• Repetitive Strain Injuries

    There are many different types of Repetitive Strain Injuries (RSI) and these are categorised by the overuse of certain movements and motions.

    Commonly RSI occurs as a result of an individual undertaking a task typical to them. Be it associated with their occupation, hobby or sport, a repetitive motion can lead to a strain on a particular body part.

    People prone to this are typically employees working within a labour intensive or repetitive environment, for example secretaries, electricians, painters or workers on a production / assembly line.

    Sufferers can also be players of field, track, racquet or handball sports.

    Those who are involved in occupations, interest and hobbies such as these are generally more vulnerable to developing the symptoms linked with repetitive strain injury.

    Some of the most common RSI types are Carpal Tunnel Syndrome, De Quervains’ Syndrome, Tendonitis, Tenosynovitis and Back Pain such as Spinal Stenosis.

    This guide explains the injuries which are most often categorised beneath this heading and how these can be avoided. As ever we provide a jargon explained guide to the most common sports injuries in RSI together with a straightforward guide to products that can help if you suffer one of these injuries yourself.

    What is Carpal Tunnel Syndrome (CTS)?

    Carpal Tunnel Syndrome typically affects women more than men and is often seen amongst those aged 50-54 and 75-84.

    This condition causes pain, numbness and a burning or tingling sensation in the hand / fingers, and symptoms of CTS can range from mild to severe.

    There are a number of tendons which assist in finger movement and these pass through the carpal tunnel, as does the median nerve helping to control sensation. CTS occurs when the space inside the tunnel is made smaller by a build-up of fluid within the tissue which in turn places pressure on the median nerve causing pain and numbness. Often these symptoms are increased when the wrist and fingers are flexed.

    Interesting Fact: CTS is a common condition during pregnancy, affecting up to 50% of pregnant women. It is thought that this may be due to the fluid retention that often occurs during pregnancy, which places additional pressure on the carpal tunnel and causes symptoms. Symptoms are normally less severe and will often get better within three months of giving birth, although in certain cases it can continue for up to a year.

    Sports related to Carpal Tunnel Syndrome include golf and tennis.

    A guide to Carpal Tunnel Syndrome

    What can you do to prevent Carpal Tunnel Syndrome?

    If spotted early treatment of CTS can prove very successful but if left it can lead to numbness, weakness of the hand and nerve damage.

    Treatment depends upon the severity of the symptoms, mild to moderate responds well to non-surgical intervention – using a Wrist Support or / and corticosteroid injections.

    In more severe cases surgery is normally required to reduce the pressure within the median nerve.

    What should you do if you suffer from Carpal Tunnel Syndrome?

    Wearing a Wrist Support at night or if needed during the day is the simplest way to ease the symptoms of Carpal Tunnel Syndrome.

    Anti-inflammatory drugs such as ibuprofen and naproxen can be used in the treatment of CTS or a doctor may recommend corticosteroid injections to the affected area.

    As a long term solution surgery is used to eliminate the compression to the median nerve by cutting the ligaments pressing onto it.

    What is De Quervains’ Syndrome?

    De Quervains’ Syndrome or Washerwomans’ Sprain is a type of repetitive strain injury which occurs when the sheath holding the two tendons controlling thumb movement become inflamed. This can result in pain travelling to the thumb and forearm, with the swelling affecting a person’s ability to grip.

    Interesting Fact: Although De Quervain’s can affect anyone, it is most common with women who suffer from it eight to 10 times more often than men.

    De Quervains’ Syndrome often affects those who partake in sports which require a firm grip such as squash, badminton, golf, canoeing and tennis.

    What can you do to prevent De Quervains’ Syndrome?

    Avoid excessive hand and wrist movements such as twisting, pinching and strong gripping. Also, aim to avoid applying thumb pressure.

    What should you do if you suffer from a De Quervains’ Syndrome?

    Treatment of De Quervain’s usually involves the use of a thumb/wrist splint immobilising the thumb for between four – six weeks in addition to refraining from any activity which is likely to aggravate the condition.

    In mild to moderate cases ice therapy such as a cold pack may be applied to reduce inflammation and your doctor can prescribe anti-inflammatory medication.

    Surgical release of the tight tendon covering may be required if treatments prove unsuccessful, this will help to eliminate the friction that causes inflammation, restoring the tendons’ smooth gliding capability.

    Early intervention is the key to successful treatment, patients who have developed De Quervain’s gradually will often be more resistant to treatment and it may take longer to relieve. What is Carpel Tunnel Syndrome? What is Tendonitis?

