One of the most common complaints I see is for repetitive strain injuries (RSI). Unlike other injuries, RSI’s don’t have a specific time frame for recovery; in fact, they are notorious for hanging around for months, if not years. Poor management is often to blame for this whether it’s misinformation or mismanagement. RSI pain and disruption can be relentless and affect our work and leisure on a daily basis, it is understandable that we would search for a quick fix; unfortunately, there is no such thing when it comes to a RSI.
RSI’s are overuse injuries, they occur when the tissue concerned has been used to exhaustion, and not been given adequate time to rest and heal. They are often work or sport related, typically seen in movements that are done repeatedly, day in day out, causing overloading. Examples include typing or use of mouse (carpal tunnel syndrome, tennis elbow), running (Patellofemoral and Plantar Fasciitis), swimming (Rotator Cuff Tendinopathy).
What sufferers of a RSI are often unaware of is the time they can take to heal. As someone who has experienced considerable overuse injuries, I can attest to this. Even with the knowledge I have often found recovery a slow and frustrating process. Sticking to the advice of your therapist is paramount. So how do you know you are getting the right advice? This is tough, I see many people who have been given unfortunate and incorrect advice including:
Inject the site with cortisone (see my article regarding the dangers of cortisone)
It’s a structural issue: your pelvis is tilted, or your spine is out of alignment. RSI’s need load and rest, not a change in your posture or tilt of your pelvis.
Stop all activity: rest is important but total rest is unnecessary and detrimental to recovery (see more below).
RSI’s typically affect tendons (the tissue that attaches muscle to bone). Tendons do not heal quickly; the process of rebuilding new tendon can take upwards of 3 months, not what most people want to hear! Being patient is paramount, ignore it and it will hang around indefinitely.
Rest and Load
Rest: After correct diagnosis the first thing is to avoid the aggravator for a period of time. This is a tough one if it involves your work so coming up with a plan is important. The aggravator is of course the repetitive action, typing, playing the guitar, swimming, running etc.
Don’t underestimate the rest time required to get on top of a RSI. Most people rest for a week or two and think they’ve done all that’s required. This is often not the case; adequate rest from the aggravating activity can often be months. Anyone who has experienced an Achilles tendinopathy or Plantar fasciitis will tell you this.
Loading is vitally important and where a knowledgeable therapist is invaluable. Too much, too soon can be detrimental, finding the correct load is the key. The loading is what will helps to rebuild the tendon, finding the correct balance is vital.
What about massage?
Tendons attach to muscle; therefore most RSI’s have a muscle component and often include muscle pain. I have found trigger point therapy (a form of massage that works on trigger points within the muscle) to be effective for some people. It can compliment a management program of loading and rest.
Management
Managing a RSI can be frustrating, knowing recovery can be a timely process is important. Expecting a quick fix often sees individual’s seeing multiple therapists and spending considerable sums of money on false hope.
Time, rest, and loading are the keys to recovery.
Common RSI’s
Plantar fasciitis
Carpal Tunnel Syndrome
Shin Splints