Part I of II: Prevention of Hand Injuries Associated with Gardening

Farmers and gardeners in NEPA always say that Memorial Day, the “kick off” day for planting without the fear of frost, however, it is not too early to start to prepare…not only the beds but your body! While gardeners are anxious to work in their gardens and enjoy the fruits of their labor, a relaxing and enjoyable activity can turn dangerous quickly. Precautions are necessary as repetitive stress injuries such as shoulder and elbow tendonitis and carpal tunnel syndrome can stem from raking, weeding, digging and pruning. Additionally, simple scrapes, blisters, and bites can turn into serious problems if not treated appropriately.  Since prevention is the best approach, the American Society of Hand Therapists (ASHT) promotes warm-up exercises and injury prevention tips to help all levels of gardeners avoid serious and long-term injuries while enjoying this popular outdoor activity.

ASHT recommends following these upper extremity warm-up exercises prior to gardening:

Note:  These exercises should never be painful when completing them.  You should only feel a gentle stretch. Hold 10 seconds and repeat 5 times. Should you experience pain, please consult a physician or hand therapist.

1. Forward Arm Stretch: Fold your hands together and turn your palms away from your body as you extend your arms forward.  You should feel a stretch all the way from your shoulders to your fingers. (PHOTO 1)

2. Overhead Arm Stretch: Fold your hands together and turn your palms away from your body, but this time extend your arms overhead.  You should feel the stretch in your upper torso and shoulders to hand. (PHOTO 2)

3. Crossover Arm Stretch: Place your hand just above the back of the elbow and gently push your elbow across your chest toward the opposite shoulder.  This stretch for the upper back and shoulder and should be performed on both sides. (PHOTO 3)

ASHT recommends the following guidelines to prevent injury and foster healthy gardening practices:

• Wear gloves at all times.   Bacteria and fungus live in the soil and a small irritation or cut can develop into a major hand infection.  Glove choice should be specific to the specific task.  Thick, leather or suede gloves may protect your hands from thorns, cuts and scrapes while pruning roses.  Rubber or latex coated gloves may be appropriate to aid in grip when working in the soil.
• Keep your hands and arms covered.  Be especially careful if you live in an area where you may disturb a snake, spider or rodent living in your garden.  You will be better protected from poison ivy, insect bites, ticks and other common skin irritants that may inhabit a garden.
• Take a break every hour or switch to another activity.  Overuse of repetitive motions, such as digging, and sustained/constant gripping can cause tendonitis of the wrist, elbow or lead to carpal tunnel syndrome.  Break up large tasks into short sessions, with a rest and stretch break between gardening sessions to reduce muscle fatigue.
• Use a tool when digging into unfamiliar or new areas.  Buried sharp objects can cause tendon lacerations or punctures.  Use the correct tool for the task at hand in order to avoid accidental injury. 
• Store your tools to prevent accidents.  Learn how to use and store your tools correctly to prevent accidents, and keep sharp tools out of the reach of children at all times.  Also make sure to put all tools away after use to prevent future injuries.
• Regular/periodic tool maintenance.  Keep garden tools in top working order to reduce the physical effort required for yard and garden work.
• Use well designed tools.  Use tools with non-slip rubber or padded hands to protect the smaller joints in your hands.  Make a circle with your index finger and thumb—that is how the grip of the tools should be.  The shape of the handle should provide equal pressure along the palm. 
• Avoid awkward motions.  Using better body positioning minimizes muscle pain.  Work with the wrists in a neutral position by avoiding the extremes of motion (up, down and sideways).  Hold objects with a light grasps or pinch. To avoid a tight sustained grip.  Use both hands for heavy activities like lifting a bag of potting soil and alternate hands on more repetitive tasks like scooping dirt out of the bag into a pot.
• Plan ahead.  Use a basket or large handled container to carry supplies to the garden.  The basket should be carried with both hands, distributing the workload equally and decreasing stress in the joints of your upper body.

Professional Contributor: Nancy Naughton, OTD, CHT, is an occupational therapist and certified hand therapist practicing in NEPA. Model: Heather Holzman

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”  Next Week: “Prevention of Gardening Injuries” Part II of II.  

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM. Access of all of Dr. Mackarey's articles at our Health and Exercise Forum.