Computer Related RSI What is RSI? Repetitive Strain Injury or RSI refers to a constellation of work-related, disorders, due to diffuse involvement of muscle, fascia (covering layer of muscles), tendon, nerves or blood vessels, typically involving the neck and upper limb; though any part of the body, e.g., back, legs, eyes, vocal cords, etc. may be affected. The syndrome is characterised by disturbance in the balance between load and physical capacity, preceded by activities that involve repeated movements or prolonged periods spent with one or more of the relevant body parts in a fixed position as one of the presumed etiological factors. RSI is also known as Work Related Musculoskeletal Disorder or Computer Related Injury. Causes of RSI Human factors Environmental Factors Work related factors. Age + Light, Glare + Poor office ergonomics + Gender + Noise + Lack of breaks + Lack of Strength + Poor Ventilation + Stress + Lack of Flexibility + Temperature extremes + Adverse Workstyle 3 Commonest RS!'s in India + Thoracic Outlet Syndrome: tension in the muscles at the side of the neck constricts the blood vessels and nerves leading to shooting pain or numbness in hands and wrists. + Myofascial Pain Syndrome: chronic contraction knots within muscles. + Nerves that are tethered in place by years of overuse in a single posture, @.g., Cubital Tunnel Syndrome (compression of ulnar nerve at elbow) Common Symptoms of RSI + Discomfort, fatigue or pain (sudden or gradual) + Swelling, redness, paleness or warmth + "Catching" (pinching sensation) or "snapping" (crepitus) associated with movement + Loss of grip strength (muscle weakness), heaviness or clumsiness ofthe hand. Decreased range of motion orstifiness Burning, numbness, tingling, "pins and needles" Aconstantneed to stretch or massage one's arms Visual strain or fatigue while working ‘Slow accumulation of injury ocours with gradual development of difficulty in day-to-day activities such as shaking hands, opening doors, holding newspapers, using a comb, or even holding a teacup RSI Prevalence in India ‘The worlds largest study on RSI performed by RECOUP including 35,000 IT professionals (2001-2009) found a prevalence of 75%. ‘Three smaller Indian studies have reported identical figures. When should you seek medical help? ‘Seek expert care AS SOON AS POSSIBLE, because delay of a few days could make the difference between a quick and complete recovery, and a long drawn struggle to overcome RSI. It is worth seeking references from injured co-workers or others before ‘choosing your doctor, rather than trying out the nearest Physician, Orthopaedist, Physiotherapist or Corporate Hospital that you can find. Be especially wary of a diagnosis of “Spondylitis” >> 70% cases of RSI are initially misdiagnosed, according to a research study). DEEPAK SHARAN’S Severity Score for RSI* D uration of symptoms E fect on activities of daily living E xertion level P ain intensity Ability to maintain speed of work K nown physical health issue Stress H ours of continuous work per day Area affected (out of neck, shoulder, elbow, wristhand, upper back, lower back, hip/thigh/buttock, knee, ankle/feet) Restricted movernents of affected area Activity Restriction during work Nerve Related Symptoms S leep Disturbance due to pain * Presentod ata Specal Session at Worl Ergonomics Congress in Brazilin Feb 2012 RSI Severity Grading Ttervention Severity panerwention Duration of Recover Saget _ Ergonomic modifications z Mi + Stretches {month ‘Stage 2} Physical Therapy : Moderate _| (SHARAN'S Protocol) 28 month Stage 3. | Mind Body Methods, EMG 3 month Severe | Biofeedback, Aquatic Therapy Stage & | Medication 35 month, Complicated (for Neuropathic Pain) ‘sometimes more WHAT CAN BE DONE TO TREAT RSI? SHARAN'S Protocol for RSI Skilled Hands-on Approach for Release of Myofascia Articular Neural and Soft-tissue mobilisation mah Nano, Narra, Pare SEVERE MODERATE MILD DISCOMFORT DISCOMFORT DISCOMFORT (MAINTENANCE. =s Stretching = contr ihe strength smebization Perens eee end ca pees ene ody ps : Se ery (ese PeesTips for Prevention: + Take a 5 sec. break ("micro-break") every 5-7 minutes, and at least a 2-minuto broak overy 30-40 minutes (macro-break’) Use a break reminder software such as 'Workrave’ or Prevent RSI + Learn correct typing technique and postu, the right equipment setup, and good work habits from qualified Ergonomist. Get your workstation professionaly assessed + Hold the mouse lightly and use 2 fingers for clicking. Get your hands well away from the mouse when you are nol using. + Place monitor at your eye level. In case of Laptop, use laptop raiser, extemalkeyboard and mouse, + Iftelephone useis frequent, use aheadsetinstead ofhandset Str to p { = RECOMMENDED POSTURE Shoulders relaxed and elbow stay ose tothe body lve, inne with torso Back, thighs and hip fly supported Hans, west and forearm in-line paral to floor Fettuty ee spores eta hs ve forest * Carry your Laptop in a well padded backpack or a trolley. + Periodically evaluate your environment for ways to reduce stress, Try to keep your desk uncluttered so you can always find things. Make sure programmes are set up correctly on the computer, and use a macro programme to reduce keystrokes, + Drink plenty of water (6-8 glasses) regularly during the day. Avoid caffeine and smoking, + Emphasise diaphragmatic (abdominal) breathing to reduce pressure on your chest. + When faced with unavoidable stress, step back and evaluate your reactions. You can't eliminate stress in life, but you can modify your reactions so they don't harm you. = L es hes ent sos When you develop RSI symptoms - DO NOT + Startusing the lefthand for the mouse. + Take a vacation hoping the pain will go away with rest, Not only will the pain retumn when you get back to work, you could be left without adequate medical leave! + Selt-medicate (painkillers, ointments, altemative medicine) + Use a neck collar, crepe bandage or wrist splint (especially while working). + Joina gym orstart weighttraining or swimming, + Discard the pillow and start sleeping on the floor orhard bed, + Undergo vigorous oll massage. + Undergo cervical traction orisometriciresistive neck exercise + Consider Steroid Injections or Surgery withouta second opinion. All these modalities have the potential to worsen your existing situation RECOUP Remember: If work causes pain, it is not normal and something needs to be done about it. Seek RSI Prevention and Treatment Solutions from: RECOUP Neuromusculoskeletal Rehabilitation Centre: #312, 10th Block, Anjanapura Layout Further Extension, Lal Bahadur Shastri Nagar, Near Gottigere and L&T Cement Factory, 80 Feet Road, Bangalore ~ 560062, Karmataka, India Phone: #91-80-32423424, 64504334; Hotline : +91 98451 55449 Fax: +91-11-45823555, RECOUP Branches: Jayanagar, Indiranagar, Sarjapur Road, HSR Layout, Vijayanagar, ITPL(Bangalore), Other Branches: New Delhi, Patna (Bihar), Hyderabad, Secunderabad (AP), Thrissur, Kozhikode: and Thiruvananthapuram (Kerala), Ghaziabad (NCR/UP) ee erty