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Monday, March 10, 2008

RSI

I have finally found hidden amongst my computer files the information I collected about RSI for a college course I was teaching a couple of years ago. I had promised to forward the information to a number of people who asked for it and I will do my best to find the appropriate emails and do so, but in the meantime here it is. I hope it is of use to fellow RSI sufferers

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, not tucked under your arms – causes 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.


GENTLE WARM UP EXERCISES

Warm up soaks and stretches

Perform the stretches in a basin large enough for you to immerse your hand, forearm and 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.

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 headrest, 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

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.

This information has been gathered from various sources, however I can't as yet find the file with the bibliography but will edit the post when I track it down.

off to do my stretches,
for now
Ruby xx

6 comments :

Queen of the froggers said...

Thats a great load of information, especially the stretches. Thank you. x

Stephanie N said...

I am bad, I slouch into the couch with my legs outstretched on the coffee table, crossed, so my spine is slowly sinking into the couch. My couch is only a few years old, but I have been off work for 2 months now so when I sit up to get up, I hear a spring twang when I do-that tells you how long I sit there :(
I'm bad-I will behave from now on-thank you for the info!!!
I'm going to bring it to knitting night this week!

Jox said...

thank you for all this info.
I havn't knitted for a while because I got a really sore shoulder and tennis/golfers elbow.
I am itching to get back to my knitting so I will try all the things you have suggested.
thanks again.

Susie Hewer said...

"Avoid marathon knitting session"???!!!!!!!!! Tee hee, you can't mean me. Very useful info there thanks Ruby. xxx

Medea said...

Thank you very much for all this. I will put in in my blog to let my swedish friends read it. And I put in a link to you to of course!!
Thank you again.

KnittingPony said...

Thank you so much for this post - I recently started to knit more loosely and this has helped so much more than I could have imagined! I shall print out your tips and keep them near me when I knit. x