Up until I injured it, I didn’t even know that there was anything there to injure. I had been working out in the garden carrying stones in a bucket (a large muscle activity involving upper arms, shoulders, core, back) on and off for a day, when I finally sat down and noticed a general ache around the sternum area, as well as everywhere else I should hasten to add! Over the course of the next few days, all the aches disappeared except the one in the sternum. It was at that stage that I realised I’d injured something, I just didn’t know how bad it would be. Symptoms can include pain, tingling and an itching sensation around the centre of the chest area.

Over the course of the following week, I resumed my normal life doing picture framing, but noticed that I could induce bad pain in the sternum area when attempting to push against something heavy. This wasn’t good! At this point I did a little research and found out about costochondritis.  It is an injury to the soft connective tissue between the ribs and the sternum and can take a long time to heal due to the fact that there is not a huge supply of blood circulating to this area. I also got the advice of my GP who said that I just needed to rest it.

For the next 3 months I did my best to rest the chest area, which meant no lifting, pushing or carrying of anything remotely heavy in weight (including shopping bags!). One main difficulty I found was trying to rest the sternum while sleeping. The natural position of the body when sleeping on your side is to have both arms on the bed. This posture forces the sternum to be compressed and as a result does not give the area ample rest during sleep. Having restless nights also doesn’t help matters in this regard. One solution that I found is to sleep whilst hugging a pillow. The pillow has to be a puffed out largish one to keep the chest area open. It has proven to be a very useful method.

After 3 months of resting, the sternum had improved to the extent that I could actually do more. The question was, how much more? This, I found out by trial and error. If I did too much, the sternum would get more prickly, “itchy” and sore. It followed the same pattern every time: perform an activity, followed by prickly, itchy soreness for a few days, then it would calm down and I’d feel better again after a week. The trouble was that this went on for the best part of a year! Even now – some 14 months after the initial injury, I still have to be choosy about whether to try lifting something heavy or not. All in all, this injury has taken a long time to get better, and is one I could most certainly have done without!

The following are a few recommendations I would make for anyone suffering from costochondritis -

• Rest up well for 2-3 months, avoiding all lifting of things including heavy shopping bags.
• Hug a pillow while sleeping on your side to keep sternum area from being compressed.
• Gentle reintroduction to exercise – yoga can be a good form of exercise to start recovery, so too is swimming.
• You can use NSAIDs, eg ibuprofen to help with symptoms, but consult your GP first. I have also found much relief by taking Devil’s Claw (a natural anti inflammatory)
• Have patience and don’t rush your recovery. After 14 months I feel like I am back to 90%, but I’ve been in the 70-80% range for a long time (nearly a year) and have frequently found a way to aggravate it somehow, usually by carrying something heavy.  This has happened even up to the 13 month mark!

This condition has certainly been very persistent, and has been quite frustrating to deal with mentally as well as physically, but after 14 months I am finally feeling like I am getting there. Fingers crossed!

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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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Homedics massager

As you will know from reading this blog, I have had a chronic RSI condition in my forearms for over 14 years. I live with it by avoiding computer use as much as possible. Whilst resigned to having this condition long term,  I am always looking at ways to try to rehabilitate it somehow. Usually when things get more painful I resort to digging out an old, vigorous Homedics massager that I bought in the US. It’s a heavy duty one that is probably more designed for deep tissue massage of the back and neck, however, it can and is used by me to reach deep into the forearm extensor muscles for a relieving massage (although you have to be careful not to overdo it). This usually takes the pain down to background levels, at least temporarily.

The massager is, however, still only treating the symptoms of the RSI. What I really need is to try to strengthen the forearm muscles to an extent where they can resume being normal muscles tissue again (as opposed to the knotted, tense mass that is there right now). I have always drawn a blank as to how to do this.

NSD Power Ball gyroscope

I recently came across a friend with a NSD PowerBall Gyroscope (which I’d seen plenty of advertisements for but hadn’t got round to trying out), and my curiosity got the better of me. Amongst its claims is that it can be used as a “Rehabilitation product bringing gentle non-impact relief  to Carpal Tunnel syndrome (CTS), Repetitive strain injury (RSI), tendinitis, arthritis, and all wrist related ailments. Spinning for just five to seven minutes per day is enough to start your rehab!”.  Lofty claims indeed! I was keen to get my own Power Ball and get started!

