Peace at Hand's Healing Blog


Wrist Splints and How Not to Use Them

Posted on February 17, 2010 in: Advice - Tags: RSI, treatment

One of the really interesting things about massage is how client types seem to come in waves.  If I see one runner with piriformis issues, three more will probably follow.  Lately, the issue has been repetitive stress injuries of the wrist caused by overuse of the computer, like carpal tunnel syndrome.

The most common treatment I hear about is splinting the wrist.  Sleeping in a wrist splint is absolutely a good treatment for RSIs. 

Typing in a wrist splint is not. 

Let me repeat that: Please do not wear your wrist splint while you are typing on your computer.

I hear of people doing that all the time, and what really floors me is that they claim to be following their doctor's advice.

Maybe doctors really are advising patients to type in wrist splints.  On the surface, if you are looking at the wrist in isolation, I suppose it might seem like a good idea.  But--stop for a second and remember that song about how the wrist bone's connected to the arm bone and consider what has to happen if we force the wrist in to a fixed position and then continue typing.  Other muscle groups (or other parts of the same muscle groups) are brought in to play, doing work that they weren't designed to do.  Its like using a screwdriver as a hammer.  It can be done, but its a really good way to break your screwdriver.  I promise you that if you type in wrist splints for hours a day for a few days running, you are going to hurt in places that feel totally unfamiliar to you. 

And my question is why.  Why should we develop a treatment plan for one issue that is only going to create new issues in other places?  It doesn't make sense.

The real treatment for a RSI is to stop doing the thing that caused the injury in the first place.  I realize our society isn't built in a way that often allows us to stop working, even when our health is at stake, so if you aren't going to stop typing (or doing whatever it is that caused the problem), at least minimize it.  If the problem is on your right side, look at tasks that you can begin doing with your left.  Brushing your teeth.  Holding the phone.  Carrying your coffee cup.  You would be surprised by how much strain you can relieve just by moving small but frequent tasks to your "good side."

Keep the splints, but wear them around the house when you aren't using your hands, and absolutely sleep in them.  Sleeping in them is key.  If you need to type or carry on with those fine motor tasks, look for soft braces.  Something that will give you a little compression and support without having a solid splint built in to them.  A quick trip to CVS should be able to supply you with what you need, and once you're looking at the options, the two types of braces will be obvious.

If you are one of those people who is under doctor's orders to type in splints...well, I would never tell a client to ignore something that their doctor told them to do.  What I suggest is this: Call your doctor.  Explain to them why the splints might be bad, and ask what they think.  Do a little research, and then do what feels right to you.

But mostly?  Don't type in a wrist splint.

Training Tip for Runners #1:

Posted on April 20, 2010 in: Advice - Tags: running, AIS

Stretch well, and stretch your whole body:  Ask any runner whether they stretch after a run.  Most of them will get a little shifty eyed and guiltily admit that they don’t.  If they do stretch, they often say they don’t stretch as much as they should, or that they only bother with their legs.  Somehow, these folks can find a way to carve an hour out of their day to run, but can’t find the extra ten or fifteen minutes to properly stretch afterwards.

No runner wants to hear this, but the fact is that it is better to run for slightly less time and stretch properly than it is to run for longer and neglect stretching.  Stretching can prevent cramps and strains, increase flexibility and fluidity, help maintain proper postural alignment and reduce the effects of lactic acid build-up.

Not only is it important to stretch, its important to stretch the entire body.  Although it is easy to focus on the legs and glutes--running’s powerhouses--running is a full body workout, and there is a natural connection between our shoulders, arms and back.  The stress of running can cause our shoulders to contract and elevate, the motion of the arms can tax the back, and the impact of running can compress the lower back and spine.   Somewhere down the line, the foot bone is, in fact, connected to the head bone.

Active Isolated Stretching (AIS) can be a great solution for a reluctant stretcher.  Designed as an athletic stretching technique, AIS targets specific muscle groups with a series of facilitated stretches to lengthen muscles and restore flexibility.  In many cases, clients perceive a change in the way they feel immediately, and over time it is possible for AIS to rehabilitate and restore overused and poorly functioning tissue. 

AIS can be incorporated in to a sports massage session, or serve as its own therapy, and practitioners are able to provide clients with take home stretches to continue the work between sessions.  Over a series of 4 to 6 sessions, clients can expect to see increased flexibility and fluidity, decreased muscle fatigue during runs, and in general, less soreness and stiffness.

Smile while you work. You'll feel better.

Posted on May 10, 2010 in: Advice - Tags: advice, athletics

This is not wisdom that I can take any sort of credit for.  Its actually an idea that my yoga teacher shared a few weeks ago.  She was talking about how common it was to see students putting on their "game face" as they tried to hold a challenging or uncomfortable pose, and how counter-productive that was.  "The advanced form of any asana," she tells us, "is doing it with a smile."

