Repetitive Strain Injuries (RSI)

Repetivie Strain Injuries (RSI) affect many people in diffent settings. This articles explains the factors that can contribute to RSI and things that can be done to help to avoid them.

Repetitive strain injuries (RSI) are defined by NHS choices as “a general term used to describe the pain felt in muscles, nerves and tendons caused by repetitive movement and overuse.” [1]. In work related RSI this often refers to injury in the upper limbs including hands, wrists, elbows, arms, shoulders and neck [2]; but can also include a wider range of complaints in other areas of the body such as the foot, ankle and leg [3], especially in a sports setting. People often identify conditions such as carpal tunnel syndrome (CTS), hand or wrist tendonitis [4], and tennis or golfers elbow as work related repetitive strain injuries; but any activity that places a continuous repetitive strain on a tissue can result in injury.

In a sports setting this may include patella-femoral pain syndrome or PFPS (a type of knee injury), Achilles complaints, some rotator cuff strains (type of shoulder injury), ilio-tibial band syndrome or ITB syndrome (pain over the outside thigh and knee), tendonosis of the foot presenting as ankle pain, etc. This means a wide range of people can be affected by an RSI in many different settings. The first question we usually hear in the Spine and Sports Injury Clinic Thanet (covering Margate, Ramsgate, Broadstairs areas) is “how did the injury occur?” Frequently people struggle to identify a specific starting event for their pain, usually because it has occurred so gradually over a period of time. When a task or activity is very repetitive it can cause an inflammatory response in the tendon or muscle tissue. If the repetitive force is reduced to a manageable level at this stage then repair can still occur [4]. However, if the strain is maintained at the harmful level then more complex changes can occur to the tendon, muscle and nerves [4]. This then makes the complaint more complicated to deal with and (in practice at SSi) may increase the duration of recovery.

So how do you avoid an RSI in the first place? It is important to review the variables that may contribute to a repetitive strain within your environment. Such things include:
 
  • Repetitive work tasks or prolonged work tasks. [1,2,4]
  • Sustained or excessive force tasks. [1,2,4]
  • Ergonomic positions that result in poor posture or awkward work positions. [1,2,4]
  • Heavy computer use. [4,5]
  • Poor movement control in sporting activity. [3]
  • Poor training schedule in sporting activity. [3]

Simple adaptions can go a long way in reducing the likelihood of developing an RSI.

  • Taking brief but frequent breaks when performing a repetitive task. [1,2,6]
  • Reducing the intensity of high force tasks with the use of aids, light weight tools, reduced weight/size of the item, etc. [2]
  • Improve ergonomic position and workstation set up. [1,2,6] (See our ergonomic desk position information sheet for more details)
  • A suitable strength training programme for the areas most at risk to RSI. [6,7]
  • In sporting activity, exercises that improve strength and movement control within a sports specific setting.
  • In sporting activity use of a varied training schedule that avoids repetitive excessive overload of a body part.

However, if you develop pain that may be associated with RSI then it is best to seek early advice. Once the pain has been on going for a lengthy period of time (over 3 months) then the changes that have occurred in the area become more complicated and the management of the injury more difficult. At the Spine and Sports Injury clinic Thanet (covering Margate, Broadstairs, Ramsgate) we review a wide range of contributing factors and develop a treatment plan tailored to the causes of your RSI. If you’d like more information on treating an RSI please contact the clinic.

Registered Osteopath

References

[1]  NHS.UK; Repetitive Strain Injury (RSI) – NHS Choices; Last Reviewed January 2016; Accessed April 2016
[2]  Managing Upper Limb Disorders In The Workplace; The Health and Safety Executive; August 2013
[3]  Coordinative Variability and Overuse Injury; Hamill, Palmer, Van Emmerik; BMC Sports Science, Medicine and Rehabilitation 4:45 (2012)
[4]  Work-Related Musculoskeletal Disorders of the Hand and Wrist: Epidemiology, Pathophysiology, and Sensorimotor Changes; Barr, Barbe,
      Clark; Journal of Orthopaedic and Sports Physical Therapy 34:10 (2004): 610-627
[5]  Patient.info; Overuse Phenomena And RSI; Last Reviewed May 2014; Accessed April 2016
[6] Interventions for the Prevention and Management of Neck / Upper
      Extremity Musculoskeletal Conditions: A Systematic Review; Boocock et al.;
      Occupational and Environmental Medicine 64:5 (2007): 291-303