Pain that gets in the way of gardening

[elliemater]

Do you ever have things in the garden left to do, but you can't finish because something hurts too much? Do you just push ahead and get it done? Or do you mutter to yourself, gather your tools, and stomp inside to take a Tylenol and grab some ice?

Pain often gets in the way of my gardening. I can ignore some of it, but other pain I cannot since there are certain injuries and conditions in which I am trying to avoid surgery. I thought I would put together some little tips I have learned over time, and maybe it will be helpful to someone in some small way.

First, let me list some of the pain causes I have so that maybe you can identify with a cause you have as well. I have Sjogren’s Disease, which is an autoimmune condition. One of the interesting manifestations is accelerated joint degeneration. Meaning arthritis at 100 mph.

So my right thumb (all three thumb joints) pops painfully in and out, making it very difficult to grip or pinch. My right wrist has torn ligaments, making the carpals shift painfully…cannot bear weight on the flat hand anymore. The right hip is degenerating, so deep sitting for periods of time will produce popping and hobbling. Right ankle has been sprained three times, so its ligaments have 51% of their tensile strength left…equals a snapping and weak ankle. Right great toe joint is fusing. You need 60 degrees of extension at that joint to walk normally and 90 degrees to run…I have 30 degrees left (but I can run just fine if I see a water moccasin!). Let’s see…bony spur under the right patella (no kneeling!) and two fractures in the spine at L-5, meaning that the entire spine is moving forwards on the sacrum (no tall kneeling, long term standing, repeated forward bending or any backward bending).

What the hay! So I hurt. Big wacky doodle…many people have pain and accomplish much more than I do. Should I sit in a chair? No way. I still have gardening to do and I am stubborn. But I would be very dumb to go about things wily-nily. When my spine reaches a certain degree of movement it means surgery, and I do not like the outcomes of the surgeries we have at the moment for this condition. So COMPENSATION is a huge word in my gardening vocabulary. I go around the mountain, rather than over it, every chance I get.

My first follow-up post will begin with the hand and wrist.

[elliemater]

Thumb and Wrist Pain:

One of the first things to wear out from manual work with the hands is the basal thumb joint. This is the joint that separates us from the apes (in hand function). It is right at the wrist, at the bottom of the thumb. The joint is made by three bones, and so the one in the middle gets quite moth-eaten and worn with wear and tear (arthritis). Things like wide gripping, hard gripping, hard pinching, pulling pork, peeling potatoes with a knife, and hand weeding are a problem when this joint is hurting.

There is nothing that can be strengthened muscular-wise to fix this. “Conserve and protect what you have now” is the best strategy. With this in mind, if you like to hand-weed, soak the soil first and use a small pair or needle-nosed pliers that you set aside for this task (they will get rusty). Pushed down into the center of the weed, they can get that taproot without your having to make several hard pinches.

Pruners that increase your power while decreasing the demand on your grip are good to use, and they are called bypass pruners. Choose a tool that fits your hand, so ladies with small hands, get tools that have a span you can cover without a wide open grip.

A rigid splint is pretty useless in the garden, because you are trying to move and use your hand and it is rigidly holding it. What will happen is a contest between your flesh and the hard splint material…and the splint will always win. Better to utilize the neoprene type wraps. You must go above and below the joint, so it needs to go just past the middle joint that makes the “chicken drumette” of the thumb, and it must CROSS the wrist. This happens to be the one I use but there are a bunch out there: www.rehabmart.com/product/comfortcool-thumb-cmc-restriction-splint-7013.html . Notice the separate wrap right around the basal joint. That is important. This one can be worn under large gardening gloves and washed in the washing machine. If you get an over the counter model at Wal-Mart, remove any rigid metal or plastic pieces inside of it before wearing.

Now the wrist. If any of you have enjoyed falling upon your outstretched hand a few times, you may have wrist pain when shoveling in your garden. The wrist bones (carpals) are two little rows of bones, held together by ligaments. A fall on outstretched hand (FOOSH) can sprain the ligaments so badly that the bones are not held stable anymore. There are no muscles that attach to these bones that you can strengthen to help this condition. Ligaments are like panty (knicker) elastic…once they’re shot, they’re shot. Only surgery will tighten them again. Right now, surgery for wrist instability is not a great answer for a person who wants to remain active in the garden. It is helpful in other situations.

So just like the thumb, conservation of what you have is the best defense. Support the wrist when you plan to shovel. Any activity that makes your wrist hurt may benefit from support. Athletes use tape. A LOT of tape. There are a jabillion wrist supports out there. Remember, a rigid splint is not necessarily the best choice when you are doing tasks that require your wrist to move. Wear what helps; don’t wear anything that causes pain elsewhere in your hand. Here are a few: www.activeforever.com/search?q=comfort%20cool%20splint&utm_source=Bing&utm_medium=cpc&utm_content=Comfort%20Cool%20Products&utm_campaign=Independent%20Living

[elliemater]

Elbow:
Well we ought to list “Tennis Elbow” and “Golfer’s Elbow” under wrist, because these are actually muscles and tendons that move the wrist, not the elbow. But the place they originate at is just above the elbow, so we tend to think of this as “elbow pain.” People who use weed whackers and such (like blowers) and do a great deal of pull-cord (lawnmower etc) in their gardens are very prone to “Tennis Elbow.” People who use hand tools that require pulling the wrist inward tend to get “Golfer’s Elbow.”

