Welcome to our Articles!
A wide variety of articles are being collected for the Typing Injury FAQ and The
RSI Network newsletter. These articles will be on permanent display here and may be
updated periodically by their authors - if they so desire.
Recent Additions
Muscle Spasms Mimic
Symptoms of Carpal Tunnel Syndrome & Cause Repetitive Strain Injury,
by Zev M.Cohen, M.D.and Julie Donnelly, L.M.T.
Do you suffer from chronic low back pain? Do your knees hurt
when you go up the stairs, and your hands hurt when you try to open a jar?
Have you been diagnosed as having carpal tunnel syndrome? These
conditions can all be the end result of muscle spasms! While it
seems incredible that a simple thing like a spasm can cause so much
trouble, it’s easy to understand when you take a close look at the body.
Repetitive Strain Injury and Back Pain
,
by Zev M.Cohen, M.D.and Julie Donnelly, L.M.T.
Low Back Pain – The
crippling condition that prevents you from living your life fully! Many
people go to their chiropractor and it feels better for awhile, but the
pain keeps returning. These
conditions can all be the end result of muscle spasms!
While it seems incredible that a simple thing like a spasm can
cause so much trouble, it’s easy to understand when you take a close
look at the body.
A Unique Approach to Workforce Wellness,
by John Schlyer, CPE
In recent years, the psychosocial aspects of process improvement
have been introduced through the "lean manufacturing", teaming
approach. The teaming has focused on identifying, and developing
individual habits that promote process effectiveness. As we began developing our improved wellness model, our
question was, "why wouldn't this same teaming approach, being used in
manufacturing processes, work well in a process focused on individual
wellness"?
Return to Table of Contents
Selecting
a Treating Physician by Joan Lichterman (East Bay RSI Support Group)
Selecting the right treating physician for you is one of the most important decisions you
need to make, as this person is critical to your recovery and (in some states, like
California) may be instrumental in securing needed workers' compensation and vocational
rehabilitation benefits.
How
to Start an RSI Support Group, Judy Doane,
The large information gaps that exist for people with injuries that tend
to heal very slowly create the need to seek out others with similar
injuries and to find resources. The desire for a regular meeting develops
in the community and one or more persons then initiate the process of
organizing meetings. The composition of the group that attends will depend
largely on the community from which it springs. The following is an
outline that incorporates some of the typical elements of that process.
Occupational
Medicine and CTDs by Kevin Byrne, MD
Occupational physicians view Cumulative Trauma Disorders (CTDs) differently from
other physicians in large part because the concept of illnesses resulting from chronic
work exposure is fundamental to occupational medicine.
Epidemiology and CTDs by Kevin
Byrne, MD
Cumulative Trauma Disorders (CTDs) present a host of problems because of their prevalence
and financial impact. Although CTDs are pervasive in many segments of our society, they
are still perceived with skepticism.
Physical
Therapy for RMIs by Randall Helm, PT
Physical therapy is a health profession specializing in the rehabilitation of people from
all walks of life. Physical therapists are among the primary caregivers in the fight
against repetitive motion injuries. RMIs, RSIs, and CTDs are terms that are often
interchanged to describe a host of work-related upper-extremity dysfunctions.
A Physical
Therapist's Perspective on RSI by Jackie Ross, PT
A physical therapist's perspectives about symptoms and treatment
of RSIs.
Chiropractic
Health Care by Dr. Timothy Jameson
An overview of chiropractic health care, its theories about the onset of repetitive strain
injuries (RSIs), and how it goes about treating these injuries.
Treating Carpal Tunnel and Other Repetitive Strain Injuries
Without Drugs or Surgery by Rick Allen, DC
The most common medical treatment focuses on the carpal tunnel is a combination of wrist/forearm bracing and anti-inflammatory medication. If that doesn't help, surgery is
suggested - cutting the flexor retinaculum across the wrist. While this gives dramatic short-term relief of the symptoms, it can create additional
problems.
