For farriers, aches and pains are just part of the trade. You’ve probably worked out ways to shake off any physical discomfort to keep going or have learned to just deal with sore muscles and joints whenever you have the time. Yet, aches and pains that you might think are a standard part of your profession can actually be something more ominous.

Placerville, Calif., farrier Marijke Ellert started to experience pain in her wrists when she was working. At first, she found no cause for concern. She just assumed that the pain was from tendonitis — until her right hand started going completely numb.

“It used to be just when I was working. And then it would be even when I was on my days off, even when I was doing stuff that wasn’t labor intensive with my hands,” says Ellert. “When I started to have those symptoms, I felt like it was more than just tendonitis.”

Farrier Takeaways

  • Getting “pins and needles” in your hands or experiencing numbness or weakness in your hands or wrists are all symptoms of carpal tunnel syndrome. The symptoms can range in intensity and build over the years.
  • Taking precautions like changing your forging and shoeing techniques to minimize physical stress can do a lot to prolong your career and improve your health.
  • Carpal tunnel release surgery can relieve extreme symptoms and ultimately improve your ability to perform your job well, as well as your overall quality of life.

Ellert sought help from a doctor, who directed her to a hand surgeon who performed nerve testing on her wrists. The tests revealed that Ellert didn’t have tendonitis — she actually had carpal tunnel syndrome.

Pinpointing The Symptoms

Carpal tunnel syndrome, or CTS, is caused by pressure or constriction of the median nerve at the wrist, also known as the carpal tunnel.1 According to Mike Miller, a farrier and surgeon from Huntsville, Ala., the symptoms include weakness of the intrinsic muscles in the hands, pain in the wrists or hands, and a “pins and needles” feeling. These symptoms can present over the area of the nerve in the wrist, but will most often affect the fingers. The fingers’ dexterity can be affected by these sensations, and loss of grip strength and muscle wasting can occur if the syndrome goes untreated.

The symptoms can range in intensity, and can ultimately affect a farrier’s ability to work normally. Petaluma, Calif., farrier RT Goodrich says that when he struggled with carpal tunnel syndrome, he often wasn’t able to perform simple aspects of his job.

“It got so bad, I had a hard time gripping my tools,” he says. “My hammer would just go flying out of my hand. My hands would be numb and ache at night.”

The symptoms can last for years before they build to a degree that becomes intolerable. Vaughan Ellis, a farrier from Emerald in Victoria, Australia, says he experienced the “pins and needles” feeling in his hands for nearly 20 years before seeking treatment. At first, carpal tunnel syndrome only affected his hands at night, but then it slowly began to affect them during the day.

“I didn’t fall into the category where I lost grip strength,” says Ellis. “However, as it escalated, it did begin to affect me during the daytime, particularly when driving or holding anything in one position for any period of time. I was also experiencing pins and needles and numbness during the day, which I had not had before. It would be even worse after particularly hard days — not just shoeing, but any manual job.”

Ellert also experienced symptoms for nearly a decade before the pain began to have a serious negative effect on her work.

“It affected pretty much everything,” she says. “I was dropping tools a lot. There were times when my wrists hurt so bad, I couldn’t work. This was a really frustrating point in my life, for sure. That is just a frustrating feeling, to not have your hands do what your brain is trying to tell them to do.”

What Placerville, Calif., farrier Marijke Ellert thought was a case of tendonitis turned out to be carpal tunnel syndrome and Kienbock’s disease.

Managing And Monitoring Symptoms

There are things you can do to decrease the stress that is placed on your body during forging, trimming and shoeing. Although precautionary measures aren’t a guarantee that you’ll avoid developing carpal tunnel syndrome, they can still have a positive effect on your career and physical health. Goodrich says that Hope, British Columbia, farrier Bob Marshall gave him some career-saving advice when he was beginning to experience symptoms of carpal tunnel syndrome.

“Bob is a real stickler on technique and body mechanics,” he says. “The way you grip your tools, the way you address the anvil, it’s all very important. The thing with me is I had a death grip on my tools all the time, like most of us do. Just that constant gripping and hammering, or squeezing on the tongs — my wrists were shot. He would really focus on using your whole arm, shoulder, elbow and wrist and not gripping your tools so tight.”

Keeping your tools in good repair and making sure you are mindful of your technique can also help reduce physical stress. Goodrich says that forging and other parts of farriery don’t involve brute force so much as they do technique and finesse. The grip you have on your tools and how you address your anvil can do a lot to either hurt or help your body. To combat overexertion during forging, for instance, there is a simple technique you can use.

“One thing people tend to do is flop their elbows out,” Goodrich says. “I had an apprentice one time who would do that; her elbow was going 90 miles an hour, so I put a dish towel under her armpit, and got her to relax her arm and keep her elbows in. She was heading for arm surgery if she’d kept that up.”

Miller adds that wearing a wrist brace during the night can also help by keeping you from unintentionally flexing them.


That is just a frustrating feeling, to not have your hands do what your brain is trying to tell them to do …


Of course, you should seek diagnosis and treatment from a licensed medical professional if you think you have carpal tunnel syndrome. Catching and caring for this particular physical malady can go a long way toward prolonging your career and keeping your body in good condition.

Ellert advises farriers who think they might be developing carpal tunnel syndrome to monitor their symptoms. She also says that there is a simple test you can do to help you determine whether you might be developing carpal tunnel syndrome.

