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Repetative strain injury to thumb

Discussion in 'General Issues and Discussion Forum' started by Emma82, Feb 7, 2011.

  1. Emma82

    Emma82 Member

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    Hi, I have developed RSI to my first carpometacarpal joint and it is becoming increasingly more uncomfortable when working, especially when using a nail file, Ive still got a good few years left of work yet so I want to try and stop it getting any worse! Im wondering if it might be the nippers I use, I dont go for the cheapest ones but I dont go for the most expensive either. I just wondered if anyone had any tips or if anyone knew of any specific nippers that would be easier on the joint? Thanks.
  2. Catfoot

    Catfoot Well-Known Member

    Hi Emma82,
    Some pods I know use cantilever ones.
    Personally, I can't get on with them as the fulcrum of the instrument is too far away from the patient for my liking, but they swear by them.

    Hope that helps


  3. Emma82

    Emma82 Member

    Thanks Catfoot, I will give them a try and see if they help.
  4. Yes cantilevers and make sure that they are sharp, doesn´t matter what your using if they are blunt then you require more force to do the job, therefore more strain.

    Also Emma if you have been out in practice for awhile get a mate from school to have a look at the ergonomics of your pallitive care technique, maybe there are a few bad habbits creeping in.

  5. G Flanagan

    G Flanagan Active Member

    Emma I sympathise. I have the exact same problem. Funnily enough mine is aggravated by the injections (I give lots of ankle blocks). In the grand scheme of things I'm still a newbie in the profession and thus I would love some advice also. I gave myself a depo medrone injection ( well i distracted my joint and showed a friend how to do it) which helped for around 4 months but I'm hesitant to continue with steroid for the rest of my days.

    Any further advice would be useful
  6. carol

    carol Active Member

    I cured mine by using 11cm nippers instead of standard issue 15cm. They fit my hands better, but the main thing is make sure whatever you use is sharp, blunt nippers will give you a sore thumb and stiff wrist every time...and lay off self treating..don't you know wha that stuff does!!! ;-)
  7. Admin2

    Admin2 Administrator Staff Member

  8. Emma82

    Emma82 Member

    I hope it doesn't come to that George, that sounds painful and I'm a wimp! Thanks everyone for your useful advice, Im gonna go and order some new cantilever nippers now and hope they do the trick, Ive got another 30 years of work ahead of me yet so need to get it sorted!
  9. Another idea for you Emma get stuck into the biomechanics and you will use the nail nippers less, which will help.
  10. PostMortem

    PostMortem Active Member

    Hi Emma, I can also sympathise with you. Before going out and buying new nippers, get intouch with your supplier/rep and ask them to bring samples. Try as many different nippers as you can and preferrably (budget allowing) go for the ones that feel most comfortable in your hand.

    Technique is also critically important, I am able to use my left hand almost as comfortably as my right when using my nippers, this can help to reduce awkward wrist postures.

    How much 'outside of work' exercise do you do? Changing the way you use your hand through other activities could help to reduce the effects of the repetition we experience and increasing the strength of those muscles over what we would normally require of them may reduce the trauma to them, 80/20 rule.

    Good hunting.
  11. efuller

    efuller MVP

    Examining the physics of the situation, there is a trade-off between the increased leverage you get with longer handles and the farther apart you have to spread your grip to get around the handles. A lot of nippers have curved handles so that the distance the end of the handles are apart is not so bad at the farthest end from the hinge where you have the best leverage. Also shorther jaws will give you better leverage, or more precisely, the nail less leverage.

    The assumption is that the pain comes from increased compressive force at the joint. The compressive force in the joint will be higher when there is higher force in the tendon trying to move the joint. You will need less force in the tendon the closer the tool handle is to your wrist.

    Resistance from the nail is not just a leverage issue, it's a pressure issue (force / area) So, the more nail you try to cut at once, the more resistance you have to overcome. So, take smaller bites.

    A lot of thought to say don't do what hurts. Hope this helps in choosing new nippers.

  12. DTT

    DTT Well-Known Member

    Hi Emma

    You may want to consider a different grip / hand hold which will have different muscle / joint usage ?

    I have worked with several pods that are NHS trained and their handhold and usage if very very different to mine.

    Isaacs and I have many discussions on which is the best , both work and I suppose its mainy what you were brought up with but a change may be what you are looking for.

    I dont know how to begin to explain it so I will ask Isaacs to see if he can find the time to make a short utube vid so you can see and hopefully that will help.


    Derek ;)

    PS ROBERT !!! You listening ?? :D
  13. Yeah yeah. I'll get right on it. Harland ;)

    actually it might be worth it. There are two very different hand positions and whilst derek and I argue as to the best, they are certainly different. So if you have an injury changing grip might help.

    I'll try to do it tomorrow.


    ps. Mine is better. Few more years del, you'll learn.
  14. footdrcb

    footdrcb Active Member

    No matter what type of instrument you use, sharp is the best. I ended up getting a cortisone injection some years ago which fixed my RSI within a few weeks.

  15. DTT

    DTT Well-Known Member

    We argue Rob ?????????????????????? Nooooooooooo really :D

    When you grow up and you're as old as me you will understand :drinks

    And seriously , YES sharp is essential whatever grip you use.

  16. Done a thread on it.

    In which I shall be affable and not argue. Honest.

    Hope I got your technique right mate.
  17. DTT

    DTT Well-Known Member

  18. Emma82

    Emma82 Member

    Thankyou DTT and Issacs for all your help. Your new thread has been very useful.

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