R.S.I. Page
Touch my hand . . .
Computer Related Repetitive
Strain Injury
Copyright &
Paul Marxhausen. THIS DOCUMENT IS
NOT AN OFFICIAL PUBLICATION OF THE UNIVERSITY
OF NEBRASKA-LINCOLN.
"We pray with our hands and often communicate with them.
We use them to
eat, work, and make love.
We employ them as marvelously sophisticated
instruments of flexibility and strength, and when they are damaged, we
- Keith L. Moore, Clinically Oriented Anatomy
As more and more work, education and recreation involves computers, everyone
needs to be aware of the hazard of
Repetitive Strain
Injury to the hands and arms resulting from the use of
computer keyboards and mice.
This can be a serious and very painful condition that is far easier to
prevent than to cure once contracted, and can occur even in young
physically fit individuals.
It is not uncommon for people to have to
leave computer-dependent careers as a result, or even to be
disabled and unable to perform tasks such as driving or dressing
themselves.
I've faced this problem myself since March of 1994, and
many friends are also affected to varying degrees. I am
not a health care professional, but I hope on this page to provide
a very brief introduction to RSI for the benefit of
students who may not
be aware of the potential for a life-altering injury. It includes
book references and links
to Internet resources that have been helpful in educating me about
this. Don't hesitate to get in touch by e-mail, but because I have to
limit my own computer use, please
take the time to consult the entire page and the listed materials at length
DEAD LINK ALERT: This site is overdue for "weeding" expired links to external sites. I apologize for the inconvenience while this is in process.
characteristic RSIs
that can result from the typical tasks they perform.
The rise of computer use
and flat, light-touch keyboards that permit high speed typing have resulted
in an epidemic of injuries of the hands, arms, and shoulders.
Use of pointing
devices like mice and trackballs are as much a cause, if not more so.
The thousands of repeated keystrokes and long periods of clutching and
dragging with mice slowly accumulates damage to the body :
another name
for the condition is
This can happen
even more quickly as a result of typing technique and body positions that
place unnecessary stress on the tendons and nerves in the hand, wrist,
arms, and even the shoulders and neck.
Lack of adequate rest and breaks
and using excessive force almost guarantee trouble.
You may have
heard the term
in connection with these injuries, but in
fact CTS is only a small and dangerous percentage of typing injuries.
and several other
related conditions may also be involved.
All of these are serious and in
advanced cases can cause great pain and permanent disability. In addition,
patients injured by repetitive strain sometimes develop
Reflex Sympathetic Dystrophy (RSD), discussed
shows proper posture at the computer.
suggests that
a monitor position lower and farther away may be better. In
addition, there are about what is
the "correct" position.
) Note that the chair
and keyboard are set so that
the thighs and forearms are level (or sloping slightly down away
from the body), and that
the wrists
are straight and level - not bent far down or way back.
If the table is too high to permit this, you may do better to put the
keyboard in your lap.
Also note that the typist is sitting straight,
not slouching, and does not have to stretch forward to reach the keys
or read the screen.
Anything that creates
awkward reaches or angles in the body will create problems.
Please note
that even a "perfect" posture may result in problems if it is held
rigidly for long periods of time: relax, MOVE
and shift positions frequently.
This isn't just about your hands and arms, either: the use or misuse of your shoulders,
back and neck may be even more important than what's happening down at your
More specifics:
While you are actually typing your wrists
should not rest on
and should not be bent up, down, or to the side.
arms should move
your hands around instead of resting your wrists and stretching to hit
keys with the fingers.
(palm rests give you a place to rest your hands
only when pausing from
you are typing.)
When you stop
typing for a while, rest your hands in your lap and/or on their sides instead
of leaving them on the keyboard.
Wrists also should not be bent to the side,
:Wrong . . . .
instead your fingers should be in a straight line
with your forearm
as viewed from above.
Research suggests that all of the above is easier to do if you
tilt the back edge of your keyboard down, away from you.
Put a prop an
inch or two thick under the edge of the keyboard closest to you, but
make sure the whole thing is still low enough so you aren't reaching
This is a good argument for getting an adjustable keyboard tray that
permits optimal positioning.
INCREASE YOUR FONT SIZES.
ever-larger monitors, many people favor tiny little fonts in their desktops and
applications.
This encourages one to hunch forward into the monitor to read
things, putting pressure on nerves and blood vessels in the neck and shoulders.
Microsoft Windows and Macintosh desktops and applications can easily
be configured to use larger, easier-to-read fonts.
Also consider
using color schemes that are easier on the eyes, particularly shades of
gray for text documents.
(If you are using XWindows on Unix or Linux,
make the fonts in your xterm windows bigger by hitting Control and the right
mouse button over the window for a menu of font sizes.)
DON'T POUND on the keys: use a light touch.
Use two hands to perform double-key operations like
Ctrl-C or Alt-F,
instead of twisting one hand to do it.
Move your whole hand
to hit function keys with your strong finger instead of stretching to
reach them.
For additional excellent instruction on healthier typing technique
& the New Zealand
(Don't do these at the speed displayed. Easy does it.)
Notice that
several stretches involve the
neck & shoulders, which have more
involvement with typing injuries than you might imagine.
From the same
source, here's some still pictures of exercises/stretches to do.