Hellerwork
Structural Integration and RSI, by Merry Nell Colborn, Certified
Hellerwork Practitioner
Hellerwork Structural Integration is a bodywork technique that combines
several modalities to provide a complete integration of body, mind, and
spirit. Hellerwork is about balance, fluidity, ease, and alignment, and
involves not only changes in structure but also changes in attitudes: an
exploration into ourselves and our relationship with our environment.
Somatic
Education: An approach to repetitive strain injuries by Paul Linden, PhD
Effective body use is not something we can take for granted or assume people have. Through
miseducation and misuse, people have learned to move in ways that are awkward,
strain-filled, and damaging yet seem normal and right. People need to be taught how to use
their bodies well, or they will hurt themselves.
Muscle Learning
Therapy by Dennis L. Ettare, MA
This speech was delivered to the Silicone Valley Forum of the Commonwealth Club
of California on 2/5/98. It was updated on 2/6/1999 with a corrected and enhanced version
for readers as well as the addition of many questions and answers. It presents a unique
treatment protocol based upon an operant conditioning (or training) model using EMG
biofeedback protocols developed specifically for chronic muscle pain.
Why Biofeedback
Training is Used in Preventing and Treating RSIs by Julie Weiner, MS, BCIAC
Biofeedback training is growing in popularity because it is noninvasive and
pain-free, and its efficacy is well documented in medical literature. A short-term time
investment (usually 8 to 20 sessions, depending on the severity of injury, and previously
learned relaxation and stress-management skills), combined with a willingness to practice
and establish new pain-prevention habits, can yield long-term health benefits.
STUDY: How to Use
Applied Psychophysiology/Biofeedback in the Prevention and Assessment of Upper Extremity
Musculoskeletal Disorders by Erik Peper, Richard Harvey and Dianne Shumay
This paper reports on applied psycho physiological investigations for studying 1) muscle
awareness at the computer and 2) applied psychophysiology to identify ergonomic positions.
STUDY: Biofeedback
Group Training Approach by Dianne M. Shumay and Erik Peper
This study investigated the psycho physiological and clinical efficacy of a group training
program derived from the individual multimodal biofeedback, somatic exercises and
computer-related disorders prevention training protocol.
RSI and
Applied Motor Control by Howard Nemerov, CMT
Basic concepts of Applied Motor Control, and how it can enhance and hasten your
rehabilitation.
A Sports Medicine
Approach to Overuse Injuries by Jeffrey Pearson, DO
General principles from sports medicine for the industrial athlete.
Holistic
Self-Defense, Mark Lipsman
Open any publication by or for writers and chances are you’ll find an
article on repetitive strain injury (RSI). Conventional treatment is
generally limited to rest, avoidance of motions that aggravate the
problem, and ergonomic improvements. These are fine, but they’re
passive—they don’t cause the body to heal any faster and may not
prevent the symptoms from recurring. In this series of three articles, I
offer some thoughts on proactive treatment for RSI. These are based
primarily on Chinese medicine and its fundamental concept of internal
energy, or chi, which flows through the body in channels, or meridians.
Repetitive
Strain Injury and Myofascial Pain Syndrome, Hal Blatman, MD
During the last few years I have followed the postings to online
Repetitive Strain Injury (RSI) discussion lists with considerable
interest, and have occasionally offered some suggestions for myofascial
pain sufferers. I’ve written this FAQ to assist in understanding
myofascial pain, a syndrome that is still quite a mystery to many people
including physicians, chiropractors, and therapists.
The
Value of Early Detection and Treatment of CTDs, Bonnie Sussman, MEd,
PT
As the incidence of cumulative trauma disorders (CTDs) increases,
companies continue to look for ways to prevent these problems or minimize
disability and costs when they do occur. Preventive efforts such as
minimizing repetition whenever possible, rotating jobs, setting up
ergonomically sound workstations, taking stretch breaks, and using
assistive devices are becoming more widespread. Although prevention
techniques are critical to success, it can sometimes be hard to know how
much and where to apply them.
