RSI Prevention and cure

RSI is a syndrome involving excessive physical strain of the neck, shoulders and arms.

It is frequently accompanied by a reduction in the capacity of the muscles and tendons to put up with strain.

Factors which cause strain include:

Moving in the wrong way
Repetitive work
Poor work position
Poor work habits

Repetitive work consists of repetitive, short cyclical movements carried out over a prolonged period of time.

Reduced capacity to tolerate physical strain can be caused by:

Not moving enough
High work pressure/ stress
Personal circumstances which add to the strain

People prone to RSI include screen monitor workers, such as secretaries, programers, journalists, graphic designers and policy and administration assistants. Musicians, painters, cashiers, post- office sorters, etc. can also develop RSI.

RSI symptoms

RSI often begins with symptoms of stiffness and tingling sensations during work. The first symptoms usually effect the dominant hand, generally the hand used for writing or working with the mouse, but in most cases the other hand is usually also affected. The complaints gradually increase in intensity till the pain is clearly localised in one spot. This is the first phase of RSI, pain while working.

In the second phase of RSI, the relationship between pain and work is less clear. Pain is also noticeable when doing household work and continues in the evening or during the night. The pain is also more diffusely spread and is sometimes accompanied by a loss of physical strength. Quick treatment is now needed. Recognition and treatment of the symptoms in the first phase is of course preferable.
In the third (serious) phase of RSI, pain is continually felt and gets more intense with the least movement. Dressing and undressing is now painful and opening a door or turning a key in the lock becomes virtually impossible.

Expanation

Repetitive Strain Injury (RSI) as the name indicates is occasioned by repetitive movement. Physical movement such as crawling, walking, typing, writing, dancing, taking parts in sports, or laying bricks, are by their nature repetitive. In other words repetition is inherent in movement. No one gets injured by moving naturally so the wide range of symptoms affecting the neck, shoulders, arms, wrists, hands, and fingers is not just explained by repetition alone. Repetitive movement is often accompanied by excessive strain on the muscles which causes myofascial trigger points ( www. triggerpointboek.nl).

Trigger Points

Myofascial trigger points in the muscles of the upper extremities cause a disruption in this part of the body which can induce considerable pain. At the same time they disturb the originally natural pattern of movement of the body. A myofascial trigger point can be described as an easily irritated, extremely painful spot, bump or swelling, or very tight, tensed up muscular tissue.

Myofascial trigger points both weaken the muscle and keep it tensed up. At the same time, myofascial trigger points cause the surrounding muscular tissue to remain in a state of compression and tension.

These tight strings of muscular tissue in turn maintain the muscle attachments continually in a state of tension and this often induces symptoms in neighbouring joints.

Unremitting tension in the tendons of the trigger point itself restricts the circulation in the surrounding area. The build up of toxins as well as the lack of oxygen and nutrients vital for the cell's metabolism can sustain trigger points for months and even years unless action is taken.
This vicious circle has to be broken (Myofascial Pain and Dysfunction: the Trigger Point Manual, Travell & Simons 1999: 71-75)

Treating myofascial trigger points

The problem with treating myofascial trigger point is that they practically always induce pain in another spot. The usual way to combat the pain is to assume that the origins of the pain are located in the painful spot itself. But myofascial trigger points always redirect the pain elsewhere. This puts people on the wrong track including most doctors and other health care workers.

According to Travell & Simons, the standard approach to tackling pain fails so often because people focus all their attention on the pain itself and treat the painful spot, ignoring the reasons for the pain and so failing to treat it. A lack of understanding of this concept leads inevitably to incorrect diagnosis making it impossible to effectively treat the underlying symptoms.

Origins of myofascial trigger points

The conditions that give rise to trigger points in a person are fairly obvious: accidents, falling, dislocation, and overwork. The particular occasion when you overdo things and strain yourself is not quickly forgotten because of the intense pain, lasting long after the event. We all now and again lift something which is too heavy,we train too intensively when we are not fit, and work too long and too hard on something we are not used to. In this way we abuse our muscles.

