Table of Contents
- What are repetitive stress injuries?
- Symptoms of RSIs
- Proper Posture to Avoid RSIs
- Exercises for Preventing RSIs and Relieving Pain
- What to Do if You Think You’re Developing an RSI
What are repetitive stress injuries?
Repetitive stress injuries (RSIs), also referred to as repetitive motion injuries or repetitive strain injuries, are one of the fastest growing occupational injuries, according to the Occupational Safety & Health Administration (OSHA). In fact, roughly one-third of all days-away-from-work cases involve some type of musculoskeletal injury, such as an RSI, the Bureau of Labor Statistics (BLS) reports. Any job that requires you sit or stand in the same position for long periods of time or repeatedly perform the same manual tasks puts you at risk for developing an RSI.
RSIs often develop gradually, so many workers don’t seek diagnosis or treatment until the condition has already taken root. Left untreated, these types of conditions can become extremely painful and debilitating and inhibit workers’ ability to perform even routine tasks like brushing their hair, much less their job duties.
Common Types of RSIs
When people think of RSIs, they tend to think of carpal tunnel syndrome (CTS). And while CTS is definitely one of the most common types of RSIs, it is far from the only. There are actually over 100 types of RSIs that people can develop affecting different parts and structures of the body. Some of the other common types of RSIs workers develop include the following.
- Raynaud’s disease
- Trigger finger
- Dystonia, aka writer’s cramp
- Nerve entrapment disorders
- Radial tunnel syndrome
- Impingement syndrome
- Ulnar tunnel syndrome
- Thoracic outlet syndrome
- Rotator cuff injuries
- Blackberry thumb (DeQuervain’s syndrome)
- Knee injuries that affect the ACL or MCL
- Epicondylitis, aka tennis elbow
Causes and Contributing Factors
There are a lot of factors that contribute to the development of an RSI. When workers have to perform a job task that mismatched for their physical body, it can cause excess strain and wear and tear on the muscles and tendons of that area. For example, if you work on an assembly line and have to constantly stretch or lean across the conveyor belt, it could affect the muscles in your back, arms, and neck. Your body is not meant to overstretch in an awkward position for hours on end. It’ll create micro damage to your body’s structures that, over time, can lead to conditions such as an RSI.
In addition to overusing a muscle and performing repetitive tasks, other factors that contribute to RSIs include the following.
- Using vibrating equipment
- Adopting an awkward posture
- Holding a static posture for excessive durations
- Performing forceful movements
- Working at a repetitive task
- Using equipment that’s poorly designed
- Working in an environment that’s poorly organized or not ergonomically sound
- Failing to take adequate breaks to allow the muscles to rest
- Heavy lifting or lifting items that are awkwardly shaped or have a disproportionate weight distribution
Furthermore, work environments that place a high precedence on speeding up production can increase the risk of RSIs for workers. For example, the increased demand for poultry has led to a 50 percent increase in production line speeds and increased automation over the last few decades. Employees’ job tasks are limited and repetitive. To keep up with production demands, poultry plant managers often conduct electronic surveillance on the line to ensure employees are working at a breakneck pace and, in one plant in Mississippi, workers were limited to three bathroom breaks a week, according to OHSA. Pushing employees to perform repetitive tasks at a faster rate without adequate breaks is a sure recipe for injury.
Workers at Risk for RSIs
While office workers and those who regularly use a computer such as writers and graphic artists are at risk for developing RSIs, they are definitely not the only ones who are susceptible. Some of the other types of employees who often sustain RSIs include the following.
- Construction workers
- Manufacturing and assembly line workers
- Loaders, movers, stock handlers, general transport
- Truck drivers and bus drivers
- Healthcare workers
- Farm, dairy, and field workers
- Restaurant workers
- Mail carriers
- Cleaning industry workers
- Butchers and meat packagers
- Telephone operators
- Seamstresses, tailors, sewing machine operators
Symptoms of RSIs
The symptoms depend upon the exact type of RSI and how severe the case it is. Most cases of RSIs include some or all of the following.
- Pain and tenderness
- An achy sensation or throbbing
- Numbness, tingling, pins and needles
- Soreness or burning sensation
- Weakness or lack of muscular endurance
- Clumsiness and loss of coordination
The symptoms usually appear gradually. You might first notice them only when you’re performing the repetitive job task. They might subside after you’ve rested a bit. A lot of patients report that the numbness or cramping wakes them in the night. If left untreated, the affected area could become inflamed and swollen, and the symptoms will worsen and become constant. Additionally, many patients begin to experience anxiety and depression because of their physical symptoms.
