What is RSI?
Repetitive strain injuries (RSI) occur because of repeated physical movements which will do damage to tendons, nerves, muscles and other soft tissues in the body. Occupations ranging from factory work to keyboarding can lead to RSIs. Nerves from the spine which control these structures can become irritated anywhere along their path and can then lead to increased damage if left untreated.
In the working world the rise of computer use, keyboards that permit high speed typing as well as the use of mice have resulted in an epidemic of injuries of the hands, arms and shoulders. The thousands of repeated keystrokes and long periods of clutching and dragging mice slowly accumulates damage to the body. The most damage is done the quickest with actions which are small, repetitive with not much force needed (4,5). RSIs can be brought on more quickly as a result of poor technique and body positions which place unnecessary stress on the tendons and nerves. In upper body work this can manifest itself as stress on the hand, wrist, arms and even shoulders and neck. Lack of adequate rest breaks as well as using excessive force almost guarantees trouble. Getting a RSI checked and dealt with as soon as you feel symptoms, or preferably not waiting until you feel symptoms, will help prevent long term possibly disabling problems.
The most common injury in industry today is carpal tunnel syndrome. According to Pinsky (6) the percentage of all illness in the U.S. workplace due to RSI has gone from 14% in 1978 to 56% in 1990.
What are Symptoms?
tightness, discomfort, stiffness, soreness or burning in hands, wrists, fingers, forearms or elbows
tingling, coldness or numbness in hands
clumsiness or loss of strength and coordination in hands
pain that wakes you up at night
How do I prevent it?
ensure correct typing posture: monitor should be lower and further away, thighs and forearms should be parallel, wrists should be straight and not resting on anything while typing and your back should be straight
increase font sizes preventing hunching forward
use a light touch on your keyboard and mouse
take lots of breaks to stretch and relax
keep your hands and arms warm
don’t tuck telephone between shoulder and ear as it will aggravate any neck problems leading to nervous system interference
listen to your body
visit your chiropractor to correct joint dysfunctions before problems occur
What do I do if I have it?
Run, do not walk to your chiropractor right away! Dealing with RSIs early is critical to limiting damage and sparing you a lot of hurt, trouble and frustration. By the time you feel symptoms there has already been damage done and if you try to ignore the pain you may sustain serious injury.
What will my chiropractor do?
Management of an RSI is always combined with adjusting any subluxations to remove interference to the nervous system and is the only way to permanently end the hold the injury has on you as well as get you better faster. There are four phases of management for overuse syndromes (5):
The goal in phase 1 is to control pain. Here your chiropractor will be helping you to control inflammation. Home icing, adjusting and electrical modalities will be done here.
The goal in phase 2 is to restore range of motion. You will be given stretches to do at home, your chiropractor will continue adjusting necessary joints and this is where special soft tissue techniques, such as active release therapy to break up scar tissue comes into play.
The goal in phase 3 is to restore muscle fitness. All components of phase 2 will be continued and a strengthening component will be added to help in long term care.
The goal in phase 4 is prevention of future injury. Maintenance care will be suggested by your chiropractor as well as modifications in lifestyle and ergonomics.
Depending on the history of your injury, your compliance with treatment plans and the degree of your injury will determine how fast you will pass through the phase of care.
References:
Field, LD, Savoie, FH (1998). Common elbow injuries in sport. Sports Medicine 26(3):193-205.
Plancer, ILD, Peterson, RK and Steichen, JB (1996). Compressive neuropathies and tendinopathies in the athletic elbow and wrist. Clinics in sports medicine. April 15(2):331-71.
Khan, K, Brown, J Way, S, Vass, N, Crichton, K, Alexander, R, Baxter, A, Butler, M & Wark, J (1995). Overuse injuries in classical ballet. Sports Medicine May 19(5):341-57.
Leahy, PM (1995). Improved treatment for carpal tunnel. Chiropractic sports medicine May 19(5):341-57.
Mooney, V (1998). Stretching and strengthening exercises are key components of care: overuse syndromes of the upper extremity: rational and effective treatment. Journal of musculoskeletal medicine 15(8):11-18.
Pinsky, A (1993). The carpal tunnel syndrome book. Warner books.