Some myths:
I have had Tennis Elbow for years, and it is a tendonitis.
Wearing a strap around my forearm is a great idea.

Tennis Elbow is initially a tendonitis, or inflammation of a tendon. Tendons join muscles to bones. At this stage anti-inflammatories and ice can help. You must find and STOP the cause of this for it to go completely away and not return. Sometimes this is not possible. After several weeks, or with frequent reoccurrence, inflammation is not the main problem; the tendon begins to degenerate. Fatty cells take the place of collagen that provides the strength of the tendon. That degenerative condition is called “tendinosis.” That is a more difficult thing to heal. Wearing a forearm strap partially redirects the line of pull for the tendon and muscle, but it can actually stiffen the joint between the two bones of the forearm right at the elbow. It also provides an unnatural line of pull, which conflicts with the lever mechanism we have for each joint.

So sticking to our topic of how to deal with this in the garden, for anyone who has pain with pull-cord activities, try to change your position so that you can pull underhand rather than overhand. Using wrist muscles improperly is often caused by lifting more than our shoulders can support. We initiate by extending the wrist upwards. If you can, strengthen your shoulders. At any rate, don’t lift more than you can manage with a neutral wrist (the wrist is in just a bit of extension). Use a body strap with weedeaters and the like, and try to avoid holding the equipment up with wrists fully extended. Use the big muscles rather than the small ones whenever you can.

[elliemater]

Shoulder:
WOW! This area is really too complicated to cover in this little blurb. Some basics can be mentioned though. We give hard use to our rotator cuff muscles, and the tendons fray with time and use. There are four tendons of the rotator cuff, and three of their muscles live on the shoulder blade. They rotate the shoulder, and the way the tendons attach on the shoulder bone makes a cuff appearance. And so, “rotator cuff.” (Not rotary cup!)

Generally speaking, wear and tear in the shoulder is a contest between little muscles that rotate outwards and also stabilize the shoulder bone in its cup and the big muscles mostly located on the trunk that rotate the shoulder inwards. In the garden, pulling things away from the body can hurt the rotator cuff. You may get a tendonitis (inflammation) or a tear even. Trying your best to take the job away from the little outward (external) rotators and giving it to the big guys that rotate inwards (pectoral and latissimus) can be a big help. Again, for those who do pull-cord in the garden, try an underhand pull towards you rather than overhand away from you. It is awkward, but it can really help if you already have a bit of injury or degeneration at the cuff.

There are many other things that go wrong with the shoulder, and if you have something specific that you would like to try to problem solve for gardening, please feel free to PM.

[elliemater]

The Back:
No, I am not going to cover every joint of the body…hahaha! But MANY MANY of us have back woes that interfere with our enjoyment of gardening. Blanket advice is rather dangerous because the problems with the back can vary so much from person to person. What helps one may injure another.

Probably the most common issue here is a bulging disc in the low back. Some call it a slipped disc, but I can guarantee that this is not true. It doesn’t slip anywhere…behind your ear or otherwise. Next time you cut up a chicken, break open the back and see how you have to pry the little discs loose from the vertebrae bones. They don’t slip. They do bulge.

I can really compare the disc best with a jelly donut. The disc has soft inner contents and a tougher ring outside. If you mash the front of your donut hard enough or often enough, the jelly will bulge out the back. It might even squirt out of the back of the donut. Most of our disc bulges are located at the back of the disc, right where we have spinal nerves and the spinal cord to make problems. The disc has some capacity to heal a bulge. Once the contents have extruded out of the bulge, however, either the body will eventually break it down or it can wedge against a structure, causing you extreme pain. No exercise will fix this. Your body cannot put the toothpaste back into the tube.

Things in the garden that can really cause damage to our discs include lifting heavily or repetitively, sustained or repetitive forward bending, or activities that put great compressive load on the disc. Sitting on a low crate and pulling hard on a tough weed while leaning forward can increase the load on the disc by something like 270%. Wow! So you thought you would save your back by sitting on a crate to weed…maybe not so much! Unloading the discs happens when you lie down with knees elevated (pillows etc). If your back is sore at the center (spine, not outer muscles) after gardening, lying for a time with pillows under the knees is helpful.

If you must reach the ground from standing, it is helpful to hold a stout stick in one hand and lean on that, and lift one foot a bit as you lean forwards (golfer’s lift). You can of course reach forward by bending the knees, but after some time or repetition the thigh muscles get tired and you begin bending with the legs straight…badness!