Vision
Health Management: Visual Ergonomics in the Workplace, Dr. Jeffrey R.
Anshel, BS, OD
Vision is our most precious sense. Our eyes are in constant use every
waking minute of every day. The way we use our eyes can determine how well
we work throughout our lifetime. Over 80% of our learning is mediated
through our eyes, indicating the important role our vision plays in our
daily activities. Vision disturbance is a silent enemy that only appears
after a long period of continued stress.
Kids
and Computers: Eyes and Visual Systems, Dr. Jeffrey R. Anshel, OD
Today, millions of children are using computers every day, at school and
at home, for education and recreation. Visual demands in school require
the integration of a number of different vision skills: visual acuity
(sharpness of vision); visual fixation (eye aiming); accommodation
(focusing); binocular fusion (forming a single image); convergence
(turning of the eyes); field of vision (side vision); and form perception
(recognizing shapes). These systems can be stressed and overworked if not
used efficiently. Computer viewing is complicating how children use their
eyes in school because these visual skills are not yet fully developed in
children—making any near-point activities that much more difficult.
Return to Table of Contents
20 Clinical Truths About RSI by Peter
Bower, MD
Carpal
Tunnel Syndrome from Nidus Information Services
An extensive report on CTS with information, resources, and literature. Part of the
Well-Connected library http://www.well-connected.com,
which consists of over 90 in-depth reports on common psychological and medical problems
and wellness topics. Reports are reviewed by physicians at Harvard Medical School and are
updated quarterly.
STUDY: Computer
Related Symptoms: A Major Problem For College Students by Erik Peper, Ph.D. and
Katherine H. Gibney
Computer use among students has increased dramatically in the last few years. Many
universities now require a computer and computer literacy for enrollment. When questioned
about computer use most students report discomfort such as dry eyes, neck and shoulder
tightness, back pain and exhaustion.
The Role of the
Neck in RSIs by Robert L. Kane, DC, CCUCS and David A. Browning, DC
Recently, medical research has been targeting the role of the cervical spine
(neck) as it relates to upper extremity injuries (hand, wrist, elbow, arm, and shoulder).
Specifically, the role of cervical biomechanics (the motion occurring at the joints of the
neck) is now seen to play a significant role in RSI.
Double Crush & CTS
by Dr. Robert L. Kane, DC, CCUCS
Medical literature has repeatedly documented the involvement of multiple injury
sites in repetitive strain injuries. This is commonly referred to as a "Double
Crush" Syndrome.
NonSurgical
Treatment Options for Upper Extremity Overuse Injuries by Richard N. Norris, M.D.
Repetitive motion disorders can usually be treated nonoperatively with success,
especially in their early stages. However, it should be kept in mind that nonsurgical
treatment isn't always the conservative path, and there are many conditions that respond
quickly and reliably to surgical procedures.
After "Ouch"
What? Changing How You Use Your Body by Jesse Parker, PhD
Just how much of your body are you involving in your task? If you’re
using a bar code scanner, are you just flipping your hand from the wrist, with your
forearm and top arm "standing by"? Or, if you operate a computer or play piano,
are you just punching the keys with your fingers, while the rest of your arm "hangs
in there"? Stop! Don’t ignore the rest of your body! Get it involved in that
task, along with your hands and fingers.
CTS Surgery: To Cut or
Not to Cut by Tammy Crouch
"If it looks like carpal tunnel, cut it." Is this your doctor? I hope
not! But this is a quote from a real live surgeon. Thankfully this man is in the minority.
Sometimes surgery is not the best way to treat the symptoms of CTS, yet it's still
recommended in a number of cases where, with a little detective work and time, the problem
could be handled in a much less invasive manner.
Incidence
of Reflex Sympathetic Dystrophy in Repetitive Strain Injuries, Lisa M.
