Healthy Living

The term RSI is the abbreviation of 'Repetitive Strain Injury'. Literally, the term means 'physical condition due to repeated overload'. It is a collective term for various pain problems in the neck, shoulders, arms, wrists and hands (and exceptional of the legs) due to chronic overload. Only pain due to overload due to repeated movements and/or static postures is called RSI. Overload caused by a 'one-off' high load is not caught under the term RSI.
The pain is only called RSI if it is more or less chronic. This means that the complaints persist for a longer period of time (often three months as a lower limit is maintained).

It is not necessary that the pain is continuously present. Pain that occurs after several weeks of hard work and leaves after several days of rest is referred to as 'RSI-related complaints'. Another term for RSI is Work related MusculoSkeletal Disorder (disorders of muscles and skeleton caused by work). RSI is indeed usually linked to the work, but can also be caused by a regularly exercised hobby.

Complaints

RSI is a collective name for muscle, nerve and tendon disorders from neck to fingertips and caused by the prolonged burden on the same muscles. Symptoms such as pain, fatigue and stimulation of the neck, shoulder or arm are also included. Overall, 3 phases can be distinguished in the disease picture of RSI.

Phase 1: less severe At this stage there is pain and fatigue on the fingers, hands, wrists, arms, shoulders or neck during work or after a long period of work. The symptoms are local and can be accompanied by cramp or feeling dull. They'll get less quickly if you stop working. In your spare time or at night, it doesn't bother you. So there is a clear relationship between the work and the pain, but usually you can continue to perform your duties normally. In the case of inrecognition of symptoms and intervention on time, the symptoms can decrease or disappear entirely.

Phase 2: serious In the second phase, the complaints continue to last even after working time and may even disturb the night's sleep. There is no clear relationship with certain work. The pain occurs in all kinds of tasks. Normal tasks can no longer always be performed without pain. The complaints extend to tingling, irritations and loss of strength. The pain radiates to other parts of the body.

Phase 3: very serious At this stage, the pain is always present, even at rest if you are not working. There are sometimes swellings in the arms or changes in the skin tone occur. Sore spots can feel cold. There is a paralyzed feeling with clear tingling. At this stage you can no longer even do light work. It is also no longer possible to do ordinary chores in the house.

In about ten percent of cases, a doctor can make a specific diagnosis, such as carpal tunnel syndrome, a tennis elbow or corrugated arm, a mucus purse inflammation to shoulder or elbow... But usually no specific injury can be determined.

How does RSI occur?

Many people think that only screen workers can get RSI. In this context, people also speak of a 'mouse arm'. But it also occurs in other professions. For example in construction, the textile sector, at cleaners, cash register staff, musicians, DJs, painters, assembly band workers, butchers... The common characteristic of the risk groups is the regular work in which the same hand/arm movement is often made and often works in the same unfavourable attitude.

• Disorders in the neck and shoulder area in particular that are less easily localized are mainly caused by prolonged static work postures with little interruption (e.g. long-term work on a microscope or long-term display work). The effect of a prolonged static load of neck and shoulders consists of a direct effect due to local overload, but also complaints can occur in arm and hand because the blood flow of the arm decreases.
• Complaints that are mainly caused by frequent movement, dynamic actions, are often more lokalisable. These kinds of repetitive movements result in a high dynamic load of the body. Due to the repeated movement, friction can occur between muscles, tendons and bones. Especially with greater exercise, extreme positions of joints and a high frequency of movement, the risk of complaints is greater. RSI is due to being out of balance of the load (e.g. work) and the taxability (the quantity a person can handle). RSI is created by a combination of factors.
Known risk factors for rsi on the onset are:
• work organisation: large workload, few breaks, overtime, stress
• workplace: always the same (wrong) working attitude, exercise of too much force
• individual: no relaxed working method, certain physical characteristics such as poor condition

In addition to the design of the workplace and the proper use of this workplace, factors such as the nature of work, behaviour and mental stress (work stress) also play an important role in the onset of RSI. The chance of rsi on the origin of RSI is therefore expressed on the basis of the 5 x W model: Work tasks, Working hours, workload, workplace and Working attitude. The first 3 factors can be brought together under the term work organisation.

Treatment

There is no specific treatment for RSI. If you suspect that your pain symptoms may be RSI, you should contact your gp and/or company doctor as soon as possible. The sooner the complaints are addressed, the more likely they are to disappear completely eventually. Unless specific physical abnormalities are discovered (e.g. carpal tunnel syndrome), the treatment will have to address the various risk factors. For the patient are important points of attention:

• avoid stress and excessive workload
• healthy eating
• regular relaxation
• A good working attitude is essential,
• specific exercises whether or not under the guidance of therapist
• posture therapy
• fitness training
• any medication prescribed by the doctor

• workplace adjustments
• adapted furniture
• adjustments to work organisation

Because there are always multiple factors involved, full rest is not recommended. However, the painful muscle groups must be temporarily spared. The usefulness of specific physiotherapy techniques (such as Human Dieck or Cesar therapy, connective tissue massage, haptotherapy...) and alternative medicine such as acupuncture, ayurveda or Chinese medicine do not exist enough scientific data.

