How to Protect your Hands 

This guide is to assist you in understanding the effects of external stresses on the joints in your arthritic hands and learn joint protective methods. After you learn the few principles of protective use, you will recognize that you may have been putting a great deal of damaging stress on your hands while doing everyday activities. Recognizing this, you can begin to do something positive to help yourself.

You and your family need to understand that there will be times when you must ask for help. Continuing an activity that is painful can promote joint damage. If there seems to be no way to complete the task through protective methods, ask for help. Persistent use of arthritic joints during a stressful activity can do more harm than good.

You should not get involved in prolonged activities that tax you beyond your endurance. Start everything with the understanding that you can take time out, quit, or get help to finish the job. Work and rest must be in sensible proportions.

Principles of Hand Protection
It is known that continued and rather constant use of the hands in natural ways puts stress on arthritic joints and the tissues that support them. This kind of use can contribute to deformity. Deformity can lead to limitation in the use of the hand(s), with loss of dexterity and skills.

Stresses to Avoid:

• Avoid using a tight grasp. A tight grasp can happen when carrying heavy objects such as handbags, shopping bags, pails or baskets by the handles. It also happens when using screwdrivers, shears, and pliers. Tight grasp contributes to ulnar deviation which is shifting of the fingers towards the little finger side of the hand and dislocation of other joints. You need to learn to hold everything no tighter than necessary.
• Avoid pressure against the radial side of each finger (the side of the fingers closest to the thumb). This pressure encourages ulnar deviation of the fingers. Positions or tasks that contribute to this deformity include propping your chin on the side of your fingers, using the thumb side of the hand and fingers to push up from a chair, turning a key in a lock, pushing a drawer shut with the side of your fingers, or using one hand to open latch-type door catches.
• Avoid all pressure against the backs of your fingers. This contributes to dislocation of the large joints between the palm and the fingers (metacarpal-phalangeal joints). Positions or tasks that can contribute to this dislocation include pushing against the backs of your fingers when you arise from a chair or propping your chin on a closed fist.
• Avoid excessive and constant pressure against the pad of the thumb. This happens when you must pinch too hard to manipulate small objects will force such as opening a car door, sewing through tough fabrics, or pushing against the thumb when arising to a standing position. This pressure contributes to a dislocation of the thumb joints. The thumb is necessary for all skills of the hand.
• Avoid prolonged periods of holding the same position. This can include tasks such as holding a book or doing needlework for extended periods of time.

Principles of Joint Protection:

• Always use the strongest and/or the largest joint possible to do the task. This means instead of using your fingers, use your wrist. Instead of using your wrist, use your elbow. Instead of using your elbow, use your shoulder.
• If you must lift an object, scoop it up in both hands with your palms upward. You will be lifting with your wrists, elbows, and shoulders instead of with your fingers.
• Use your whole body, whenever possible, to move bulky or heavy loads. Put items on a cart and push it or push boxes across the floor with your feet.
• Slide all objects which will slide and put whatever is practical on wheels. For example, slide pots and pans across the stove and counter to the sink. Use a kitchen cart to carry foods and dishes, and a laundry cart for the laundry.
• Add leverage to the appliances and fixtures to reduce the force to operate them. For example, lengthen the lever of the can opener (electric), put an extension on the water faucet, put a lever on the door key, car key, etc.
• Hold all handles straight across the palm, never diagonally. For example, hold your knife and fork for cutting in overhanded grasp and hold a mixing spoon the same way.

Remember - Put your weight on the palm and never on the thumbs, sides, or backs of the fingers when arising to your feet.

Stress Reducing Suggestions:

• Cut meat with a steak knife, a paring knife, or a rocker knife. Hold the knife and fork handles straight across the palm with the sharp ends coming out by the little finger. To cut, you will be using your shoulder for motion and force. You can also try a pizza wheel for cutting your meat.
• Lift a coffee cup with both hands, or use a mug with large handles.
• Lift a dinner plate with both palms upward. 
•  Press water from a washcloth with shoulder and elbow strength, or use a large spoon.
• Squeeze toothpaste by pushing down on the tube with the little finger side of your hand or your palm.
• Dial a telephone with a pencil held straight across your palm.
• Use an extension on the water faucet. Push it on and off with the palm of your hand.
• Use an extension on your door and car key. Rotate it with the palm of your hand.
• If opening the car door is difficult, use an aid. Twist a jar cap off and on with the palm of your hand.
• If you must open a jar on your own, obtain a rubber jar gripper to assist you. Get help in loosening new jars and ask your family not to screw them on too tightly.
• Peel the skin off potatoes and carrots with a vegetable peeler. Use the style that has a handle you can slip your fingers into.
• Vegetable paring and cutting boards can be made at home using aluminum nails. They can also be ordered from medical supply catalogs. It can be used to hold the vegetable (on to the nails) while you peel and slice it.
• Stir mixtures in a bowl by holding the spoon straight across the palm and stirring with elbow motion.
• Slide pots and pans on the kitchen counter to stove and/or sink. Select only your lightest weight cookware. Do not try to handle heavy iron skillets.
• If you need new everyday dishes purchase the plastic type. They are lightweight and easier to wash and handle. Lightweight china, such as Corelle by Corningware, is recommended.
• Use a high kitchen stool with a swivel seat and good supportive back so that you can sit if the job is going to take more than ten minutes.
• Try a bent coat hanger for an oven hook. Use it to pull the shelf or pan out far enough to check your cooking.
• Use an electric can opener. You can add length to the lever to reduce the force needed in pushing down. Never use the kind in which you must twist between your finger and thumb.
• Use a crank-type flour sifter. The spring-squeeze handle is not recommended.
• Use mitt potholders. They enable you to lift hot pots with your palms instead of your fingers.
• The toaster-oven is very suitable for the limited baking required for two persons. The window front allows you to see into it, it can sit on the counter, and eliminates possible struggles with a tight oven door.
• Use another pan for a prop when pouring batter out of a bowl into a pan for baking.
• Add a belt loop to any door at home that is difficult to open. This could be the refrigerator or oven door. Slip the belt above the wrist and pull. This reduces the stress on your hands and fingers. 
•  A lightweight reacher helps you get things beyond your reach, either in the cupboard or on the floor. It can also help in making the bed. A dressing stick can be used to lift a dress and hanger off the closet rod, push off your shoes and socks, and lift straps up over the shoulder.
• If your iron seems heavy, try a travel iron. Whenever you iron, slide the iron to and from the article rather than lifting it. You probably should not be doing a great volume of ironing. If you must do a lot of ironing, sit to do it. There are adjustable height ironing boards that are designed to give you room for your legs when you sit.
• Lightweight brooms are usually available in grocery or hardware stores.
• Tank style vacuum cleaners, with a rotating top, allows you to clean in every direction around it without moving it.
• A kitchen cart can be used to move foods from the refrigerator to the counter, to the stove, sink, and table. Use it to set and clear the table.
• Use a laundry cart to transport laundry from one destination to another. Never carry a heavy load of laundry in a basket. Remember that dampness adds weight to the laundry.
• Getting the groceries from the car into the house is a strenuous task and even more difficult if you must climb for your spouse or family to bring in. Or, take a rest break and bring in the remaining groceries at a later time.