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18/May/2023

How to keep up (or start) walking for health and pleasure when it’s cold outdoors

It’s not quite winter yet, but it sure feels like it!

And if you’re like me and love to get outdoors and walk, it can be a little tough staying motivated when it’s cold, wet and wintery. But there are things you can do to boost your motivation, stay active and even come to relish the experience of walking in colder weather.

But, I hear you ask, why would any sane person want to get off their warm, cosy couch, put aside the remote control and brave the elements??? Because exercise doesn’t take a break for the colder months 😐 and we need to engage in regular, consistent exercise year round.

And while it can be challenging at times, we all know how much better we feel after we hit the pool, go for a walk, or take part in an exercise class. Being active every day helps us manage our pain, get better quality sleep, and improve our mood. It also helps us manage our other health conditions. And it gets us out of the house so we can connect with others – our friends, teammates, gym buddies, and other people walking their dogs in the park.

Knowing all of that doesn’t make it easy though, so here are some strategies to help you get out there.

Timing is everything

Plan to go walk when your body has had a chance to loosen up. Do some stretches, or have a warm shower to relax your muscles and joints so you can walk more easily and with less pain. The Arthritis Foundation has some basic stretches you can use before you head out the door.

Dress for the weather

Your usual exercise gear may not cut it when it comes to walking in colder weather. You need to think layers. The clothes closest to your skin should draw moisture away from the skin (known as wicking) so your skin doesn’t stay damp. It should also dry quickly. Look on the labels for mention of wicking or polypropylene. Avoid cotton. When cotton clothes get wet, they stay wet, making you colder.

Next, add an insulating layer of fleece or wool to keep you warm. And finally, add a layer that will resist wind and rain. The beauty of layers is that you can take them off and put them back on if/when needed.

Choose bright colours so you’ll be seen through the fog and rain, even on the greyest days 👕👚🦺. And at the risk of losing my Melbournian status 😉, there’s something lovely about ditching the black clothes and wearing bright colours on a gloomy day.

There’s no such thing as bad weather, just the wrong clothing, so get yourself a sexy raincoat and live a little.“ Billy Connolly

Now accessorise!

I’m not talking bling here, 💎💍 though; like adding colour, bling can definitely brighten your day 😊. But I’m referring to appropriate socks and footwear. It’s best to wear walking shoes that are waterproof or dry quickly. And they need good traction – it can get very slippery out there! If you’ve got old shoes from last winter, check the soles to ensure they’re still ok.

It’s important to know that the walking shoes you wear in warmer months are unlikely to be suitable for walking in colder months. The tops of these shoes are generally a lightweight mesh that lets air in to keep your feet cool. Not what you need on a cold walk!

You also need to protect your extremities (this is a must if you have Raynaud’s). Wear gloves or mittens, a hat that covers your ears, a scarf, sunglasses and sunscreen. Even in the colder months, your skin can be damaged by the sun’s rays.

Oh, and depending on the length of the walk you’re planning, you might want to take a lightweight backpack or bag for your water bottle and to store any of the layers you remove.

Get a walking buddy

Having a buddy to walk with can be fun and boost your motivation on cold days. This could be your partner, kids, family, friend, neighbour, pet 🐕🐈, or a walking group.

Or go on your own

Sometimes you just need some time to yourself.

Be aware of the walking surfaces

Slips, trips and falls are enemies of anyone with a musculoskeletal condition. So we need to take care out there. Uneven surfaces, moss, wet leaves or mud on footpaths and trails, and slick tiles at the shopping centre can all be dangerous. So keep an eye on the surfaces. And check out this info from MyHealth.Alberta.ca for some tips to lower your risk of falling.

Explore new areas

Whenever you can, take the time to explore new walking paths, rail trails, parks, or neighbourhoods. It’s amazing what you discover when you go beyond your own backyard.

Always check BOM 💣

Visit the Bureau of Meteorology (BOM) or your weather channel of choice, and get the weather and rain forecast. This will help you dress appropriately and may also affect your timing. If you like walking in the rain, you may decide to head out regardless. But if you’re not a fan, the radar will give you an idea of when to go (just don’t forget your umbrella – just in case).