“Press across your palm, where the carpal tunnel is, with the thumb of your opposite hand. If your fingers start to go numb after 6 seconds, then you’re starting to have some inflammation of the area.”

Miller says that another test you can try, called the “Phalen’s test,” can help you determine whether you’re developing carpal tunnel syndrome. All you have to do is bend your wrist down for about 30 seconds. This increases the pressure on the median nerve, and can spark the “pins and needles” symptoms.

Getting Surgical Care

When carpal tunnel syndrome develops to the point that it’s significantly affecting the mobility and usability of your hands, surgery can become necessary to get rid of the symptoms. Miller says that you should consult a physican as soon as the symptoms become persistent.

“I tried sleeping with my hands elevated at night, but this didn’t work for me,” says Ellis. “I didn’t ever seek other therapies, lotions or potions, although I did try magnetic wrist bands for a period of time to no avail. I made an appointment with my general practitioner, who referred me to a technician for a conduction test to determine the extent of my carpal tunnel syndrome and to confirm diagnosis. An appointment was then arranged to meet with a specialist surgeon to discuss my options and make arrangements for surgery.”

Carpal tunnel release surgery, which is used to relieve the symptoms, can be done two different ways: either as open release surgery, which is done through one 2-inch incision made in the wrist, or as endoscopic surgery, which is done through two ½-inch incisions in the wrist and the palm.2 Miller says that during surgery, the transverse carpal ligament, which goes across the carpal tunnel, is cut to release pressure in the carpal tunnel, giving the median nerve “room to breathe.” The operation itself doesn’t take very long — only about 10 minutes.

Depending on the extent of the surgery and the individual, recovery can last a week or 2 to 8 weeks or more. Miller says that as long as the skin is given a chance to heal, a farrier can return to work.

Ellert recommends surgery for anyone whose medical diagnosis identifies them as a surgical candidate, and adds that it can be life-changing. She decided to get surgery to relieve her own symptoms, but wanted to look more closely to ensure there were no other health problems contributing to the pain, which she says was comparable to the aching pain caused by a sprain. She requested an MRI before getting surgery, which revealed that she also had a bone disease called Kienbock’s disease. This disease was slowly killing the lunate bone in her wrist by cutting off its blood supply. Because of this, Ellert had to get a major wrist restructure and part of her radius removed, which she chose to do when she got carpal tunnel surgery. The hardship of undergoing such extensive treatment has paid off.

“There is no numbness or tingling in my hands at all. The carpal tunnel syndrome is completely gone. You can’t even tell there’s a scar from that surgery.”

Ellis also encourages any farrier suffering from carpal tunnel syndrome to seek medical treatment for it.

“The outcome from getting surgery was a marked improvement in quality of life. I only wish I had done it earlier,” he says. “That would be my advice to other tradesmen: don’t procrastinate and don’t pursue silly home therapies or alternate methods.”

References

  1. National Institute of Neurological Disorders and Stroke (2018, July 13). Carpal Tunnel Syndrome Fact Sheet. Retrieved from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Carpal-Tunnel-Syndrome-Fact-sheet
  2. John Hopkins Medicine. Carpal Tunnel Release. Retrieved from https://www.hopkinsmedicine.org/healthlibrary/test_procedures/orthopaedic/carpal_tunnel_release_135,29

The Business Of Recovery: Preparing And
Managing Your Practice While Recovering From Surgery

To some, 8 weeks off for recovering from surgery can be a welcome break. To farriers, it means preparing their practices for an interruption in routine and income. Marijke Ellert, Vaughan Ellis and RT Goodrich share advice for preparing your practice and making a smooth recovery.

Keep Clients Informed

One of the most important things you should do when preparing for surgery and recovery is letting your clients know what’s going on. Ellert says that she kept her clients up-to-date on everything when she was dealing with health problems. Because she had to get surgery to address both carpal tunnel syndrome and Kienbock’s disease, she took 8 months to recover. However, she had given her clients enough time to make plans for their horses.

Find Helping Hands

One of the farrier industry’s defining features is its sense of community. Ellert, Ellis and Goodrich all had help managing their practices when recovering from surgery. Goodrich has two other farriers who work under him and were able to take over his practice when he was recovering from rotator cuff surgery. Ellert and Ellis both had friends and colleagues pitch in to help whenever they could. Ellert recommends asking for help prior to getting surgery to make planning easier.

Get Back In The Saddle

Even though surgery can keep you out of commission for a while, being in recovery doesn’t mean you can’t see your clients. Goodrich says that as soon as he was able to, he would ride along with his helpers to shoeing appointments. Doing this can put your clients at ease in the presence of a farrier they aren’t familiar with, and can also demonstrate that you’re on the mend.

Expect The Unexpected

Setting aside an emergency fund is one of the best things you can do for yourself, in case you ever need surgery or are unable to work for an extended period of time. Even if you feel you don’t need to worry, saving something from each job you complete can make a big difference during an emergency. “I think it’s important for young farriers to start setting themselves up because you don’t know,” Goodrich says. “It could be a misplaced kick, or a bad accident with a knife or hammer — you never know. Your career could end instantly, and you just don’t know it. If you haven’t prepared yourself for that, you could get caught unaware.”

 

November 2018 Issue Contents