The units are actually quite inexpensive (less than £10 for the basic model). The more expensive ones have electronic counters in them so you can count rotations and gyroscope speed RPM, which I decided was superfluous to my requirements. My NSD Power Ball arrived in a few days from Amazon and I ripped the package open with great enthusiasm and interest, as well as much hope!

The theory behind the Power Ball is that spinning the gyroscope inside the ball offers a resistance to motion of the ball. Spinning  the gyroscope is started by means of a short piece of string (or alternatively by means of an additional electric base unit at extra cost). Rotation of the ball with the hand/wrist keeps the gyroscope running and maintains resistance. The gyroscope, when in motion, will actually start to produce a gentle whirring sound. The faster the hand/wrist rotation, the faster the gyroscope spins and the more resistance the ball offers and vice versa. The resistance that you encounter is therefore  controllable in infinite degrees, and can be tailored to your own needs (or degrees of injury) which is useful.

Gripmaster

What I have found thus far (after about 1 week’s use) is that it is a really good way of getting the forearm extensors exercised in an aerobic manner (as opposed to the continuous micro movements that computer keyboard/mouse input dictates, which can lead to RSI conditions). I can honestly say that I have never felt the forearm muscles heat up as much, which is surely a good thing (I can sense blood rushing into them, which will hopefully be good to promote healing).  I am also coupling this with using a medium/low strength Gripmaster hand exerciser, and adding in a few forearm stretches too. I am keeping this routine to 2 to 3 x 10 to 15 minute timeslots each day. I realise that it’s important not to overdo it!

Having had such a long term injury, I am under no illusions as to the uphill battle I face to rehabilitate it, and it’s still too early to assess the long term benefits of using the Power Ball Gyroscope with a forearm extensor RSI injury such as mine, but so far I haven’t needed to use the big massager for forearm extensor pain relief again which is a good sign! I will report back here after more prolonged use to let you know how things are working out. I at least have a little hope to cling on to for now!

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I may not be a medical professional, but I am able to tell when I encounter descriptions of body motion that just make plain sense, and this DVD contains some enlightening information. In a collection of well narrated chapters complete with diagrammatic video illustration, the evidence is laid bare of our common tendencies to keep our bodies out of balance, causing pain through muscle tensions that, in turn, keep our bodies in bad posture. This is due in part to us having mapped the body in a particular way, eg in relation to position, when in reality the position is entirely different.

This DVD is broken into multiple sections covering the many aspects of posture imbalance, and covers areas from the head to the feet and just about everywhere in between. Posture is translated by the authors as ‘Body Maps’ which are essentially memories in your mind of where you think your individual body parts are and how you use them. The DVD highlights how you may have had a flawed map (understanding) of your various body parts in your mind from a very young age. This may have led you to actually move according to those flaws and results in the straining of some parts of your body which can lead to pain. As the narrator tells us, “We move in the way in which we think we are constructed …”, either consciously or unconsciously. Wrong body maps can be responsible for many bad posture related problems, from walking to sitting, to using a computer.

Subjects covered in the DVD include -

• Body maps – identifying flaws in the human body map and how to recognise those errors
• Balance – identifying correct balance with core posture, and identifying posture related pain
• Kinesthesia – learning free and fluid movement to correct body imbalances
• Arms – covering shoulders, elbows,  wrists and hands
• Legs – covering hips, pelvis, knees and feet
• Breathing – covering lungs, skeletal/muscular system, diaphragm
• Mapping the whole body
• Correcting the map
• Inclusive attention

The areas I can relate to most pertain to the shoulders, arms, wrists and hands. These are covered in detail and are very applicable to the RSI sufferer. The main posture/skeletal issues with RSI type injuries are listed, adding to the viewer’s knowledge and understanding through plain and straightforward explanations along with clear diagrams and video.

From previous experience, I knew that over-supination of the wrists was a bad thing, but now I know about the natural axis of rotation of the forearm and how it ties in with a neutral position wrist, as well as why supination causes so many injuries.

The company website rather generously shows sample videos of some chapters which are well worth checking out, and will give you a sneak peak of the DVD content and style as well as some key body map information!

• ‘Elbows’ chapter
• ‘Arms’ chapter
• ‘Forearms’ chapter
• ‘Hands’ chapter
• ‘Lower Back’ chapter
• ‘Balance’ chapter
• ‘Lungs’ chapter

I also found the section on breathing very interesting. It’s probably the first time I’ve been able to picture the role of the diaphragm in breathing, and I certainly had my lungs mapped as being a bit lower than they actually are. The related section on the ribcage was also revealing to me having just recently strained my sternum connective tissue whilst gardening. It  also reinforces the benefits of some breathing practices including Yogic breathing (Pranayama).