Another good source of stretches is the innovative Web site.
See videos of
stretches at the
or download a
who have an
of stretches for computer/desk workers.
There are now
available that can remind you
to take breaks and show you stretches.
Text files discussing stretches are
. Finally,
check out the great animated exercises on the
Hold the mouse lightly,
don't grip it hard or squeeze it.
Place the pointing device
where you don't have to reach up or ove close to the
keyboard is best. Better yet: learn and use
keyboard equivalent commands
(see lists
whenever possible, as no pointing device is risk-free.
Even trackballs
have injured users.
Here's some more shortcuts for
A comprehensive document on mouseless Windows use
, free from KnowWare Publishing.
With the latest versions of
Apple's OS X operating system, there are similar
that reduce mouse usage.
Here's a couple links that detail these sometimes less-well-known shortcuts: .
Keep your arms & hands warm.
Cold muscles & tendons are at much
greater risk for overuse injuries, and many offices are over-air-conditioned.
Eliminate unnecessary computer usage.
No amount of ergonomic
changes, fancy keyboards, or exercises are going to help if you are
simply typing more than your body can handle.
Don't try to be the fastest,
most powerful hacker around - the cost is too high.
Also: is there
recreational computer use you can reduce?
Can some of your electronic
mail messages be replaced by telephone calls or conversations in person?
And lose the computer/video games . . . which often involve long,
unbroken sessions of
tense keyboard or controller use. If
nothing else,
the game every 3 - 4 minutes. Don't sacrifice
your hands to a game!
Consider voice recognition.
Software that allows computer
control or full voice dictation has become powerful, easy to use, and affordable.
Some amount
of voice recognition is even being included in popular operating systems
and can be used to reduce your mouse/keyboard use at no cost. (Note: I recently tested the speech recognition built into
Windows 7 and was startled at how good it was both for control and dictation, even on a slower, older computer. - PMx)
However, it's also possible to seriously injure your voice
through overuse/misuse, so it's not the cure-all for RSI.
Since this technology continues to change rapidly, stop by
and their forum for more information.
A good article to check out is Guillaume Marceau's
Evaluate other activities. Problems may be caused or
aggravated by other things you do frequently. Sports, carrying children,
hobbies requiring intense small work (like knitting), and excess
effort/tension in
other daily things may have enormous impact too.
DON'T TUCK THE TELEPHONE BETWEEN YOUR SHOULDER AND EAR
so that you can
type and talk on the phone at the same time.
This common procedure is very aggravating
for your neck, shoulders, and arms.
TAKE CARE OF YOUR EYES.
Eyestrain is also a
related, widespread problem that should be addressed at the same time you are
setting up your computer for healthier use.
See these articles from
PAY ATTENTION TO YOUR BODY. Pain is your body yelling that
it's in big trouble, but learning what is comfortable or awkward for your
body before you're in pain may prevent injury.
"Physical re-education" through
, T'ai Chi, ,
stretching,
or dance classes all may be helpful.
KIDS ARE AT RISK TOO .. . with increasing hours in front of
the computer at home and school, using equipment that rarely is set up
correctly for people their size.
This examines the problem, as does this
To help kids learn to compute safely, see the
Also, read this
published by Cornell University.
The program
can be downloaded for free.
More tips ......on
preventative posture and correct technique are on the
maintained by
Dan Wallach & Scott Wright.
A great starting place for learning
healthy computing is, well . . .
When you find one,
listen to them and check with them
about any changes you intend to make or therapy you want to try.
about the Health
Center.) In order to be an educated patient,
take time to read the other resources
linked to on this page,
or the books below.
(Note: Dealing with RSI means wading through a lot of confusing medical
terminology.
Remember that "RSI" is a
mechanism of injury, not a diagnosis.
Where or how seriously you are injured, and how best to treat it, varies
immensely from person to person.
Also, many systemic disorders such as
diabetes can mimic or exacerbate RSI, and these can be ruled out by medical tests, so don't go
chasing a treatment you may have heard about UNTIL YOU'VE SEEN A DOCTOR.
No wrist splint, arm rest, split keyboard,
spinal adjustment, etc. is going to let you go right back to work at
full speed if you've been injured, and even carpal tunnel sufferers who
undergo the release surgery on their wrists can be back in pain and
trouble if they don't make the long term changes in technique and work
habits that hurt them in the first place.
from someone who's been there. Healing
can happen
but it may take months, even years.
That's why it's important that you . . .
DON'T GIVE UP!!!
Many RSI patients do regain
the ability to work and substantial
freedom from pain, although they may find that they remain
vulnerable to re-injury and flare-ups.
DON'T GIVE UP.
Recovery may take much longer
than you think you can bear.
DON'T GIVE UP.
Almost everything in your life may
turn upside down in the course of dealing with long-term recovery.
DON'T GIVE UP.
There are many, many resources listed on this page (see below), and if none of them
is a fast "magic fix", taken together they can give you the tools to hang in there.
Don't give up.
What about TMS? There has been a great deal of controversy and discussion about
the mind/body pain theories of Dr. John Sarno and others, who attribute some common and intractable problems like back pain and RSI to something they refer to as "Tension Myositis Syndrome" or TMS.
