Preventing, treating, and understanding repetitive stress injuries

BY DR. VIKAS PURI

“If we ignore the symptoms of RSI and they are not treated in time, they can cause a great deal of suffering, and it is important to note that if nothing is done to address the injury or remove its cause, the damage could become permanent.” Dr. Vikas Puri

Repetitive strain injuries (RSIs) are among the most common types of workplace injury and one in ten Canadian workers are affected. The emotional pain that accompanies the physical pain takes a psychological toll not only on the worker, but also on their co-workers, families and loved ones.

Also known as musculoskeletal disorder (MSD), the term repetitive strain injury (RSI) refers to a number of injuries that affect the body’s muscles, nerves, and tendons. Some common RSIs include tendinitis, tenosynovitis, and carpal tunnel syndrome

If you have ever developed a burning, aching pain while repeating the same movement for a long period of time, or shooting pains and weakness in your hands after scanning product, cutting meat, or making beds for example, you’ve probably experienced the early stages of repetitive stress injury (RSI).

According to Statistics Canada, some two million Canadians suffer from repetitive strain injuries and more than half of these injuries are caused by work related activities.

Common treatments include physiotherapy modalities such as lasers, shockwave treatment, ultrasound, and TENS machines.  These are designed to decrease inflammation, breakdown scar tissue and heal injured muscles. Physiotherapists then begin an active exercise program to re-strengthen muscles and complete a full recovery. Throughout this program of care, specific chiropractic adjustments are performed that maximize spinal function and flow of nerve energy to the muscles to maximize healing potential and reduce recovery time. In addition, you are educated on proper workplace ergonomics to prevent injuries or reaggravations in the future.

Ergonomics is the science of matching the work to the worker. In an office environment, a major focus would be insuring that employee workstations fit the worker – not the employee made to fit the workstation.

To design a healthy employee workstation properly requires an understanding of the limitations of the human body, especially in terms of muscle and soft tissue fatigue.

Here are some examples of the most common office ergonomic challenges. The first is the desk. The working height of a standard desk is 30 inches, for which we expect it to be comfortable for both the 5-foot-2-inch and a 6-foot-2-inch employee. But the reality is that this standard desk height is appropriate for the 6-foot-2-inch employee. The average female is 5-foot-4-inches, which would suggest that the standard 30-inch working height is too high for the majority of female workers in the office.

When the working height is too high, the employee will adopt a posture where the wrists are extended when keyboarding, the neck is extended, shoulders are hunched and back is flexed forward off the chair. These postures increase muscle and soft tissue fatigue, eventually leading to pain when the postures are sustained or repetitive.

Fitting the workstation to the employee would require lowering the desk to the appropriate working height so that the keyboard and mouse are on the desktop along with the monitor resulting in a neutral posture not only for the arms and shoulders but also for the neck and back.

This seated working height cannot be neglected when considering sit-to-stand workstations. It is important to investigate how far the workstation can be lowered in the seated position as many do not lower past 27-inches, which is still too high for most women.

The second ergonomic challenge is the chair. The majority of employees have what would be considered an ergonomic chair based on its features of adjustability, arm and back support. In order to acquire the health benefits of an ergonomic chair, it is necessary to consider the physical size of the employee.

For example, a seat pan that is too wide or too short, results in the inability to engage the armrests and backrest, respectively. The backrest and the armrest serve to take the load off the back, shoulder, neck and arm muscles. An improperly fitting chair is little better than sitting on a stool if the employee is not engaging the features of the chair meant to provide a break for the muscles and soft tissues of the body.

So please improve your ergonomics, do regular stretching and strengthening exercises, and take frequent breaks from your workstation.  This will help ensure good health!