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Healthy Helping Hands
Caring for the tools of your trade

By Austine Mah

Originally published in Skin Deep, January/February 2009. Copyright 2009. Associated Skin Care Professionals. All right reserved.

One of your greatest assets as a skin care professional is your hands. You use them in every aspect of your work: greeting clients with a handshake; completing client charts; performing facials, waxing, and other treatments; prepping before and cleaning up after treatments, and dashing off thank-you notes. It is your hands that allow you to work. They are an integral part of your livelihood as a skin care professional and are critical to the client's treatment experience.

"Be kind to your hands and give them a break," says
Denise R. Fuller, author, esthetician, and industry consultant in Port St. Lucie, Florida. Monthly massage focusing on the upper body, hands, and arms should be something that professional therapists receive and not just give." As skin care professionals, it's important we remember we can only give to others when we are healthy and strong, having first given excellent care to ourselves.

Prevention of injury is critical for skin care professionals. Alma Chan, a physical therapist in Fort McMurray, Alberta, Canada, says it should be a top priority. "By ensuring the work environment is set up in such a way to place the minimum amount of strain on the body, and by exercising to maintain adequate strength and flexibility in the joints, a skin care professional minimizes the chances of developing injuries," she says. Chan recommends several strategies for injury prevention.

Avoid Repetitive Movements.
Although this is not always possible, try to switch hands, or use varying movements, such as positioning yourself so you are not always moving your hands/arms in the same direction.

Avoid Sustained Positions.
Holding yourself or part of your body in one position for more than 10 minutes at a time is not recommended. If you must do so, get out of the posture for a minute or so, then return to it. Take breaks and rest your body in a variety of positions.

Practice Good Posture.
When sitting, ensure you are seated comfortably in a supported chair or stool. Your feet should be flat on the floor, with knees and hips at a 90-degree angle to your torso. Trunk bending or rotation should be avoided. Whenever possible, place clients in chairs or on beds that are mobile so you are not straining or compromising your posture to reach them. Try to create surfaces and working areas so there is space to rest your arms while using your hands. When standing, adjust the client's position so that you are not required to bend or twist. If you are required to stand for long periods of time, doing so on a floor mat can help reduce strain on the lower limbs and spine. Placing a small stool in front of you and putting one foot on the stool (alternating legs every few minutes) can help reduce stress on your spine. Wearing flat, supportive shoes will help avoid unnecessary strain on the back and legs.

Stretch and Strengthen.
Perform simple stretching exercises before your daily tasks to improve overall circulation and warm up your muscles.
Despite doing your best to care for yourself, you may experience discomfort, injury, or pain to your hands. Not all conditions are the same. Knowing the differences can help you develop the best care strategy.

Tendinitis.
This is inflammation of the tendon (fibers connecting muscle to bone). Tendinitis can occur anywhere along the arm, elbow, and hand, including the wrist and finger joints.

Tendinosis.
This refers to overuse that leads to tiny tears in the tissue in and around tendons.

Tendinopathy.
This term describes both inflammation and micro tears. Specifically, lateral epicondylitis, commonly known as tennis elbow, is common to people who work with their hands performing repetitive or sustained movements. When repetitive movement occurs, friction or overuse of the tendon can cause damage. Symptoms of lateral epicondylitis are pain and tenderness above the elbow, and reduced strength in the elbow, hand, and wrist.

Carpal Tunnel Syndrome.
The base of the hand houses a narrow area of ligament and bone known as the carpal tunnel. Within the tunnel is the median nerve, one of the main nerves between hands and fingers. Repetitive movements of the fingers, hand, and wrist, especially for prolonged periods without rest, can increase the pressure within the tunnel and exert pressure on the median nerve. Symptoms include tingling or numbness in fingers and hands, pain in the wrist, which may radiate up to the forearm and shoulder, and weakness in the hand.

If you are injured, alleviate irritation to the injury by resting the area and reduce inflammation with ice. Depending on the severity of your injury, decrease your workload by modifying your hours or tasks. Prescription or over-the-counter anti-inflammatory medications can also be beneficial.

Chan suggests that you begin by consulting your physician, who may refer you to a specialist. The first course of treatment should always be conservative. If physical therapy, and/or all other forms of conservative treatment, such as acupuncture and massage have been exhausted, your physician may recommend a consultation with a surgeon. A surgeon may use such diagnostic tests as CT scans, MRIs, nerve conduction studies, physical exams, or X-rays to determine whether surgery is warranted. Surgery should be the last resort.

Physical therapy can also help recovery with hands-on treatment and specific exercises to stretch and strengthen muscles, and to help to develop a program to restore full function. In the case of carpal tunnel syndrome, a splint supporting the wrist may be beneficial; in the case of lateral epicondylitis, a brace can reduce stress on the tendon.

As with many things, time is a great healer. The length of recovery time will vary with the degree of injury, the length of time the injury was aggravated before treatment, and the continued exposure to stressors.

Still, there are guidelines. Chan says soft-tissue injuries will heal in approximately four to six weeks, depending on the degree of injury. Returning too soon can delay healing. When surgery is required, healing time will vary with the procedure.

Austine Mah is president of Austine Inc., an educational marketing firm dedicated to advancing education in the skin care industry. She is certified by the National Coalition for Estheticians, Manufacturers/Distributors Associations, and is an educator and author. She is recovering from tendinitis as a result of lifting and carrying and expects to return to full function at work.




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