” … by IrishJobs.ie,  Enable Ireland and Assistive Technology Training specialists asked more than 1,000 employees about how comfortable they were as they work.”

OK, this was a smallish survey of 1000 employed individuals in Ireland, but perhaps it provides  a glimpse into how widespread Repetitive Strain Injuries actually are in the workplace. The findings showed that -

“… workers now typically spend from two to more than six hours seated at work, typing at the computer or on the phone. Of the 45pc who have experienced RSI symptoms, the back was the most affected area, followed by the neck, wrist and hand. Arms and shoulders were also seen as problem areas. More than half of survey respondents said they only suffered from mild discomfort, but 44pc said it was painful enough for them to be aware of it. Four per cent described their RSI symptoms as “extremely painful.” “

I have suspected for a long time that a larger percentage of workers than officially register an RSI do actually suffer from mild forms of RSI quite frequently. They are, however, perhaps just trying to deal with the symptoms themselves and are reluctant to appear like they are complaining to their employers about anything that may impact their job security or the perception of their ability to work.

Note: Despite searching for the actual survey results from  Enable Ireland, I can’t find an original source for it. If anyone has a link, please drop me a comment.

I did however come across this very useful looking document titled “A Tool For Everyone” about RSI for employers and managers on Enable Ireland website, which does reference a 45 percent figure, just not the survey I was looking for!

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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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Don’t get me wrong, I’m no technophobe and realise that social media is playing a big role in people’s lives these days, but it was perfectly obvious to me that this person lived a virtual life almost all of the time! Her ‘real’ friend sitting next to her was relegated to staring out the window  most of the time, but was occasionally invited to check out a witty comment sent by one of her companion’s virtual friends. The insanity of this is that it shows how we are slowly losing the ability to communicate in any traditional, ie personal form. The new ‘normal’ is becoming the social media way.

So what? I hear you all ask. Well,  aside from the implications for “real” social skills, all of the virtual lives that we are leading are at the cost of our bodies interacting with computers, phones, and other hand held mobile devices nearly all of the time!  Which means we are clicking them and using small repetitive micro movements in doing so. I really fear that our virtual lifestyles will lead to a  guarantee of an epidemic in RSI type conditions, and the debilitating pain that goes with them.

Is it not about time that we questioned the importance and necessity of our virtual lives against the necessity that we will have a healthy future in which we will be able to do perform our work as well as successfully interact with real people?

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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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One question they asked that has stuck in my mind to this day was, “When was the last time you listened to music?”, to which I replied well, “In the car driving here”. Their response was, “No, when was the last time you listened to music just to enjoy the music, not as part of something else?”. I really had to rack my brain to think that one through. I couldn’t remember. Not for many years and probably when I was a lot younger, had a lot more time on my hands and a lot less to worry about – probably in my teens! I had to be honest and say, “I really don’t remember”.

The lesson she was trying to impart was that we rarely take the time in life any more to just enjoy simple things that once were a source of relaxation. Music should have been there to enjoy and relax to on its own. By then my life was so busy that music had been demoted to something less.

It may be a part of the reason we hanker after music during our childhood to teen years. Back then, we had more time to listen to music with fewer worries and distractions in our lives. Not only that, but we spent time listening to whole albums from start to finish (which back in my day were on vinyl) and playing them to death whilst memorising the lyrics. This changed in my busier twenties, demoting music to be something listened to when I was driving about, at my desk whilst working or when I went for a workout at the gym. It just wasn’t something I had time for any more on it’s own, yet it was still an important part of my life, just not for relaxing to. In other words I always added something else into the mix with music without obtaining any of the mental relaxation that could be found from listening to an entire album and doing nothing else.

Move forward a couple of decades, and we find ourselves in a completely different situation. The invention of home computers, MP3 files and players have completely revolutionised music and the way we listen to it. We now have thousands of files on our players that are very easily mixed and are frequently listened to in random order, which can be great, and really allows you to find stuff in  your collection that you’d forgotten about. However it has led to being spoiled for choice, and we tend to flick through music tracks at the push of a button, not listening to albums in the way they were intended to be appreciated. Many artists spend a lot of time sequencing an album into a specific order which ‘flows’ or tells a story, and is really part of the overall experience of that music. This sequencing is more often than not completely wasted with shuffle plays of MP3 players, and really adds to the sense that music is just a cheap commodity in our already over commoditised life.

If we spent a dedicated hour a day to do nothing but listen to a favourite album the way it was intended to be listened to and for no other reason but to enjoy that album, we’d find that the music does a wonderful thing and takes us to a different place, where we can lose our worries and stresses for an hour and start to relax again, just as we did when we were younger. It may also help us to de-stress and unwind from tension induced conditions such as RSI.

So when was the last time that you really listened to music?

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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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The reason that developments like this are exciting is that the games business, being a cutting edge, technologically advanced industry, usually pushes the boundaries of software and hardware development for the sake of market share.

Technology like this for, say, computer controls would ordinarily evolve a lot slower if there were a lesser need for it aside  from gaming. However, once developed, you can see how it could easily transform into some kind of gesture control for computer operating systems and applications. Who knows, you may even get a workout whilst doing a spreadsheet in the future!  Will a workout mat eventually replace the old desk?  Maybe we can eliminate the need for going to a gym!  Do employers only hire fit people in the future?

We are certainly at a crossroads with computers, where the basic mouse has been around too long and has created too many overuse injuries. It is more than time that we took computer input to a new level of evolution, and this may be the glimpse of what’s to come.

Whether this technology can save us from RSI related injuries is unknown, but it may help wean us off using a mouse. It may also lead to opportunities in computer use for people with all kinds of different disabilities, and not just RSI.

Is this the dawn of a new age in computer ergonomics, or is it just a gimmick ?

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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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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.

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