The Hand to Shoulder Solution
Your new resource for hand, shoulder, and elbow pain. Together, we are giving pain the middle finger and gaining knowledge to live a better, pain-free life!
Discover what might be causing pain in your fingers, pain in your hand, pain in your wrist, pain in your arm, pain in your elbow, pain in your shoulder.
Learn about your body, arthritis, tendinitis, tennis elbow, fractures, golfer's elbow, and carpal tunnel syndrome.
Hosted by Carl Petitto, OT, CHT, and Certified Hand Therapist specializing in orthopedic conditions of the hand to shoulder. Also an expert in fabricating custom orthotics.
The Hand to Shoulder Solution
Ep 18 - Navigating Shoulder Health: Tips for Workers & Professionals to protect your joints
Exploring shoulder health reveals the common pitfalls many professionals face daily. This episode dives into practical strategies for optimal shoulder use in various occupations while highlighting preventative measures against injury and discomfort.
• Understanding common shoulder conditions and their symptoms
• Discussing the impact of poor ergonomics in the workplace
• Examining shoulder health for various professions
• Practical tips for preventative care against shoulder injuries
• Highlighting the importance of early intervention and professional consultation
Thank you for your support! Please consider leaving a review or sharing this episode with someone you know who could benefit from these shoulder health insights.
Hello and welcome to the new show, The Hand to Shoulder Solution, with me, Carl Petitto.
If you are experiencing pain in your arms and hands, this is your resource.
Subscribe, listen, and share to help us give pain the middle finger for good!
This is a resource to help you mitigate pain at home and become more educated on what to ask your doctors and therapists. No medical advice will be given, and you should always see your medical professional for any questions.
Thank you, and welcome to the show!
Welcome back to the Hand-to-Shoulder Solution Giving Pain the Middle Finger. I'm your host, carl Petito. I'm an occupational therapist and a board-certified hand therapist. I've been practicing since 2000. I specialize in the rehabilitation of orthopedic conditions affecting the fingertips through the shoulder. Today I want to talk about how to optimally use your arm and shoulder, specifically the shoulder, safely.
Speaker 1:I want to discuss ergonomic considerations and just basically good, healthy habits for preserving the health of the shoulder and preventing painful syndromes and conditions. This is not treatment or specific treatment advice. This is information sharing so that you have a basic knowledge of how the shoulder works, how I should protect the shoulder, how to prevent painful conditions. I want folks to understand that there's a lot that can be done. There is a lot that could be done for prevention, also for treatment, and one of the most important things to understand is that the sooner any problem can be treated, the easier it is to treat. So I want you to also clearly understand that it is very important to get a professional evaluation and professional examination to find out exactly what is the cause of the pain so it can be treated effectively If it goes on too long.
Speaker 1:The longer it goes, the harder it is to treat and it's very, very difficult on the patient. It can be if it's delayed too long. So let's get into it. So I want to talk about some different professions office workers, barbers and hairstylists, construction workers. I used to work as a welder, as a machinist, as an aircraft mechanic, fabricating parts for aircraft. I worked construction for a while. I've worn a lot of different hats over the years. I can really remember what it's like to work in awkward positions and experience shoulder pain. So let's talk about office workers.
Speaker 1:It's really easy to get in the habit of getting into a forward rounded position Most of the time. Most things that we do are in front of us. Of course. We're looking straight ahead, we're reaching straight ahead, ahead, and it's easy to get into a slouched or forward rounded position. And what that does to the shoulder is there rocks a shoulder blade forward. So if you rock the shoulder blade forward, you get pinching off of tissues that travel between this roof of bone, the acromion bone, which is part of the shoulder blade, and the head of the humerus, which is the ball on the ball of socket, the muscles of the rotator cuff. They're connected by tendons to the outside part of the ball and they travel underneath that. So when the shoulder gets rounded forward and slouching, for example, that tissue will get pinched off and it'll start causing things like tendonitis of the biceps tendon, which is inflammation of the tendon. It will cause bursitis, which is inflammation of a flat little water balloon type of a shock absorber that's underneath that roof of bone, underneath the acrobion and the balloon. Part of the flat water balloon is living tissue that's it's called the bursa sac. Part of the flat water balloon is living tissue it's called the bursa sac, and when that has pressure on it a lot, that starts to get really inflamed and very, very painful. It's relatively easy to treat if we catch it early. Sometimes your physician will even give you an injection of a steroid to reduce inflammation. What I like to do is have people put their hand behind their back and it rolls the head of the humerus forward and exposes that bursa sac, that little flat water balloon. So a piece of ice can immediately reduce that inflammation.