Sattler, MS, PT
Reflex sympathetic dystrophy (RSD)—recently renamed complex regional
pain syndrome types I and II—is a documented condition described in the
literature as a pain syndrome occurring as a result of trauma to a body
part. Repetitive strain injuries have been described as injuries that at
least partially involve microtrauma to soft tissue. In a number of cases
patients with RSI have slowly developed RSD, which has been neglected in
the literature. I have recently been introduced to the possibility that
many RSI patients have "mild" or "early" RSD, and I
want to alert other clinicians as well as patients.
Return to Table of Contents
Computer Solutions to
Computer Pain: How to Stay Healthy at the Computer with Email Tips by Erik Peper and
Katherine Hughes Gibney
Once a week, employees at San Francisco State University open their electronic mailboxes
and find the latest issue of Healthy Computing Tips™. These are short specific
recommendations broadcast by email to promote health in the workstation.
Improving Visual
Comfort at a Computer Workstation by Dr. Jeffrey R. Anshel, BS, OD
Visual discomfort occurs at a computer workstation when the visual demands of your task
exceed your visual abilities. The problem can be resolved by treating your visual
condition, if any, or by making your visual task less demanding.
Healing from RSI
by Nancy Kramer
Awareness is your key to recovery. With increased awareness, you'll be able to do
more, with less pain, because you'll do it smarter and with less impact on your body.
Intrigued? Read on!
RSIs & Stress
by Debbie Stiles, R.N, M.N.
The association between RSIs and psychosocial stress continues to be
investigated, but few studies have specifically looked at RSIs. Many studies, however,
have found significant correlations between physical health problems and job stress.
Are Exercises Safe?
by Mark Pinsky
A recent paper by Kwan Lee of Louisiana State University, Naomi Swanson of the
National Institute for Occupational Safety and Health, and others raises questions about
whether commonly recommended exercises are safe for VDT operators, including RSI sufferers
and those at risk for RSIs.
Return to Table of Contents
The Role of Ergonomics in
Process Design, Product Design and Design for the Environment by Edward Grossmith,
CPE, and Gregory Chambers, Manager EH&S, Quantam Corp.
Profitability is the prime corporate motivation for ergonomics intervention.
Quantam has redefined their concept of an ergonomics program to include all elements of
worker productivity as well as the creation of an environmentally safe product. A whole
company philosophy looks at all elements of good ergonomics design (air, light, noise, the
work station) simultaneously; and as such, crosses over traditional boundaries to
encompass the entire work force into one EH&S program
Ergonomic
Inaction- Congress puts OSHAs Ergonomics Standard on Hold by Vernon Mogensen
While Congress consumes itself with the impeachment and trial of the president, many
Americans are becoming increasingly frustrated as the nation's policy problems go
unaddressed. Of special interest is the tremendous growth of repetitive strain injuries
(RSIs) among office workers using video display terminals (VDTs).
Arguments
for a National Ergonomic Standard, Ann B. Pudoff,
Do we really need a national ergonomic standard? I think so. The health
and safety of employees should be a primary concern of all employers and
managers. Their challenge is to provide a work environment free from
ergonomic hazards, through awareness and prevention: raising everyone's
awareness of the risk factors and providing resources and guidance toward
preventing repetitive motion injuries (RMIs). It seems to me that a
national ergonomic standard is necessary to accomplish this effectively.
Employers tend to pay attention when the Occupational Health and Safety
Administration (OSHA) develops a standard and makes compliance mandatory.
Work-Related
Musculoskeletal Disorders Prevention in Washington State, Rick Goggins,
Ergonomist
In the State of Washington, one of the Department of Labor and Industries'
(L&I) responsibilities is workplace safety and health. Washington,
like California, has a state-plan version of the federal Occupational
Safety and Health Act, known as WISHA—the Washington Industry Safety and
Health Act. The department has recently focused on ergonomics and the
prevention of work-related musculoskeletal disorders (WMSDs), which are
the most common and costly injuries in Washington workplaces.