Take your phone

It’s handy for listening to music, podcasts, and audiobooks and taking pics of the things you discover on your walk. It’s also essential for safety. Unfortunately, accidents can happen to us all, so stay safe and take your phone in case you need help. Or so you can call someone to pick you up if the weather becomes nasty!! 🚗🚓🚕

Add some mindfulness to your walk

Much of the pleasure of walking outdoors comes from enjoying the beauty of the changing seasons. So on your next walk, focus on your surroundings and how you feel. Try using the 5, 4, 3, 2, 1 method. For example:

  • What are 5 things you can see – e.g. the stripes on your gloves, the different hues of autumn leaves, a dog chasing a ball, fluffy clouds, ducks enjoying rain puddles.
  • What are 4 things you can physically feel: e.g. your feet on the ground, your partner’s hand, the wind on your face, the way your stride lengthens as you get into your rhythm.
  • What are 3 things you can hear: e.g. leaves crunching under your feet, children laughing, thunder in the distance.
  • What are 2 things you can smell: e.g. cut grass, rain coming.
  • What is 1 thing you can taste: e.g. your coffee traveller. ☕

Walk indoors

If you’re not a fan of exercising in cold and wet weather or you’re worried about slippery wet surfaces, walk indoors. Do laps of your home, hire/buy a treadmill, or walk briskly in your local shopping centre, gym or community centre.

Stay hydrated

Even though you may not be sweating as much as you would be on a hot day, your body is still losing water through your sweat and breathing. Take a water bottle with you and drink when you need to.

Set yourself a goal

If you’re still finding it hard to get motivated, set yourself a goal. It may be the ability to walk a certain distance without being out of breath or taking part in an upcoming fun run/walk. Choose something that matters to you, then create a SMART goal – that is, it’s Specific, Measurable, Achievable, Realistic and has a Timeframe. Read more about goal setting.

“Sunshine is delicious, rain is refreshing, wind braces us up, snow is exhilarating; there is really no such thing as bad weather, only different kinds of good weather.” John Ruskin

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issuestelehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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31/Aug/2022

Are you like me and find supermarkets ridiculously cold? It doesn’t matter what season it is outside; inside a supermarket, it’s Arendelle, and Elsa has just turned everything into snow and ice ❄⛄.

This can be really uncomfortable, especially if you have a musculoskeletal condition. And if you have Raynaud’s phenomenon, it can make your extremities – especially your fingers – turn white and numb.

What is Raynaud’s phenomenon?

Apart from having a really cool name – it’s a phenomenon, for goodness sake! 🙃 – what is Raynaud’s??? First, it’s named after the French doctor who originally described it, Maurice Raynaud, and being French, it’s pronounced ‘ray-nose’ (with a silent D).

Raynaud’s phenomenon causes the blood vessels to the extremities, usually the fingers and toes, to constrict more than usual in response to cold temperatures or stress. When this happens, the blood flow is restricted, causing the extremities to become cold and turn white, then blue. When blood flow returns, the skin becomes red and returns to its normal colour.

Raynaud’s phenomenon can occur on its own – this is primary Raynaud’s phenomenon. Or it can occur alongside or ‘secondary’ to another disease or condition – this is secondary Raynaud’s phenomenon.

Both primary and secondary Raynaud’s phenomenon episodes can last from a few minutes to hours.

Other parts of your body, such as the nose, lips and ears, can be affected too.

Fortunately, Raynaud’s phenomenon rarely causes permanent damage.

Maintaining a balance: vasoconstriction and vasodilation

Your body protects your internal organs (your core) by maintaining a stable core temperature – it’s not too hot, not too cold, but just right 🐻🐻🐻.

One of the many ways your body maintains this stable temperature is through vasoconstriction and vasodilation. This essentially means that your blood vessels (vaso) narrow (constrict) or widen (dilate) as needed.

In the cold, blood vessels constrict to reduce blood flow to your extremities, such as the fingers and toes. This keeps your core warm. In the heat, blood vessels dilate, and blood flow increases to your skin, moving the warm blood away from your core.

These processes help your core remain at a constant temperature, usually around 36-37°C.

For people with Raynaud’s phenomenon, for some unknown reason, blood vessels constrict, not to keep your core temperature stable but in response to cold, stress or emotional upset.

