It doesn’t help that RSI isn’t a terribly visible condition. Even so, when I was wearing 2 arm braces pretty much on a permanent basis, initially they attracted some comment along the lines of, “What have you done to your arm(s)?”. After some time, however, my colleagues became accustomed to seeing me wearing them and I simply became the guy with the arm braces. It also doesn’t help that an RSI such as mine can preclude the movements that caused it, ie working at a computer, but does not necessarily (and thankfully) mean that other activities can’t be undertaken, ie ones that do not employ the same worn-out muscles. When the activities that can still be engaged in happen to be recreational in nature, this only serves to feed suspicion that the RSI somehow isn’t genuine.

I am fortunate in that I can participate in an outdoor activity that involves the use of my arms, and that is kayaking. To the uninformed, that might seem like a contradiction. How is someone who gave up their career because of forearm pain able to paddle? Some brief consideration of the movements involved should answer that question. There is a substantial difference between clicking a computer mouse and a keyboard all day every day and lifting a paddle in and out of the water over a period of a few hours per week. Indeed, the latter could be deemed as a healthy movement involving mainly the upper arm muscle groups including biceps/triceps and shoulders, with minimal forearm motion, and only a light grip. Regardless, I do still have to be mindful of my paddling technique as, for example, incorrect paddle grip could lead to exacerbation of my RSI, especially in the right hand wrist. Indeed, I have invested in a “neutral bent shaft” paddle that is ergonomically designed to lessen the impact of paddle stroke upon the wrists. It is also exceptionally lightweight.

It is easy to form immediate judgements about others’ conditions, but I would encourage anyone who is suffering from an RSI, or who knows someone who is, to educate themselves on the subject thoroughly before jumping to conclusions concerning capabilities.

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Repetitive activities, including computer use, can adversely affect more than just the wrist, hands and arms, but also the neck and shoulders. Some years ago, my wife developed a constant and debilitating shoulder problem on her right side. At the end of each day in the office, her shoulder would ache such that the muscles would feel as if they were exhausted. Being right-handed, the most obvious association was with her computer mouse, yet it was apparent that this type of large-muscle ache would most probably not be addressed by using a different, more ergonomic mouse. It wasn’t until she moved jobs and her new desk included a drop down keyboard and mouse tray that the shoulder injury disappeared. Simply lowering the mouse pad had solved the problem. Even today, should she momentarily use a laptop and external mouse on a table top, for example, the shoulder issue will recur.

In addition, the range of occupations potentially affected by RSIs is wide. On several occasions now, I have encountered checkout cashiers wearing tell-tale arm braces which I instantly recognise  as probably indicating an RSI. I have chatted to such individuals and, indeed, they inform me that the repetitive motion of swiping products in front of the barcode scanner has caused their injury. I have recently heard of a tree surgeon having to scale back workload due to pain in his arms from the constant overhead operation of a chainsaw.

Examples of occupations at high risk of RSIs include:

• Journalists, programmers, software engineers – anyone using a computer to do their job
• Construction workers
• Checkout cashiers
• Production assembly line workers
• Machine operators
• Postal sorting workers

Sometimes it is not necessarily repetitive motion that is at fault, but holding the same position for hours on end. For example, many neck problems develop after possibly years of bad posture and/or inadequate breaks whilst staring at a computer screen, or performing any occupation that involves looking downwards (eg a jeweller). Even sleeping is not without hazard, if you are in the habit of lying on your front with your head to one side for example.

Of course, the key words here include “repetitive”, “overuse” and “habit”. The same principles apply in addressing these conditions:

• Awareness
• Good ergonomics
• Adaptive software or hardware (this can include anything from computer mice to chairs to running shoes!)
• Adequate breaks
• Improvement of posture
• Therapeutic exercise such as yoga, pilates etc
• Avoidance, if necessary

So, regardless of whether you are at work or play, upon experiencing the first twinges of pain, it is time to become aware of the cause and to address them accordingly. The choice is yours – you can make the necessary adjustments to your work or leisure habits now, or be forced to give them up entirely later.

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Usually RSI sneaks up on you and hits you when you are most under pressure and least able to cope with or, indeed, rest from its causes. Often it seems RSI hits conscientious hard workers. In my case, I went from being a top performer to a problem employee in the space of  less than 10 years. This steady decline was not something that I wished for, wanted or felt happy about, but there was very little option, later at least, to change course. I could make management happy by working harder and thus continue to hurt my arms and hands, and I knew that backing off work would mean less throughput, less visibility and fewer financial rewards. It’s a vicious cycle.

I can remember how it ultimately felt when I quit. In one respect, there was the relief of being free from the cause of pain but, on the other hand, there was the bitter feeling of how the injury had made me fall from being a top rated performer to simply a problem employee in the space of 10 years. In truth, the injury had led me from loving my job to becoming almost disillusioned with it when I realised that I just couldn’t perform my role any more due to the pain. It’s a nightmare journey with a lot of frustration along the way.

