Transcription:
Avoiding Repetitive Strain Injuries

Melanie Cole (Host): Repetitive strain injuries can slow you down and limit your ability to perform everyday tasks. They can even impact how you work. My guest today, is Tara Pearce. She’s an occupational therapist at Henry Mayo Fitness and Health. Tara, first tell us a little bit about repetitive strain injuries. How common are they and what’s the most common way people get them?

Tara Pearce, Occupational Therapist (Guest): Well, if you type on a computer or use any electronic device; you are at risk for getting repetitive strain injury if you do not do it correctly. So, they are very common. And the most common way of getting it I would say is a computer. People love to do all sorts of data input these days and unfortunately, they don’t – employers don’t always give you the correct tools that you need to ensure that you don’t have to take off because of a repetitive strain injury.

Host: Tara, you’re an occupational therapist. Tell us what ergonomics are.

Tara: Oh well, ergonomics is basically your positioning of your equipment and your body to provide the least stress on your muscles, your joints, and to ensure that you can perform a task without causing an injury. So, ergonomics can consist of the type of equipment that you are using, all the way to how you are positioning your body.

Host: It’s so important for listeners to understand what that is and what you do. So, let’s start with some symptoms. How do we recognize that it’s not just a one-off if we are feeling pain in our shoulder or our wrist or our elbow and what do you do once you start to realize, this is kind of happening everyday and even carrying over into my time that I’m away at work?

Tara: Yes, one of the key factors into realizing it actually is your ergonomics at work is go home on the weekend and all of the sudden, it starts to go away. That’s a ding, ding, ding. It’s probably happening at work. And it means that something in your setup is just maybe off a little bit enough that you are not using the larger muscles to do that job or that workload. Oftentimes, people accidentally put too much of the work in their little fingers versus their back, having good posture and those little fingers just aren’t designed to take big loads. So, they will let you know. They will talk to you. And when they continue to talk through the weekend; or they go away, that’s when you need to seek some professional help.

Host: Speaking personally, Tara, it happened to me and so I know – I’m an exercise physiologist and I know better, but if it can happen to me, listeners, it can certainly happen to anyone. And I switched the mouse I was using, the chair I was using, the angle that I was holding the mouse. So, speak about some of those treatments and how we can look at our work space and say, I’m getting mouse elbow or my chair or carpal tunnel, any of these things. Describe that for us.

Tara: So, you can have all the fancy equipment, all the things that say ergo or ergonomic or best fit; but if you do not approach it correctly, you will still end up with a repetitive strain injury. So, for example, the mouse and the keyboard. When you use either of those items; you never want to rest your wrist on the platform or on the wrist rest. In fact, it is called a wrist rest because you are supposed to be resting not working. You are not allowed to work when you are using the wrist rest. And so, if you keep your wrists in a neutral manner; then you are never at risk for potentially getting carpal tunnel which is putting pressure on that bottom side of your hand, when you press it down. The same thing goes for your mouse. And it can actually transfer over to using a laptop as well and your phone. You don’t want to put any pressure on that palmer side of your hands. Speaking of which, if we have any laptop lovers out there; I hate to say it, but laptops can only either make your wrists happy or your neck happy. You cannot make them both at the same time, happy. So, the best suggestion is actually to turn it into a desktop. You need an external mouse and an external keyboard, and a laptop stand so that your neck doesn’t bend and disrupt your nerve pathways at your neck and so that your hands are nice and level and not causing any irritation with your tendons, around your elbow or around that nerve that is most famously known as the carpal tunnel syndrome.

Host: Tara, again as someone who has tried a bunch of mouse’s and a bunch of chairs; I finally found a mouse where I am turned, my thumb is up instead of my wrist turned where my hand is facing down. And I was getting real elbow problems. Tell us about the mouse and why did I have trouble when I was using the mouse that was down.

Tara: So, first, what were your symptoms when you were having trouble using the mouse facing down?

Host: Oh, my elbow, right where tennis elbow or mouse elbow. Oh yeah, and then once I supinated and turned my arm back up with the mouse, my pain went away.

