Chef Connection

How to reduce wrist and shoulder pain when using a chef knife.

I have always enjoyed seeing a chef carry all their knives to and from work. Like any trade’s person, care for your tools is paramount. Chefs are excellent at caring for their tools but leave much to be desired when it comes to maintain the body wielding them.  Today we are going to cover some common injuries working with a chef’s knife and how we can take steps to prevent them.

Now before we get into this, I do want to note that this article is not designed to treat the signs and symptoms of carpal tunnel syndrome. If you are experiencing chronic pain in your hands at work please go to your doctor and get it assessed by them. They will connect you to a specialist that can help get you on a path to recovery. This article focuses on ways to reduce your chance of showing the signs and symptoms of carpal tunnel syndrome.

Shoulder, Elbow, Wrist. Connected for better or worse.

The human arm has been designed for a large range of motion. This was helpful for climbing when we lived in more prehistoric times. Our elbow can produce force and help us lift and carry objects. Finally, our dexterous hands are able to hold and manipulate any object or tool to get a task done.

While the huge range of motion of our arms allows us to do many tasks, they can easily repeat a task that may not be the safest to prevent repetitive strain injuries. Let’s start with the wrist and work our way up the arm.

Wrist Movements and Problems:

Chef’s usually hold a knife with a pincer grip. Using the thumb and index finger to hold the blade wile the palm and fingers wrap around the handle to steady the movement. This allows fast and accurate work when chopping or prepping various food items.

The wrist has 7 bones in close proximity. Within these bones there are tendons, nerves, ligaments, and blood vessels passing through them.  The bones are arranged to allow for flexion, extension, radial deviation, and ulnar deviation. Simply our wrists are designed for a high amount of movement. However when we hold one position for an extended period of time we run the chance of impinging various structures that pass through the bones of the wrist.

One common injury we may see is carpal tunnel syndrome (CTS). This occurs when the median nerve is impinged as it passes through the carpal tunnel. This is usually caused by the transverse carpal ligament becoming inflamed by the wrists being held in an awkward position for an extended period of time.  CTS is usually pain through the thumb index and middle finger and can be debilitating in server cases.

Hold a chef’s knife with a flexed wrist is a perfect culprit for the cause of these symptoms. But we can remedy this problem with a few specific fixes to the workstation.

Reducing your chance of wrist pain

Workstation Height for high precision work.

If you are doing high speed work like julienning or dicing there is a chance that the workstation can be too low and will place our wrist in an extended position. This can cause the pressure on the carpal tunnel and boost the chance of carpal tunnel. To remedy this, we want to create the conditions for a neutral wrist position.

Reduce flexion positions while working with a chef knife

Reduce flexion positions while working with a chef knife

 
Maintain a flat neutral wrist as often as possible.

Maintain a flat neutral wrist as often as possible.

 

When julienning, or dicing you want the workstation to come up higher so that you are not forced to extend the wrist. Bring your forearm and hand up your stomach until you have a neutral wrist and a 90- 110 degree position at the elbow. This is the height you want the board at to work on. This will allow for precision and speed while still maintain a safer wrist position.  You can raise cutting boards to the height you need by ordering a riser or stacking some cutting boards together. Make sure you place a wet cloth between each board to keep it from slipping. Always make sure that surface you are working on is secure to prevent any accidents.

Shoulder Position and maintenance while working with a chef knife.

The workstation height will create the conditions for a safer wrist and elbow position. The shoulder is going to take a little more practice and training. During knife work we want to make sure our shoulder stays in a relaxed or lowered position. Many chefs will hunch over time because they are looking down at there work.

We want to create opportunities for the shoulders to be held in slightly retracted position. Think all the cues for ‘proper posture’ you were told growing up. The easiest way to get this position is to raise your shoulders towards your ears-> pull them back - > and then lower them back down. See the pictures below:

Now obviously you will not be able to maintain this position forever. No one can hold the perfect position forever because this takes energy. The best way to remedy this is to take regular movement breaks to give our shoulders a break. About every 20 – 30 minutes you can do one the following three movement patterns. They will take 30 seconds to do so they won’t drop your productivity.

8 Shoulder rolls back wards and forwards. 

Gif Credit to: spotebi.com

Gif Credit to: spotebi.com

5 Shoulder blade pinches.

Chest opener and Back hunch stretch

Hold for only about 5-10 seconds

Hold for only about 5-10 seconds

Hold for about 5-10 seconds.

Hold for about 5-10 seconds.

Once you build the habit for these exercises you will not notice the time it takes to complete them is pretty short. The exercises will promote a better posture by create the movement needed to prevent your shoulders from falling in.

Go give this a try! Your wrists and shoulders will thank you

What happens to the body in high heat and what to do about it.

Working in the heat can be an exhausting and dangerous. And many chefs know first hand what it is like to work long hours over a grill or next to a hot oven. If the heat is not managed properly, we can start to see drops in cognitive processing and increased fatigue.  Even worse symptoms like nausea and fainting can occur in longer periods in high heat conditions. To better manage the heat, we need to better understand the effects heat has on the body. We can then manage the causes and symptoms we may feel when working in the kitchen.

