The idea is to have two waterproof (plastic storage boxes work fine) containers. Each one  should be just greater in length than the distance from your elbow to you finger tips. These should be filled with water to a depth enough to cover your arms when fully submerged.

One container should be ‘hot’ – not too hot.  ie. no greater than 40-45^oC (104-113^oF)

The other container should be ‘cold’ – cold tap water with a few ice cubes (or an ice cooler pack) in it to chill further to no lower than 10-15^oC (50-60^oF)

You will also need to have a clock or timer handy with seconds/minutes easily visible. A kitchen timer or stopwatch is good for this purpose.

The procedure is simple, and involves submerging your arms into the ‘hot’ bath for 1 minute, followed by submerging them for 1 minute in the ‘cold’ bath. Then repeat this switching between baths for 10 to 15 minutes (longer if desired).

You can repeat contrast baths a few times a day if necessary, but it may be impractical to do this at work. You could also increase the time from one minute in each bath to two minutes in each bath if found to be more effective.

This temperature cycling should help relax any stressed out muscles a bit, and give some immediate pain relief. At the peak of my RSI condition after coming home from work every night, I would do contrast baths to get some pain relief. Its a low cost and self administrable procedure that can help reduce RSI pain.

Please check with your health advisor first if you have diabetes, heart problems or Raynaud’s Syndrome before doing contrast baths so that they can determine whether it is advisable for you to proceed.

Rate this post! Note: There is a rating embedded within this post, please visit this post to rate it.

Previously, while living in the US, I was sent for Bio Feedback monitoring, and was ‘hooked up’ to many electrode pads around my neck, shoulders, and arms. These were to be used to measure muscle tension in all the upper body limbs including the neck and shoulder area.  The sensors are connected to a computer which plots out the associated muscle tensions on a monitor, so you have real time visualisation of the various muscle tensions you hold in your upper body when operating computer equipment. You are actually seated in front of a real keyboard and mouse, and asked to type and enter data like you normally would in your daily life.

I was actually quite surprised at how much tension the signals showed, and was constantly told to relax the posture to drop the tension levels – not an easy task!

I had to really try to relax my whole body from my head to neck to shoulders to arms to wrist angle to make even the slightest difference. The difficulty was trying to hold it there whilst typing and using a mouse.

Emphasis was placed on relaxing muscles that control the upper limbs, as well as suggestions on how to become more relaxed in the mind both inside and outside of the office environment.

As with other RSI awareness education therapies, there was no magic bullet for me with Bio Feedback, but it certainly helped to raise my awareness of how tense my upper body limbs (including shoulders) became while operating computer equipment, and that really is an important part of the RSI education process.

Rate this post! Note: There is a rating embedded within this post, please visit this post to rate it.

There are a lot of braces out there, and what works for one person may not work for everyone. Braces are usually made out of neoprene or elasticated material coupled with a metal or hard plastic support to immobilise the wrist.

The primary use of the wrist brace should not be forgotten ie to rest wrist joints and forearm muscles that drive the wrist motion (forearm extensors, flexors), and reduce the pain associated from overuse injuries. While this may sound like a good thing, quite often if you wear a brace while using a computer, you will end up using other muscles in a strenuous way to do the same work, and can cause other injuries because of this.

There is no such thing as an ideal wrist brace, it really depends on what they are trying to do.

In the course of your RSI journey you way well encounter many different styles of wrist braces.

My general rules concerning wrist braces are -

1. You shouldn’t jump in and buy a wrist brace without first seeking advice from a physiotherapist or doctor.
2. Ideally, it should be used to rest (heal) the wrist and the overused (painful) muscles that drive the wrist extension and flexion, and not worn when using a keyboard or mouse.
3. Exceptions to the rule are perhaps specific braces intended to stop excessive flexion of the wrist if you are prone to this. It’s a far better idea to be able to spot this flexion yourself and change it, but if you have difficulty doing this then a brace may be required. Alternatively have someone stand and watch over you with a big stick, you will learn faster then!
4. Braces used to rest the wrist should not be too tight, just a snug fit. Over tightening can lead to restricted blood flow to the hand and wrists.
5. Consider wearing a wrist brace at night in bed to avoid sleeping with your arms/wrists/hands in bent positions. It is critical that you don’t have a tight brace when doing this so as not to restrict blood flow.
6. Don’t use them unless you have to. Its better to know your pain, when it happens and try to make adjustments to your  work practice etc to reduce the causes than it is to just ‘bandage up’ your injured wrists into a brace.
7. Neoprene braces can be hot, sweaty, smelly and itchy to wear even for short periods of time. Better to look for ventilated elastic material ones.
8. Wrist braces are not a good  universal fit for everyone, so you may have to make some adjustments to it to make it comfortable, including cutting bits out of it or adding some customised padding.
9. Wear them at work and they do flag to your employer and colleagues that you have a RSI problem!