It was also a sad day to finally say goodbye to my engineering position, in which I was qualified and had spent the best part of 20 years doing, in a career that I really had enjoyed. And, of course, the future lay before me with a very large question mark over it. There were a lot of mixed emotions.

The one thing that still rankles me is how the transition from a star employee to a problem one can happen. An injured worker isn’t very useful to a company and there is a breakdown in relationship between employer and employee when you get injured, which I guess relates to the business ethos. It’s a fact of life that, if you are limited in learning new things because you are injured, then you are becoming less and less useful. The only contribution for a long term employee is knowledge of the job. This can be tapped into in an advisory role for a while, but once that knowledge is imparted or becomes dated, your usefulness rapidly diminishes and you become a problem that needs to be addressed. Should I have done more? Should my employer have done more?  There are many open ended questions that linger with me to this day, ones that I know will never have an answer.

If I could change one thing, I’d have taken the injury more seriously a lot earlier. I can’t over-stress this point to anyone reading this who has just developed an RSI. It is very important to break free from the underlying causes before you too end up going from star employee to company problem.

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Civil liberty infringements aside, this example shows how ignorant some employers are to RSI and how it manifests itself. RSI is pain induced by micro movements of a repetitive nature, which ‘flares up’ and produces painful symptoms when doing many small micro movements over long periods of time eg typing on a keyboard or clicking a mouse. In bad cases, it can cause pain and weakness, for example in wrists, which may affect other activities, or other repetitive everyday tasks. The condition does not, however, generally affect the muscles groups associated with doing many tasks requiring larger motion, including most motions involved in working out at the gym.

The irony is that with RSI, activity that is based on large non-repetitive motions and especially cardio based activity should be encouraged since movement of the larger muscular groups will enhance blood flow to injured areas and promote natural healing. It should not be criticised and brought up as evidence against an RSI claim. To do so just shows the complete ignorance of the individuals and organisations involved.

It is a travesty that the perception is that someone with an RSI condition should be effectively seen to be in a wheelchair and/or doing nothing before they look like they have RSI to an employer. If they were observed continually texting on their phone or playing video games all day that would be a different story! However, being criticised for living a normal macro movement life whilst trying to keep fit and healthy is an outrage.

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“There is a growing awareness of how much of an impact there is on students. A lot of the ergonomists I work with at different companies have been noticing that students are graduating from college and coming into the workforce already with chronic repetitive strain-injury problems. It seems at least from the anecdotal stuff that it’s important to start focusing more on the student population.”

This could unfortunately be the start of the RSI epidemic wave that I have long been expecting. The younger generation coming through universities and colleges of further education are the ones that have been exposed to ‘technology’ since they were born and have grown up accustomed to a hi-tech life full of computers, mobile phones, gaming systems and other ‘daily use’ gadgets in complete ignorance of the danger that they pose. They are the generation that have grown up with an ever expanding level of text messaging.

What this generation does not appreciate are the dangers associated with RSI type conditions and their implications for future employment (and earnings) prospects. I also wonder whether employers realise the risks of employing people with these conditions, especially into computer intensive jobs. It may not be too far in the future before employers start to check for these conditions during a pre hiring medical examination, although it may be hard to diagnose without honesty from the potential employee.

What is obvious to me is that ergonomic and RSI health awareness training currently aimed solely at employed adults has to be brought into schools, colleges and universities also to educate the future employees before they succumb to a debilitating RSI condition when they start their employed adult life.

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• Computer operator professional or otherwise
• Deep in concentration about your work, intolerant of interruptions
• You slouch at your desk, peering at the computer screen, unaware of your posture
• Working on a key project with tight deadline
• Stressing about achieving that deadline
• Working in a competitive environment in uncertain times
• Spending your work time at a computer for 5-10 hours a day
• Taking minimal breaks, and most of these are spent checking email /surfing the web
• Lunch is frequently a sandwich eaten at your desk whilst working
• You are a heavy coffee drinker
• You spend a cumulative 30 min/day sending text messages on your mobile phone
• You go home after a 10 hour day and relax by ripping some CDs to mp3, updating your iPod, catching up on personal email and unwinding by playing a ‘shoot ‘em up’ on your computer/games system for 2-3 hours
• You spends 6-8 hours sleeping before starting the cycle again