In brief, they posit that such chronic pains are real and have a physical cause: emotionally-mediated muscular tension causing oxygen starvation and pain in tissues. Consequently, it is claimed that counseling and psychological methods can bring relief to sufferers.
The author of this web
page himself found that understanding these concepts was an important part of recovery.
than expand this website to cover this huge topic, I suggest starting at the
where there are resources, links, and testimonials.
link after each listing, which will take you directly
to that particular catalogue item.
If you buy from
Amazon, they will handle all billing, shipping, etc. and inquiries should
be directed to them.
Some of these books & others are
also available from
By the way ... these books are pretty much listed in the order I became aware of them, not in order of quality or relevance.
Some of the ones I personally consider indispensible are way down the page.
Widely regarded as the primary reference
book on RSI is:
REPETITIVE STRAIN INJURY: A COMPUTER USER'S GUIDE
Dr. Emil Pascarelli & Deborah Quilter
(ISBN 0-471-59533-0)
If you use any kind of computer regularly,
check it out and read it, whether you are already injured or not.
Your career could depend on it.
repeat one more time: it's easier to prevent RSI than to remedy it later.
Deborah Quilter now has a
with info on RSI, her publications, and her presentations.
Dr. Pascarelli's Complete Guide to Repetitive Strain Injury : What You Need to Know About RSI and Carpal Tunnel Syndrome
by Dr. Emil Pascarelli
W June 11, 2004
Dr. Pascarelli has written a new book (2004) on RSI recovery. Here's some of what one reader said about it:
"This 4th of July weekend I took a look at Dr. Emil Pascarelli's
which was just published. . . .
He spends some of his time discussing issues that affect musicians which is
something that we have discussed on Sorehand.
He also has excellent points
on what RSI is not.
One thing that alarms me a lot as a victim of CTS is
that colleagues are think that they have this as well. Most people do not.
In fact most people in my support group have TOS and the Dr. has a good
discussion of this.
He does emphasize the whole conservative treatment philosophy and
section on biomechanics as well as one also on how to beat RSI.. One issue
that affects a lot of my co-workers that the Dr. also discusses is vision in
addition to ergonomics and dealing with pain.
The section on emotions is
not as extensive as the one that was in his earlier book with Deborah
Quilter on Repetitive Strain Injury in general. But I found the book really
helpful and others may wish to read it as well.
RSI Theory and Therapy
for Computer Professionals
Suparna Damany, MSPT and Jack Bellis
This book easily makes the
"must read" category: in fact, in my opinion it
makes it to the "if-you-only-get-one-book-on-RSI-
get-this-one" category, although I don't think
anything totally bumps Pascarelli and Quilter out of the
number one spot.
What I've said of P&Q, I say
of this book: every computer professional needs to
This book is a "second generation" work
on RSI, drawing on the literature,
experiences, and discussions of patients and health
care professionals who have been dealing with
computer-related injuries over the past decade.
Damany and Bellis have done an excellent job at distinguishing
secondary results that
and ultimate results in the painful
circle of cumulative trauma injuries.
Additionally,
the writing style is personable, direct, and engaging.
I think this up-to-date work really does cover it all.
Well illustrated, to the point, firm in recommendations,
it's hard for me to think of a better "starting point"
for any "newbie" with RSI symptoms.
Good info, material from the book, and a good quiz are found on .
Prevention And Treatment
The Repetitive Strain Injury of the Wrist and Hand
by Kate Montgomery
ISBN #1--7
It promises a lot, and some of the stuff is debateable . . . but it is chock
full of practical information that I've found helpful and effective in
my own situation.
This book appears to have been updated and released as
I've read this and it's still a useful resource.
Most recent editions, additional information
and articles can be found at the
Recommended by many on the 'Net is . . .
A Self-Care Program
Sharon Butler
Sharon Butler has been developing a system of gentle stretching to rehabilitate
repetitive strain injuries for years now.
This book, her first published resource,
emphasized an extensive collection of
stretches intended to heal tight and injured tissues.
multiple indices help you find the stretches for your pains and/or your
occupation. More info and ordering
Also, she discusses many stretches and the theory behind them
in an e-mail compilation
But in addition to this book, Sharon now has developed fully rounded programs to
address specific, common problems in a more detailed and focussed fashion, and these can be purchased and downloaded electronically
through her new website at .
The new material goes beyond simply presenting a collection of stretches to address issues
connected to RSI in a more wholistic way.
Here's somebody else's review:
"Just wanted to say that I have seen Sharon's new program for CTS and it is "just
what the doctor ordered" (we wish). If all doctors would prescribe these programs
instead of surgery, drugs, etc, then thousands of people would be getting over their
RSI problems pretty quickly.
Her book remains the best book on the subject, but these programs could be said to
supercede the book.
There is much new info, all presented
in the clear and carefully written style of her book. In effect, she has published a
stack of new books, each one written for a specific condition.
program of stretches she provides is meant to provide relief from the pain of RSI
(and should actually be all you need to put you back to where you were before the
condition began). But she does explain that if you want to address the issues that
enabled the condition to occur, you may need to go beyond the stretches in
program. She recommends looking into Alexander, Feldenkrais, Rolfing, or
Hellerwork. I would add yoga to that list.