Remember though, wrist braces are not a solution to RSI, they are really only there to rest an injury and ease pain. To address your injury it is far better to try to make adjustments to your work to stop the motion that is causing you to have the pain. In other words, you should monitor your wrist, hand motions at a keyboard etc, and make adjustments to your bad working practices, including posture changes. You should also introduce more regular breaks away from your computer along with a good stretching routine and some physical activity.

Rate this post! Note: There is a rating embedded within this post, please visit this post to rate it.

The RSI pain cycle once ‘locked’ into is a hard one to break free from. The common mistake is to address only one or two factors. If the sufferer is at an early stage of RSI, and is fortunate then one change eg ergonomic setup may be enough to break free, but any medium/long term sufferer who is trapped in this cycle should consider addressing most/all of the underlying trigger causes to allow the transition to an RSI free life. The second diagram (click image to enlarge) shows the key areas to address to break the cycle.

You can also download the 2 diagrams in Breaking The RSI Pain Cycle (pdf)

Rate this post! Note: There is a rating embedded within this post, please visit this post to rate it.

It should also be noted that video gaming is a highly addictive pastime (I speak from the experience of my youth). Video games are designed to be addictive; let’s face it, if they were not, players would rapidly lose interest and move onto something else, and the manufacturers would not sell many games.

There are usually very high levels of repetitive motion involved to complete a game stage and there are usually many levels to  complete, which allow the individual to achieve the elevated status of finishing that level (quite often against the clock) and progress to the next with a sense of achievement. There is a high degree of addiction involved in this process which can involve spending literally many hours in a sedentary position whilst making very repetitive motions with your arms, hands and possibly feet while using keyboards, mice, joysticks and other types of controllers.

In the specific case described in the article, a girl came down with a bad skin condition involving sore lumps in her hands and feet after playing for hours on a gaming machine. In a quote from the article that refers to a Swiss doctors’ report it states that,

“Excessive video gaming is currently regarded as an alarming health issue… Recently, organic pathologies such as acute tendinitis, called Wiiitis, or video game-induced knuckle pads have been added to the list of video game-related pathologies. We report… ’PlayStation palmar hidradenitis’ as a cutaneous (skin) pathology induced by console gaming.”

They also recommended that,

“If you’re worried about soreness in your hands when playing a games console, it might be sensible to give your hands a break from time to time and don’t play excessively if your hands are prone to sweating.”

It’s easy to make these recommendations but try telling that to an addicted game player when they are close to achieving that ‘next level’. The medical community does not currently appear to address the addictive nature of computer gaming as well as the resulting conditions. To be honest, I can’t see any way to control this other than extensive education or (more radically) forcing developers to programme in rest breaks to gaming software itself, maybe between levels (you can just see that happening!).

My guess is we will continue to see more and more of these types of injuries and more and more of them will be happening to children who still have a large portion of their computer intensive lives ahead of them. I think that the only way to truly address the problem is to educate parents about the dangers of such gaming systems and their potential for causing repetitive strain type injuries. However, its not just children who are at risk. How many grown adults spend their ‘away from work’ time playing 3-4 hours of video games a night? I’d say a fairly large percentage of the (mainly male) 15-30+ age group.

Rate this post! Note: There is a rating embedded within this post, please visit this post to rate it.

There are so many ways today to fritter away huge amounts of our time in our new virtual worlds. Have you ever played a video game and noticed how 3 hours of your life just disappeared?

Technology has brought us immense benefits as a society, but it has also made us slaves to a great extent, and we spend ever increasing amounts of time interacting with devices whether they be computers, mobile phones, PDAs, games consoles, MP3 players, GPS or TV remotes.

A substantial portion of employment now involves working on computers, whether it be the inputting/analysing of data, or the creation of the latest software that controls our lives. The trouble is that, the more high technology we introduce to our lives, the more time we spend interacting with it, often to the disadvantage of our health. It’s not too hard to imagine that, if current trends continue, there will be a technological gadget to interact with from the moment we wake up until the moment we fall asleep (or more scarily from the moment we are born until the moment we die!).

