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Avoiding repetitive strain injury

by Pam Honeyman BSc. BHSc. P.T., on-site physiotherapist and ergonomist.

Does your job give you a recurring and nagging pain in your neck, back or arm? If so, then you may be experiencing a repetitive strain. Repetitive strain injuries (RSI) is the catch phrase to describe spinal, upper and lower limb pains caused by repetitive motions.

The prevalence of RSI in the past decade has escalated in the office environment due to an increased dependence on computers. People who work for more than four hours a day on a keyboard seem to be at an elevated risk. Working in an awkward position and posture (poor ergonomic positioning) on the computer with poorly placed or improperly designed equipment is also a hazard.

What is the cause?

Injuries occur over time and may take a few weeks to years to evolve due to repeated stresses on soft tissues such as muscles, tendons, ligaments and nerves. Some conditions that are associated with RSI are: carpal tunnel syndrome, tendonitis, (i.e. tennis and golfer’s elbow, shoulder pain), and low back and neck pain. However, often an individual complains of vague, varied and non-specific aches that may make a diagnosis more difficult. It is important to note that if a person feels intermittent or persistent pain and/or strain without a traumatic event the pain may indicate an RSI. If treated early the individual rapidly returns to normal function, however if left untreated, the symptoms may become more severe and chronic. This is why prevention and early intervention are so important.

The following signs and symptoms may indicate your need to seek assistance from a health professional due to an RSI.

- Do you have headaches, spinal or upper or lower extremity pain after working for an extended period on a computer?

- Do you frequently feel the need to massage your hands, back, neck or arms to try to work out the tightness and pain?

- Do you awaken at night with pain or numbness in your hands and wrists?

- Do you avoid using the injured arm/hand?

- Do you find yourself shaking out your hands because they have become numb?

- Do you feel overly protective of your hands, arms, neck or back?
Do you notice that your hands or arms tingle or burn?

- Do you find it hard or more difficult to perform regular activities such as brushing your teeth or hair, getting dressed, opening cans or doors, reading a book or newspaper, chopping food, carrying groceries, or sitting and standing for long periods.

Preventative Tips

One of the best ways to treat an RSI is to prevent it from occurring initially. Here are some positional ideas to help prevent a repetitive strain as these aches and pains are often caused by small and repetitive movements that overstress the body.

You should sit in an ergonomic chair that generally contours to your body shape.

A wooden kitchen chair is not appropriate! The chair should have adjustable arm rests, back support and height levels. Chairs do not have to be excessively expensive to be comfortable. It is best to go to a store that sells office chairs and sit in several to see what design best suits you. One size does not fit all!

While sitting, your back should be comfortably supported by the back of the chair. Please avoid perching at the front of the chair!

Position your hips so they are bent about 90 to 110 degrees and the knees at 90 degrees to avoid compression of blood vessels in the thigh. This will promote good circulation.

Your feet should be flat on the floor or slightly angled while resting on a footrest. Your feet should never dangle unsupported or rest on the chair legs.

Sit at arm’s length from the computer.

Position your head directly in line with your shoulders, avoiding a forward head posture. Look forward comfortably, eyes focussed on the top two thirds of the screen.

Rest your arms easily at the side of your body with the elbows bent at approximately 90 degrees.

When mousing keep your arms in the same position as above while resting them on the armrest or on the computer table. Avoid straightening or angling your elbows away from the body. While typing, your arms do not need to be supported by the armrest.

Position your wrists in a straight line to the keyboard or mouse. Do not bend them up or down.

If your computer table does not allow for proper upper body positioning a keyboard tray may be of benefit.

Rest frequently to reduce eyestrain and muscle ache and to allow yourself to stretch. Spend five to ten minutes an hour away from the computer to rest.

If you have a tendency to talk and type at the same time, try a headset or speakerphone. The cradling of the phone on the shoulder is a sure-fire way to cause muscle strain and/or a headache.

Physiotherapy and RSI

Physiotherapists are well trained to treat RSI. Physiotherapy treatment of RSI includes extensive education on how and why we develop RSI and how to avoid the condition by providing ergonomic and postural tips. Modalities such as laser and the interferential current can also help in the healing process. Specific hands-on treatment will aid in pain relief and maximize conditions for tissue healing. Clients are also given specific exercises and stretches to address their particular injury, all to provide a comprehensive treatment program.


To book an appointment with Pam Honeyman, please contact

Pam Honeyman BSc., BHSc. P.T., /CAFCI (acupuncture certification) , Registered Physiotherapist

Procare Rehabilitation, 890 Yonge St Suite 600, Toronto (Yonge and Davenport - 2 blocks north of Bloor) 416 324-2240

Copyright © 2007 Pam Honeyman

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