I also thought that she maybe erred on the side of giving less info in general in the
book, even though it is loaded. She seems to want to be very careful not to confuse
people or overwhelm them with more information than they may want to read. I
think she has done an excellent job in the new programs of explaining RSI - what it
is, what causes it, how to solve it - and still presenting it so that anyone who really
reads it can understand.
Bob Anderson, Illustrated by Jean Anderson
ISBN 0-679-77084-4
Shelter Publications, Inc.
PO Box 279
Bolinas, CA 94924
Ph. 415-868-0280
$9.95 US $13.95 Canada
(Previously "Stretching At Your Computer or Desk")
This book quickly provides the
maximum useful information for computer and desk
workers, explaining work hazards, when to stretch, where to
stretch, the benefits of stretching, and how to stretch
the first eight pages.
Subsequent stretch routines are applications targeted to real-life situations:
"Stretches for Keyboard Operators", "Office Meeting Stretches", "Stressed
Out Stretches", etc. and are followed by an overview on avoiding repetitive
an explanation of good h in-depth instructions
and concludes with an excellent bibliography and
The unambiguous message is that stretching should be part
of one's day right where one is, not something requiring leotards, a gym
membership, and a chunk of one's vanishing spare time.
Shelter now also publishes a break program based on this book, which runs
on both Macintosh and PC platforms.
(Notably, it can successfully provide
breaks during CD games on the Macintosh, to help your kids learn safe computer
Carpal Tunnel Syndrome: How to Relieve & Prevent Wrist
"Burnout!"
Rosemarie Atencio
HWD Publishing, PO Box 220 XA,
Veneta, OR 97487. (503)935-1608 FAX (503)935- + $2.50 s/h;
the VHS tape (20 mins) is $2l.95 + $2.50
s/h or you can buy both & get a free 8 1/2 x 11 laminated poster for
$39.15 including s/h.
COMFORT AT YOUR COMPUTER :Body Awareness Training for Pain-Free Computer Use
Paul Linden
This book also comes highly recommended. The author says:
"The book is a user's manual for the human body. The book starts by helping
people understand and FEEL the structure of their own bodies and what
produces strain or comfort. It goes on to show how to work at computers --
and set up
workstations -- in ways that will minimize physical strain. The
book covers desktop workstations, laptop use, and standing workstations."
You can access more of Linden's
material on
Prentice Hall, 1995.
By Joan Stigliani
1st Edition June 1995
ISBN: 1-; 296 pages, $21.95 credit card orders
800-889-8969; Email
The author sez: "The book takes an integrated approach to computer-related health problems, and
covers RSI, eyestrain, stress, and radiation exposure (including electrical
sensitivity). It's not a straight ergonomics text, but explores the
body-mind-machine connections in computer work."
How your computer can hurt you - and what you can do about it
By Don Sellers
Peachpit Press (800-283-9444).
Peachpit Press sez:
From eyestrain to carpal tunnel syndrome, computer-related injuries are on the rise. This easy-access, well-illustrated guide explains a
variety of potential hazards and what you can do to reduce your risk. Includes chapters on backache, headache, tendinitis, radiation,
pregnancy, kids' concerns, and much more.
Randall Helm, P.T.
Like similar titles, this book addresses the whole picture of health and
fitness in connection with computer use.
Equipment set up, breaks,
fitness, nutrition, and more are covered.
Well illustrated.
The author
discusses and illustrates many good
REPETITIVE STRAIN INJURIES
The Complete Guide to Alternative Treatments and Prevention
by Timothy J. Jameson
This book provides information on RSI that includes
alternative treatments, in contrast to (or to complement, I should say)
Pascarelli/Quilter's standard-med emphasis.
The difficulty in treating
RSI has prompted a great deal of interest in alternative therapies.
I think the real strength of what Dr. Tim has written is his emphasis on
an interdisciplinary treatment approach.
In contrast to consulting a single practitioner
who may have limited perspective and treatment preferences,
Dr. Tim advocates for a team effort that *includes* standard medical
professionals but brings in other practices such as chiropractic, acupuncture,
massage, and others.
Also, I think the book gives a decent basic rundown on
the physiology of RSI, and includes good rehab information. While I
consider some of the therapies presented here to be very questionable,
at a minimum you will learn what each method claims to achieve
for you from a writer who is not trying to sell one of them over the other
but hopes to draw something from each.
THE REPETITIVE STRAIN INJURY SOURCEBOOK
by Sandra Peddie
The author says: "The book covers both personal and practical issues of RSI.
I've tried to give readers a comprehensive look at RSI, covering everything from the medical diagnosis to emotional repercussions to
getting benefits. Because I've struggled with RSI for many years myself, I've included dozens of interviews with sufferers, as well as an
account of my own experience with RSI. "
REPETITIVE STRAIN INJURY A Handbook on Prevention and Recovery
by David Ruegg
Of particular interest to UK residents, written by an RSI sufferer in
Britain and covering UK resources.
CRS - COMPUTER RELATED SYNDROME The Prevention & Treatment of Computer-Related Injuries
by Dr. Richard Dean Smith and Steven T. Garske
A Sorehand list reader says: "exercises are pretty good. no index. not as complete
as Pascerelli/Quilter, but a good complement. A friend
of mine is being treated by Dr. Smith and really
respects him."