    What is Tendonitis?

    One of the most common repetitive strain injury types is Tendonitis.

    This is a problem that can strike in many different body parts when a tendon within the body becomes inflamed.

    Some of the most commonly affected areas by tendonitis include the elbows, wrists, arms, shoulders, legs, knees, ankles and hips.

    Interesting Fact: Statistically, sufferers of this condition are highly prevalent within sport:

    • Bowlers within cricket develop problems within the shoulder – Rotator Cuff Tendonitis
    • Basketball players suffer in their knees due to the amount of jumping they perform – Patellar Tendonitis
    • Tennis or Golfers Elbow
    • Footballers – Achilles Tendonitis

    A variety of sports can result in Tendonitis including running, tennis, golf, football and cricket.

    Article on Tendinopathies

    What can you do to prevent Tendonitis?

    Take up training prior to a new sport to develop strength and flexibility.

    Learn the proper technique in which the sport or activity is carried out to prevent injury.

    Be sure to warm up thoroughly before exercise and cool down afterwards.

    What is Tenosynovitis?

    Tenosynovitis is a type of repetitive strain injury that is similar to tendonitis in a number of ways, however it differs as it affects the sheath of the tendon.

    More often than not, cases of tenosynovitis develop within the fingers, and the syndrome is known as trigger finger.

    Sufferers of tenosynovitis may experience a limited range of motion within the fingers, and may feel a cracking when trying to straighten the affected fingers.

    Racquet based sports such as squash, tennis and badminton are often related to Tenosynovitis.

    Thumb & Wrist Injuries

    What can you do to prevent Tenosynovitis?

    Aim to avoid excessive movements to the affected area. Exercise the area affected to strengthen the muscle around the tendon. It’s a good idea to seek the advice of a physiotherapist for this.

    Be sure to warm up thoroughly before exercise and cool down afterwards.

    What should you do if you suffer from Tenosynovitis?

    Surgical intervention is very rarely needed with this condition, we recommend:

    • Rest. It is important to rest to allow the condition to settle. Sometimes a splint, firm bandage or brace is put on a wrist if this is the area affected.
    • Ice packs over the affected area may ease swelling and pain.
    • Anti-inflammatory painkillers are often prescribed, these ease pain and help reduce inflammation.
    • Physiotherapy may be advised, especially if the condition is not settling with the above measures.

    What is Spinal Stenosis?

    Spinal Stenosis is a form of back pain which often relates to Sciatica. Symptoms include back pain, buttock pain, cramping in the leg and tingling. The condition is either genetic or brought on as part of the ageing process.

    Most of us will suffer back pain at some point in our lives. While it may be painful, many problems are non-serious and usually fade within a couple of weeks. The length of pain vary depending on the severity:

    • Acute – This is usually caused by an accident and can last from one to seven days. This is a mild or severe pain.
    • Sub-Acute – Generally a mild pain but can be severe. This pain lasts from a few days to a few weeks.
    • Chronic – This type of mild / severe pain can be caused by illness or other identifiable causes. Chronic pain lasts for more than three months.

    The number of reported back pain cases within the workplace is on the rise, according to recent studies. Due to the uncertain economic climate, many are reluctant to miss work.

    Over 9 million work days were lost in 2008/09 due to back pain and other musculoskeletal related problems, making it the second biggest problem next to stress. Thankfully, most of these problems are easily preventable with correct guidance and a little bit of insight.

    Back pain is more likely to appear in tasks that involve:

    • Lifting bulky or heavy loads
    • Incorrectly carrying loads
    • Repetitive tasks that require bending over – packing goods
    • Driving long distances without proper seat / rest supports
    • Crouching or bending for long periods of time – this includes working at a PC
    • Pulling, dragging or pushing heavy loads
    • Working while physically tired
    • Reaching, twisting, and stretching
    • Sitting in one position for extended periods

    All of the things above have the potential for a strained back muscle or ligament.

    About Spinal Stenosis

    What can you do to prevent Back Pain?

    Generally, the best way to prevent back pain and its effects is to remain active. Muscles weaken the longer they remain unused.

    Spinal Stenosis in Brief.

    What should you do if you suffer from Back Pain?

    Back pain is often caused by long periods of inactivity and poor posture. However, in the event of severe pain that shows no sign of improvement, or further problems caused by back pain, it is recommended that you seek medical advice.

    Further factors that could influence back pain are:

    • Sitting posture
    • The position of your computer screen
    • The height of your chair
    • The position of your keyboard / mouse
    • The layout of your desk equipment

    The body can only tolerate one position for so long before it feels the need to adjust. This is why correct posture is important when sitting in front of a computer for hours on end.