If you have ever had sciatic nerve pain (down back of the leg), leaning forward with straight knees will literally stretch the sciatic nerve and aggravate the snot out of it. Don’t do it.

For some people a back brace is helpful to wear while gardening. Others find that it is not very helpful. These people may do better with an abdominal binder…elastic corset…that holds the belly in and supports the spine from the front. Here is an example: www.nulifemedical.com/store/pc/Universal-9-inch-Abdominal-Binder-178p2043.htm To help, the binder must reach above and below your painful area. So for some people it might have to be pulled far down to the crease of the hips. If you have woes at many levels of your back, try a taller binder, like 12”. At times when I have to lift wet bags of dirt I wear two of them, overlapping. Wear the binder under or over the clothes.

When you have hurt your back in the garden, stop to think about where you hurt. Do you hurt in the muscles on the sides? Try a hot pack, and then an ice pack before you go to sleep. Do you hurt only in the center part where the bones of the spine run? Try ice for 15 mins up to every 2 hours for the rest of the day and BE MORE CAREFUL, you are injuring yourself!

Ice is most helpful within the first 24 hours; after that sometimes heat is best. Ice is not a magical cure for swelling. It simply closes down the blood vessels to reduce swelling AS IT IS HAPPENING. It can also make things nice and numb. Ice or heat no more than 15-20 mins each. If you heat too long, your body will bring so much blood to the site that it will overwhelm the pressure gradient of the capillaries, just like a soaker hose in the garden. You will ooze plasma into the tissues and create essentially more swelling. So if you wear heat for several hours, don’t be surprised if it feels great at the time but within a few hours your are a stiff and painful puffball.

[elliemater]

Knees and ankles:
Down and dirty on the knees…there is a tough pad of cartilage between the shin bone and the thigh bone, called the meniscus. When it is gone, it is time for a knee replacement. Surgeries for a torn meniscus do not repair it (a few exceptions) but rather debride or smooth the torn areas so that things can move smoothly again without tearing up the cartilage on the end of the shin and thigh bones. In rare cases a repair may be attempted…if you were not allowed to bear weight on your leg for several (up to 6 or more) weeks after surgery, it is possible that you had a repair.

In the garden, planting your foot and twisting is one of the most damaging things to the meniscus (other than stepping in a hole or outright falling). So MOVE YOUR FEET when you turn, do not plant and twist! (Gardening pun "plant and twist" intended.)

There are a million knee braces and they are not universal for the different problems of the knee. If you want to know more about knee braces, PM.

If you have sprained your ankle significantly three times, you have AT BEST roughly 51% of the ligament strength left. If your ankle pops or cracks when you put foot to the floor first thing in the morning, you may or may not want to wear a canvas lace up brace to add stability to the ankle while in the garden.

Many of us have painful feet. Wearing rubber boots while walking or shoveling in the garden can make them more painful. I wear rubber boots year-round in the garden due to fireants. They do not have very supportive soles. A person can wear arch supports in the boots or purchase boots with stiffer soles to give more support when our feet are on those variable soft ground surfaces or pushing that shovel.


EASY ICE AND HEAT:
For any body part, you can make yourself a cheap ice pack and hot pack. Get a pair of (CLEAN) tube socks or boot socks. Fill them with either whole dried corn or dry rice. Tie a knot in the ends. Throw one in the freezer. Put the other next to the microwave.

Ice pack: take the sock out of the freezer and drape over the painful body part.

Hot pack: Take the sock next to the microwave and nuke it for 90 seconds to 2 mins. You might want to toss it in a pillow case and roll some layers if it feels too hot at first.

Reusable. Make more than one of each if you hurt all over. These last a LOOONG time.

[Deleted]

Older thread, but maybe a tip that can help others as it does me. I am cheap at times and have founf a 5 gallon bucket with a lid is a handy item for me.

I have a lower back/pelvis pain area from riding most anything as a kid and getting tossed often enough- dumb me would go back for more! Sooo, to make it a short, I hav many teeny fractures, healed in my pelvic girdle on the left side in the back. I can walk a bit, then must sit, even for as short as a minute, and ease the pain.

So I carry the bucket about, sit on it - taller than a crate, and also pick into it. I don't load the bucket up a lot since I also have destroyed shoulders, LOL, but it helps me. I also used to buy ( at auctions, cheaply) garden benches, you know the kind with iron ends and slats? I have 3 of those placed around in my garden area to stop and sit one.

Then, because yes I AM stubborn, I forge on as I can and try to remind myself that there is tomorrow.

[Laura_in_FL]

That's a good budget-friendly way to handle it. And dual-purpose, too!

You could also use one of those five gallon bucket tool belts to bring all of your tools with you. (It seems like I am forever having to go get tools I need but forgot to bring with me. Although the walking is good exercise, the extra trips sure slow down the garden work!) Though if you add too many tools the bucket might too get heavy for you to carry with your shoulder problems.