A massage therapist writes: "The only way to
truly beat the chronic pain cycle is through good posture
and strengthening/stretching, and the authors do a good
job of providing effective, easy to perform exercises."
Chronic Musculoskeletal Injuries in the Workplace
by Don Ranney, Alan Ranney (Illustrator)
This is evidently a medical text for health care professionals
with 10 contributors, but it may be useful to injured people trying
to educate their doctors, or involved in establishing the validity
of a compensation claim.
LIGHT AT THE END OF THE CARPAL TUNNEL
A Guide to Understanding and
Relief from the Pain of Nerve Problems
by Dr. Scott M. Fried
Dr. Fried is
an orthopedic surgeon, and judging from his book he is sympathetic,
optimistic, committed to thorough and accurate diagnoses.
emphasizes the importance of educating the patient, making informed
decisions in partnership with the patient, and of not rushing to surgery
unless there is a well-established end in doing so.
This includes having
realistic expectations of the outcome should surgery prove advisable.
It is NOT a replacement for a comprehensive RSI book like Pascarelli &
Quilters Repetitive Strain Injury: A Computer User's Guide, but it is a
valuable perspective on nerve problems and surgery and anybody involved
with either (or both) should read this before agreeing to surgery.
Dr. Fried has evidently written a second book,
I have not read.
He also has a website for his medical practice on-line at
SITTING ON THE JOB
How to Survive the Stresses of Sitting Down to Work: a Practical
by Scott W. Donkin, D.C.
talks about body awareness, ergonomics at work (down to the last minute
detail, believe me), proper sleep habits, stress management, exercise, and all
kinds of stuff Sorehanders could benefit from, and it's a pretty elementary
read. I recommend it, especially for those of us who have pain upon sitting.
It is full of great advice and fascinating info."
Simple Solutions to Prevent
Repetitive Strain Injuries, from a Concert Pianist
by Howard Richman
This is an inexpensive and efficient little booklet that lays out
principles for healthy typing.
Getting healthy people educated
on sound prevention principles without burying them with the whole
spectrum of RSI information is important, and Mr. Richmond has developed
a nice resource that fills that bill.
which includes free health
tips and illustrations.
FULL CATASTROPHE LIVING
Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness
by Jon Kabat-Zinn, Ph.D
Delacorte Press, 1990 ISBN 0-385-29897-8
This work comes out of the program of the Stress Reduction Clinic at the
University of Massachusettes Medical Center, and centers around the
practice of "mindfulness meditation", using sitting meditation, yoga, the
body scan, and other techniques.
The reader may wonder what this really has to do
with RSI, but will find the
applications discussed in section 4
extremely relevant and useful to surviving the often grim challenges
of this disorder.
The author is
careful to explain exactly what he means, and
to ground it in clear, rational, practical applications.
It's not a short book, and not a quick fix.
But I found it fascinating
and accessible and very, very applicable to anyone with chronic pain.
MANAGING PAIN BEFORE IT MANAGES YOU
by Margaret A. Caudill, M.D.,PhD.
ANYBODY in chronic pain
would benefit from reading this book.
It cuts right to the point in how we handle chronic pain, is very
well organized, with a large format, all main points of each chapter
summarized at chapters' end, and many worksheets to use to help clarify
and identify important issues.
I'll tell you up front: the book does not shrink from hard truths,
and quickly identifies attitudes that are going to hinder or sabotage
our recovery.
methods of this book may help bring about reduced pain, it's about
dealing with pain that *isn't* going away, and may never do so completely.
RSI *can* get better and
freedom from pain and recovered functionality are not unrealistic
goals, BUT it can be a really, really long haul getting there, and
survival in the interim requires learning about the topics in this
This book does NOT examine all the specific medical therapies now being
used for people in chronic pain, so you will want to do additional reading
on the topic.
But the main points of this book are things that might get
overlooked if one only looks for somebody "out there" to "fix what's wrong
THE EGOSCUE METHOD OF HEALTH THROUGH MOTION
by Pete Egoscue, Roger Gittines
Harperperennial Library 1993 ISBN
PAIN FREE : A Revolutionary Method for Stopping Chronic Pain
by Pete Egoscue, Roger Gittines
In "The Egoscue Method", Pete Egoscue has a very accessible manual for identifying dysfunctional habits of
posture and motion that are the source of much musculoskeletal pain and
disability.
His book also lays out a series of exercises to correct these
Very readable, do-able, recommended by RSI recoverees.
clinic also has a
PAIN FREE in some ways simply revists the same material in THE EGOSCUE METHOD, and
includes many of the same "E-cises" recommended in the earlier book.
it organizes itself by body section, working from the feet up to the head, and
thus it's easier to get to the material that applies to your particular pain.
these areas are functionally related, as Egoscue continually points out, and the
same corrective postures and "E-cises" may apply to different pains.
authors presenting a personal approach to wellness, Egoscue is very optimistic about
his ability to remedy a but on the other hand, his methods
are very reasonable and rational and he explains physical problems and his proposed
remedies in careful detail, so I haven't got any quarrel with him.
There's nothing
"off-the-wall" here.
One reader of his books has commented: "I find the Egoscue exercises helpful and pain-relieving if done carefully, but
the arguments in the book contradictory. (For example, are the injuries
occupational, or aren't they?