Blood vessels in your extremities narrow quickly, and your skin changes colour due to a lack of blood supply. During a Raynaud’s episode or attack, you may experience pins and needles, tingling and/or numbness in your fingers or toes. You might find it difficult to do things with your hands, as lack of blood can make them clumsy and stiff. And when the blood returns to the area, you may feel slight discomfort or stinging pain.

These changes occur in the extremities, most often the fingers. Circulation in the rest of the body is generally normal.

Primary Raynaud’s phenomenon

This is the most common form of Raynaud’s phenomenon. It’s also called Raynaud’s disease. Women, generally under 30, are more likely to develop primary Raynaud’s phenomenon than men. It can also run in families, so if you have a family member with primary Raynaud’s, you’re more at risk of developing it.

Secondary Raynaud’s phenomenon

People living with conditions such as scleroderma, systemic lupus erythematosus (lupus) and rheumatoid arthritis may develop secondary Raynaud’s phenomenon. This usually occurs later in life but can happen at any age, depending on the underlying cause.

Other risk factors for secondary Raynaud’s phenomenon include:

  • mechanical vibration – for example, using a power tool for extended periods
  • medicines – e.g. beta-blockers, some migraine or cancer drugs, amphetamines
  • smoking.

Diagnosing Raynaud’s phenomenon

Your doctor can determine if you have Raynaud’s by talking with you about your symptoms. It can be helpful to take a photo of your hands if you experience a Raynaud’s episode so you can show this to your doctor.

Although it’s generally not too difficult to diagnose Raynaud’s phenomenon, it can sometimes be hard to tell whether it’s primary or secondary Raynaud’s. Your doctor may use a range of methods to work this out, such as:

  • taking a complete medical history, including asking about family members who may have Raynaud’s phenomenon
  • a physical examination
  • blood tests
  • examining fingernail tissue with a microscope.

Living with Raynaud’s phenomenon

Most people with Raynaud’s phenomenon can manage it effectively with self-care and lifestyle changes. In some cases, medicines may be necessary.

Self-care

To prevent a Raynaud’s episode, the best thing you can do is to keep your body and extremities warm. Dress appropriately for the cold with gloves, thick socks and warm layers. It can be helpful to keep a spare pair of gloves or hand warmers in your car or bag that you can use if you’re caught out in a cold or stressful situation (e.g. a trip to the supermarket! 😱).

If you’re outside and your extremities start feeling cold and numb, go indoors and soak your fingers or toes in warm (not hot) water. Or you can warm them with a heater. Just be very careful of the heat – it’s easy to burn yourself when your skin is numb.

If you can’t go indoors, try these things to increase the circulation to your extremities:

  • Wiggle your fingers or toes.
  • Rub your hands together.
  • Make circles with your arms.
  • Massage your hands or feet.
  • Place your hands in your armpits. However, if you’re like me, your armpits aren’t always warm enough, and you may need to ‘borrow’ someone else’s warmth! Make sure it’s someone you’re close with – random strangers won’t appreciate your ice-cold fingers in their armpits! 😂
  • If a stressful situation triggers the attack, remove yourself from the situation, take some deep breaths and try to relax.

Medical care

Talk with your doctor if your Raynaud’s isn’t controlled by these simple measures. You may need to use medicines that widen your blood vessels and improve circulation.

For secondary Raynaud’s phenomenon, it’s also essential that the underlying condition (e.g. lupus) is treated effectively.

Tips for avoiding triggers

There’s no cure for Raynaud’s phenomenon, so avoiding things that trigger a Raynaud’s episode is key.