The DVD run time is a substantial 2hrs,  and certainly lends itself to being watched in stages. There is the temptation to skip straight to the section you are most interested in, however it should be watched as a whole to get the complete picture and overall message firmly ingrained in your mind. I expect that multiple viewings would be best to fully absorb the detail.

All in all this DVD is an excellent resource for just about everyone. It is not solely aimed at one specific group of people eg RSI sufferers, but covers the whole body, and should be a useful education tool for everyone, including ergonomists, physiotherapists, fitness instructors, yoga teachers etc, as well as many others including in the medical profession.

If you have posture related pain it’s likely that it’s down to your bad body map and it’s certainly time to re-educate yourself!

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In a nutshell, it combines a fairly physical activity encompassing muscle and tendon stretches from your head to your toes, with core conditioning and balance practices. This is coupled with controlled breathing techniques to allow the participant to focus their mind on the present moment. As well as the physical practice, yoga teaches techniques to promote deep relaxation and the ability to clear everyday thoughts from the mind with meditation. This powerful combination really can address a lot of the factors that lead to conditions like RSI (primarily driven by the overused micro-movements of muscles and tendons coupled with bad ergonomics and stressful working conditions).

Yoga practice can

• stretch out abused and injured arm muscles and tendons that have been used in a very poor/restrictive motion for numerous hours
• stretch out your neck, spine, and shoulders which most likely will have also been in a bad posture for hours at work, and can be the sources of a lot of RSI conditions
• enhance the blood flow to fatigued muscles
• enhance overall strength and flexibility
• stretch out tight tendons
• promote relaxation
• promote calmness through meditation
• make the participant feel good about their health
• make the participant decidedly fitter

I have only relatively recently delved into yoga. For those of you who think it’s an activity for girls and hippies, I can assure you it isn’t! It’s really a great practice for everyone and there truly are no age or gender barriers. It can be quite physically involved, which I didn’t realise before I tried it out! I really wish I had started practising at an earlier stage in life while my RSI was not as bad as it is now, when it could perhaps have helped me to address my RSI condition during its early stages.

There are many different types of yoga class out there. The class I currently attend is based on Ashtanga Yoga, and is fairly physical. It involves many stretches (some quite challenging) interspersed with vinyasas* which are physical sequences or “flows” between each Yoga pose. A typical class goes for 1 to 1.5 hrs, and follows a sequence of

• Controlled breathing practice (relaxation, focus of breath and readying self for practice
• Sun salutations (sequences of vinyasas to warm body up with)
• Standing stretch/posture sequences interspersed with vinyasas
• Seated stretch/posture sequences with vinyasas
• Reclined stretch/posture sequences with vinyasas
• Relaxation/meditation.

I can honestly say the time goes by in a flash, and I always leave way more relaxed than before I arrived. It’s a great way to switch off from the working day. The Ashtanga class is fairly physical, and it may be a good idea for you to try to experience yoga at an easier pace first of all, and there are many classes to suit. You can also get many great yoga DVDs these days so you can try it out at home if you prefer (all you need is a yoga mat and motivation!), before jumping straight into a class. I do however recommend trying to aim for a physical version of yoga, since this is what will help you achieve core strength and conditioning, giving your muscles a helpful intensive stretch based workout, coupled with relaxation and the ability to refocus your mind.

It is perhaps the idea of channelling the hyperactivity of the mind into more useful positive energy and thoughts that is one of the key aspects of yoga. If we can control the over activity of our minds, we can achieve a positive state of mind and can face day to day stresses on a more even keel, ie. it can be adapted to many areas of your life. For example, are you perhaps over stressing a lot in the office? Then maybe a 20 min break away from your desk and a bit of controlled breathing and meditation can bring your mind back to a less stressful place, and begin to bring things into perspective, which can’t be a bad thing in these crazy busy lives we now lead now can it?

*”Vinyasa has since been thought of as a physically demanding practice, which can be successful at channelling the hyperactivity of … minds. This system can also be used as a vessel for helping calm ongoing chatter of the mind, reducing stress and teaching extroverted personalities to redirect their attention to their internal experience.” wikipedia

An article from the San Francisco Chronicle highlights the benefits of Yoga practice in the high tech industry.

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