Speaker 1:Office workers often will put the keyboard forward on the desk and have to reach for it and that causes slouching and that rocks that roof of bone forward. If a person were to bring the keyboard back to the edge of the desk. That brings the shoulders back and that makes all the difference. And once in a while, you know, I like to have people just do a big yawn stretch and bring their arms back and open up those shoulders and take the pressure off internally that is causing the problem.
Speaker 1:Now let's talk about construction. So working construction, and especially doing things overhead, is very, very provocative to the shoulders. It provokes the soft tissues. It's an awkward position. By the way, the power zone of work lies between the level of the waist and the shoulders. So working within this zone is primarily mechanically effective as far as a good mechanical advantage of all the muscles and the bones and it's a safe position to work in. When you start getting down really low or up really high, that starts to really aggravate tissues and puts the skeleton and the muscles in compromising positions. That is causing pinching and causing aggravation.
Speaker 1:Now what can be done? Work still has to get done overhead, but if job tasks can be varied so for example, if I'm going to work one or two hours doing drywall above my head and then maybe I'm going to go over there and do some painting or do some framing and do something within my power zone vary it up a little bit, then go back to working overhead. Although it's a little bit inconvenient to switch different jobs and leave something unfinished for a moment, it really extends the life of your tissues, so you're not going to be out of work. Another really great idea is and this is very helpful for people to keep in mind is if you're doing something in an awkward position that is causing discomfort, anytime you have a rest break, or if you're walking from point A to point B to maybe to get some more supplies or something, go into the opposite position. So here's an example Reaching overhead, you're working and working and working, and then now you know what I ran out of drywall screws or whatever. Now I'm going to walk over there and get them. While I'm walking, I'm going to break. I'll have my arms down but reach back. I'll be reaching back and stretching. Put my hand behind my back, my hand behind my head. Just go in the opposite direction of where I've been for the last, however long that has been aggravating me. So moving in the opposite direction. Also, let's talk about just things around the house.
Speaker 1:I like to cook a lot. It's a hobby of mine and I caught myself the day I just happen to have a frying pan right here. I was moving a pan and I'm in this position and this position really stresses one specific muscle of the rotator cuff and these muscles they travel underneath this roof of bone right here and it gets pinched off in an awkward position like that. When it's out here like this and you can see this space right here is being decreased and any muscle, any tissue that is between these two bones is going to get smashed or pinched. And now watch what happens if I bring my elbow down. And now that restores the space. Now the tissues aren't getting pinched like that anymore. So let's do it with the frying pan. So we're out like this. Instead of being out like this to pick it up off the burner or to move it, I'm going to pick it up with my elbow down. Now I'm underneath the handle and my shoulder is being saved. I'm using my biceps, other elbow flexor muscles, my palm is turned, palm up. I have a good handle on that pan and I can move it anywhere I want and my shoulder is now safe.
Speaker 1:And a lot of people who have rotator cuff tear and they're dealing with it and managing it. They're managing their symptoms well. They will learn on their own to modify positions. It's very interesting when we have a talk in the clinic about that, people will say oh yeah, I'm already doing that, I already figured that out, because every time I'm out here it really hurts a lot, but I bring it down and I'm fine Picking up something heavy, a heavy bag. Now let's talk about leverage for a moment. Moment arm so the moment arm of force is basically the leverage. So if I reach out here and I have 10 pounds 20 inches away from my shoulder, the same in this position, and I'm stressing my rotator cuff muscle on the top right here, if this pan is 20 inches away from my shoulder and it weighs 10 pounds because of leverage, now that's 20 times 10, that's 200 inch pounds of force through the tendon. That's a lot of force.