Avoiding excessive strain on the muscles

If myofascial trigger points are a result of chronically overtaxing your muscles at work, lack of movement is also a major contributory factor. Being in poor physical condition makes you vulnerable to muscle overstrain. Adopting a tense or uncomfortable position at work can cause trigger points to persist.

The apparent comfort and ease which accompanies a long-established habit can blind you to the effects this is having on your muscles. If you don't use your muscles or keep them active for a prolonged  period of time, they can stiffen up and get weaker. Sitting all the time is a recipe for a trigger points. You have to move your muscles to keep healthy.

Unavoidably overtaxing the muscles

Sudden shocks to the body, such as collisions or falling, give rise to trigger points in the muscles. These are the main reasons for the pain which comes from whiplash, although this is often not realised, leaving the points untreated. Trigger points often go hand in hand with bone fractures, torn ligaments, sprains, and dislocated joints. Failure to recognise trigger points as an inevitable outcome of physical injury causes needless pain and can postpone or even completely exclude the possibility of future recovery.

Mistreatment of the muscles

According to Travell & Simons, medical treatment of various kinds can be the direct cause of trigger points and myofascial pain. Trigger points are certainly caused by physical immobility occasioned by the constraints imposed on the body by corrective devices such as clamps, slings and plasters (in the case of fractures). If pain is still being felt long after an operation, we can reasonably assume that trigger points may exist in the muscles which have been cut, stretched, or traumatised in some way or another during the operation. Doctors sometimes continue trying to treat the painful spot without realising that it may be derived from the myofascial pain.

The importance of healthy movement

Immediately we suspect RSI (preferably in the first phase) all repetitive, short- cyclical work must be stopped immediately. An essential part of the treatment entails the patient learning to listen to his or her own body. By listening we mean paying attention to pain in the course of the work but above all in adopting a more detached attitude to our work and looking at it in perspective. Our therapy aims at reducing the tension in tensed up muscles and helping the blood to circulate so as to give the self-healing mechanisms of the body a chance to do their work

In addition, it's also important to increase the body's physical resistance and energy level with the aid of healthy, therapeutic training exercises. In our training, we believe in the importance of motion and movement that involves the area of the upper extremities (back, neck, shoulder, harm, wrists, and hand) and is accompanied by healthy, sound breathing.

That's why we have developed the Flow Motion system. This therapeutic, integral training system is based on the same techniques as Yoga, Tai Chi, gymnastics, swimming, and power training. Our therapy also includes the use of unique devices like the AquaSwing®, BasicAbTouch, and StirringWheels, all specially designed by Basic Touch. Where most conventional fitness equipment operates on the basis of linear or isolated patterns of movement, Flow Motion focuses on patterns of motion that are more in keeping with the body's natural, healthy three-dimensional movement.

The treatment

There are four different phases in our program of treatment with phase three and four mostly overlapping.

1. Part of the process of encouraging the self-healing process is to develop thoughts that help and aid the process, such as “that’s just the way things are,” “I’m going to do something about it.”
Negative thinking doesn't help and has to be changed. Thinking that doesn't help the healing process includes : “why me?” Or “I can't keep this up.” Or “I’m never going to get rid of it.“ Or “I’ve got an incurable physical ailment.”

The first phase of treatment is a difficult one. It is quite common for the pain to get worse during the first weeks after you start. The morale is often lowered.

Recognising and respecting your limitations

2. In this phase we need to focus on the signalling function of the pain and the consequences of exceeding our limits. Slowly the relationship between overtaxing ourselves and the pain is re-established.
Say, for example, pain occurs when you’re vacuum cleaning at home. When this occurs we need then to stop immediately and drop the idea of finishing the job.

Gradually increasing the tempo

3. We need to build up our physical stamina as quickly as possible. Flow Motion with the AquaSwing® is perfect for this since it is useful and enjoyable at the same time.
When we are nice and relaxed we exert ourselves without straining too much and this soothes the nerves, improves muscle power resistance and coordination. The exercises are graded by difficulty so we can gradually build up the program moving onto the next stage when we are ready.

Changing your attitude

4. This phase is concerned with attitude: changing your attitude to your immediate environment of those around you, and the environment's attitude to you. In this phase we have to draw up a work resumption plan and make it clear to those around us that our attitude has changed and we have learned to say” no.”