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Repetitive stress injuries (RSI)

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A repetitive stress injury (RSI) is an injury caused by the overuse of misuse of a particular body part which performs a repetitive action. Small forces at a high frequency cause injury to muscles, soft tissues, nerves, and connective joint tissues. RSI’s are common workplace injuries for people on computers for long hours or employees on assembly lines. Repetitive Stress Injuries develop slowly over time. RSI’s could be debilitating conditions from the fact that it decreases the functional capability of the person afflicted. Common types of RSI’s include carpal tunnel syndrome, bursitis, tendinitis, tendonitis, epicondylitis, and trigger finger.


Causes of RSI’s obviously from the name stem from actions that are repeated on a frequent basis. “Common causes of RSI’s include working in awkward positions, holding static postures, the use of vibrating tools, and a poor work environment” (CUPE)[1] This means that actions such as typing or putting the same piece together on an assembly line could lead to serious injuries. Other common situations for RSI’s include playing a musical instrument or sports such as tennis or golf. Poor posture while sitting at a desk and typing for 8 hours is a job description leading to many of the work related RSI claims. It is also seen that temperature has an impact on repetitive stress injuries. Many air conditioned offices have a higher incidence of RSI due to negative effects of cold temperature on tendon efficiency.

Signs & Symptoms

There are common signs or symptoms one could look for to recognize a repetitive stress injury.

  • Joint pain
  • tingling
  • numbness
  • loss of strength
  • stiffness
  • tight muscles
  • redness
  • swelling
  • skin color changes
  • functional deficit compared to normal


An easy way to treat minor repetitive stress injuries is to take more breaks at work. If the joints are loaded less frequently, the symptoms are less likely to be apparent and worsen. Time between tasks is shown to allow stretching of muscles and tendons. Static positions held for a long time encourage stiffness and muscle fatigue making a person more susceptible to injury.

Ergonomics is an essential step in preventing RSI and reducing the symptoms in people with repetitive stress injuries. As seen below proper monitor height and angle is important if you need to be working at a computer for a long period of time. A monitor lower and farther away is better for the neck and for the eyes. The chair also is appropriate to support the back while being at the right height to keep the arms and thighs level. Wrists also do not touch the keyboard while typing. It is important to educate employees and patients with RSI on ergonomics to change lifestyles in order to combat this condition.

There are also many theories about hand position and typing technique to reduce the risk of RSI’s. On the left the wrist is constantly at an angle and one hand needs to stretch the fingers to most of the keys to type. The technique on the right is more appropriate for pain free typing. The wrists are straight and both hands are used equally. The figure on the right shows less of an awkward position and a distribution of stress onto more joints alleviating stress to individual joints.

Along the same line as ergonomics, simple things like using less pressure on the mouse or keyboard or switching between tools is important. If possible talk to others about performing the task in different ways. Accomplishing typing by using a keyboard, mouse, and voice recognition rather than just one modality would diversify the muscles and tendons used in the tasks. Repetitiveness would be drastically decreased.

Assistive Technology

Ease of access features on the computer is a great start to help in reducing the propensity of RSI’s. The on screen keyboard function provides another way to input type into the computer. Voice recorder will allow one to take notes by dictation and enter them in at a later date in a slow and convenient matter. The magnifier will also help people see text so they don’t have to hunch over and strain to read fine print.

Splinting is another form of assistive technology. The purpose of the splints is to maintain a sustainable position for the joint that is splinted. The splint will prevent undesired movement and serve as a reminder for the user to be mindful of their body and to change their actions accordingly. In the example of the wrist, the splint would prevent sustained awkward positioning while providing support for strained muscles and ligaments due to the injury. Some splints similar to the one below stretch the tendons to decompress the median nerve in the wrist for the case of carpal tunnel syndrome.

Ergonomic devices such as keyboards and mice provide a more comfortable using experience. Natural hand positions were studied and assistive devices were made to emulate those positions. These devices are less likely to be seen with overuse injuries.

A tablet PC and digital pen is another alternative device to use for work related repetitive stress injuries. The goal of treatment and prevention for this is variety, therefore the more assistive devices one can switch between; the less likely a RSI will occur. Writing with a pen creates different forces on the joints of the hand compared to typing. The user would write on this tablet with the digital pen and the words would be converted to type on the computer.

Dictation or voice recognition software is a great tool to use as another alternative. The user speaks into a microphone and the text appears on the screen. The only limitation to this software is that training must be done to have the program recognize the user’s speech.

See Also

  • Cumulative Trauma Disorders
  • Repetitive motion disorders
  • Overuse Syndromes