Hand usage can affect cumulative trauma soft-tissue issues in the arms, neck, shoulders, and back.
- By Charlie Braxton, Ron Bowles
- Feb 01, 2017
Chances are that at some point in our lives, each of us will somehow hurt our hands. We might smash them, scratch them, scrape them, bash them, burn them, freeze them, poke them, puncture or prick them, but it is almost certain they will be bruised, contused, and abused. Many of the injuries people sustain may be slight, often barely noticeable. But too frequently, the results to the hands could be worse, even catastrophic. If you include all the little things that happen to them, the hands may be the most common site of injuries that people suffer. No surprise here as the hands are the prime instrument for reaching out to the world to manipulate all manner of tools and devices. Here are some major reasons people hurt their hands—and, more important, what leaders can do to help prevent these all-too-common injuries:
As mentioned, because people do practically almost everything with their hands, they're the body part most prone to repeated and prolonged exposures and use. Besides maneuvering doors, obstacles, tools, and loads, they're also the first line of automatic defense against anything approaching that might potentially harm the head or torso. For example, if you start to fall into a surface, isn't the instinctive reaction to stick out one or both hands?
But this can lead to problems from even mundane events. For example, I prefer writing by hand when composing an article. But if I'm at it long enough, my hand can begin to get sore or even cramp. If I persist over a prolonged period of time, this repeated use could lead to developing several serious hand dysfunctions or disorders—just from something as simple as writing. Of course, many workers exert a lot more pressure with their hands than writing in their daily tasks, and over many years. Combining repetition with force has been shown to significantly intensify hand issues. On top of work, each of us also employs our hands at home and in favorite activities, as well; these rarely seem to rest.
Compounding this, I've seen many even using their hands as a tool (hammer, jack or pry bar, brace, even as knife or thermal sensor).
Hands-On Approach 1. Spread exposures by offloading.
The 90 percent of people who are right-handed are at increased risk to injuring their dominant hand. (Left-handers, who live in a world of right-handed-designed tools and equipment, tend to be more balanced in their hand usage because they have to.) Predominantly employing one hand—on tools, opening jars, everywhere—puts that hand at greater acute and cumulative risk. And force tends to transfer more toward that same side of the body. (Yes, hand usage can affect cumulative trauma soft-tissue issues in the arms, neck, shoulders, and back.) So consider helping workers offload, using their off-hand more, especially at first in tasks that aren't as crucial (drinking coffee, grasping, etc.). This approach also has the side benefit of waking up awareness.
Attention can tend to flit from one point to another; this lack of direction translates into lowered awareness of potentially acute and cumulative risks. Specifically, hand injuries are especially closely related to instances where attention drifts elsewhere. Since people use their hands so much, it's practically impossible to maintain attention on them continually while using them.
When I think of the incidents I've had in my life, almost every one happened when I was focused on something other than what I was doing. In other words, my attention was split. Attention seems to have a range of focus relative to the task at hand, ranging from fuzzy—ever driven somewhere without remembering the details of how you got there?—to laser-sharp, such as narrowly avoiding a car swerving into your lane.
Hands-On Approach 2. Practice controlling attention.
Focusing attention is a skill. Like any other skill, there are ways to develop it—and at any stage in life.
Playing music, practicing martial arts, and meditating all come to mind as some ways of honing concentration and focus. But there are many more. There are six components to attention (Scanning, Selecting, Switching, Sustaining, Sequencing, Self-monitoring) of which the last, Self-monitoring, is critical to preventing hand injuries. My experience in transferring hand safety skills is that almost everyone can raise their ability to "check in" their hands' placement, level of tension, and strength, and more, at least a few times a day to start—and then build up hand attentiveness skills from there.
No question that improving mindfulness and attention skills can directly lead to a decrease in overall hand injuries and injuries in general. But this entails much more than just reminding people to "Pay attention!" or to "Watch where you place your hands!"
It seems like the higher the perception of danger we realize, the more focused we become. But on the other side, believing ourselves to be "Safe" can lead to a false security that can lull us into assuming and acting as if nothing will go wrong and we won’t become injured. Because people use their hands so much, most of the time without apparent problem, the dangers to our hands can range from the unnoticed to the unrecognizable, and it's easy to become hand-complacent, taking hand safety for granted.
But we've found it doesn't work long term to just show gruesome pictures or videos of hand injuries. This approach can actually backfire, resulting in workers admitting they are turned off/disengaged by this approach.
