» Understanding Repetitive Strain Injuries
Understanding Repetitive Strain Injuries

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A repetitive strain injury refers to recurring pain affecting the nerves, muscles, or tendons of a joint due to tissue damage that is caused by repetitive movements. In the arms, this particular type of injury is also called work-related upper limb disorder or non-specific upper limb pain. Joints that are most commonly affected by repetitive actions include: the wrists, hands, elbows, forearms, shoulders, and neck.

Accordingly, conditions such as tendonitis, carpal tunnel syndrome, lateral epicondylitis, cubital tunnel syndrome, and Guyon canal syndrome can be described as repetitive strain injuries.

  • Tendonitis/tendinopathy in the hand or wrist is characterized as inflammation or wear and tear in the tendons that is the result of overuse or poor mechanics.
  • Carpal tunnel syndrome refers to pain or pins and needles in the wrist and hand due to repetitive actions such as prolonged typing. Repetitive load causes swelling and constriction of the carpal tunnel which puts abnormal pressure on a large nerve in the wrist.
  • Lateral epicondylitis, which is also commonly known as tennis elbow, is an injury that often develops due to overuse the forearm tendons attaching at the elbow.
  • Cubital tunnel syndrome is characterized as discomfort in the fingers, wrist, and forearm that is the result of pressure being placed on the nerve in the elbow joint.
  • Guyon’s canal syndrome refers to pain that develops due to pinching of a significant nerve in the wrist that extends along a narrow tunnel known as the Guyon’s canal.

These types of conditions are often linked to the particularly repetitive movements of workers such as cashiers, stockers, and assembly line personnel.  If posture and ergonomics on the job aren’t ideal, or the loads are too high for too long, the tissue wear and tear begins to create issues.   

Long hours at the computer (think essay or thesis writing) or many years of daily computer work can result in hand and wrist injuries too. Good posture at a computer helps a lot but overuse injuries can still sneak up slowly. 

Many different sports (e.g., tennis, swimming, golf) are higher risk for upper limb repetitive strain, often due to generating force and impact on a ball, while firmly gripping.  

Training or equipment errors, poor mechanics or an imbalanced exercise vs rest schedule can leave you vulnerable to overuse strain.  If the muscles are weak or the load is greater than tissues can handle – damage can occur.

A repetitive strain injury is associated with a number of symptoms that include but are not limited to pain, stiffness, cramping, numbness, tingling, or burning sensations, decreased mobility, muscle weakness or swelling in the affected joint. The injury can range from minor to serious. If you suspect you’ve developed some overuse issues, a bit of relative rest can be helpful. 

Stay active, stretch, and move often but if possible avoid the painful repeated movements for a few days to allow some healing to occur.  If your hand or wrist has pins and needles or tingling at night or during computer use for example, a wrist brace may help limit provocative positions that are otherwise hard to control.  This will allow the sensitivity of the nerve to diminish.  The use of ice or heat can help alleviate painful symptoms for a while and allow you to do more of your activities of daily living with less pain while you are healing. The tricky part with RSI is that where you feel the pain may not be where the problem starts so you need to get some professional advice.  

Physical Therapy is a front line approach to starting the healing process. It involves an assessment of your posture and mechanics at work and play as well as your overall health and fitness indicators to determine how you developed an overuse injury.  You can learn strengthening techniques and stretching routines to restore muscle balance, and promote tissue health as well as receive hands-on tissue techniques to relieve your pain and improve mobility.  The guided exercises target stiffness and discomfort, help restore mobility in the joint, and increase the strength of the injured muscle or tendon. 

If you believe you are suffering from a repetitive strain injury, now is the time to schedule a consultation with a Physical Therapist.  The licensed Physical Therapists at Purposed Physical Therapy can design an individualized program for you that can promote a quicker recovery and help prevent further injuries. Most importantly, a Physical Therapist can help you implement task modifications that will allow you to quickly return to your normal routine without exacerbating the symptoms.

Speak with a Physical Therapist today and let our experts help you experience long-term relief from repetitive strain injuries. 

References

1. van Tulder M, Malmivaara A, Koes B. Repetitive strain injury. Lancet. 2007; 369(9575):1815-22.
2. da Costa JT, Baptista JS, Vaz M. Incidence and prevalence of upper-limb work related musculoskeletal disorders: A systematic review. Work. 2015; 51(4):635-44.
3. Tjepkema M. Repetitive strain injury. Health Rep. 2003; 14(4):11-30.
4. Van Eijsden-Besseling MD, van Attekum A, de Bie RA, Staal JB. Pain catastrophizing and lower physical fitness in a sample of computer screen workers with early non-specific upper limb disorders: a case-control study. Ind Health. 2010; 48(6):818-23.
5. Ratzlaff CR, Gillies JH, Koehoorn MW. Work-related repetitive strain injury and leisure-time physical activity. Arthritis Rheum. 2007; 57(3):495-500.
6. Helliwell PS, Taylor WJ. Repetitive strain injury. Postgrad Med J. 2004 Aug;80(946):438-43.

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