Should you worry about equipment set ups, or
not? He's not clear.) A grain of salt is indicated.
Here's another caution -- the exercises ask you to activate your lower
back/hips -- but many of us are prone to over-extension in that area.
forgot about this and threw my back out doing his exercises.
Look at how
over-extended the lower backs are in the photos of the models.
So my advice
is proceed with the help of a physiologist or therapist who knows their stuff.
I'm not sure it's entirely safe to try at home, especially if your injuries
are complicated and old."
Have heard Egoscue has a new title: PAIN FREE AT YOUR PC.
I assume it covers
the same ground as the previous titles.
A SOREHAND reader comments on it:
'I got the "revolutionary method" one from the library, and had trouble figuring
out which were the right exercises for me, tho his arguments seemed convincing
and some of the exercises felt good.
Then I decided to try the new one, "...at your PC". It's relatively inexpensive
(about $12US). It has sets of exercises for those in pain, 3 levels of computer
users (power user=1-2 hours per day!) as prevention, Office Therapy for Power
Users, Breaking the pattern of pain - I'm not clear on when he recommends this.
I've been doing the Office Therapy ones - mostly because I can't make myself do
the home series which starts out at 1 hour, goes down to 30 minutes after you
reach a threshold with the "Supine Groin Stretch", which is just very awkward
for me to do, with a makeshift "step ladder".
However, I do think at least one of the stretches (arm circles) has helped
quite a bit with my Pronator Teres Syndrome.
when I first did it, 25 each way,
it immediately produced a flareup. I waited a few days, and then built up from
5 each way, and I can type longer without pain.
Long enough that I'm tempted
to do too much.
So, tho I haven't really followed all his instructions, I do think its helpful.
For what it's worth.
I feel it has moved my plateau a bit in the right
direction.'
Myotherapy : Bonnie Prudden's Complete Guide to Pain-Free Living
by Bonnie Prudden
Ballantine Books 1985
Exercise expert Bonnie Prudden presents her method of releasing the
muscular spasms, called "trigger points", that are believed to underlie
much chronic muscle pain.
She covers both the "quick fix", which is to
"release" the spasms with firm manual pressure, and the long-term fix,
which involves exercise and fitness to keep trigger points at bay.
RSI patients mention this kind of therapy as being helpful and it is becoming
a part of neuromuscular massage across the country. Prudden's institute also
CARPAL TUNNEL SYNDROME AND REPETITIVE STRESS INJURIES:
The Comprehensive Guide to Prevention, Treatment, & Recovery
by Tammy Crouch
North Atlantic Books. Berkeley, CA
I have only read the 1st edition, which was not too impressive, but
evidently it has undergone substantial expansion
and revision and sounds like a more comprehensive resource.
Bear this in
mind if you go looking for this in the library.
THE REPETITIVE STRAIN INJURY HANDBOOK:
An 8-Step Recovery and Prevention Plan
by Robert M. Simon, Ruth Aleskovsky
Owl Books.
Jack Bellis says: "As for coping, I got tho following book from my library, and it had the best
"coping" info I've seen among 6 books I've read, about 75 pgs from a female
sufferer, down to the most intimate details."
Relaxercise : The Easy New Way to Health and Fitness
by David Zemach-Bersin, Kaethe Zemach-Bersin, Mark Reese
Harper San Francisco 1990
"I am really getting some good help from a book my Feldenkrais practioner
recommended: "Relaxercise" by David Zemach-Bersin
The current thinking about my injury is that much of it is coming from the
neck and shoulders.
The exercise for relaxed shoulders has helped me
tremendously. I wish I could comment on the exercises, but the relaxed
shoulders exercise is the one I gravitate toward whenever I need help.
think I have gotten my money's worth." (quote: Judy L.)
Muscle Pain Relief in 90 Seconds: The Fold and Hold Method
by Dale L. Anderson
John Wiley & Sons ISBN:
This book is a self-help manual of a form of soft-tissue care
that is called strain-counterstrain or preferred position release.
I've seen this touted by a number of therapists and it seems
reasonable.
I haven't found it to be a "magic bullet" when I
get pain or cramping but it does seem to be a useful additional
tool for muscle pain control.
I'm thinking it probably relates to 'myotherapy' or 'trigger
points', addressed in other publications.
by Clair Davies, NCTMB
New Harbinger Publications, 2001
ISBN 1-; U.S. $19.95
8 1/2 x 11; 267 318 illustrations
There's an emerging concensus among those who treat cumulative trauma injuries
that part of what produces the pain, and keeps it around for so long, are
something called "trigger points": tight, inflamed "knots" in your muscles and
soft tissues.
A number of treatment options aim at unlocking and releasing
these points.
One such approach is in Clair Davies book, which stands out
in taking the approach that the injured person themselves should be able to
locate and treat these painful areas.
The book is thorough and accessible,
and I've found the information indispensable in keeping me operational
after my problems with musculoskeletal pain.
This should be part of your
"RSI first aid kit".
Soft Tissue Massage for Pain Relief: How You Can Massage Away the Pain from 37 Health Conditions
by Bernard Schatz
Hampton Roads Publishing Company 2001
A reader opines: "Ten Star rating on this book.....Simply explained, easy to do and it seemed
to me very effective. I happened to see it in a health food store.
