Arming You with Tips for Living with Arm Weakness

by Kathy Wechsler on Wed, 2006-02-01 09:00
Chris Rice using a remote control with a splint for support.
A splint can provide helpful support for your hand.

Everyone’s ALS is different. There’s no set process in which the disease occurs. Weakness can start in the legs, arms or the muscles that control speech and swallowing.

Weakness may start in your hands, or it may start in your shoulders, creating problems as functional abilities change.

“Arm weakness affects everything from getting out of bed to getting dressed, bathed, and doing the things that you want to do, like turning pages in a book or working on a computer,” says Gail Miller, an occupational therapist (OT) at the MDA/ALS Center at Johns Hopkins University in Baltimore.

“What we are looking to do is find out where the problem is and then facilitate that action so that the bottom line is that the job gets done.”

To “get the job done,” Miller uses the “KISS” System: Keep It Safe and Simple.

Here are some simple suggestions for living a safe life with arm weakness:

  • Maintain shoulder and elbow joint motion by having a daily routine of stretching and range-of-motion exercises. Swimming is another great exercise, but make sure you have a safe way to get in and out of the pool.
  • The “prayer position exercise,” which is done by putting your hands together as if you’re praying and pointing your fingers up and down, helps stretch fingers and wrists and releases stiffness in forearms.
  • Miller doesn’t recommend squeezing a stress ball because you already do a lot of gripping and clutching in your daily activities. Too much squeezing will fatigue your muscles, and contribute to imbalance.
  • When your shoulder muscles are weak, your arm’s weight can pull apart the shoulder joint, causing pain. A sling, which is supported with a strap across your back and over the opposite shoulder, cradles your arm close to your body and can help you protect this joint from stretching.
  • To make feeding yourself easier, sit at a table and support your arm by propping your elbow on a few books or pillows to get your arm up high enough for easy eating. You can place a stand-up mirror on the table and do your makeup, shave, or brush your hair or teeth using the same energy-saving method. This takes the workload off the shoulder muscles. Also, don’t be afraid to ask for help if feeding yourself gets too tiring toward the end of a meal.
  • Sometimes a suspension arm sling will make feeding yourself easier. It hangs from above your wheelchair and supports your arm. If you don’t use a wheelchair, you can adapt a floor stand. Check your MDA loan closet for this equipment.
  • If you’re able to suck through a straw, try putting a long straw in a drink so it stands up by itself. Then you can lean into the straw instead of picking up the glass.
  • A lightweight splint, similar to those available at the drugstore for carpal tunnel syndrome, cocks your wrist back, supporting your hand in its best functional position. It helps your fingers to bend easily, which maximizes your grip, helping with many tasks of daily living.
  • Modify tools to fit your hands. You can use foam curlers or tubing to thicken the grip of your fork, toothbrush and other everyday tools. The more you increase the friction on an item, the less force it takes to hold it. Visit www.dynamic-living.com for other options.
A man props his arms up while combing his hair.
Propping your arms or elbows makes everyday tasks easier.
  • Take showers rather than baths. Miller recommends avoiding baths if you don’t have the arm strength to protect against a fall. If you start to fall, you won’t be able to catch yourself. The bathtub is a dangerous place if your arms are weak.
  • Sit on a bath bench or seat while showering: You’re more likely to fall when you’re naked, wet and slippery. While taking a shower, rest your elbow on the shower wall to wash your hair instead of holding your arm over your head.
  • Sit down at a table to dry your hair. Prop the hair dryer up or get a stand and prop your elbows on the table.
  • Getting up from a toilet seat without using your arms is easier and safer if you increase the seat height. You can use a raised toilet seat or a bedside commode positioned over the toilet.
  • Conserve energy while cooking. To prepare food, you can slide the pot, pan or bowl along the countertop instead of lifting it. Take shortcuts whenever possible. It helps to buy food that’s already chopped, such as packaged frozen vegetables.
  • Don’t waste energy trying to hold up a book or magazine. You can prop it on a table, bookstand or music stand. If your hands are weak, the eraser end of a pencil can serve as an inexpensive page-turner.
  • For working at a desk, position yourself so you’re sitting with your forearms and your elbows resting on your chair arms or desk to relieve the stress on your upper arms. A keyboard wrist rest can help to support your hands. (See “On-Screen Keyboards.”)

For additional tips about living with ALS, consult Everyday Life with ALS: A Practical Guide, available through your local MDA office or by contacting publications@mdausa.org.

Kathy Wechsler
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