Reprinted from The RSI Network - Issue 32 - October'98

Jesse Parker, PhD
Bellevue, Washington
(206) 643-0726


Ouch! So, you’re the computer operator whose left forearm is beginning to hurt, or maybe you’re the supermarket clerk whose right hand is beginning to stiffen after repeatedly passing items over the bar code scanner. Perhaps you’re the pianist who has worked on a difficult passage again and again and again, and you’re starting to feel a tingling sensation in some of your fingers. Now what?

You read some articles about repetitive motion injuries, and you suspect that you may be a candidate for such injuries. Your health and safety director at work recommends reading about "no-no’s" such as incorrect posture, excessive force, overuse, and insufficient rest, and you try to follow the advice given in those articles. But the stiffness isn’t getting better, and the pain is maybe a little worse than it was.

Perhaps you then invest in a wrist rest, or an ergonomic keyboard, and you also try popping some anti-inflammatory medication. Later, you may try Rolfing, or some other therapeutic massage treatment, but despite all this, your hand or arm or fingers aren’t feeling much better.

Well, maybe that’s because you haven’t examined how you’re performing your specific task. You'd better do that right now, before it’s too late. How are you using your body, or not using it? That’s where you should start if you want to find a solution to your stiffness or pain.

Anatomical Involvement
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.

For example, take a piece of chalk (or a marker) and try to draw (or maybe just imagine drawing) a small, horizontal figure 8 on a blackboard or marker board (or imaginary board). Trace over the same figure 8 again and again, by just moving your hand from the wrist joint, while the rest of your arm remains stationary. Doesn’t that feel terrible? Now, try doing the same thing, only this time move your entire arm from the shoulder, keeping your wrist loose, and trace that same figure 8 repeatedly. Now, make a bigger figure 8, and really feel that entire arm involvement. Doesn’t that feel freer, all over?

Here’s another example: Make a bunch of dots on the board, by just flipping your chalk-holding hand from the wrist joint toward the board (without moving your forearm or top arm). Do that again and again. Ouch! Now try the same thing, but use the rest of your arm from the shoulder, as you gently flip your wrist toward the blackboard. Feel better? Remember, whatever your task is, the more you can involve the larger muscle groups of your body, the less you're subjecting the smaller muscle groups (such as forearm and hand) to stress.

Bend your hand (from the wrist) down as far as it will go. Just force it a little bit more, and hold it there for a moment. Is that comfortable? Of course not! Now bend your hand up from the wrist as far as it will go and hold it there. That feels awful, too, doesn’t it? Each part of your body prefers a comfortable range of alignment, and doesn’t enjoy being twisted or otherwise forced out of that comfortable range for too long a time, if at all.

If you operate a computer and your keyboard position consists of your hands being held high while your wrists are held down low on the desk or on a wrist rest, forget it! The other extreme, with the wrist being held high, is just as ridiculous. Depending on what else you’re doing (or not doing), some part of your body will sooner or later react to this misalignment with symptoms of stress. So, maintain a reasonably comfortable alignment at all joints.

Everything Moves
If your wrists aren’t moving, whether held high, low, or even comfortably level with your hand—if they're held in a fixed, rigid position while your fingers are punching keys, for example—that’s a sure-fire prescription for tension and stress. Similarly, if your hand is flipping back and forth across that bar code scanner from the wrist joint, and your forearm and upper arm aren’t moving along with it, you’re in trouble. Those stationary components of your body are saying, "Use us. Don’t ignore us. We want to be part of the action. Let us help you!"

Here’s a suggestion: Try punching the keys the way you punched those dots onto the blackboard, using your fingers as extensions of both your hands and your forearm and top arm as well. Now, look at those wrists—are they flexing, and thereby slightly changing their alignment with respect to your forearm? If your wrists are flexing, you’re doing it right; if they’re staying in one position, you’re doing it wrong. Listen up! Loosen up! Everything moves.

So, you’ve passed that food item over the bar code scanner. It didn’t register, and you have to repeat the process. Well, don’t just stop where you are and go back in a straight line to repeat the action. Instead, use an oval or a figure-8 motion to go back and forth over the scanner. The shortest distance between two points may be a straight line, but to avoid stop-and-go activity (which is very harmful to your body), you must avoid going back and forth in straight lines—or, if you do, you must find a way to negate that stop-and-go.

Here’s an example where an apparent straight-line back-and-forth motion can have follow-through or continuity of motion: Try drawing a straight horizontal line on your board (real or imaginary), going back and forth, repeatedly from point "a" to point "b", and back to point "a", etc. Stop when you get to either point before you reverse direction. Do you feel that stressful "muscle lock" that accompanies each abrupt stop? To avoid that, try leading with your wrist, and just before you reach either point, begin to reverse your wrist position so that it’s leading in the direction of the return movement to the other point.

As another example, consider hammering. The hammer may "stop" when it reaches the nail and pushes it in, and so will your hand gripping it. However, if you flex your wrist up, at that instant, to lead your arm "up and away" (while still holding on to the hammer), you’ll greatly reduce the stress of that repetitive activity.

Avoid Abrupt Changes of Speed
Try not to slow down or accelerate too abruptly, as this can create jerky movements and subject your muscles and tendons to stress. Go back to the blackboard. Trace that figure 8, once more, again and again. Do it at a slow, comfortable speed. Then alternate between flooring it and slowing down all the way. Feel the stress of those abrupt changes of speed?

The Best Mode of Power
On your blackboard, draw a long vertical line starting at the top and going down. Are you pushing the chalk against the blackboard, or are you pulling it down against the blackboard? If you were to move a heavy table to another position on the floor, would you be pushing it or pulling it from point "a" to point "b"? Which is less stressful to the body? When it seems there may be only one way to perform a task efficiently, allow some time to examine alternate power modes, and choose the more efficient way. Don’t just accept that what you’ve always done is "the only way." There is always a solution to a stressful activity; all you need to do is find it.

Listen to Your Body
Consider pain or discomfort as your body’s alarm clock. When repetitive activity causes pain or stiffness or other stress symptoms, it’s time to wake up.

Caution: Any pain you experience may very well need medical attention, and you may need to rest that portion of your body and forego a particular activity for a period of time, before taking steps to finding a better way to perform your task. Forget the "no pain, no gain" philosophy! Get in tune with your body to achieve positive, healthy results. Your goal is a happy body. The power is within you. Do it, now!

About the Author
Jesse Parker has a PhD in musicology from Stanford, and has taught piano at various universities and conservatories. He has applied the principles highlighted in this article to pianists with physical problems, and has also provided consultation to computer operators. In addition, he has addressed various groups, from the Seattle RIST group to many local chapters of the National Musical Teachers Association in Puget Sound, as well as in the Dallas/Fort Worth area. Jesse lives in Bellevue, and is available for workshops and consultations.

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Last Updated: 10/21/00