    To help you maintain good posture, PhysioRoom.com offer a range of workstation accessories designed to support your body and provide you with a safe working environment. Correct posture can help prevent repetitive strain injury (RSI) which is also a cause of back pain.

    The key to good posture is to sit up straight and to make sure that your lower back is supported. Keep your thighs at a right angle to the rest of your body, or sloping down.

    The following products can help support proper posture:

    If you are currently suffering from back pain, these items can help make it more manageable:

    The basic rule is to keep your feet firmly planted on the floor, but if it’s more comfortable to use a footrest, then do so. By putting your feet on the ground, you are able to support your back.

    What is tennis elbow?

    Lateral Epicondylitis or Tennis Elbow is a condition that results in pain around the outside of the elbow & for most this pain only occurs when using twisting movements such as turning a door handle or opening a jar. Although in some cases the pain may be constant travelling down your arm from your elbow towards your wrist making daily living difficult. For example, holding a knife or a fork as the arm can become stiff. The site of the pain in tennis elbow is where some tendons from your forearm muscles attach to the bone around your elbow. The pain is thought to be due to an injury, or several tiny injuries, to one or more of these tendons resulting in a tear which in turn leads to inflammation & scarring.

    What Causes the Condition?

    Overuse is the primary cause of this condition, working the forearm muscles repeatedly, either within sport:

    • Playing racquet sports
    • Sports that involve throwing – such as the javelin or discuss
    • Swimming

    Or within the workplace from carrying out repetitive tasks:

    • Manual work that involves turning or lifting of the wrist – plumbing or bricklaying
    • Fine movements of the hand and wrist, such as typing or using scissors

    The symptoms of Tennis Elbow can last for some time as the tendons are slow to heal, for mild to moderate cases expect from a number of weeks to months. At its most severe pain can persist for more than a year. However the pain will eventually subside with or without treatment.

    Non-surgical treatment is always recommended in the first instance & you should rest the affected area. Refrain from any activity which might place the tendons under unnecessary stress or cause further irritation.

    Anti-inflammatory creams and gels are often recommended for tennis elbow rather than anti-inflammatory tablets. This is because gels and creams provide effective pain relief and reduce inflammation without causing side effects, such as nausea and diarrhoea.

    A corticosteroid injection (medication containing a steroid) can be recommended if you have a particularly painful tennis elbow that is making movement difficult. Most people who have a corticosteroid injection find that their pain initially improves significantly. However, studies have shown that this treatment is only effective in the short-term (around six weeks) & its long-term effectiveness is poor.

    If your tennis elbow symptoms are particularly severe or persistent, you may choose to seek further professional guidance & meet with a medical practitioner. A physiotherapist will be able to show you exercises to help stretch and strengthen your forearm muscles. They may also recommend that you wear a splint or support to help & encourage the tendons to heal.

    Surgery should only be considered as a last resort in the treatment of severe or persistent tennis elbow, this aims to relieve the painful symptoms by removing the damaged part of the tendon

    Self-care advice – Prevention

    • Rather than using your wrist and elbow more than the rest of your arm, try spreading the load to the larger muscles of your shoulder and upper arm.
    • If you play a sport that uses repetitive movements, such as tennis, you could get professional advice about your technique so that you do not strain your elbow.
    • Before playing a sport that involves repetitive arm movements, such as tennis or squash, warm up beforehand and gently stretch your arm muscles to help you avoid injury.
    • Use lightweight tools or racquets, and enlarge their grip size, to help you avoid putting excess strain on your tendons.
    • Wear a tennis elbow splint when you are using your arm, and take it off while you are resting or sleeping to help prevent further damage to your tendons. Ask your GP or physiotherapist for advice about the best type of brace or splint for you to use.
    • Increasing the strength of your forearm muscles can help prevent tennis elbow. A physiotherapist can advise you about suitable exercises to build up the muscles of your forearm.

    Interesting Facts

    • In around three quarters of cases of tennis elbow, the dominant hand (the one that is used the most) is affected.
    • Tennis elbow is fairly uncommon. Approximately five in every 1,000 adults in the UK are affected by the condition each year.
    • Tennis elbow usually occurs in adults. Men and woman are affected equally. The condition tends to affect people who are around 40 years old.
    • Despite being called tennis elbow, racquet sports are only thought to be the cause in about 5 in every 100 people.
    • It mainly affects people between the ages of 35 and 55. Women and men are affected equally.

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