Proper Posture to Avoid RSIs
Keeping proper posture is paramount to minimizing stress on your body and the risk of developing an RSI. This is true of with any job, but it’s particularly important for people who work at a desk job all day, typing. If you have to sit for long periods of time at work, do a quick check to see if you’re using good posture.
- Make sure your back is supported, particularly in the lumbar area. Your chair should allow your back to keep its natural S-curvature. Adjust it if necessary so your back muscles don’t have to work as hard.
- Adjust the height of your chair so that your upper arm is vertical, you have a natural 90-degree bend at your elbow, and your forearms are horizontal.
- Make sure your feet are supported, ideally with your feet flat on the floor. If need be, use a foot rest.
Optimizing Your Workstation
You’ll also need to ensure your workstation is ergonomically sound. Ergonomist Trevor Shaw recommends setting up your desk areas as follows to avoid unnecessary strain and injury risk.
- Adjust your keyboard so that the keyboard is approximately four to six inches from the front edge of your desk.
- As you’re typing, make sure your wrists are straight. If you find that it’s too difficult, use a wrist rest.
- Position your mouse near your keyboard so that you don’t have to outstretch your arm to reach it. This could cause strain in the arm, cause the shoulder to twist, and put extra strain on the upper back.
- Adjust the height of your screen so that it’s roughly the same height as your eyes. If it’s too high or too low, it will cause you to tilt your head backwards or downwards, placing too much stress on the neck.
Other ways to Prevent RSIs in the Workplace
In addition to using good posture, there are several other things you can do to reduce your risks of developing and RSI or re-injuring yourself.
- Take micro breaks often. Move around, stretch, and give your muscles a short respite from the task at hand.
- Use an appropriate tool for the job. For example, if you’re in the cleaning industry, use mops and brooms with handles that are long enough; using too short of a handle will cause you to hunch and lean.
- If you have to stand for long periods of time, make sure you’re standing on rubber mats and try to change your position and weight distribution often.
- Use proper lifting techniques, i.e., reduce the weight and load of the box if possible, squat to pick up, keep the load close to your body, and avoid jerky movements.
- Use a comfortably loose grip on any tools you use. The same applies if you’re a truck driver; keep a relatively loose grip on the wheel to prevent overstraining your hand, wrist, and forearm muscles.
- Use dollies, carts, or hand trucks when possible.
- Change tasks often if possible.
- “Be aware of your own level of fitness… But strength and fitness cannot protect your spine from the cumulative traumas of lifting and other risk factors,” recommends the National Education Association.
- If you have to work in cold weather, perform warm-up exercises prior to beginning your shift to reduce muscle strain.
“While in some cases redesigning the workplace is the best way to prevent RSIs, often many simple and inexpensive remedies will eliminate a significant portion of the problem. For instance, providing knives with curved handles to poultry workers so they won’t have to unnaturally bend their wrists; taking more frequent short breaks to rest muscles; providing lifting equipment so nursing home workers won’t strain their backs lifting patients by themselves; or varying tasks to break up the routine of activities,” explains OHSA.
Exercises to Prevent RSIs & Reduce Pain
You will want to speak to your doctor and/or physical therapist about the types of stretches and exercises you should be doing if you have an RSI. Different types of exercises are appropriate for different types of RSIs.
- Wrist twist – For example, if you have tennis elbow, you can try pronator/supinator strengthening exercises. These are the muscles that twist the wrist. Hold a light weight in your hand with your thumb pointing upward. Turn your wrist inward all the way, then outward all the way. Hold each position for a couple of seconds and repeat. You can also try massaging the area for a few minutes and applying pressure using a couple of fingers on the affected elbow.
- Wall sit – If you have strain in your arms, hands, or shoulders, try the wall sit. Stand facing a wall. Extend your arm along the wall, keeping it parallel to ground. Keep your hand on the wall, and turn your torso slightly away from it, opening up your chest. Stretch your fingers as far out as possible. Hold for up to a minute, and repeat on the other side.
- Wrist stretch – Stretch the flexors, the muscles that flex the wrist by straightening out your arm with your palm up. With your other hand, push your palm downwards. You’ll feel a good stretch along your wrist. Hold for a couple of seconds and repeat.
Some patients report that general stretching, massage, and yoga help their symptoms, too. However, because some exercises might aggravate an RSI and because appropriate exercises are very injury-specific, it’s important to talk with your doctor or physical therapist before beginning any exercise or stretching program.
What to Do if You Think You’re Developing an RSI
If you suspect that you’re developing an RSI and it’s starting to impede your ability to work at full capacity, you do not want to put off getting it checked out. As aforementioned, delaying treatment will only make matters worse and it could wind up causing irreparable damage.