  • Avoid being out in the cold for long periods, especially if you’re not dressed warmly.
  • Make sure your whole body is kept warm, using several layers of clothing to trap body heat.
  • Keep your extremities warm with gloves, woollen socks, earmuffs and/or a beanie.
  • Use hand warmers. These small, often disposable products produce heat on demand and are helpful when gloves aren’t enough; you can buy them from supermarkets and chemists.
  • Remember, hand sanitisers often have a cooling effect, so when using them, be prepared to warm your hands quickly.
  • Avoid smoking cigarettes or drinking caffeinated drinks as nicotine and caffeine constrict blood vessels.
  • Review your medicines with your doctor; if they’re causing the problem, discuss possible alternatives.
  • Be aware that holding something cold, such as a can of drink, can trigger symptoms.
  • Learn to recognise and avoid stressful situations.
  • Keep a journal of when episodes or attacks happen, as this may help identify triggers.
  • Look after the skin on your hands and feet – with our frequent hand washing and use of hand sanitiser, it’s easy for our hands to become dry and cracked. Cracked skin is an opening for germs to get in and potentially cause an infection.
  • Exercise regularly to maintain blood flow and skin condition. Being active also has many other health benefits.

Complications

For most people, Raynaud’s phenomenon is uncomfortable and a nuisance but is basically harmless, with no lasting effects. However, in rare cases, loss of blood flow can permanently damage the tissue. This may lead to skin ulceration, tissue loss and scarring.

Talk with your doctor if you notice any changes in your symptoms.

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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30/Jul/2020

….your hands!

Did you know that each of your hands has 27 bones, 27 joints, 34 muscles, and over 100 ligaments and tendons?

They really are amazing, complex and delicate structures. And we often take them for granted – until something happens – we hit our thumb with a hammer, we slam a finger in a drawer or we develop a musculoskeletal condition.

Many conditions such as osteoarthritis and rheumatoid arthritis cause pain, swelling and sometimes disfigurement in hands. Other conditions such as Raynaud’s phenomenon and carpal tunnel syndrome can make your hands painful, and can cause pins and needles, as well as numbness.

For many people who have hand conditions, the colder months can make it worse. Your joints may ache more because of the cold, the constant hand washing can make your skin dry and the use of hand sanitiser (which often has a cooling effect) makes it feel like your fingers are about to drop off.

But there are things you can do to decrease hand pain, deal with the cold and COVID, and make everyday activities easier.

Look after your hands. Inspect them for things such as swelling, nail and skin changes and any changes to the joint shape or direction of fingers and/or thumbs. By being aware of our hands and any changes that occur, you can seek advice sooner and prevent things from getting worse..

Wash and dry your hands regularly and thoroughly. Just as washing with soap and water for at least 20 seconds is necessary to help prevent the spread of germs (including SARS-CoV-2), drying your hands thoroughly is also important. Germs love moisture and thrive in moist places. Drying your hands reduces your chances of spreading or picking up germs when you touch things with damp or wet hands.

Apply a moisturising hand cream regularly to keep your skin healthy and nourished. With our more frequent hand washing and use of hand sanitiser, it’s easy for our hands to become dry and cracked. Cracked skin is an opening for germs to get in and potentially cause an infection. And if you have a condition such as scleroderma or psoriatic arthritis, skin care is an important part of your overall management plan. You may need to use a medicated skin cream, rather than an over-the-counter product. Talk with your doctor or pharmacist for more info.

Use assistive devices if your hands are painful and stiff. They can help if you have difficulty gripping or holding everyday items. Assistive devices such as jar openers, book holders, tap turners, button hook and zipper aids and easy grip utensils can make tasks easier by reducing joint stress and eliminating tight grasps. You may need to speak with an occupational therapist about what equipment is best suited to you. Also check out our online shop. We have some products available to help you with your everyday activities.

See a hand therapist if you have hand/wrist pain or a condition that affects your hands, especially if it’s causing you issues with your day to day activities. Hand therapists are occupational therapists or physiotherapists that have undergone advanced training to become experts in the assessment, diagnosis and treatment of upper limb problems (shoulder to hand). They can provide advice on joint protection and energy conservation (e.g. splints) as well as recommendations for adaptive devices/equipment to improve hand function.

Splints and other supports may be an option. They can give support to a painful joint by providing mild compression, warmth and/or joint protection. There are two main types of hand or wrist splints – resting splints and working splints. The choice of splint will depend on your condition and your current needs. Splints need to fit your hand comfortably and correctly, so speak with a hand therapist about what’s best for you and how often you should wear them.

Exercise your hands, as well as the rest of your body. Regular hand exercises can reduce stiffness and support your joints by keeping your muscles strong. If you’re considering hand exercises, it’s best to get advice from a hand therapist or other specialist as to which exercises are most suitable for you. Exercises should be mild and should not cause you additional pain when you’re doing them. See our Hand information sheet for some basic range of motion exercises.

