendicular to a wall. Place your hand (the one closest to the wall) on the wall, fingers pointing down. If you feel tension doing just that, come closer to the wall and move your hand lower until the tension goes away. Rotate your body away from the wall, and tilt your head to your shoulder (on the side opposite the one that is touching the wall). You should feel a slight tension running down through your elbow to your fingertips. Hold for 10 seconds, then release, and repeat 5 times, 6-8 times/day. If you stop feeling tension at that level, try doing it with your arm higher up. Eventually you should be able to do this stretch with your hand at shoulder height. I started out with my hand at about hip height and now I can do shoulder height. For the ulnar nerve, the stretch I was given is to start with your hand touching your shoulder, fingers curled toward the shoulder and elbow in (your wrist should be by your collarbone). From there gradually unbend your elbow, moving your arm out to your side at the same time, until you feel tension. Same deal with repeating.
- Forearm extensor and flexor stretches, straight elbow
- strengthening -- I'm just starting with this one, but he has me doing wrist flexion and extension exercises. Also we do one where I hold a weight, palm down, then move my wrist back with the other hand, let go, hold my wrist up, then gradually release. I do all of these with a one pound weight.
- Another great stretch I have found is to make a fist with your thumb on the inside, hold your arm straight out in front of you, palm down, and using your other hand gradually pull the fist downwards. If you move it at different angles, you can feel it at different parts of your forearm.
My OT also has me doing "fours and fives." Basically, you alternate between folding your four fingers, and folding all five down, in varying patterns. The idea is that there is a point where I have some pain where the tendons from the index finger and the tendons from the thumb cross, and due to the pattern of typing they are getting stuck together. You try to use a different sort of pattern to loosen them up. Another similar exercise is to straighten either your thumb or your fingers (but not both at the same time) and just wiggle your wrist around, then switch.
Ice can be helpful in the middle of the work day, to sort of calm down your tissues. I find that it mostly provides about 15 minutes of numbing, which relieves the pain some, but no really lasting effects.
I think the general idea is to do these stretches and such so that you never have more pain after doing them than you did before. These are all supposed to reduce your pain, not increase it! If you have increased pain, either you're doing it too hard or you're doing it wrong, or in the case of strengthening, you tried to do too much, too quickly, and you may not be ready for strengthening at all.
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no subject
Date: 2008-05-07 07:17 pm (UTC)no subject
Date: 2008-05-08 01:43 pm (UTC)no subject
Date: 2008-05-08 02:17 am (UTC)no subject
Date: 2008-05-08 01:43 pm (UTC)* nerve glides 6 times a day (ideally, I don't always do that many -- hold for 10 sec, 5 reps each)
* flexor/extensor stretch 6-8 times a day (5 reps each direction each hand)
* soft tissue massage 1-2x/day
* 4's and 5's 3-4x/day
* ice 0-1x/day (5 mins each side)
* strengthening either 1x/day or every other day
When I'm at therapy we usually do ultrasound, soft tissue massage, and strengthening, plus I do 5 mins on the arm bike.