An
Argument for Ergonomic Workstations: Increased Productivity by Richard Donkin
The source of this information is the book Ergonomics, Work, and Health by
Stephen Pheasant (Macmillan, 1991). This book has a full list of references and has a
section on the cost effectiveness of ergonomics.
Overhead Glare Linked to
Muscular Symptoms - VDT News
VDT users report more musculoskeletal pain as well as visual discomfort and
eyestrain when the brightness level of overhead lights increases, according to a 1994
study by Dr. James Sheedy and Ian Bailey of the University of California's School of
Optometry, Berkeley.
Wrist Rests:
Issues and Products by Scott Wright, MS-HF&E
A quick overview of current wrist rest guidelines with a special focus on wrist glides
that move with the arm during mouse use.
Motion
Based Ergonomics™ Keyboard Retraining, Norman J. Kahan, MD, and
Vivienne Griffin
Over the years, computer-related injuries have increasingly plagued the
modern office workplace, debilitating hundreds of thousands of workers,
causing pain, impairment and, in some cases, disability. The vast majority
of computer-related injuries can be attributed to specific faulty
movements and awkward postures inherent in the act of typing, which may
cause fatigue, inflammation of muscles or tendons, compression or
entrapment of nerves, as well as pain or weakness in the upper limbs and
neck. Recognizing and correcting these movements is at the heart of a new
and emerging field known as keyboard retraining, a largely overlooked but
critical component in the fight against RSI.
Motion
Based Ergonomics™ Keyboard Retraining, Part II: "Mousing",
Norman J. Kahan, MD, and Vivienne Griffin
In recent years, the mouse has become an integral tool for most computer
programs as well as for working “on line”. Unfortunately, as computer
users have become more dependent on mouse input devices, the number of
repetitive strain injuries (RSI) related to the mouse has been on the
rise. Most of these injuries can be traced back to both faulty movements
and awkward postures when using the mouse. To complicate matters, the
number of “mice” now include many options, including traditional a two
or three button mouse, (mechanical or optical) trackball, mouse pen, joy
stick, touch pad and glide point. There are even foot and head mice. The
following pitfalls and guidelines apply to whichever mouse you choose to
use. Remember, gadgets alone won’t prevent the development of RSI, but
learning how to use them properly can.
Guidelines
for Laptop Computer Users, Vivienne Griffin, and Norman J. Kahan, MD
Today, many computer users have turned to convenient portable laptops as
either an adjunct to their work stations, or as an alternative to a desk
top computer. Just as desktop computers have specific guidelines and
recommendations for safe and healthy use, so do laptops. The following is
a list of things to consider and try to promote and ensure comfort when
using them.
Return to Table of Contents
Alternative
Keyboards- A User Survey by K.S.Wright, MS
Results of a 1996 alternative keyboard user survey representing users of a wide
variety of alternative keyboard brands and types.
Tyranny of the
Keyboard by Jay Hersh
Hardly anyone would place the modern computer keyboard in the rank of medieval torture
devices such as the rack or iron maiden, and yet today there are tens of thousands of
people in whom the keyboard strikes the same terror as felt by those of that heinous era.
Return to Table of Contents
Mark Goldstein
(Goldtouch) Q&A Interview
Several issues of interest considered and implemented into the Goldtouch Mouse.
RSI
and Mouse Bite are a Pain in the Neck! Michael Roberts, B.App.Sci.
(Physiotherapy)
With the increasing use of personal computers in homes and offices around
the world, there is an increasing incidence of computer-related disorders.
When the RSI epidemic swept the world in the late 1970s it was believed
that the arm symptoms were coming from the wrists and forearms or from the
complainants’ heads (i.e., "It's all in their heads.").
Return to Table of Contents
STUDY: Computer
User Perception of the Effectiveness of Excersize Mini-Breaks by Arthur Saltzman, PhD
A workplace intervention for PC users is evaluated. Computer operators, who
used an ergonomic software program that encourages frequent short stretching breaks, were
asked to rate the effectiveness of the program.