The first thing you’ll need to do is tell your employer. OHSA requires that employers identify and correct hazards such as those that lead to RSIs. Your employer cannot try to change and fix the job conditions if it isn’t aware of your injuries or that your job duties are causing a problem. So be open with your employer and tell your supervisor or HR manager about your symptoms. If your condition is work-related, it may be compensable under workers’ compensation laws. But, you’ll need to inform your employer and file a workers’ compensation claim in a timely manner so that all of your doctor’s appointments and treatments will be covered.
Choosing a Doctor for Treatment
Unlike other states that mandate workers use a company doctor for work-related injuries and conditions, Washington statutes afford workers the right to use a doctor of the their choice for their work injuries. However, when you go to the doctor, tell him/her about your work tasks that likely contributed to the injury so that he/she will document the work-related nature of your condition.
The University of Michigan cautions: “Unfortunately, finding a doctor who is competent to diagnose and treat RSI can be a challenge. Some doctors doubt the existence of RSI, and many others dismiss it as an insignificant problem. Some doctors don’t know the first thing about treatment, while others encourage their patients to undergo unnecessary (and possibly dangerous) surgery in hope of a quick fix. With that in mind, know that you must be careful and selective when choosing a physician.”
Diagnosis for RSIs can be tricky because there are no specific testing methods for these types of soft tissue injuries. Muscle strain and pain don’t show up on an MRI or CT scan. Rather, doctors have to use the patient’s symptoms, medical history, examination, and observation. The doctor might have you stop the repetitive task for a period of time, and if your symptoms lessen or dissipate, it’ll be a good indicator that you have an RSI.
Treatment for RSIs usually involves ice compresses, splinting, anti-inflammatory drugs, pain medication, steroid injection, and/or good old-fashioned rest. When the injury is work-related, you also might need an occupational therapy program to speed your recovery.
Workers’ Compensation Benefits for RSIs
When workers develop health or medical conditions as a result of their work duties, they are entitled to several types of workers’ compensation benefits.
- Medical benefits – All of your diagnostic tests, treatments, medical aides, surgeries, follow-ups, physical therapy, rehabilitation, and prescriptions related to your RSI will be covered under workers’ compensation insurance. So long as the condition is work-related, and your treatment is reasonable and necessary, it should be covered.
- Travel reimbursement – If you have to travel more than 15 miles to obtain treatment, you’ll also likely qualify for travel reimbursement. At the date of this writing, the travel reimbursement rate is $0.575 per mile.
- Income replacement – If you have to miss work because of your injury, if you have to take a lesser paying job, or become partially disabled because of it, you’ll also qualify for income replacement benefits. This is called time-loss compensation. Your benefit amount doesn’t totally replace your income, though. Typically, your check will amount to 60 to 75 percent of your pre-injury wages, depending on how many dependents you have.
- Vocational counseling – You might also be able to work with a vocational counselor if need be. A vocational counselor can help you and your employer try to modify your current role to accommodate your condition. If that’s not possible, the counselor can assess your ability to work and help you develop a rehabilitation plan.
Challenges to RSI Workers’ Compensation Claims
Many employees run into problems with their workers’ compensation benefits when they file a claim because of RSIs. First, like many soft tissue injuries, some types of RSIs are difficult to medically substantiate and doctors rely on patients’ reports of injury and symptoms for diagnosis. You can’t, for instance, prove tendon pain in your knee using an X-ray. If your injury doesn’t require surgery, it can be hard to prove you’re really hurt because there’s no fool-proof RSI lab test you can provide. With enough medical evidence, legal counsel, and tenacity, it can be done though.
Another problem that arises is with demonstrating the cause of your condition. In order to qualify for workers’ compensation benefits, your condition must be related to your job. Because multiple factors can contribute to the development of an RSI, employers often refute workers’ claims using the justification that the worker’s injuries are not work-related in nature. It will be up to the employee to prove that there is a link between her job duties and her condition.
Yet another factor that complicates claims is procrastination. Workers often wait too long to report their injuries. With RSIs, many workers try to shake off the symptoms, hoping they’ll just go away and that the pain will subside. But be warned that you may not qualify for benefits if you wait too long to report an injury and file your claim. This is why it’s essential to tell your employer about your symptoms and get checked out by the doctor as soon as you start noticing that something is wrong. This way, you can get the treatment you need and the benefits to cover your expenses.
Get Professional Legal Help to Secure Your Benefits
If you developed a repetitive stress injury or other condition related to your job, you should qualify for benefits. But as noted above, it’s not always that easy or straightforward. Many workers benefit from hiring an attorney to help them navigate the workers’ compensation claims process and handle any obstacles that arise along the way, like challenges to the severity of the injury or whether it is work-related. An attorney can make sure you have enough evidence to prove your claim and secure the benefits you need.