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It’s getting hot in here. No, literally getting hot inside.

Measuring the heat in a room is not as straight forward as keeping a thermometer on the wall and checking the temperature. We need to take into account the humidity in the air, the air flow, and speed at which we work. Humans are also not the best at monitoring their body temperature until we have a problem, so we are also going to understand the ways we measure and categorize heat in humans.

The human body in heat:

Humans are able to manage the heat via one main mechanism, sweat. When humans begin to heat up from the environment or exercise, they begin to sweat heavily. This is one of the bodies on board cooling systems and when utilizing it properly it can be one of the most effective ways of managing the heat. Unlike other animals, humans use sweating as one of the primary ways to regulate body temperature. Sweating lowers the bodies temperature by evaporating the sweat off our bodies in the heat. This works best in dry conditions where the moisture can be evaporated and cause a cooling effect.

But surface temperature of the body can be very different than what is happening inside. The symptoms of heat stroke and heat fatigue are caused by an increase in the internal temperature of the body. Since the heat is increasing inside the body, it can be difficult to reduce the temperature quickly when problems arise. It is also more difficult to notice when the body is over heating because the skin temperature may not be a good indicator of how warm the total system is. One of the best ways to prevent this is to spot the signs of heat exhaustion before it is a problem.

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Spot the signs of heat related illnesses:

Heat Cramps

WHAT TO LOOK FOR

  • Heavy sweating during intense exercise

  • Muscle pain or spasms

Heat exhaustion:

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WHAT TO LOOK FOR

  • Heavy sweating

  • Cold, pale, and clammy skin

  • Fast, weak pulse

  • Nausea or vomiting

  • Muscle cramps

  • Tiredness or weakness

  • Dizziness

  • Headache

  • Fainting (passing out)

Heat Stroke:

WHAT TO LOOK FOR

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  • High body temperature (103°F or higher)

  • Hot, red, dry, or damp skin

  • Fast, strong pulse

  • Headache

  • Dizziness

  • Nausea

  • Confusion

  • Losing consciousness (passing out)

The tough part for many people is knowing when they will have symptoms of heat related illnesses. Everyone is able to acclimatize to different temperatures and humidity. But heat illnesses are also impacted by the person’s hydration levels, fatigue, clothing choices, diet, and drug use. The end points of heat illnesses may be the same but when we get there will all be different.

So what is a chef to do when working in the heat all day? Let’s look at a few things you can do today to manage the heat.

Managing the Heat

Before your day begins:

Make sure your day starts right with a boost of hydration. Coffee and energy drinks are diuretics which means they will cause a loss in water over time via urination. When you wake up take the time to drink a full glass of water and always keep a glass water with you while you enjoy anything with caffeine. 

Eat a proper meal.

Dehydration not only reduces water content but also reduces the electrolyte balance in our cells by sweating out salt. This can be prevented by eating a proper meal before the work day begins to give yourself the electrolytes your need.

Wear moisture wicking clothes:

When the term ‘moisture wicking’ is used it essentially means a material that will allow sweat to pass through it faster and away from the skin. This will allow it to evaporate faster and keep the sweat from building up as close to the body. You can find lots of moisture wicking clothes for a great price!

During your workday:

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Drink Cold Water:

This may seem obvious but drinking cold water cools down internal body temperature faster than room temperature water. It’s not the be all end all of lowering body temperature but it does help manage increasing body temperatures over time.

During Microbreaks remove yourself from the heat:

If you are taking a small break, take the time to remove yourself from the kitchen and hottest part of the restaurant. Preferably somewhere with effective air flow so the sweat can evaporate and cool your temperature.

Post Work:

Take a cooling shower:

Ice baths are the be all end all for decreasing a person’s temperature quickly in emergency high heat situations. This may not be available to everyone but a cold shower can have a similar effect.

Making the Kitchen a little less hot.

Kitchens have a couple standards in place already that really help manage the heat levels. Firstly, they have ventilation hoods above the main cooking stations. These do a massive service of pulling hot air out of the kitchen and forcing it out of the building.

While the hoods are sucking the hot air out of the kitchen we also want to make sure we are replacing this with fresh cooler air back into the kitchen. Some newer kitchens have HVAC systems, that pull cooler air from the dining room and replaces it in the kitchen. If you don’t have a ventilation system doing this then invest in a fan that will blow cooler air from a window or doorway into the kitchen. This fresh air is most likely cooler and dryer than the moist air in the kitchen and will create a greater evaporation of sweat.

Create a hot work policy:

Create a checklist or flow for the kitchen team to better manage the effects of the heat. One simple way to do this is to make sure everyone has done the following before service:

  • Cold water is at their station

  • Is hydrated before they start

  • Has eaten a meal.

  • Make sure everyone knows the signs and symptoms of heat related illnesses and to notify management if they see it happening.

Seems simple but this is really going to help manage the chances of having a heat related condition while working.

There you have it! We can’t make the hot conditions in restaurant go away completely but we can manage it a little bit better. This can make the difference in the hot summer months and will reduce fatigue levels for your team.