The Postural Dialogues
Chapter 3: Repetitive Strain Injuries
Chris Wood, R.M.T., B.A., B.Ed., D.S.W.
I was at a family barbeque a couple of weekends ago when I heard a very familiar question, “Uncle Chris, my shoulder hurts. Can you fix it?”
This question was quickly followed by my 23 year old nephew asking, “Do you think that this could this be the start of a Repetitive Strain Injury?”
I must admit that I was pleasantly surprised that at his age he was concerned about his long term physical health and though he didn’t realize it, improving his posture. This was more surprising since unlike his brothers, physical fitness has never been high on his priority list.
Then I realized that my nephew had recently started a construction job.
My nephew, who has always been a bright and observant young man, had obviously been watching and listening to his co-workers and recognized one of the long term risks associated with his chosen occupation, Repetitive Strain Injuries.
Being the experienced uncle, I realized that for several reasons this was not the right time or place to talk to him about his injury and potential risk of other injuries.
The following is an email I sent him a few days later,
Sorry I couldn’t get into your questions about Repetitive Strain Injuries with you further last weekend. I thought that this email would be a great starting point to help answer your questions and concerns.
First off, let me fully explain what a Repetitive Strain Injury is so there is no confusion on your part. Then you will also have a better understanding of how to avoid it.
As an former instructor at my college (Fionna Rattray) taught, Repetitive Strain Injuries usually occur in the work place when we force our bodies to do the same (repetitive) movements over and over again. This can lead to poor posture, muscle imbalances, fatigue and damage. It is often the muscles, tendons, and nerves of the shoulders, neck, and arms that are affected. The symptoms often include pain, numbness, and weakness. As we try to compensate for the initial discomfort by changing our posture or muscles used, the pain will often migrate from one area to another. Things like inadequate rest breaks and emotional / psychological stress can make the condition worse.
Repetitive Stress Injuries can lead to chronic tissue fatigue and even impaired motor control.
Some of the conditions that fall under the Repetitive Strain Injury umbrella include,Tendonitis, Tenosynovitis, Trigger Points (knots in your muscles), Myalgia (muscle pain), and nerve entrapments such as Thoracic Outlet Syndrome, Pronator Teres Syndrome, and Carpal Tunnel Syndrome (you should know that the first two syndromes are often misdiagnosed as the last).
Don’t worry though, there are some things that you can do to help yourself. First off, you need to exercise and establish a program of stretches and strength building exercises that first improves and then maintains your proper posture. Decreasing both the muscle tension and hypermobility in your joints is also important. My suggestion would be to try Yoga and / or Tai Chi.
Of course you also need to have good nutrition. No buddy, your Mom and your girlfriend did not make me say this. It’s true, when we consume the proper nutrients on a daily basis we not only fuel our bodies properly but we assist in its maintenance and constant repairs.
When you are on the job site it is important to look at how all the tasks are performed and how your body feels. Are you using some muscles more often than others (especially the muscle(s) that relaxes when that one contracts). One important muscle to watch is the pecs or pectoral muscles of the chest. If the pecs get too strong and the muscles in the back are allowed to be stretched and weakened then the pecs will begin to pull the arm out of the shoulder joint. At first this will just cause rounded shoulders which just look bad, but in time as the condition worsens the arm will impinge or press against the muscles and nerves around the shoulder joint. This muscle imbalance can decrease the range of motion in your shoulder and be quite painful.
You should also watch to see if some body parts are being kept in uncomfortable positions. An example of this would be when you are sitting at a computer desk with your shoulders raised to type or use the mouse. It is also important that your feet are planted firmly on the floor or a stool.
When on the worksite are you being asked to perform the same task repeatedly, often at high speeds or rapid movement, with little or no movement of your neck and shoulders? This too can lead to problems over time.
My next suggestion would be to not only watch your posture and how your muscles are used when you are fresh, but to do it when you are tired after doing the job for several hours. It is amazing how our posture changes and we use different muscles when extremely tired. This is where it is important to take adequate breaks and to keep yourself well hydrated. Do drink lots of water and electrolytes (as found in many sports drinks).
The other thing to consider is the work environment and your personal happiness with the job. If you are unhappy or not satisfied with parts of the job or the work environment; be it a coworker, a boss, company policies, or how things are organized and run, job stress can occur. This stress can quickly worsen your problems. As I have always said, being passionate about your job and enjoying the work environment is very important.
So that is my spiel about Repetitive Strain Injuries and how to avoid them. As I told you at the barbeque, drop by my clinic and I will treat you and help get your shoulder injury on the road to recovery.
Your Uncle Chris
Please note that the story you have just read is fictional and not based on one specific person. The email conversation is also fictional and has been created to explain the importance of proper posture. Please read the future segments of this series to learn more about posture and the various conditions that occur as a result of improper or poor posture and what you can do to improve yourself.
For other installments of the Postural Dialogues or articles on massage therapy please visit my website at www.chriswoodrmt.com.
Chris Wood, R.M.T., B.A., B.Ed., D.S.W.