A Modern Perspective on Repetitive Stress Injuries

Young woman messaging with smartphoneTexters’ Thumbs and Knitters’ Knuckles

by Moshe Lewis MD, MPH

Every day at work you execute thousands of precise, frenetic keystrokes while hunched painfully over a monitor. You text and type and staple and file until the stroke of five, performing a daily marathon with your forearms and fingers. And like a marathoner, your tireless performance comes at the cost of physical pain. If left unchecked, your low-impact daily tasks may be putting you at risk for a repetitive stress injury.

Repetitive stress injuries, or RSIs, are caused by repeated everyday actions. The two most common RSIs are tendonitis, the inflammation of a tendon; and bursitis, the inflammation of a bursa sac. Some well-known examples include carpal tunnel syndrome and tennis elbow. Though repetitive stress injuries often start as an inconvenient ache, the symptoms can become far more severe if they are ignored.

People sometimes assume that their risk of RSI depends on the amount of time spent on a certain action. The time spent is actually less important than the number of repetitions. For example, if you spent two hours typing only one hundred words, your risk is far lower than a friend who typed an epic two thousand words in only twenty minutes. Furthermore, if your friend repeated her typing binge several times daily over weeks and months, she might start to accumulate orthopedic damage if she didn’t rest prudently. This repetition of a task over time is what leads to RSI symptoms, even if the task is only done for a few hours every day.

The most severe RSIs require physical therapy and medication. Yet the majority of RSIs are easily reversible. Paying attention to your posture and switching to more ergonomic products can help to prevent or alleviate the painful symptoms of repetitive stress.

Your Computer Surprise

Your keyboard may be the most dangerous part of your office. Computer use is one of the leading causes of office-related RSIs. To fight this epidemic, many ergonomic products are now available to help you improve your posture and take stress off of vulnerable joints.

One of the most common and effective office aids is the ergonomic keyboard. Its 70’s-futuristic split curved keypad surface elevates typing hands to a less damaging posture. Critics have questioned the effectiveness of ergonomic keyboards since their inception, but it’s hard to argue with results– a 2010 study showed that typists with RSI related disorders were able to reduce the severity of their symptoms by using ergonomic keyboards.

Your Laptop and Notebook Computer

But what about the computer user on the go? In this modern era, mobility is everything and laptops are more common than ever. You might have noticed that the term “laptop” is slowly falling out of style in favor of “notebook computers” or iPads. This is in part because your laptop is a terrible surface for a portable computer! Not only does your lap overheat a computer, the hip-height keyboard and
screen puts strain on your wrists and your neck. Your lap is less steady than a table, which also makes for high-stress typing.

To reduce risks for RSI, try elevating the computer to eye-level and connecting an external keyboard to your laptop. This will allow you to use the computer as comfortably and ergonomically as you might use a desktop. Also, if you are at risk for RSIs, it may be best to avoid buying an ultracompact netbook. Netbooks have keyboards that are smaller than regular laptops, and this can increase the likelihood of typing with incorrect posture.

Your Phone

Texting and phone browsing have become key parts of professional communication, and they have simultaneously become a frequent source of RSIs. Smartphones tend to be heavier than regular cell phones. This extra weight can reduce the bloodflow to the thumbs when using the phone, causing thumb injuries and aggravating carpal tunnel syndrome. Android phones and iPhones increase your RSI risk for the very reasons they make such enticing gadgets—the touchscreen and added functionality makes them more useful, and thus they tend to keep your
fingers active when you might otherwise be still.

A recent study suggests that to reduce the likelihood of RSI, you should use both thumbs when texting and take breaks in between writing messages. If you find your hands truly in need of a rest, try an old-fashioned remedy: use your phone to talk instead of type.

Your Life

Office work is a leading cause of repetitive stress, but remember that your home life has just as many possible sources of RSIs. Even when relaxing, it is important to keep repetitive stresses under control. Cooking, gardening, needlecraft, and leisure sports all have their own risks. Game controllers are notorious culprits—early Nintendo use sparked an epidemic of “Tetris fingers”, and new game controllers like the Wiimote have even spurred cases of tennis elbow in fervent gamers.

To prevent home and leisure injuries, simply remember that even light exercise puts stress on joints. During your leisure time, remember to take it easy! Stretch before playing, and take breaks before a slight stiffness becomes a full-blown injury.

Moshe Lewis MD, MPH

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