Tips for working on a screen

1. Viewing distance and font size: Place the display at the recommended viewing distance. Depending on font size, adjustments may be required.
   Display size: Distance to display
   14 inches:    50 - 70 cm
   15 inches:    55 - 75 cm
   17 inches:    60 - 85 cm
   19 inches:    70 - 95 cm
   21 inches:    75 - 105 cm
2. Display placement: Place the display right in front of you. This way you avoid looking aside for a long time.
3. Use laptop/notebook: Do not use a laptop/notebook for more than two hours a day. If you have to work longer regularly, connect your laptop to a docking station or a separate display, mouse and keyboard.
4. Setting armrests: Set your armrests so that your elbows are properly supported sit upright and bend your forearms at a 90-degree angle relative to the upper arms. Make sure you don't sink, or your shoulders are pushed up by the armrests.
5. Height-setting chair: Set your seat to the same extent that the top of the armrest is equal to the top of your desktop.
   It is good to regularly rest your arms on the desk and/or armrests to relax the muscles in the neck-shoulder region. Keep your hands during typing and mice in such a way that the axis of the forearm in the longitudinal direction extends into the middle finger. Never rely on the worktop or wrist rest alone or primarily during typing or mice because the weight of the entire arm is concentrated on the fragile wrist area.
6. Thickness desktop: The legs may not be stuck under the worktop at right-set seat height. A good worktop is no thicker than 5 cm.
7. Document holder: Use a document holder if you regularly type documents. Place the document holder between keyboard and display if you don't type blindly.
8. Footrest: If your feet are not adequately supported, use a footrest. The knees must form a corner of approx. 90°
9. Headset: Use good microphone headphones when you need to do screen work while on the phone call.
10. Mouse/keyboard: The ergonomic responsible thickness of a keyboard or mouse is up to 4 cm. The thicker the mouse, the more the hand bends back.
11. Cables keyboard/ mouse: Keyboard/mouse cables must allow an easy placement on the desk. Avoid reaching far to keyboard or mouse. These must be directly at your fingertips when your arms rest on your desktop at a 90-degree angle.
    Hold the mouse in the hand in the extended forearm, do not bend the wrist back or to the left or right. For small mouse movements, the forearm must be supported by the tabletop or by an armrest. Make larger movement with the mouse from the elbow and not from the wrist. Leave the side of the palm resting on the mouse pad. An ergonomic mouse ensures the most natural position of wrist and hand. Place the mouse in the hand and let the fingers rest relaxed on the mouse buttons. Ideal is a wireless mouse that can control you at both hands.
12. Faltering mouse: Clean the rolling mechanism when the mouse falters.
13. Reflections: Use blinds when you suffer from reflections through incoming light from outside. Tilt your display or move it onto your desk when the mirrors are caused by the lighting.
14. Variation of posture: When you sit at the desk all day, the variation in posture is limited. Change attitudes regularly by e.g. make a phone call or consult with a colleague.
15. Reading glasses: The reading section of your varifocus glasses or a small reading glasses is less suitable for display work. You may need special (computer) glasses so that you can look closely on the screen without bending your head back.

Exercises to prevent RSI.

Research shows that it is important to regularly hold short breaks in order to prevent RSI. It is important to relax the overloaded body parts by doing exercises or by performing other activities. That turns out to yield more than passive pause. Multiple short breaks are more effective than one long break.

A good starting position for these exercises is the following:

• sit or stand with a straight back.
• keep your head straight, crown points to the ceiling.
• the shoulders are low.
  Exhale deep in and out a few times and focus your attention on the neck and shoulder area. Keep breathing well during the exercises.
• Raise your arms and make yourself as long as possible.
• Shoulders low. Think of a clock with your shoulder joint. Make circles with both shoulders. First 10 circles forward, then 10 circles backwards. Do it attentively and slowly.
• Arms hang loose along the hull. When breathing, you raise the right shoulder, while you exhale, the right ear goes to the right shoulder.
  Breathing: head upright again. Exhale right shoulder back down.
  Then repeat this exercise 2x right, then 3x left.
• Place your hands around the neck/neck. Make small circles with the head. Make the circles smaller until your head is in the middle. Shake hands and arms loose.
• Bring the shoulders to the ears and let go at once when exhaling.
• Place your hands on the shoulders. The fingers press powerfully on the muscles. Move the elbows up and down so that the fingertips always change places. In this way massage the muscles at the top of the back Hands remove, shake arms in starting position.
• Turn your hands around from the wrists (clockwise and clockwise).
• Spread and close the fingers a number of times.
• Shake the arms and let the hands and fingers go along in the movement.