Repetitive Strain Injury

Repetitive strain injury (RSI) is a general term used to describe the pain felt in muscles, nerves and tendons caused by repetitive movement and overuse.

It is also known as work-related upper limb disorder, or non-specific upper limb pain.

The condition mostly affects parts of the upper body, such as the:

  • forearms and elbows
  • wrists and hands
  • neck and shoulders

Some common RSIs are:

  • carpal tunnel syndrome
  • bursitis
  • rotator cuff tendonitis
  • tennis elbow


Symptoms of RSI

The symptoms of RSI can range from mild to severe and usually develop gradually. They often include:

  • pain, aching or tenderness
  • stiffness
  • throbbing
  • tingling or numbness
  • weakness
  • cramp

At first, you might only notice symptoms when you are carrying out a particular repetitive action.

But without treatment, the symptoms of RSI may eventually become constant and cause longer periods of pain. You may also get swelling in the affected area, which can last for several months.

If you develop symptoms of RSI and think it may be related to your job, speak to your employer. It may be possible to modify your tasks to improve your symptoms.

What causes RSI?

RSI is related to the overuse of muscles and tendons in the upper body.

Certain things are thought to increase the risk of RSI, including:

  • repetitive activities
  • doing a high-intensity activity for a long time without rest
  • poor posture or activities that involve working in an awkward position.

Cold temperatures and vibrating equipment are also thought to increase the risk of getting RSI and can make the symptoms worse. Stress can also be a contributing factor.

Jobs that involve repetitive movements can lead to RSI, such as working on an assembly line, at a supermarket checkout or on a computer.

The first step in treating RSI is usually to identify and modify the task or activity that is causing the symptoms. If necessary, you may need to stop doing the activity altogether. A splint or joint support may be helpful.

There are also things you can do to help reduce your risk of getting RSI:

  • maintaining good posture at work
  • taking regular breaks from long or repetitive tasks – it is better to take smaller, more frequent breaks than one long break.
  • trying breathing exercises if you are feeling stressed.

If you work at a computer all day, make sure your seat, keyboard, mouse and screen are positioned so they cause the least amount of strain.

If you sit a lot in front of a computer, here are some tips to help your posture:

  • Support your back.
  • Reduce your risk of pain by adjusting your chair so your lower back is properly supported. A correctly adjusted chair will reduce the strain on your back. Your chair should be easily adjustable so you can change the height, the back position and the tilt.
  • Your knees should be slightly lower than your hips. Use a footrest, if it feels necessary.
  • Adjust your chair height so you can use the keyboard with your wrists and forearms straight and level with the floor. This can help prevent repetitive strain injuries.
  • Elbows should be by the side of your body, so your arm forms an L-shape or right angle at the elbow joint.
  • Place your feet flat on the floor. If they are not, ask if you can have a footrest, which lets you rest your feet at a level that is comfortable.
  • Do not cross your legs, as this may contribute to posture-related problems.
  • Place your screen at eye level. Your screen should be directly in front of you. A good guide is to place the monitor about an arm’s length away, with the top of the screen roughly at eye level.
  • To achieve this, you may need a monitor stand. If the screen is too high or too low, you will have to bend your neck, which can be uncomfortable.
  • Have the keyboard straight in front of you.
  • Place your keyboard in front of you when typing.
  • Leave a gap of about 4 to 6 inches (100mm-150mm) at the front of the desk to rest your wrists between bouts of typing.
  • Keep your arms bent in an L-shape and your elbows by your sides. Some people like to use a wrist rest to keep their wrists straight and at the same level as the keys.
  • Position and use the mouse as close to you as possible. A mouse mat with a wrist pad may help keep your wrist straight and avoid awkward bending.
  • If you are not using your keyboard, push it to one side to move the mouse closer to you.
  • Your screen should be as glare-free as possible. If there’s glare on your screen, hold a mirror in front of the screen so you know what is causing it.
  • Position the monitor to avoid reflection from overhead lighting and sunlight. If necessary, pull blinds across the windows.
  • Adjusting the screen’s brightness or contrast can make it much easier to use.
  • If you have bifocal spectacles, you may find them less than ideal for computer work. It’s important to be able to see the screen easily without having to raise or lower your head. If you cannot work comfortably with bifocals, you may need a different type of spectacles. Consult your optician if in doubt.
  • Position frequently used objects, such as your telephone or stapler, within easy reach. Avoid repeatedly stretching or twisting to reach things.
  • If you spend a lot of time on the phone, try exchanging your handset for a headset. Repeatedly cradling the phone between your ear and shoulder can strain the muscles in your neck.

PHYSIOTHERAPY can help with RSI’s. The physiotherapy assessment will help identify the contributing factors and educate on how to address these and address structural musculoskeletal issues with appropriate strengthening and tendon loading exercises and manual therapies to address restrictions in the soft tissues and joint structures.