What can I do to prevent Carpal Tunnel Syndrome?
There are several factors that create carpal tunnel syndrome and hand pains
for hair stylists. Lets start at tip of the hand and work our way to the
shoulder, since everything is connected.
The classic way to hold a scissor, as taught in the United States, is to
place the ring finger and thumb into the holes of the scissor (also known as
the finger rings). The logic here is that you can use your index finger to
place on your customer as a guide when detailing and the middle finger acts
to stabilize the scissor while opening and closing it. As you open and close
your hand, you are forcing your thumb to your ring finger. This is a VERY
unnatural motion and causes much of the thumb damage and pain associated
with cutting. The thumb should move towards the index finger as much as
possible.
For example, when you pick up a penny, what do you pick it up with? Your
thumb and ring finger? No, usually you use your thumb and index or middle
fingers. This is the way a hand naturally opens and closes. This also
explains why stylists who cut using their index or middle finger and thumb
to hold their scissors have less carpal tunnel problems. It is interesting
to note that Europeans and barbers use their index or middle fingers more.
Only in the past 25 years have many schools taught their students to use
their ring fingers.
To alleviate this problem, scissor manufacturers started to develop
ergonomic scissors. Ergonomics is a fancy word meaning "The applied science
of equipment design, as for the workplace, intended to maximize productivity
by reducing operator fatigue and discomfort". On a traditional scissor the
handles are even, meaning that both handles look the same and are the same
length.
One of the first and most popular ergonomic scissors developed was the
offset scissor, where the thumb ring has been brought forward. This allows
the thumb to have a more natural movement and not force it opposite the ring
finger when closing. Now when your cutting hand is in the closed position,
the thumb is opposite the index or middle finger. Examples of Arius
Eickert's offset scissors are the
8315 Geisha or the
1040 Offset. Even better are the swivel thumb scissors.
These scissors allow total freedom of movement for the thumb, putting very
little stress on the thumb. An example of these scissors is the
8360 Swivel Thumb.
The next most common cutting mistake is to bend the wrist. Again, bending
the wrist causes the tendons to rub over the bone or ligament in the Carpal
Tunnel. Somewhat like a rope being dragged over the corner of a table. As
you open and close your hand, the tendons are rubbing over the bone edge.
Remember, it is best to cut with your wrist straight.
Another habit many stylists have is to cut with their elbow sticking out or
up. The bent arm is held parallel to the ground, instead of closer to the
body. The elbow works best close in to the body and when raised is subject
to a higher stress distribution.
To counter both the bent wrist and raised elbow, scissor manufacturers made
the crane necked scissors. With these scissors not only is the thumb ring
brought forward like on the offset scissors, but the whole handle is bent
downwards to fit the hand better, allowing you to drop your elbow while
cutting. The handle of one blade is directly straight in line with the
blade.
In other words, if you put a ruler over the center of the scissor tip and
run it through the center of the screw hole, the other end of the ruler will
go directly through the center of the ring finger hole. Having this very
straight blade and handle forces the thumb ring forward and down. This gives
the scissor a bird like "crane" look. Examples of these scissors are the
8340 Cobra or the
8350 Scorpion scissors. These scissors allow a more relaxed elbow
and straight wrist.
Holding your wrist and elbow wrong also makes many people slouch while
cutting. This translates into lower back and ankle pain!
If your hands or wrist hurts.
If your hand starts to hurt or feel cramped, many doctors recommend flexing
and strengthening exercises to build up the muscles in the hand, wrist and
forearm. The stretching also helps the blood flow. Here are some commonly
recommended exercises:
- Open your fingers all of the way. Stretch them out, then relax them.
Do this several times.
- Do some shoulder and neck exercises. Start by standing with your feet
apart, hands on your hips. Turn your head left and right slowly 10 times.
Lightly stretch the neck muscles.
- Now move your head shoulder to shoulder, bringing your right ear to
your right shoulder, then the left ear to the left shoulder 10 times. Do
not try to touch both shoulders at the same time...... (That was a feeble
joke by the way!). You should be loosening up slowly.
- Now roll your head clockwise a few times, then counter clockwise. You
may not have much flexibility at first, but do this every day and you will
soon feel better.
- Next stretch your arms out straight like an airplane, then let them
down and relax. Purse your lips and blow out deep. Make sure that you make
a "brrrrrrrrr" sound (this helps you complete your airplane effect). Do
this stretch a few times.
You may think, what do these stretches have to do with my hand and wrist?
Remember, everything is connected, from your hand to your shoulder and
tension in your shoulders can translate to your hands. The first wrist
problem signs many people have can show up in their shoulders or neck. A
pinched nerve in the wrist can show in strange places. Until more serious
symptoms appear, many people may not even know they have a wrist problem.
Initial symptoms may appear hours after the person has stopped cutting. For
instance, an early warning, the prickling sensation in the wrist, is
sometimes experienced when the person goes to sleep at night. Please do not
confuse this symptom with the prickling sensation you feel at night when
your cat has it's claws buried deep into your hand!
If your Carpal Tunnel Syndrome symptoms get worse, the doctor may tell you
to take an anti-inflammatory medicine such as Aspirin or Ibuprofen. You may
also be told to wear a brace to keep your wrist straight. If things get
worse, the doctor may inject an anti-inflaming product such as
Hydrocortisone directly into the wrist. They will usually only do this once
since it either works or not. The hope is that the massive dose will bring
the inflammation in your wrist down. This shot must be coupled with a change
in your work habits, such as the ones discussed above - keeping your wrist
straight, doing stretching exercises and purchasing an ergonomic scissor.
Multiple shots are usually not given, because of the side effect of the
Hydrocortisone.
Your Carpal Tunnel Syndrome just will not go away!
You have tried everything else and nothing works. You are in pain and work
is just not fun any more. Two of the most popular solutions are to marry a
rich person and move to the Bahamas where you can bask your hand in the sun,
or HAVE AN OPERATION!!!!
Argh! Yes I said it, you may have to get the cutters "badge of courage"! I
know, you are saying that you already have all this pain so a little
operation can't be much worse. Well, you are right. Carpal Tunnel operations
are very advanced, fast, relatively painless and quite successful. The
operation consists of cutting into the ligament holding all those tendons
down (remember that rubber band thing we talked about?). The ligament is to
relieve the pressure on the tendons and median nerve running beneath it. The
procedure is usually an out-patient one. You go to the hospital in the
morning and go home in the afternoon. You are put to sleep so that you do
not move (hmmm... maybe the wrong term for you Pet Groomers). Today, the
operations are usually done using an endoscopic procedure (that's another
fancy word for really small instruments). Many doctors now even use lasers.
In the old days, to cut the ligament, an incision was made from your palm
all the way down your wrist. That way the doctor could get at the Carpal
Tunnel ligament to cut it. But today, with the advancements in endoscopic
equipment, only a small incision is made in the palm of your hand, about the
point where the middle finger and the thumb intersect if you drew a line
down them. Another incision is made on the wrist on the other side of the
Carpal Tunnel. The doctors' instruments travel under your skin. Snip, snip
and your done. A few stitches, some recovery time and they send you home
that same day. You can use your hand in a limited capability after a week.
Most people have full use of their hand after 4-6 weeks.
If you think that you have Carpal Tunnel Syndrome, we recommend that you see
your doctor. The earlier you treat the problem, the better.
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