Wear gloves in the cold weather, especially if you have Raynaud’s phenomenon. Hand warmers are also helpful. If you’re going to the shops for supplies and you have to use hand sanitiser before you enter, be aware that many of them have a cooling effect. This can really aggravate your condition. Having a couple of hand warmers in your pockets can help. You can get disposable hand warmers, or reusable ones. Just remember if you use the reusable ones to thoroughly wash the fabric pouch it’s contained in between uses. They can easily become contaminated, and hygiene is everything during this pandemic.

Also wear gloves when you’re gardening, washing dishes or doing any tasks that have the potential for your hands to get dirty or damaged.

Medications may provide some temporary pain relief, depending on the underlying condition causing the problem in your hand/s. Your doctor may suggest analgesics (pain relievers like paracetamol) as well as nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen. A cortisone injection is generally not recommended for osteoarthritis of the hand, but may be used for rheumatoid arthritis or acute attacks of gout. In conditions such as rheumatoid arthritis you may also be taking disease modifying anti-rheumatic drugs (DMARDs). It’s important to take these medications as prescribed by your doctor.

With conditions such as Raynaud’s, if simple measures like keeping your hands warm hasn’t helped, you may need to be prescribed medications that widen your blood vessels and improve circulation. Talk with your doctor for more info.

Making life easier on your hands

Sometimes simply changing the way you do everyday tasks can reduce pain and protect your joints. You can make life easier on your hands by considering the following:

Listen to your body – pain can serve as a warning sign that your joints are being overworked. Try to find a balance between activity and rest by pacing yourself. Take regular breaks when completing tasks and try not to overdo it on a good day. You might like to try heat or cold packs to help relieve pain. Some people also like to soak their hands in warm water or wrap their hands around a warm mug of tea.

Try to avoid using a tight grip for long periods. For example:

  • use foam or sponge to increase the grip size of handles on cutlery, pens and other hand held devices
  • use assistive devices with thick rubber grip handles (e.g. key turners, jar openers)
  • use rubber squares and gloves to help improve grip
  • consider lever handles around your home to minimise any twisting forces (e.g. mixer taps in bathrooms/kitchens).

Avoid repetitive movements. For example:

  • prolonged typing, pruning and power tool usage particularly those that vibrate
  • when gardening ensure your tools are sharpened and well maintained for ease of use
  • if you can’t avoid these repetitive movements, make sure you take regular breaks.

Try to use your body’s larger joints and muscles when you can. For example:

  • use your forearms to carry bags instead of your hands
  • when carrying items hold them closer to your body
  • when lifting heavier items squat and use your thigh muscles.

Spread the load – try to spread the load of an object over more than one joint. For example:

  • when picking up objects use two hands
  • slide sheets and swivel pads can help move items with less strain
  • divide shopping into smaller bags and try using a backpack and/or trolley.

Find an alternative. For example:

  • buy pre-cut meat and vegetables instead of trying to cut them up yourself
  • use electrical items instead of manual (e.g. can openers and graters)
  • look for items that are easier to use (e.g. push on pegs)
  • keep a pair of scissors handy to open packaging.

Rethink personal care/hygiene – for people with decreased hand function or fine motor skills, everyday tasks such as showering and toileting can be quite challenging. To make things easier you could use:

  • a bidet to help with cleaning difficult to reach areas
  • baby wipes/moist towelettes instead of toilet paper (but remember that they’re not flushable)
  • toilet paper tongs/aids to help with grip
  • soap dispensers instead of a bar of soap
  • items to make dressing easier e.g. sock sliders, elastic shoe laces, button hole hooks/zip pullers, front fastening bras as well as dressing aids for coats and cardigans o shoes with velcro fasteners instead of laces.

Our hands are complicated and important and we depend on them more than we realise. Painful hands can often be managed with simple self-care strategies, however if your hands are causing you a lot of grief, and affecting your day to day functioning, talk with your doctor for information and support.

Contact our free national Help Line

If you have questions about things like managing your pain, COVID-19, your musculoskeletal condition, treatment options, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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