When Your Voice Means
Business by Barbie Scott, MA, CCC
If you are using speech recognition in your daily work, your voice has become a primary
tool of your work. Your voice means business, literally. If you are a speech recognition
user who struggles with poor voice endurance, you know that if your voice is not "in
working order" you can't earn money.
Return to Table of Contents
How I Recovered from
Tendinitis and RSI by practicing Yoga by Curtis McKallip Jr.
One note on this is that the author mentions that no modification to yoga
excersizes was needed. I've read in other cases of using yoga that modifications were
needed, which may be the case in many other movement-related practices, so tread with
caution and awareness of what your own body is telling you -- Ed.
Return to Table of Contents
Hot Tips on Ergonomic Equipment
by Michael Roberts, B.App.Sci. (Physiotherapy)
http://saturn.vision.net.au/~macsol/equip.htm
Ergonomics and the Alexander Technique
http://www.alexandercenter.com/teacherspage/index.html
A Conversation with Joyce Stenstrom and Marian Goldberg, formerly the Ergonomist for the
Mayo Clinic and now works as an independent consultant.
Return to Table of Contents
The Influence of Computer Monitor Height on Head and Neck Posture
http://www.uq.oz.au/~hmrburge/publications/ijiemonht/ijiemonht.html
This research describes the influence of "eye level" and "low" monitor
locations on the head and neck posture of subjects performing a word processing task.
Burgess-Limerick, R., Plooy, A., Fraser, K. and Ankrum, D.R. (in press). International
Journal of Industrial Ergonomics.
Computer Viewing Distance - Ergonomics
http://www.ur-net.com/office-ergo/viewing.htm
Integrating Neck Postures and Vision at VDT Workstations
http://tmc03.human.waseda.ac.jp/~wwdu97/PrcHP/213/
Some New Visual Considerations at Computer Workstations
http://www.combo.com/ergo/vangle2.htm
Viewing Distance and Angle at Computer Workstations
http://www.combo.com/ergo/vangle.htm
Return to Table of Contents
Insult to Injury: Workers Comp
(Santa Rosa Press Democrat Online - Special Report)
http://www.pressdemo.com/workerscomp/index.html
The Press Democrat's four part series investigates the workers compensation maze
of confusion, delays and litigation in California.
- Benefits in Doubt -
Workers comp was set up to help people hurt on the job, but 200,000 Californians a year
will spend years trying to secure their benefits.
- Debilitating Delays -
One out of every five workers injured on the job last year are mired in a workers
compensation maze of confusion, delays and litigation.
- Legal Limits - The
litigation rate in California workers compensation has doubled in 12 years. Find out why
this is becoming such a troubling and costly trend.
- Restoring Benefits -
Creating a system of gathering information on workers comp could be the first step toward
solving its problems.
Return to Table of Contents
Hacking the Hand, by Susan McCarthy
http://www.wired.com/wired/archive/3.12/mccarthy.html
Robert Markison's passion for technology and the human body
has made him one of the top surgeons working on repetitive strain injury.
Hurting Hands, by Sewell Chan
http://www.harvard-magazine.com/issues/mj98/jhj.undergrad.html
In the computer laboratories of the Science Center, where I write most of my papers and often check my e-mail, the click-click of chattering keyboards can fill the
air late into the night as students hammer away on term papers, thesis chapters, and electronic missives. The buzz used to seem charming, or at least motivational,
as words flew from fingertips onto computer screens. But lately, the pain of thinking up a cogent argument has been supplemented by raw physical pain, and typing
seems more a hazard than a tool.
Return to Table of Contents
The RSI Network Newsletter - Archive
http://www.tifaq.com/rsinet/archive.html
RSI-UK's Online Articles
http://www.demon.co.uk/rsi/articles.html
Computer Currents Interactive - The Ergonomic Office Archives
http://www.currents.net/magazine/national/ergo_index.html
Return to Table of Contents
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