Repetitive Strain Injury (RSI)

June 14, 2024

Repetitive Strain Injury (RSI) 

There’s a greeting card on the shop shelf with a lady holding her shoulder with one hand, in pain, whilst pointing with the painful arm……..‘Sue had Repetitive Strain injury from always pointing out where her husband went wrong!!’ 

A lighthearted tip of the hat to a very common group of symptoms. Repetitive Strain injury (RSI) refers to a range of conditions which may be caused by repetitive tasks, forceful exertions, vibration or even sustained / awkward positions. RSIs commonly affect muscles, tendons and nerves, most usually in the upper limbs. However, with quite simple changes in behaviour and with occasionally some relative rest, symptoms can often be effectively managed.  

What Causes RSIs? 

It is often the result of persistent mechanical loads on specific body tissue that slowly accumulate stress beyond the tissues capacity and thus result in the gradual onset of symptoms. Such forces may include: 

Repetitive motions: such as typing, using a mouse, assembly line work. 

Forceful Activities: actions that require repeated significant effort like lifting heavy items, ‘bashing’ items, with the body part being used like a mallet. 

Awkward Postures: positions that strain the body like hunching forwards over a desk or holding tools awkwardly. 

Vibration: prolonged use of vibrating equipment such as hand tools/ power tools.  

Other factors may influence who may be more likely to experience symptoms: 

• Individual factors – being female, suffering diabetes, increasing age and pregnancy all increase the likelihood of developing pain.  
• Physical wellbeing factors – smoking, obesity and poor general fitness all increase the likelihood of developing pain and the length of time it takes to recover.  
• Psychological wellbeing factors – stress, depression and anxiety all increase the likelihood of developing pain and even increase the severity of pain and the length of time it takes to recover as does fear of movement, activity and work. 

What Symptoms are likely from Repetitive Strain Injuries? 

Once a tissue is taken past its threshold of coping with certain loads or postures then a variety of symptoms may develop, such as: 

Pain and Tenderness: often localised to the affected area or radiating away distally. This can start as a mild ache that intensifies over time to a pain, a burning sensation or, if ignored, into a sharp, shooting pain. 

Stiffness: reduced flexibility in the joints or muscle tissues may progress and sometimes locking or spasms of muscles can occur eventually. 

Numbness or Tingling: with gradual vascular or nerve compromise these symptoms may arise, particularly in the extremities of the hands or feet. 

Weakness: with persistent exposure to strain, eventually strength can be affected as muscle tissue fatigues. 

How can I help myself? 

The majority of work-related repetitive strain cases can be self-managed or treated conservatively with adaptation of tasks, physiotherapy treatment and advice. However, your attitude and the actions you take are the most important factors in preventing long-term problems. The most effective way to manage symptoms are to;  

• Report early any symptoms you think may be work-related. Firstly, you may have a lawful duty to report your injury. Secondly, by informing your employers they are then able to make any necessary adjustments to your workplace or working practices, either temporarily for yourself on an individual basis, and permanently for the team to improve overall workplace wellbeing. Also, in reporting it to your line manager, they may be able to refer you for physiotherapy support at work or externally. 
• Avoid overly prolonged static postures, keep mobile and active, and take breaks from performing the same repetitive body movements to rest and stretch the body or move onto another task where able.  
• Practice daily stretches to the affected region at the earliest sign of onset. 
• Talk to your GP or pharmacist about what pain relief may be right for you. If your pain is controlled.  
• Apply gentle heat (if not red and inflamed) to soothe tight muscles or ice (wrapped in a damp towel) to have a numbing effect around the region and, along with elevation, reduce any excessive swelling if present.  
• Ensure you are following all manual handling techniques correctly at home and work – when lifting keep the load close to your body, use your legs on lifting, pushing and work within your capability. In the upper limbs, make sure you are holding your limbs in a comfortable position for the majority of your tasks and not near the ends of their natural ranges. 
• If work can adapt your tasks and / or hours, if needed, then try and keep at work and keep active but at a more manageable level. 

Fundamentally though prevention is better than reaction to symptoms hence why highlighting issues to your employer may hopefully bring positive changes to the work environment. However, make sure you react early and let work know early on should you recognise symptoms and try your very best not to ignore symptoms and just hope they will disappear and continue to overload tissue.

How can physiotherapy help? 

At Physiotherapy Matters, our physiotherapists can conduct a thorough assessment to confirm a diagnosis and work with you to help you manage your symptoms and return to normal activity by;  

• Helping you understand your condition.  
• Helping identify the factors that may have contributed to your symptoms and provide advice on how to minimise these, including manual handling or safe DSE use.  
• Developing symptom management strategies so you always feel in control.  
• Completing ergonomic workplace assessments to minimise any work-related risk.  
• Providing an individualised exercise program to improve mobility and strength to address symptoms but also to prevent future episodes, including work-hardening programmes.  
• Providing additional manual therapies that may help ease symptoms, such as:  
• Taping to provide postural support,  
• Soft tissue massage to reduce any muscular tension in the surrounding muscles, 
• Mobilisation of the lower and upper back to reduce stiffness, 
• Acupuncture to reduce pain