Lets break down each point and try to inject some solutions -

• Computer operator professional or otherwise
  Can’t change a lot here (short of changing careers!)
• Deep in concentration about your work, intolerant of interruptions
  I’m not suggesting that you should not be concentrating on your work, but you need to recognise that interruptions, including going for breaks, are very important to your wellbeing!
• You slouch at your desk, peering at the computer screen, unaware of your posture
  Posture is not always an easy thing to correct since you often feel comfortable slouching, however slouching is often  having an adverse impact on your muscles, tendons and nerves. Good ergonomics is key and you need to pay attention to them. If you are working for a company with an Ergonomist, listen to what they have to say and make those changes.
• Working on a key project with tight deadline
  Again not a whole lot you can do to change this, but try to understand that your current project, future projects, and your entire workload could be put at risk if you develop a RSI condition. It is in the interests of both you and your employer to keep you healthy both now and in the future. This fact is often lost in the everyday hectic business environment.
• Stresses about achieving that deadline
  Stressing about a variety of things in life is part of human nature. However, you are not likely to improve either your work output or your health by stressing over a work related task or deadline. Your muscles will tighten up, and cause tension in much of your body which can exacerbate RSI conditions. As a result, it is important to reduce this tension. Short ‘sanity’ breaks as well as taking lunch and tea breaks can help act as stress busters. For more mental relaxation try taking up yoga and/or meditation, or perhaps some other physical pastime.
• You are working in a competitive environment in uncertain times
  Once more not much you can do here unless you want a career change. Just remember that you are far more valuable to your employer as healthy worker. Pacing yourself, but being a dependable, reliable worker is key here. Blasting through your work at break-neck speed may make you look like a superstar, but is not sustainable, and may lead to even more work/pressure/expectation, at detriment to your health.
• You are spending your work time at a computer for 5-10 hours a day
  This is something you can reduce, and need to do so dramatically if you are hitting these types of hours per day at a computer. You can do this by introducing break timers to your computer, and making sure you take ‘micro’ breaks throughout the day. At least one 5 minute ‘micro’ break every hour is ideal. You also need to adhere to official break times even if you don’t feel like taking them.
• You are taking minimal breaks, and most of these are spent checking email/surfing the web
  If you are spending break time checking email and surfing the internet, then this isn’t a physical break. Your body won’t thank you for this type of rest.
• Lunch is frequently a sandwich eaten at your desk whilst working
  Many people skip lunch breaks. This may be due to workload, social reasons or perhaps just to free up time to do email. However, by making the choice to stay at your desk, you are not letting your body get the physical break that it requires when using a computer all day. Even if you set out with the best of intentions, eg reading a book or newspaper, you are likely to get interrupted by fellow workers or the telephone, and end up jumping back on to the computer as a result. It is always best to ensure that all breaks are taken away from your desk.
• You are a heavy coffee drinker
  Caffeine is a diuretic, and as such will cause you to lack hydration which is what sore, tight muscles need to heal. Better off switching to water.
• You spend a cumulative 30min per day sending text messages on your mobile phone
  This is an activity that has to be reduced by everyone. Texting is repetitive in nature and can increase the small repetitive motions in your thumbs and fingers. All these small clicks will add to an already heavy arm/hand workload, and should be avoided as much as possible.
• You go home after a 10 hour day and relax by ripping some CDs to mp3, updating your iPod, catching up on personal email and unwinding by playing a ‘shoot ‘em up’ on your computer/games system for 2-3 hours
  If you have a career using a computer then you seriously do not want to be using them after work for relaxation purposes. If you do, you will just be adding more risk to your already high RSI risk lifestyle. Computers at home are seldom set up ergonomically and are often located in decidedly tight, unergonomic spaces. All computer/gaming/gadget use at home should be severely restricted or eliminated if you work with computers during the day.
• You spend 6-8 hours sleeping before starting the cycle again
  If sleeping is the only time that you are not interacting with a computer, mobile phone, handheld or other gadget, then I’m surprised if you don’t have an RSI condition already! Resting your body is not something that needs to happen only when you sleep. Resting from computers isn’t necessarily all about sitting, sleeping etc,  it can take the form of some other physical activity eg swimming, cycling etc, where you start to get blood flowing around your body which will promote healing of tight, damaged and stressed muscles.

You don’t need to meet all of my listed risk criteria to be at risk of developing RSI. The key is to recognise where in your life you can see similarities with the criteria, accept that you may be putting yourself at risk, and make some lifestyle adjustments accordingly to minimise those risks.

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Many of these jobs will involve working at a computer for many hours a day, often continuously. If employees are working longer, in stressful environment because of job security reasons, they will be exposing themselves to health risks on top of job security risks.

According to one article -

“The TUC said research among 2,600 union safety reps showed that almost two thirds reported that stress or overwork were a concern in their workplace.

TUC general secretary Brendan Barber said: “Stress casts a gloomy shadow over far too many UK workplaces. And as the current economic crisis creates more anxiety about job security, stress is likely to increase.”"