Speaker 1:If you have a bag and add a shake case or something and it's on the floorboard of the front passenger seat, you're in the driver's seat and you're going to get out. It's pouring rain. This happened to me the other day. It's pouring rain and I don't want to get out. Walk around the other side, open the door, pick up the bag. If the bag were behind the seat I would not reach back for that bag behind the seat because that is one of the most risky things that a person can do and that's how a lot of rotator cuff tears happen. But if it's forward and I can reach down and grab that, I'm going to reinforce my own wrist and I'm going to pick up that. Now I'm using two hands. It's not practical for me to get both hands underneath the handle and pick it up both hands on the handle, so in that case I'll just grab my own arm and that's taking pressure off my shoulder. So little habits like that really really go a long way. And then, as soon as I can, I bring that in close to my body because, again, I don't want to leverage, causing all of that force focused on the tendon. I'm going to reinforce and I'm going to bring that in close and you know it. Just, it just happens quick. It just becomes a habit that, okay, I got my bag and I'm out of the car and I'm on my way and I didn't injure myself.
Speaker 1:And of course, as we get older, our tendons, our tissues become less supple and inflexible and then also wear and tear occurs over the years. Supple and flexible and then also, wear and tear occurs over the years and you might have an underlying irritated, torn, worn out tissues that are ready to tear, and we don't know it, so let's not risk it. So when we're taking a look at the power zone, remember that the power zone lies between the area of the waist and the shoulders, and ideally we want to keep our work in front of us and between the waist and the shoulders. If we're working with a customer for example, a barber or a hairstylist is working with a customer and they're in the chair, we have to position the work so that the work is in their correct position, so we're not working up too high and we're not working down too low. But if the customer can be positioned to where it's at a comfortable position, it's within that power zone, between the waist and the shoulders or the. The barber or the hairstylist is on a stool. So between positioning the customer and positioning the worker, uh, they have to be in a position of safety. I call it for the joints because, remember too, the barber is not going to have just one customer during the day, they're gonna going to have several. So that's a lot of wear and tear on the joints, on the muscles, on the tendons that connect muscle to bone, on the ligaments which connect bone to bone, and then it's a cumulative effect as well. So then you have multiple days of that, so you have multiple clients every day, then you have multiple days of multiple clients and it really, really adds up.
Speaker 1:Now, reaching behind we talked about that. Grabbing a heavy bag or heavy object behind the seat of the car. Never want to do that. It's ideal to get out of the car, open the back door and get anything out that you need from a head-on position. Also, even just you know, let's go back to the cumulative effect. Sitting at a desk, we don't want the trash can behind and always reaching back or files, we want to. If something is behind you, you want to turn around and face it head on and get it. But reaching behind is always, always difficult. Store clerks when you're in the store, just just watch and see if they're picking up heavy things. The arm is out like this and turned.
Speaker 1:If again, if any, if anyone could bring the elbow down and then reach, that makes all the difference and that really I'd be so happy if everyone could prevent a tear of the rotator cuff muscle or muscles. But you know, not everything can be prevented, but we can decrease the chances of it and then also, over the long term, we can decrease the unnecessary wear and tear on these tiny tissues. So again, I just want you to have an awareness of that. Be mindful, especially if anything is hurting while you're doing it, try a different position and that will really make all the difference for you. And especially if you've been having any discomfort that's been lasting for a few weeks, you really should be seen by a physician, a physician assistant, a nurse practitioner. You really should be seen by a physician, a physician assistant, a nurse practitioner and a therapist. And let's look at the structure, let's look at the function of everything and pinpoint where are things going wrong and let's fix it sooner rather than later. Thank you for watching. We'll talk soon. Thank you.