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Sunday, January 26, 2014

Posture, Exercise & RSI

Posture is the way we sit, or stand, or walk, you know.
Good posture or bad posture can change the way I grow!
It also makes a difference in how I work and play,
Good posture is important, so I use it every day!

A very good friend of mine is the latest in a long list of crafters I know to have been hit with RSI related problems brought on by a combination of computing and knitting. Its one of those things that tends to plague knitters and in particular knitwear designers as when we're not knitting, we are on the computer typing up patterns and running numbers through spreadsheets. And much of the time these activities are undertaken in less than ideal situations and a lot of the time, poor posture and incorrect seating is contributory to the problems we experience.

I promised my friend that I would try and find amd re-publish a blog post I wrote several years ago that included information about RSI and also the simple exercises that I undertake each day to try and alleviate the problems. So here it is and I do hope it is of use to anyone suffering from any form of RSI:

We all hear and talk about RSI but exactly what as knitters are we vunerable to?

The chief forms of RSI which affect knitters are:

Carpal tunnel syndrome
Tennis elbow
Golfers elbow
de Quervain’s disease
Trigger finger
Cubital tunnel syndrome

What is RSI? It is classified as a neurovascular syndrome and is identified as chronic or prolonged pain in the hands, shoulders, back or neck, caused by the constant repetition of a series of movements. Its onset can be insidious, its diagnosis problematic and its results irreversible.

It affects the soft tissues, nerves, tendons, muscle and cartilage. If left untreated, it can lead to permanent disability.

The truth is, that as knitters, we spend hours repeating a small number of motions, so therefore are at risk of RSI; as is anyone who sews, crochets, plays a musical instrument or works on a computer.

RSI develops over time and its symptoms often come on gradually. Once you become aware of the symptoms there is another catch. Diagnosing RSI is difficult.
Therefore we needs defensive tactics whether already a sufferer or just a concerned knitter.

You can do many things to keep your symptoms in check or to prevent RSI.

TAKE FREQUENT BREAKS. PUT DOWN YOUR NEEDLES AND FLEX YOUR HANDS, FINGERS, WRISTS, SHOULDERS.

AVOID MARATHON KNITTING SESSIONS.

WARM UP! STRETCH YOUR HANDS BEFORE YOU KNIT.

Knitters can be at risk the moment they sit down. Many of us slouch, shoulders drooping and head bowed. Manipulating the needles forces the hands and elbows into an unnatural fixed position for long periods of time. The wrists are flexed up, stretching the tendons. The fingers and thumb exert pressure to hold needles and yarn. Passing the yarn over the needle involves repeated finger movements and the weight of the work in progress also drags on the wrists. Over time the rhythmic sequence of knitting and purling can pinch nerves and other soft tissues.

Sitting properly can spare your aching hands. The back supports your entire body, and proper spinal alignment is needed. Sit up straight without hunching your shoulders and neck. Your feet should be squarely planted with legs bent at a right angle – NOT CROSSED. Keep your elbows close to the body, bent at a comfortable angle, not sticking out from the body. Hold needles in your hands, and if possible not tucked under your arms as this can cause additional shoulder problems.

There is no correct or wrong way to grip the needles but try not to bend the wrist back too much. Circular needles are better than straights as they spread the weight of the knitting and wooden are better than metal or plastic as they flex with the hand rather than resist.

If you are having problems thicker needles are better than thin as you are not gripping as tightly. With crochet hooks you can make a handle out of sponge rollers to prevent you having to grip the hook so tightly.

In addition tight knitters put extra strain on their hands, so try and loosen up and relax your tension slightly – use a bigger needle.

CARPAL TUNNEL SYNDROME

CTS is probably the best known RSI. More than 8 million Americans alone have this condition in which the hands’ median nerve is trapped inside the carpal (wrist) tunnel. This cavity is formed by the transverse carpal ligament, an elastic tissue that surrounds the eight bones in the wrist. When repetitive movements irritate the slippery protective lining of the flexor tendons, they become swollen inside the carpal tunnel, compressing the median nerve. This leads to pain, tingling, loss of strength and reduced range of motion.

CUBITAL TUNNEL SYNDROME

Also know as Ulnar Neuropathy. Caused by leaning on elbows, holding the telephone, knitting, typing – anything that requires repeated bending and straightening of the elbow. This can lead to inflammation of the ulnar nerve, which travels from the neck to the elbow then to the fingers. Symptoms are similar to CTS except the pain is felt in the ring and little fingers.