The chances of developing an RSI condition in this environment is high. Using a computer for more than 6 hours a day makes you susceptible to RSI type injuries. If you add in stress and worry over job security to this situation, it can be like adding fuel to an already smouldering fire.

It is important that all computer users realise the risks to their health that are inherent when times are tough and stress levels are high. In this situation it can be difficult to look beyond the next month, but it is way more important to take a long term view because the implications of coming down with a long term injury and its subsequent economic impact can be a lot worse than the immediate economic impact of losing your job. No job is ever worth risking your health over.

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OK, so you are experiencing a long term RSI condition, ie it has gradually worsened for more than 2 years. You are in continual pain at work and find it difficult to do your job. You have perhaps gone through consultations with ergonomists, doctors, physiotherapists and just about anybody who’ll listen, but still you find no relief. You struggle to remember what it felt like not to associate pain with computer use. You may be wearing an arm brace (and probably have a large collection of them by now), and you probably have a sizeable collection of strange ergonomic mice at your computer that don’t seem to help. Your employer keeps expecting the same work output from you and you stress about how you can get through it. You get by by doing what you can, but generally come home each night from work and feel anxious about the situation and the searing pain down your arms. You wonder what you can do, and how you are supposed to live a normal life – you can’t remember what normal life was like before this injury!

So what are the options then? Well I remember a great bit of advice from my father (that’s what fathers are for after all). It was at the stage where I was still living in the US and wanted to return home. The prospect of a new computer intensive job and a new situation was looming, and I wondered how I’d cope because my injury was getting worse. The stress of the situation wasn’t helping either and changing countries of residence can be a very anxious time. I just wasn’t sure whether I could go on working with computers any more. I phoned my father and told him the situation, fully expecting him to tell me to stay with the job. I was, however, surprised when he said rather straightforwardly, “Well, you’ll need your arms and hands for everything else you decide do in life”. In other words, it wasn’t really an option to keep doing something that could ultimately make me any more disabled. I knew then that I had to consider doing something else.

Before coming to any radical decisions, I really strongly recommend trying to adopt all the suggestions in RSI – What to do? (Part 2 – RSI Dealing With Progressive Symptoms) in the majority of cases you will see improvements.

In addition I’d recommend -

• Eliminating as much computer interaction as possible at work, home and elsewhere
• Eliminate text messaging entirely
• Eliminate use of games consoles if you use them
• Get as physically fit as possible, go swimming
• Use meditative techniques to relax and ease the pain, maybe as part of a Yoga class
• De-stress your life wherever possible
• Get at least 8 hours of sleep a night
• Stick to core work hours – if you are in really bad, continual pain, consider medical leave
• Talk over options with your employer – there may be something else less computer intensive that they can find for you to do
• Find a good physiotherapist who can do deep tissue massage
• Find a RSI support group and share your experience with others. Hear what has worked for others and get free helpful advice
• Consider a career change – it’s tough to do and can be stressful in itself, but there are still jobs out there that don’t require computer use, or at the very least involve less computer use. I am now a self employed picture framer!

RSI conditions can be tricky to get rid of. I have been away from my computer intensive career for two years now, and I still have bad RSI symptoms. Interaction with a computer for 5-10 minutes can make it start to hurt badly, so these conditions are not easy to shake off. There is no ‘magic bullet’ to fix them.

Look after your arms and hands, remember you will need to use them in any new career you decide to take. Good luck with finding a solution that works for you.

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“Only one in six workers takes a regular lunch break.”

“One consequence of the credit crunch is that breaks are getting even shorter as job insecurity increases.”

“Employees are struggling to keep on top of to-do lists and think the answer is to work harder, eating a sandwich at their desk as opposed to taking a full lunch break, and also not having sufficient breaks during the rest of the day.”

“The vast majority of people are having lunch at their desk while working. That’s the average person now. Very rarely do they get out of the office.”

“If senior management create a culture that lunch is for wimps, it’s counter productive. We all need breaks.”

The research quoted in this article, if valid, foretells a very bleak scenario for office workers and in turn for the vast majority of those workers who spend their lives working on an office PC. Unfortunately, the article makes no reference to computers or computer related injuries, and I feel this is a major omission by its author(s).

The consequences of the above findings are abundantly clear however, and will directly relate to an increase in the number of reported repetitive strain injuries. If the research is valid, then we could be on the verge of a large RSI epidemic.
Breaks are there for a reason, and never more so than in today’s computer operating office environment. It is imperative for our health and safety that break times are observed religiously, and it is an extremely worrying trend when scenarios develop where we fear for our jobs over our health. The situation is of course exacerbated by the pressures of the office work environment as I described in this previous blog entry.

I myself am a victim of the “not taking a break to get though workload” syndrome, where other workers around me did take breaks regardless of workload. They are still happily employed in the same occupations, whereas I am not. Please learn from my mistake.

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