It’s about direction of rotation, does the wrench turn left or turn right, there isn’t the same notion of up and down / in and out because that portion happens when the bolt or nut turns. Also, anything rotation is moving the opposite direction on the other side of the rotation, so if you have to tighten a screw that turns towards you it’s the opposite
Stretch, focus on muscle groups in your hands or arms or shoulders or neck if you can’t get up, back or hips or calfs or ankles if you’re standing