GOLFERS ELBOW

Also known as Epicondylitis, results in small ruptures in muscles and tendons located in the inside of the elbow. The muscles and tendons that bend the wrist start in this region. Wrist and hand movements create small tears and scarring in the muscle and tendon fibres. Symtoms are the same as tennis elbow but felt on the inside of the elbow. Tennis elbow is felt on the outside of the elbow, travelling down the forearm to the middle and ring fingers. Bending the wrist back or turning the palm upwards makes it more painful.

TRIGGER FINGER

This is a condition where an irritated tendon cannot slide easily through a cavity. A knot forms blocking the space leaving the finger bent.

 I try and do at least some of the following warm up exercises every morning.

GENTLE WARM UP EXERCISES

1) Warm up soaks and stretches

Perform the stretches in a basin large enough for you to immerse your hand, forearm and if possible, elbow. The water should be as hot as you can stand.

Finger stretch: Stretch out your fingers as wide as you can and hold for a slow count of 10 to 20 seconds. Bend your fingers and hold for a count of 5. Repeat up to 10 times.

Wrist stretch 1: Pull your hand backwards gently with your fingers and hold for a slow count of 10. Repeat with the other hand.

Wrist stretch 2: Make a fist. With your other hand, push down on the fist and flex it forwards towards the wrist. Hold for a slow count of 10. Repeat with the other hand.

2) Quick stretches during the day

Wrist tendon stretch

Place your hands together in the prayer position. Raise your elbows out to the side, keeping the palms together. Spread your fingers wide and bring them together again, slowly, five times. Repeat.

Chin tuck

Good for in a car with a head rest, or lying down with a cushion under your head. Tuck your chin down toward your chest and push your head against the headrest or cushion. Hold for a count of twenty then relax. Repeat 3 times.

Shoulder shrugs

Stand or sit up straight. Shrug your shoulders as high and tight as you can and hold for 10. Relax. Repeat 3 times. Then shrug your shoulders back as far as you can and hold for 10. Relax. Repeat 3 times.

AND FINALLY, THE DONT’S
These are the things we probably all do much of the time!

Don’t keep wrists bent towards you for long periods (flexion) as irritates the nerves and tendons in the wrist.

Don’t tilt your hand in the direction of the little finger (Ulnar deviation) - this position folds the tendons over the wrist bone putting needle strain on the tendons.

Don’t grip or grasp an object for long periods of time. This contracts forearm muscles, pull tendons and creates pressure and rubbing in the carpal tunnel.

Don’t pinch (grasping with only the fingers) – causes additional pressure in the carpal tunnel.

Don’t keep elbows bent forward (as in at a keyboard) for long periods – causes compression of the nerves causing irritation.

Don’t slouch.

Don’t lean over your work. Strains neck and shoulders. Also can impinge on nerve roots.

Don’t keep your arms in a work position for a long period of time, the constant stress of supporting the weight of your arms and your work can irritate the shoulder.

I also go for regular sports massage to relax the muscles and to remove the built up toxins found in them and this helps a great deal. But if you haven't got time for exercising or massages, just change your position regularly, let go of the needles or stop typing, stand up, walk around, move your shoulders, but remember to treat your body gently and with respect. 

I do hope some of the information may be of help

for now,
Ruby xx

5 comments:

ThatCleverClementine (aka "ByGumByGolly'sMum" said...

Brilliant post, Susan! Thanks for bring a LOT of great information together into one place. Even this former massage therapist will benefit from the reminder!

Anonymous said...

Thank you for this, I have suspected RSI which I'm going to the doctor to try to get diagnosed on Friday. I am a keyboard worker as well as a knitter so :(

Your exercises will come in very useful for me!

Lorna said...

This is excellent advice - thanks! I've been having trouble with my left hand. I crochet, sew, use a computer all day and also play the accordion - I'm doomed! Perhaps not, if I start following your advice.
thanks again!

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baukje said...

Hello Susan, i came to visit your blog to look if your program for the salon pour L'amour du fil, is ready. Then i came across this post. So important info for crafters!!!!!!! May i put the info on my blog please with of course a link to your blog?