Repetitive Strain Injury Series — Part 1

Woman knitting
Any movement repeated for long periods can lead to strain

If you spend time on a computer, tablet or smart phone, you’ve likely felt complaints from your neck and shoulders, or discomfort in your hands, wrists or arms. Or maybe you like to cook, knit, garden or do other activities that involve repetitive movements.

I’ve written this series to help you stay comfortable and prevent (or recover from) repetitive strain injuries.

In this post, I’ll give you an overview of repetitive strain injury (RSI): what it is, why it happens and what you can do about it.

The Hidden Dangers of Repetition

Office worker risks repetitive strain
What’s wrong with this computer set up?

“Hazardous work” is a term no longer limited to jobs and activities with a high risk of sudden or serious physical injury. While being at your desk on a computer or texting from your couch may seem innocuous, they harbor a cumulative danger: sitting statically, making the same small movements over and over with your hands, often in isolation from the rest of yourself.

A couple years ago, a friend of mine started an accounting job. She worked 50-60 hours a week during tax season. It wasn’t long before her shoulders and arms started aching, then her wrist began to hurt.

Like many people, she didn’t know anything about repetitive strain injuries (RSI) or ergonomics. Her employer certainly didn’t provide proper information or equipment. In fact, the desks at her company didn’t even have keyboard trays, a rudimentary piece of ergonomic equipment. Employees needed a doctor’s note in order to get a tray installed!

What Is Repetitive Strain Injury?

People who play games (analog & digital) can strain tendons

Repetitive strain or stress injury (RSI) is an umbrella term used to describe a range of problems in the hands, arms, neck, shoulders and/or upper back from overuse (i.e., doing the same repetitive movements for hours a day). Activities that may result in RSI symptoms include typing or texting, playing an instrument, running a cash register or espresso machine, playing racquet sports or gutting fish (as was the case with my brother who’s a fisherman).

Symptoms vary widely but usually involve repeated micro-trauma to muscles, tendons and/or nerves. Common medical diagnoses for RSI include carpal tunnel syndrome, elbow tendonitis, thoracic outlet syndrome and ulnar nerve impingement.

Common Causes of RSI

Many factors can contribute to repetitive strain, including:

  • Doing repetitive tasks with your hands and arms on a regular basis
  • Working long hours and/or not having sufficient breaks
  • Working fast, under stressful conditions or in a cold environment
  • Sitting or standing in the same position for a long time
  • Working on equipment that doesn’t fit your body
  • Poor posture and movement habits
Elbow Tendonitis Pain
Pain, burning, numbness and muscle weakness are common RSI symptoms

Common Symptoms of RSI

Symptoms can vary widely. Here are some common ones:

  • Pain, soreness or burning sensations in the hands, arms, shoulders, neck or back
  • Tingling or numbness in the arms or hands
  • Muscular weakness, fatigue, stiffness or feelings of heaviness in your shoulders, arms and hands
  • Cold hands
  • Difficulty carrying or holding things
  • Tremors, clumsiness or dropping things
  • Difficulty with normal activities such as opening doors, brushing teeth, buttoning clothes, chopping vegetables, etc.

How Can Doing Something So Mundane Cause So Much Pain?

If you type 60 words per minute, you’d make 20,000 keystrokes per hour. Doing that for half a typical workday would rack up 80,000 keystrokes a day—that’s not including all the moving and clicking you do with your mouse.

Hands on keyboard
How much work do your fingers do per day on your device?

Depending on the type of keyboard you have, the amount of force needed to activate a key ranges from 1-6 ounces (and most of us strike keys with more force than necessary!). If you used an average of 4 ounces of force per keystroke and made 80,000 strokes, your fingers will have exerted 10 tons of force on the computer per day. That’s how something as seemingly innocuous as sitting at a desk pressing little keys can add up, often to the point of pain or injury.

Our bodies are pretty resilient, so these little strains can take months or years to be experienced as symptoms. At first these may be minor and/or go away after a few hours or days of rest. So it can be easy to ignore early signs of repetitive strain injury.

The reality is, by time you start to feel pain, a significant amount of inflammation and injury has already occurred. RSI is cumulative, meaning if you don’t make a change, the damage to tissue worsens over time. RSI isn’t something you can “power through”. The sooner you take action, the quicker and easier your recovery will be.

What to Do if You Experience Repetitive Strain

The most important thing you can do is to pay attention to your symptoms rather than ignore them. Make any obvious adjustments you can to your set up (maybe no more typing on your laptop in bed!), as well as your own alignment and ways you move.

Exercise & stress reduction can help

Interrupt the Cycle of Inflammation and Strain

Here are some simple things you can do:

  • Rest your hands and arms as much as possible
  • Reduce or stop activities that exacerbate your symptoms
  • Get moving! Go for walks or do other exercise that doesn’t aggravate your symptoms. Among other benefits, exercise increases blood flow which speeds tissue healing
  • Find ways to reduce your stress, such as taking a hot bath, being in nature, meditation, qigong, Feldenkrais or anything else you find calming and restorative
Eat less processed and more fresh, whole foods!

I also recommend addressing overall inflammation in your body:

  • Reduce the amount of inflammation-generating foods in your diet (sugar, refined carbs, industrial seed oils, processed meats, etc), and add eat more anti-inflammatory ones (fresh vegetables, berries, fatty fish, ginger, turmeric, etc.)
  • Talk to your health practitioner about supplements that may be supportive (magnesium, alpha-lipoic acid, fish oils, etc.)

Get Support from a Professional

Ways to Take Care of Yourself
The sooner you address RSI symptoms, the better

If your symptoms persist or get worse, make an appointment to see a qualified health professional. If you see a medical doctor, he/she will most likely prescribe traditional physical therapy. However, alternatives to physical therapy are often much more effective for RSI, including the Feldenkrais Method®, Alexander Technique, biofeedback and acupuncture.

Tune in Next Month… In Part 2 of this series, I’ll reveal the three habits that contribute to repetitive strain and the most essential part of preventing it.