Wrist and arm pain

[Guest Johnnie]

My normal hammer weight is 3lbs. I get muscle fatigue after a few minutes of heavy blows! By fatigue I mean my forearm muscles are hard as rock. No pain after though just takes a few minutes to relax my arm.
Must be down to technique I guess, anvil is at the right height etc and being a builder/electrician for 25 years the muscles should be up for it!!
Let us know how you get on with the Hofi DVD.
Happy forging!!

[Borntoolate]

Borntoolate
We call that a leg vise :)

Oh wow! I thought the leg vice was that metal thing with the post sticking down. I stand corrected! There are some puns in there maybe....

[billyO]

Hello all, I had to respond....

Any good physical therapist will all give the same advice no matter what the injury. . .

Not necessarily, each injury should be treated individually (speaking as a PT for the past 17 years). But all PTs will give the same advice about this type of sprain/strain injury. Rest the overworked muscles, ICE the inflammed tissues, stretch the tight tissues and gradually build into any activity involving strength, especially when impact is involved.
just my 2 cents....

[PeteH]

A possibly - oddball suggestion, based on my own experience in carpentry, not ironwork.

Do you perchance have a hammer with a fibreglass handle ? A long time ago, when I was doing a fair amount of structural carpentry, I bought one. I'd been using a regular wooden-handled hammer, and the fibreglass one was the same head-weight and the same length but it had a rubber sheath on the grip.

Well, after a day's work with the new hammer, my arm was killing me. Day 2, more of same. I gave the fibreglass hammer away and went back to a wooden one.

[george m.]

Dear BillyO,

Why ice and not heat? I had always thought that in reality they are interchangable because they both increase blood flow to the area being heated or cooled. The body is either trying to cool off the area or heat it up by dialating the blood vessels in the area and increasing the blood flow. Is there more going on than just increased blood flow?

Stimulatingly,
George M.

[EGreen]

let the dang hammer do the work! if you use a long handled sledge,choke up and use your forearm as a bit of leverage.

[billyO]

Why ice and not heat? I had always thought that in reality they are interchangable because they both increase blood flow to the area being heated or cooled. The body is either trying to cool off the area or heat it up by dialating the blood vessels in the area and increasing the blood flow. Is there more going on than just increased blood flow?

Good question, George, and not a quick answer (it rarely is with me, I guess), however since you asked, I'll give you my standard heat/ice speech...(can I bill for this?)

Yes, there is more going on than just blood flow, but you're correct in your thinking that vasodilation is the key.

Just so we're all on the same page, let me give a little background. With any mild/moderate musculoskeletal soft tissue injury, there's an acute and chronic phase of injury/healing. **My disclaimer: (Severe injuries should be evaluated by a surgeon, even though they have the similar physiological responses, that's why I'm not including them here.)** The acute phase is immediately following the injury to 2-3 days after the insult has been corrected, and the chronic phase is post-acute to healing. (to all the MDs, athletic trainers, and others in the audience who know more details than I do, please forgive my generalizations...) During this acute phase, there is still active swelling occurring and the goal is to prevent this excessive swelling (the chemical components of swelling initiate the tissue repair process, but excessive swelling impedes healing and rehabilitation). We prevent excessive swelling by what I call RICEM. Rest, Ice, Compress, Elevate and Medicate with NSAIDS as appropriate. What I mean by appropriate is you can ALWAYS put an ICE the injury, you can ALWAYS REST the injury, but compression may not be appropriate (ie, I wouldn't compress a neck strain), elevation may be difficult (ever elevate a hip strain???) and meds may not be wanted or contraindicated.
As mentioned, heat always causes vasodilation, so this is contraindicated during active swelling because although heat feels good to most people, it will mainly contribute to more swelling and slowing down your recovery.
There's also some debate as to the timing and/or depth of the vasodilation with icing (if I'm still current on my reading of the research) so the medical field still prefers ice during the acute phase of an injury (again, unless specifically contraindicated).

So why ever use heat? The other thing that happens during both the acute and chronic pases of most soft tissue injuries is that all the surrounding soft tissue tends to spasm and contract in what the medical field calls 'muscle guarding' or 'muscle splinting' and this is the body's natural protective response to help prevent further injury. If you're not moving the injury, you're not increasing the damage, inflammation (Rest?) and pain. Heat will almost always relax soft tissues (a warm rubber hose is much more flexible than a cold one) which helps to make moving and rehab easier (a good thing from a PT standpoint most of the time), but remember heat always causes vasodilation, so this is contraindicated during any active swelling/inflammation.

In my experience, the patients who do the best with sprain/strain type injuries are the ones who are able to pay attention to their discomforts and pains and learn to distinguish which ones are from tightness/guarding (heat and gently use these) and which ones are from inflammation/swelling (usually more of a soreness or burning, but mild inflammation is also often described as an ache) and to Ice these.

So this begs the question "does this mean that I only need to ice the first few days after my injury?"
My thought is that, in general, if you have any soft tissue pain when at rest, your body is telling you that you have inflammed tissues and these need to be iced and rested. Also, there is good research that ice can reduce spasms, and ice also tends to numb sensory nerves temporarily so this can help provide some temporary pain relief, further tipping the scales in favor of trying ice first. Don't forget to consider it the depth of the injury/inflammation. Tissue temperature changes from heat and ice only penetrate an inch or so, so this needs to be considered when deciding to use heat or ice. In general, what I tell all patients is to try ice first, if that doesn't provide any relief after a couple of days, then try heat if you want. Ice will never slow down healing, heat might. Howerever, if you use heat, you need to pay attention to how the area feels 30-60 minutes after you remove the heat. If it feels good, then continue to use heat if you want. However, if there's no relief or increased sorenss/ache 30-60 min after taking the heat off, then you're incresing the inflammation and you should NOT use heat.