Tara: So, that tells me most likely, when you were mousing palm down, again, you were resting that palm onto the mouse rest and that was causing your extensors in your forearm that attach to the outside of your elbow to do a lot of work keeping your wrist in slightly held extension and that’s not in neutral. That actually will cause those little guys to yell at you if you use them for too long without doing hourly stretch breaks. And so, once you transitioned to kind of resting on the pinky side of your arm, with your thumb on the side; you most likely are not extending that wrist anymore and you are probably using more of your shoulder to move the mouse.

Host: Wow. What an excellent analysis. What would you like people to know about things that they can do? You mentioned stretch breaks before. And what about strengthening? When we talk about sports injuries; we say oh you can strengthen to prevent some sports injuries. Can we do some things to help prevent these from happening in the first place?

Tara: I would say the best prevention is good posture. So, any postural exercises, anything with your core or your shoulders. That’s really actually where you want to start. Because the reason why people start to get the repetitive strain injuries is because they are no longer trusting their core. They are no longer trusting their good posture or their shoulders and the correct position and they end up having to overuse those muscles that are on – that attach from the elbow to the wrist and that starts to break down quicker because they are just smaller. So, it’s not necessarily people think of oh I need to work on my grip strength or my biceps. It’s not actually that. People usually have pretty good strength there. It’s their core that needs better strengthening. So, any just back exercises, shoulder strengthening, triceps are good too, but just to get you into a good posture. Even if you have a buddy at work that can say, heh go back into your good posture. Even just a little bit of a reminder can help you from overloading those smaller muscles.

And another way to prevent overloading of those smaller muscles is you put a little timer on your cell phone for an hour and every time it goes off; stretch your forearms. That’s the one stretch people forget. And they don’t often teach it either. But if you just stick out your arm, palm up or palm down, have your elbows straight and push on either the back or the front of your hand to stretch your forearm muscles; you can stretch those little muscles that people often overload. And one of those stretches on either side hourly, can help relax those muscles so that they don’t get overstimulated and then talk to you on the weekend.

Host: Come on listeners, which of you did not just try what she just was saying with the stretching your forearms? How many of us did not try that? I think we all did. Tara, what would you do as treatment, when it gets so bad that we can’t really treat ourselves and we’ve looked around and tried to fix up our workstation? What would you, as an occupational therapist do for us, to help?

Tara: So, if I were to personally come on-site, I would see if there is something that you missed. You could potentially have a friend do this. Take a picture of how you are sitting at your computer or your work station from the eye-level of your wrist or your hands. So, to the side. So, it’s a profile picture. And the things that you are looking for when you see yourself, because oftentimes you can’t really tell unless you are looking at a picture or yourself; you are looking to make sure that you are using your core, that you have good posture, that your elbows are not extended, that you are not reaching for that keyboard, that it’s nice and tucked almost like it’s touching your belly button like you are wearing it like a belt. You want it nice and snug, no reaching. You also want to make sure that your hands are not higher than your elbows. So, that’s a very key feature. Because even just a little bit of angle; can put you at risk for carpal tunnel or repetitive strain injuries at the elbow. So, I would say first see if a friend can take a picture. Look at those particular angles, see if anything is off, adjust it if you can and if you can’t; you can always go to your employer, ask if they have somebody who works in ergonomics to come out and do exactly what I just said or you can get a referral and you can come see me and I can help problem solve.

Host: Wrap it up for us, your best advice with avoiding repetitive strain injuries at the workplace and what you want us to know about Henry Mayo Fitness and Health.

Tara: So, I think one interesting piece of information to ponder about is that if you are typing on the computer, average 50 words per minute, for an eight-hour day; you are putting 693 pounds of force per finger. So, that means the most important information is to stretch. Stretch hourly. If you stretch hourly, and you have good posture; it will really go a long way. And that is probably the most valuable information that I would like people to know.

Host: It is great information. Tara, thank you so much. What a great segment and listeners I know that you will find this a great segment as well. Share it with your friends because so many of us have those issues and she’s given you such great information on ways that you can get around them and fix your work station, so you don’t come up with these painful repetitive strain injuries. You’re listening to It’s Your Health Radio with Henry Mayo Newhall Hospital. For more information, please visit www.henrymayo.com, that’s www.henrymayo.com. This is Melanie Cole. Thanks so much for tuning in today.