A Fine Motor Mess?

Here's an advertisement I saw on the Long Island Rail Road this morning:


I know that ads are designed to grab our attention and provoke thought, and this one did just that.  But instead of viewing Tivo's offer as an enticing opportunity to speed up television viewing by swiping past commercials, I just saw the crappy message it delivered.

Last week I spoke with a kindergarten teacher who told me that she has noticed a marked decrease in her students' fine motor skills ever since the advent and omnipresence of Ipads and other touch devices.  She told me how kids are struggling to grip and utilize pencils and crayons as they simply don't have the strength and coordination to do so.  She lamented that children struggle to hold a book and turn the pages!

I'm not preaching here.  I know this technology is here to stay and is the new norm for today's kids.  My own spend time on tablets each day, although we do our best to limit it.  (I wonder why many leaders of the tech industry limit or forbid their own kids from using the very devices they peddle to us?  (http://www.nytimes.com/2014/09/11/fashion/steve-jobs-apple-was-a-low-tech-parent.html) What do they know that we don't yet?  But I digress.).  I'm just suggesting that we continue to give our kids (and ourselves) the opportunity to hone and refine our fine motor skills before they evaporate.

What are fine motor skills?  They are precise movements of the hands, fingers, eyes, lips and mouth.  Gross motor skills involve the bigger movements of the trunk and limbs and include activities such as walking, running, climbing, throwing, kicking, etc.  Traditionally, physical therapists deal in the realm of gross motor skills, while occupational therapists deal with fine motor acquisition.  Crossover  exists between the two as both disciplines deal with human movement, which is sadly taking a hit with the progression of technology.

Why do these fine motor skills matter?  This past weekend, if you live in the Northeast and have kids, you undoubtedly spent time dressing and undressing them to go out to play in the snow.  Hats, gloves, buttons, buckles, laces, zippers all needed manipulation.  I'm sure many of you struggled and wished your child could have taken care of it for themselves.  But beyond children's ability to dress themselves lie numerous other enriching opportunities which require fine motor skills.  How about the manual dexterity needed to manipulate the strings of a guitar or keys of a piano?  Or the grasp needed to throw a ball?  Or the ability to write with good penmanship?  Or to be able to manipulate a paintbrush to create a piece of art?

Movement, both fine and gross, has helped define us for millennia.  As technology moves us forward in many aspects, let's not allow it to move us backwards in others.

Tips for the Snow

The first "big" snowstorm is looming for us here in the Northeast.  It's like the Superbowl for the meteorologists as they breathlessly predict snowfall accumulations so varied in scope as to leave us scratching our heads.  Do we really need to prepare, or will this be like last year's false alarm when NYC transit was shut down over 6 inches of snow?  Fear sells, and I suppose the same applies to the weather.

But this post isn't about sensationalized weather reporting.  It's about an ounce of prevention.  I am accustomed to working with people every day who are already in pain.  But if I can share a few tips and reminders that might prevent you from getting injured, I'd prefer to do just that.

So, here are a couple of things to keep in mind as the snowpocolypse/flurries bear down on us:

• If you have to shovel, protect your back by bending at your knees and hips.  The discs that separate your vertebral bodies and provide cushion and movement are more vulnerable to injury if you're lifting with a rounded back.  Your erector spinae muscles (which extend your spine) will fatigue quickly if you're over relying on them to do the heavy lifting.  Use your glutes, quads and hamstrings to power your legs and spare your back. 

• When shoveling, alternate sides so that you'll reduce the risk of developing an overuse tendonopathy (irritation of your tendons).  Set a number and change hands and sides evenly so that you spread the load and demand.  With a heavy snow and a long driveway, you might be going at it for a while.  Be smart about it.

• Shoveling snow can be vigorous exercise.  We are coming off a season where diets and exercise typically have gone south for a while.  Just take it easy and recognize that you may be more deconditioned at this time of year than you think.  Take breaks if you have to.

• Beware of black ice!   Last year, I stepped out of my front door to retrieve my paper.  My feet nearly shot out from under me as I flailed to regain my balance.  Black ice can be very deceptive.  All looked normal as I stepped out without first assessing the path.  But I was lucky that I didn't crack my head open.  I remember going into my clinic that day and telling my office manager, "We're going to have several post-surgical patients for Colles (distal radius in forearm) and shoulder injuries within 2-3 weeks."  I wasn't rooting for it, of course.  But I knew that the treacherous conditions were going to cause numerous F.O.O.S.H. (Fall On Out Stretched Hand) injuries.  Sure enough, we had an influx of just such patients over the next month.  Take care, wear sturdy shoes, and take your time!

• Offer your help.  If you live in the suburbs and you know that your elderly neighbor can't clear their own walk, consider giving them a hand.  If you're in the city and see someone struggling to navigate those treacherous corner crossings (usually several days post-storm, when massive puddles of slush make things especially hairy for older folks), consider offering them your arm.  It might slow you down for a moment, but it'll feel good to get a "thank you" for your efforts.  Falls for the elderly typically come with outcomes that are much worse than for younger generations.

Go out and enjoy the season's first flakes this weekend.  Have fun, but take good care.   And remember, you'll be back on the beach in no time!