Well worth the $18 cost. Try it.....you learn a lot from doing the massage
yourself, how to feel for where the spots/tightness are, how to listen to
your body--what it says so you can adjust how you are doing things.. I used
it in conjunction with myofascial massage by a professional. But they are
different, mentally and physically.....BOTH....together are good."
Computering & Exercise: Escape The Aches
And Pains Of Computer Work
by Dr. Ricky Lockett
LK says: "It
emphasizes the need to be physically fit in a world that has become more and
more sedentary.
He makes a lot of good points.
Has some excellent
definitions for various computer injuries and hundreds of various stretches
and strengthening exercises.
I found some excellent strengthening exercises
for my shoulders and neck that work just the right areas that I have needed
to work but was unable find exercises that didn't make other areas of my
body hurt...I also drove over 500
miles rountrip to see him.
Currently, I am only doing exercises and
stretches that are in his book.
I have had great improvements!"
WOUNDED WORKERS:
The Politics of Musculoskeletal
by Penney Kome
1998 ISBN 0- (paperback)
The author says:"
Wounded Workers is sort of a Whole MSI Catalogue.
It reviews the medical, WCB, legal, union/management,
ergonomics, computer workstations, self-help and
legislative ramifications of work-related upper
extremity disorders, lists tons of resources online and
in the real world, and generally provides a map for the
labyrinth in which so many MSI patients find
themselves. U of T Press arranged for the manuscript to
be peer-reviewed twice, to ensure that the scholarship
is accurate & up-to-date--but the text is written for
the general public & provides translations for many
technical terms."
I've read this: it is extremely thorough, and it
advocates for workers concerns without trying to
demonize anyone.
COPING SUCCESSFULLY
Maggie Black & Penny Gray
Paperback: 128 pages
Publisher: (January, 1999)
By Tommye-K. Mayer
" For those RSI sufferers who've got one "good" hand, Tommye-K's tips
for managing, presented in a user-friendly tone,
enable resting the
damaged hand while it recuperates as much as possible, while still
maintaining an active lifestyle."
Order from
Lilly Walters
This manual on one-hand typing can be ordered or downloaded from Ms. Walters'
Not having read
it myself I'll just comment that two-handed people with one RSI-injured hand
should be cautious about trying to make their one as-yet uninjured hand take up
the whole load of typing without making other changes in work load, breaks,
A good portion of this book can be previewed for free.
Living Well With a Hidden Disability : Transcending Doubt and Shame and Reclaiming Your
by Stacy Taylor, Robert Epstein (Contributor)
Haven't read this one but sounds good.
Dealing with RSI means more than
just sorting out medical and ergonomic issues, there are heavy emotional
and social impacts as well, and many RSI patients tell me that the
"hidden disability" aspect of RSI is tough to deal with.
Job-Damaged People:
How to Survive and Change the Workers' Compensation System
By Amy Clipp
" This book teaches injured workers what they must do if they are to get out
of the workers compensation system with their health and incomes intact. . .
This book presents the information you need to stop being a victim and start
receiving the benefits you are entitled to. "
Order from
How to Apply For and Win Social Security Administration Disability Benefits
By Frederick A. Johnson
PUBLISHER: MARCH 3RD BOOKS RING BOUND Pages:304 ISBN#: 0--X
"This is the 2nd edition of the first manual written for the non-attorney ever
published. It reveals the standards of judgment SSA uses to determine disability and tells
exactly what must be done to make it easy for SSA to grant benefits. "
How To Take Charge When You're Injured On The Job
By Christopher Ball
Publisher says: "This is the only book that shows you how to handle a California workers' compensation claim from start to finish. Workers'
Compensation expert, Attorney Christopher Ball guides you through handling your legitimate claim from start to finish. "
also has resources for other states, spend some time searching there ...
HEALTHY COMPUTING WITH MUSCLE FEEDBACK
by Erik Peper, Katherine Hughes Gibney
Publisher's blurb says: "A clear intervention blueprint for the successful management of repetitive motion injury and pain. It recognizes the
big picture (muscular sensory awareness, stress management and optimal performance), while simultaneously
attending to specific clinical and educational interventions (ergonomic assessment, surface EMG sensor placement
and trainee training strategies). A comprehensive how-to-do workbook for consultants and clinicians focusing on
the prevention and treatment of muscular skeletal pain disorders."
Repetitive Strain Injury? Rx: Yoga!
by Gail Dubinsky, M.D.
Pamela writes: "A reminder that there are special yoga tapes available that
are targeted specifically to RSI patients.
Information can
be found at .
The author of Rx:Yoga! is Dr.
Gail Dubinsky, who treats soft-tissue orthopedic injuries,
and is also a long-time yoga practitioner.
I reviewed the
tape for MC Journal , and
found it to be extremely appropriate -- I suffer from
carpal tunnel and tendonitis, and found the yoga poses to
be very doable and helpful."
Overcome Neck And Back Pain
by Kit Laughlin
"I'm 34, programmer, and am in the same boat as you: lots of neck and
shoulder pain, and being diagnosed with arthritis in the neck as well . . .
I started doing a lot of exercise focused on shoulders and
neck, and I have had some good results with that. By making the
shoulders and neck stronger, I can go longer behind the PC. Also, doing
a lot of stretching, and keeping the time behind the PC to a minimal (if
possible) has helped as well . . .