The Web has expanded the information available at our fingertips by a staggering amount. It has also changed the way we spend large amounts of our leisure time (news surfing, watching videos, e-shopping, chatting, talking, sharing photography, socialising, network gaming, browsing) but this has come about at the expense of our health since we are now sitting in a sedentary posture for hours on end making small repetitive movements with our arms, hands and eyes, often in a slouched, bad posture. Before the Internet was available, we obtained our information from books, magazines, newspapers, talks etc which at least involved a walk to the newsagent, library, pub, town hall etc. Socialising was solely done by interacting with people you physically met, and gaming involved running around the public park kicking a football. Nowadays the exercise involved is often no more than climbing out of bed and turning the computer on, and we wonder why obesity rates are spiralling out of control! Not only do we have all this technology available, but we also feel compelled to use it for longer (often hours at a time) in a way that we never did with other more conventional pastimes.

The one thing that all of this technology has in common is that it has forced us to replace lots of big movements with lots of small, repetitive movements, and spend many hours interacting with virtual worlds on a small screen instead of interacting with the real world. It has disassociated us from reality, and made us feel like this virtual world is hugely important, so much so that we can’t imagine life without it. It has led us to be at a heightened risk of developing many types of problems including the very real threat of Repetitive Strain Injuries (RSIs). It has also just as worryingly made serious addicts out of all of us.

Rate this post! Note: There is a rating embedded within this post, please visit this post to rate it.

The article indicates that RSI is part of an ever increasing phenomena affecting 115,000 workers last year a staggering 34% increase from the previous year. If ever we needed evidence that RSI is reaching epidemic levels, then this is it.

It also contains a quote from Pauline Cole (a spokesperson for the Association of Chartered Physiotherapists in Occupational Health and Ergonomics (ACPOHE))

“A lot of people are using computers more, even in jobs you wouldn’t traditionally expect it”.

This is the trouble with RSI conditions. Just about every job these days requires interaction with computers, and this can present major challenges when a worker is affected with RSI, there are few options out there to allow them to work whilst avoiding computer use and allowing their bodies to recover, except for perhaps manual labour.

In another revealing quote from the article, this time from Bunny Martin (who runs charity Body Action Campaign)

“schools tend to have a single standard computer set-up for nine and 15-year-olds alike.”, and alarmingly she notes that “around 60% of children she meets have first symptoms of RSI, including strain-related pain in the neck and shoulders.”

This is a staggering fact and if RSI is impacting children years before they start looking for employment then we truly are sitting on a RSI health time bomb.

All in all an excellent summary article on where we are at with RSI.

Rate this post! Note: There is a rating embedded within this post, please visit this post to rate it.

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.

Rate this post! Note: There is a rating embedded within this post, please visit this post to rate it.

The common position for hands hovering above a keyboard is as shown on the right, which I refer to as the ‘claw’. This position elevates the tension in the aforementioned extensor muscles, causing them to become fatigued over prolonged periods of time. Typing whilst the hand/wrists are in this position (another common posture mistake) will further increase the muscle and tendon stresses making the situation worse.

What may not be so obvious is that moving the wrists into a more neutral ‘level’ position (see image) can still create enough continual tension in the forearm extensor muscles. This is not always apparent unless, like me, you already have a bad RSI condition and can notice the pain in already injured muscles.

This is a much better position than the ‘claw’, and the forearm extensors are far less tense. They are however still in tension which may lead to forearm extensor fatigue when held in this manner for long periods of time eg 6-8 hours a day hovering your hands over a keyboard at work.

The final image on the right shows a ‘hanging’ wrist position which, if adopted, places minimal stress on the forearm extensors, (they should in fact be relaxed in this position), and is a good posture to aim for when typing. You can then utilise the weight of your hands and fingers to type, lifting the arms from the shoulders and elbows instead of placing the burden on the forearm extensors and associated tendons.

You don’t even need to be at a keyboard to try out these different wrist angles. Just hold your hands in these positions for 2 minutes and observe the different tensions in the forearm extensor muscles. Start to imagine what it is like for your body to hold this tension for up to 8 hours a day at a computer, and ask yourself whether it may be more beneficial if you changed your posture to one that has far less muscle/tendon tension in it.

Note: In order to successfully utilise the ‘hanging’ wrist position you will most likely need an ergonomic computer set up with a drop down keyboard tray, perhaps even an adjustable position keyboard tray.

Rate this post! Note: There is a rating embedded within this post, please visit this post to rate it.

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.

Rate this post! Note: There is a rating embedded within this post, please visit this post to rate it.