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The Pain Of Repetitive Strain

If we were to sustain an injury, most of us would expect it to happen while doing something active, but the most sedentary of activities – sitting at your computer day in and day out – can be just as debilitating, writes Zaza Motha.
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Many of us spend long stretches of time in front of our computer, without realising that what may seem to be inaction may actually lead to injury, particularly to the wrist, elbow and upper arm.

“Repetitive stress or strain injury (RSI) is a term that is used to describe the pain felt in muscles, joints or tendons caused by repetitive movements or the overuse of a muscle when an injury has occurred,” explains Dr Ntlopi Mogoru, a sports physician and medical practitioner, and CEO of the Road Accident and Medicolegal Assessment Clinic.

According to BodyLogic physiotherapist Fatima Pahad, repetitive stress injuries are generally related to occupation or sport-specific activity. Some of the more common injuries are:

Tennis elbow (pain focused on the area where your forearm meets your elbow);

Golfer’s elbow (pain on the inside of the elbow, with a general weakness in the wrist);

Carpal tunnel syndrome (a numbness and tingling in the hand and arm which is caused by a pinched nerve in the wrist); and

Iliotibial band syndrome (ITB) (common in runners, where the ligament that runs from the pelvic bone to the shin bone becomes tight or inflamed).

There are three main culprits: repetitive movements, prolonged high-intensity activity without rest periods, and activity related to poor or awkward postures – all of which are hallmarks of most desk jobs. This makes computer users particularly susceptible to RSI.

RSI is a soft tissue injury that can occur in the muscles, tendons, fascia, ligaments or neural tissue, and can even cause muscle tears in extreme cases. “Muscle strain is categorised as Grade One, which includes minor tears; Grade Two, which includes moderate damage; and Grade Three, which includes complete rupture that may require surgical correction.

“Strains and sprains are treated with the aim of first ensuring good tissue healing, and then strengthening,” Pahad says. Even nerve tissue disorders may be classified as a soft tissue problem, she adds, pointing out that altered neurodynamics are commonly found in association with spinal problems or repetitive strain injuries.

Doctors aren’t sure exactly why RSI develops. Many sufferers don’t exhibit swelling, inflammation or other obvious problems, yet they have the symptoms. Also, it’s not clear why some people develop RSI and others who do the same repetitive tasks don’t.

But you can help to prevent it by setting up your workstation correctly, and ensuring that you vary your activities. And, if you have any symptoms, see a physiotherapist sooner rather than later to prevent the problem from progressing.

How to keep RSI at bay

Type in a neutral position. Make sure your elbow is positioned slightly higher than your wrist – at 90 degrees or more.

Sit up straight and maintain a healthy posture.

Take regular breaks – 15 to 20-second breaks for every 15 minutes you spend at your desk.

Stretch from time to time.

Vary your routines.

Make sure that you don’t follow the same routines at home. Try to do other things that don’t involve a lot of wrist usage.

Signs and symptoms

Dr Ntlopi Mogoru lists these common symptoms of RSI:

  • Pain in the affected area (joint or muscle).
  • Loss or reduced strength and sensation around the affected area.
  • Tenderness in the affected area (joint or muscle).
  • Sensory loss, such as a pulsating or tingling feeling around the affected area.


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