I can recommend:
Buy the book 'Overcome Neck and Beck Pain' by Kit Laughlin, and do
the stretching exercises he describes in his book. For me, focusing on
the neck and back, but also focusing on the hip and leg exercises has
helped a lot. "
(Paul adds: yes, people think of hands and arms first when they hear
about RSI or "carpal tunnel" but neck/shoulder/back problems are at least
as common and can contribute to the pain in hands and arms, too.)
Terry Slade has compiled a very useful and diverse
worth reading for anybody recovering from, or trying to avoid, musculoskeletal injury.
More pertinent books
(mainly aimed at musicians)
mentioned above has a lot of information
on equipment, therapies, software, and
an overview of the physiology of RSI.
This site is
place to find RSI information and many more links
to other Internet RSI-related sites.
is a terrific
site to learn how to compute safely.
for current articles and discussions on computer ergonomics and injuries.
Randy Rasa
has created an excellent all around RSI resource site at
Mary Wilson's
not-for-profit organization committed
to assisting workers at-risk or injured by repetitive motion syndromes.
been active in helping workers deal with RSI for a long time now.
, their name says it all.
Dennis Ankrum has several .
The RSI Association of the UK no longer exists but their
has been archived and remains accessible
, thanks to
A great variety of information on "Working and Living Pain Free" is
More info on .
A very in-depth document on
are good starting places when searching for ergonomics resources.
A new resource with product and literature reviews is .
Excellent all-round info on
presented by the folks at F-One Ergonomics including a discussion of
emerging ergonomics versus .
is an excellent student-written page
college students,
who are a high risk group for RSI.
some interesting research and thinking about input devices and among other things has developed a
speech interface for
computer users.
has a good page of research links.
The computer ergonomics pages of , and the U.S.
Of particular value is
NIOSH's comprehensive paper on
Occupational
Health Clinics for Ontario Workers at
Dr. Charles Eaton's treatment links for
including exercises,
images, etc. Fascinating.
is a superb resource for dealing with "invisible" problems like RSI.
Massage is an important treatment & prevention measure for
Her Web site has just been expanded with RSI
tips and additional links, check it out.
Many people report that
are helpful in learning non-injurious use of the body.
A Feldenkrais practitioner has some good info on his
page, including info on
Also there are many good reports on the effectiveness
of , , and
in treatment of RSI.
Detailed info on Thoracic Outlet Syndrome from a physical therapy
viewpoint is found at
Website of .
writes about .
Similarly, one person's nicely illustrated .
has excellent slide shows and research
There are several forums dealing with RSI-connected issues (chronic pain, TOS, etc. ) on the .
Many important insights about pain and suffering at ,
sponsored by the Pain Relief Center of Northern Arizona.
Build-it-yourself low-stress computer desk plans are available from
Versions of the Pocket Ergonomist can be downloaded as a Windows
Good information at the
of Manitoba.
A from somebody who's been through it . . .
Wisconsin's WC agency has a
a host of l
has good guidance regarding occupational injury.
In a similar mode, see the Canadian
Injured people may really need legal help.
In the UK, check with the .
When getting evaluated for insurance or worker's comp., you may encounter medical
documents with "ICD-9" codes categorizing your condition.
If you want to know what
these codes mean, see
R.S.I. does
leave many people at least partially
for People with Disabilities
(many disability links),
job search site,
the UK's ,
assistive technology solutions,
A place to collect people's experiences of problems with the U.S. health care system is
For ongoing discussion with fellow RSI sufferers, subscribe to the
e-mail list by sending mail with the line
SUBSCRIBE SOREHAND firstname lastname
in the body to
listserv@listsrv.ucsf.edu
More Information at this Web site:
A whole other arena of occupational injury.
Paul's personal experiences and reviews of hardware, software, and other accomodations.
Most recent review:
including Legal Services
Local resources for staff and students at the University of
Nebraska - Lincoln.
Locate medical care for RSI.
Questions?
With these pages I've tried to provide access to everything I've heard about
RSI, but I'm not an "expert". Everything here has come to me from other people.
If you have more good resources, corrections to what is here, or encounter
dead links, please let me know so it benefits the unexpectedly large number
of people who find this site when they are looking for help.
My own experiences with treatment are necessarily limited.
have questions about RSI, in addition to seeing a doctor and reading
the resources above I strongly suggest you tap into one of my main
resources, the
e-mail list.
You can subscribe
by sending mail with the line
SUBSCRIBE SOREHAND firstname lastname
in the body to
listserv @ listsrv . ucsf . edu
Text content of this page is Copyright & 2013 Paul Marxhausen
No permission required for Web links to this page.
All rights reserved for
reproduction in print or other media. Print-outs of this page may be
photocopied for NON-COMMERCIAL informational use.
(1) Figure 1 reproduced with permission from "The Pocket Ergonomist", Copyright & 1986
David Brown and Robin Mitchell, occupational health and safety consultants,
Airport Health Centre, Mascot NSW A stretch GIFs reproduced with permission from "The Floppy Ergonomist", Copyright & 1987
David Brown. Figures 2 through 4 are public domain.
Univ. of Nebraska-Lincoln / Electronics Shop RSI Web Page /
Paul Marxhausen