Above all, don't forget the basics: If you're getting better, keep doing what you're doing. If your not getting better or if you're getting worse, you gotta do something different. And above all, forget the "No pain, No gain!" mentality but remember "Use it or lose it!"'

I'll try to clarify if necessary... Edited December 1, 2012 by billyO

[Frank Turley]

In horseshoeing school, about 100 years ago it seems, we had minimal instruction in anatomy & physiology of the horse's limbs. But when I traveled with my knowledegable farrier mentor, Al Kremen, he talked about his own horse having some swelling and lameness in the area of the deep flexor tendon of a foreleg. He had it veterinarian-diagnosed, and we irrigated the affected part occasionally with a garden hose and water (cold). When the swelling had reduced and the horse could take more weight on the leg, we applied what Al called a "leg brace." He did not mean a structure, but rather a mild liniment (heat). I think that we used Absorbine veterinarian liniment.

[Rich Hale]

I have to disagree with something said in one of the posts:
The person with the problem cannot self evaluate. Wot would you have them look for and how would they know wot they were seeing or feeling? If you look at a lot of the videos on forging on u tube you will find a lot of them are demonstrating poor body mechanics/technique. So if one is just starting out should they compare a self made video with one of those? The suggestion to go to a local meeting of area smiths is a real good way to get going in a good direction. If: They actually are given the opportunity to forge and have someone in the group that knows body mechanics and will offer thoughts towards improvement. Better yet is to go for one on one training with someone that has the proper credentials to be of value. Ya right where do youi find one of them? There are several folks that use this forum that do that. When you read these posts it will become apparent who they are. I worry a lot about small groups getting together and sharing poor techniques. Remember you can practice poor work until you get good at poor work. A big key to this whole thread is an injury is best treated by medical pros..Think aboiut wot it takes to answer any question on these forums: Computer hook up, keyboard and a desire to see your name in print. Expertise is optional.

[george m.]

Dear BillyO,

That was a really good post regarding treatment of strains/sprains. Thank you very much. I read it aloud to my wife and son and we all learned something. I'm going to print it out and keep it.

Again, Thanks,
George, Martha, & Tom

[Francis Trez Cole]

Rich is right in so many ways. Take hammer weight if you use a 2 pound hammer with an 16" handle you can swing it much faster with much the same pounds per square inch as a 5 # heavy hammer with a 9" handle at a slower speed. It is technique that is important. I had a Dr in sports medicine look at my swing (when I started researching ergonomics). He felt it was being done in a safe manner. There is risk in blacksmithing the goal is to protect your body. I have been blacksmithing for 25 years and am 54 I plan to be doing it until I am very old. Use the largest mussel group to complete the task. in blacksmithing that would be your wrist ,elbow, shoulder and torso all in one fluid motion. then a proper grip. and comfortable anvil height. I have seen blacksmiths in southeast Asia working with there elbow at its bottom of the swing at 90 degrees. Now that's a tall anvil.

the first day of an injury should be ice then you should alternate ice and hot helps move the blood in and out of the area That is what I was told years ago

[Smiddyt]

I have read through the post and watched the video's. I have also paid more attention to my grip and swing and the pain is not as bad. Thanks fo all the advice.

[knots]

I have to disagree with something said in one of the posts:
The person with the problem cannot self evaluate. Wot would you have them look for and how would they know wot they were seeing or feeling? If you look at a lot of the videos on forging on u tube you will find a lot of them are demonstrating poor body mechanics/technique. So if one is just starting out should they compare a self made video with one of those? The suggestion to go to a local meeting of area smiths is a real good way to get going in a good direction. If: They actually are given the opportunity to forge and have someone in the group that knows body mechanics and will offer thoughts towards improvement. Better yet is to go for one on one training with someone that has the proper credentials to be of value. Ya right where do youi find one of them? There are several folks that use this forum that do that. When you read these posts it will become apparent who they are. I worry a lot about small groups getting together and sharing poor techniques. Remember you can practice poor work until you get good at poor work. A big key to this whole thread is an injury is best treated by medical pros..Think aboiut wot it takes to answer any question on these forums: Computer hook up, keyboard and a desire to see your name in print. Expertise is optional.

 

 

It appears that my post is the one referenced in the quote posted above.  The last statement is the most problematic.  The Implication is that  my comments have no substance or basis to justify serious consideration is just wrong.   

 

I have been involved is forging Iron for 38 years. I bought my first anvil in 1974 and have been forging since then.  For the last three or four years age related deterioration of and arthritis have take their toll on my body joints, including my hands and wrists.  Consequently I have given a lot of consideration to how I hold and use hammer.  The picture below shows the condition of my hand and wrist.  The swelling is chronic, yet I can still forge iron by hand using the technique posted above using a loose grip and limiting the rotation and loads applied to my wrist.  And this with out serious discomfort if my forging sessions are limited to a reasonable period of time.  

 

 

Although I do agree that we should should seek out the best source of advice when at all possible, the idea that we should make no attempt to "self evaluate"  when problems of any type crop up seems outrageously narrow minded.

 

The question "Wot would you have them look for and how would they know wot they were seeing or feeling?"  is answered in the text of my post.  Which focused on the moment of hammer rebound from the anvil, and one way of using that rebound to position the hammer to reduce stress on the wrist and forearm.  

 

I believe that the best part of this forum is generating a robust discussion while keeping the tone of posts civil .