Its true.  Mentally, its harder to smile when we are uncomfortable or under pressure, but physically, smiling can make the activity easier. 

I've started trying to keep that in mind when I'm out jogging, and it turns out that it doesn't just sound good--its actually true.  When I'm running and I'm starting to feel worn out and I'm trying to get up another hill (If you don't believe that the DC area is hilly, go spend some time running or biking around the city.  Its ridiculous.) the first thing that happens is that my head drops and my shoudlers slump and my face gets  tense with effort and concentration.  The only thing that posture serves to do is make my breathing even more labored, and make fatigued muscles work harder.

Try it.  Rest your hands on the front of your neck, or even on your chest, just below your collar bone.  Now tense your jaw.  Tighten your mouth.  Frown a little.  Look like your concentrating, and feel what happens to the issue under your hand.  Maybe try to take a deep breath.  Not so nice, huh? 

Now smile.  Lift your chin a little.  Doesn't that feel better?  Didn't everything under your hands just get a little softer?  Does your breath feel more relaxed? 

The next time you're doing something challenging, whether its athletic or whether you're desk-bound, be mindful of your expression and see if you can do it with a smile.  Or, at least without a frown.  It really might make the task go down a little easier.

Learning to Relax

Posted on June 16, 2010 in: Advice - Tags: relaxation

Yesterday, Sisarina tweeted a link to an article about why relaxing is such hard work.  It talks about how few Americans return from a vacation feeling rested, how many become ill when they try to take a proper break, and how we're developing an inability to simply sit still and be.

As a society, we're taught to maximize our time, to stimulate ourselves to keep going, non-stop, through the workday.  The importance of our presence at work, at meetings, at class, at social engagements, is stressed to the point that often, even illness isn't enough to keep us in bed.  At the end of the year, our meager allotment of vacation time still hasn't been used.  We are all taught, from a young age, the importance ofpowering through, but we are no longer taught to relax.

We don't think of relaxation as something that needs to be learned or taught, but after our nervous system becomes conditioned to maintain a constant state of arousal--a low level fight-or-flight response--we really do have to re-learn how to let go.

The point was driven home for me last night.  During Savasana at the end of a yoga class, I realized I was going over my mental to-do list instead of settling my mind and focusing on my breath.  The ironic part is that we had spent the past hour or so of class discussing Santosha, the observance of contentment--the idea that one should be happy and grounded in the moment. 

This is something that I see--or rather, that I see a lack of--in my clients on the massage table.  While a person comes in for a relaxing massage and generally expects to lie passively for an hour, one of the hardest things they will do all day is let go. 

Some clients find themselves laying there, as I did, worrying about the things that they need to accomplish and trying to work out a plan.  These are often the same clients who take their laptop on vacation and sit at the poolside checking their email.  Other clients are more physically guarded.  I lift their arm, and they hold it stiffly in the air.  I slide my hands under their shoulders to prepare to cradle their head, and they lift their upper body off the table.  Often, these are the clients who suffer from chronic headaches or tension and pain in their shoulders.

Massage can be a great tool for those people who find themselves unable to just sit and be.  By physically assisting our bodies in the process of shifting from "fight or flight" to "rest and digest" (or, in more technical terms, from our sympathetic nervous system to our parasympathetic nervous system), we remind them of what it is like to be in that state.  And, on a more conscious level, we remind ourselves that nothing bad will happen if we allow ourselves a bit of time to recharge.  Over a mumber of sessions, those guarded clients stop "helping" me support their weight, and the mentally alert clients find themselves in a deeply relaxed state where they are no longer conscious of time passing.

Relaxing and recharging is so important, and so undervalued in our culture.  Its easy to believe we don't have time to take for ourselves, but I promise you this: after you take an hour for a massage, or a day to sit by the pool or go for a hike, your newly centered mind and body will be more equipped to deal with whatever you need to accomplish, and you will be able to handle it more efficiently.  Its a win-win situation.

And so, I challenge you to take some time to truly relax over the next few days.  Take a totally frivolous book to the pool.  Turn off your phone and computer screen and spend five minutes at your desk focusing on deep, expansive breathing.  Lay in Savasana for fifteen minutes before bed. Get a massage.  Carve out a little time for yourself, and be mindful of how it makes you feel.  If you start practicing relaxation now, you'll be able to call on that response when you need it.


Posted on March 7, 2011 in: Advice - Tags: health, stress, self-care

This month, in celebration of DC Fit Week, Sisarina is hosting a fit entrepreneur blog series, and she was kind enough to ask me to contribute.  My post about ten-minute stress relief strategies is here.

Keep an eye on the DC Fit Week blog for another upcoming post about relaxation and stress management before the end of the month.  And, be sure to check out the rest of the Fit Week site for great coupons and free classes and events around DC!  The folks putting together Fit Week are doing an amazing job!