Hands-On Approach 3. Develop "different" awareness.
A key method for developing hand focused attention—and fighting off complacency—is to practice looking for potential hand injury potentials before workers begin a task. Realistically, it's rarely possible for supervisors or professionals to lead workers through this every day; much better for this environmental/task quick assessment to become ingrained in each worker. Experience has shown that once someone gets involved working with their hands, attention tends to be on the elements of the task, not on potential hazards. Consciously looking for hazards before beginning a task helps build the skill of directing attention with control, and it also may help them identify potential hazards in order to eliminate or shield themselves from the exposure(s). We've found that the prime point to really accomplishing this (rather than workers just pretending to go through the motions or not doing this at all) is to focus on the positive benefits of using hands with greater control, strength, and flexibility.
Sure, the awareness of danger hones mental focus (at least for a short time), but it's difficult to continually live and work "on guard." But by taking a moment to scan surroundings and equipment and by thinking about what’s around and slightly different (and things always change), we've found it's more likely employees can act in ways that prevent the likelihood of an incident. Again, think "different" rather than just "dangerous." This is another mental skill that everyone can learn to a higher level with the right approach and practice.
We've also trained people to look for those things in their work area that can cause hand lacerations, crushes/smashes, and burns because these are the most common hand hazards for many. This can be extremely helpful in avoiding potential risks.
4. Things we don't know can hurt us.
Every Safety message includes taking the time to look for potential environmental and personal risk factors before doing something like reading the label on a prescription before taking it or before uncorking household chemical products. Without knowledge of the proper precautions, we're less likely to follow them.
But every worker has already heard all this, and too many still don't look ahead to consider how to forestall problems in advance. Hearing the same message for the umpteenth time is unlikely to wake up change in attention and actions.
However, what most people don't know is that there are also dangers not spelled out by labels and warnings. For example, some hand injuries occur from a sudden or unexpected loss of balance. Often our natural reaction is stopping our fall with our hands; this can and does result in damage to wrist, arm, and shoulder. My experience is that elevating practical working balance—a very learnable skillset—can greatly increase hand safety (as well as prevent soft-tissue injuries and slips/trips/falls.) But that's only half the equation. For instance, did you know you have spots around your body where your balance is worse than others? These points are affected by where we place our feet and how we distribute our weight. Working over one of what we call "Points Of Weakness" (adapted from the "throwing" martial arts such as jujitsu) can easily lead to a huge loss of balance, and then things can go very wrong very quickly.
Hands-On Approach 4. Boost practical working balance.
Everyone can learn where their Points Of Weakness are when working and then make simple and easy moves to consciously avoid balance loss and better support and protect their hands.
Learning how to employ most efficient physical principles of grip, leverage, and balance can boost control when wielding tools or in positioning materials and equipment for maximum leverage and control. In addition to sustaining hand injuries from falling, many workers wind up setting/dropping the end of a load down suddenly as their balance shifts (or, in team manual material handling, when the person on the other end of the load sets their end down unexpectedly). Or they lose control when a wrench slips and they bang their hand against a solid object (or the wrench crunches their off hand). Or a load slips and they instinctively reach out suddenly to try to steady or catch it.
But trying to tell people "Do Not Touch," to let a falling object go (as do some companies), is fighting human nature; it's hardwired into most to reach out to prevent damage. What does work better is to build in a positive, safer replacement habit. This is readily done with the right practice.
There's an old saying: "Anything that can happen will happen." In other words, there are many things not in our control. Given enough use or exposure, something unplanned or unexpected will almost certainly occur. But hand injuries are not inevitable, despite the range and volume of risks many workers face.
Hands-On Approach 5. Elevate personal control for safety.
The right mental and physical skill sets go hand in hand toward protecting employees and their hands. These skills are what we've been transferring to workers worldwide for more than the past 30 years. Experience shows we can help everyone reduce his or her frequency of hand injury while simultaneously minimizing the potential severity of any hand-related incident.
The combination keys are:
- Upgrading their skills at directing their own attention to identify potential hazards
- Reducing the number and types of unnecessary exposures we subject our hands to
- Placing themselves in the optimal body position for control of the things their hands contact, and
- Employing the best PPE that actually helps and doesn't in itself raise hand risks.
Knowledge, skills, and awareness go hand in hand toward people significantly protecting themselves from these common, and frustrating, injuries.
This article originally appeared in the February 2017 issue of Occupational Health & Safety.