Most of us take our hands for granted; we assume they’ll always be there and will function correctly whenever we need them. Although computerized technology rules much of our everyday life, construction is still a hands-on occupation. Because of this fact, construction workers’ hands, wrists and forearms are at risk for serious injury.

The hand is a complex engineering wonder that comprises 27 bones and muscles, tendons, nerves and blood vessels. The tendons in the hand attach the muscles to the bones of the hand. These tendons act as a rope in a pulley system, while the bones of the hand and wrist act as the pulley. This complex system of pulleys and ropes is needed for the most basic movements, so it makes sense that the hands and wrists can be easily injured and potentially disabled on a work site. Even minor injuries can make working on a construction site a physical challenge.

These necessary appendages commonly experience three painful, potentially serious injuries that all stem from inflamed and swollen tendons:
• Tendonitis
• Trigger finger
• Carpal tunnel syndrome

The small space through which the tendons pass from the forearm to the hand is called the carpal tunnel. This tunnel also contains the median nerve, the main nerve that controls hand movement. Due to these close quarters, any time a tendon becomes inflamed and swollen, it puts pressure on the nerve. This pressure can result in pain, tingling or numbness in the arm, wrist or hand, making grasping tools and using the hand difficult. If not dealt with early on, these symptoms will worsen and can become a permanent, debilitating condition.

Since these injuries all result from the same cause, treatment for them is much the same. The best treatment is prevention; don’t allow them to occur in the first place, or at least try to minimize the risk.

To minimize swelling, take periodic breaks to rest the hands, and avoid movements that aggravate these conditions. (Swelling is a direct result of repetitive, forceful hand movements that are the mainstay of work on a job site.) Unfortunately, this is unrealistic on a job site. Preparing the hands before work begins can decrease the need for rest breaks. A series of on-the-job stretching exercises can help to warm up the muscles and gently stretch the tendons. Other preventive measures include the following:
• Change the work process used or materials to decrease the amount of repetitive actions. Using lock nuts or button nuts can very effectively reduce repeated hand-arm twisting and turning that occurs over the course of a work day.
• Change the tools or equipment used. Whenever possible, substitute a power tool for a nonpowered hand tool; this will decrease the wear and tear on the hands and wrists.
• Use ergonomic hand tools. Sometimes a power tool just isn’t an option; this is when a relatively new class of ergonomically friendly hand tools are a good fit.
Several characteristics determine whether a hand tool is ergonomic:
• The tool must fit the task to be done. It’s best to use the right tool for the job, instead of “making it work” with the wrong tool.
• Ensure the tool fits comfortably in your hand. A tool that is too big or too small will result in unnecessary stress on the hands and wrists.
• The tool should allow for a good grip. The size of the handle is determined by the task to be accomplished. For a task that requires a good amount of force, a larger handle would be a better fit (one that is between 1 and 2 inches). For a task that uses less force and more precision, a smaller handle— to inch—would be appropriate.
• The tool shouldn’t dig into your hands or fingers. Use a tool with a cushioned handle.

By following these preventive measures, it may be possible to minimize hand and wrist injuries on your job sites. These injuries are certainly an area where an ounce of prevention is worth a pound of cure.

KELLY is a safety and health specialist with Intec, a safety consulting, training and publishing firm that offers on-site assistance and produces manuals, training videos and software for contractors. She can be reached at 800.745.4818 and Joe O’Connor edited this article.