Repetitive Stress Trauma: An Introduction
Repetitive Stress Trauma or RST is described entirely by the words that make up the phrase. Repetition implies that the injury is the result of more than one exposure. Typical RSTs result from weeks, months or years of performance of a repetitive task with a specific body part. Stress is the result of inadequate recovery time in between exposures to the repetitious task. Trauma, of course signifies bodily injury as a result of the repetitive stress.
Health care workers primarily view Repetitive Stress Trauma as an occupational or work injury. This thought is based on government statistics which indicate that those who work are more likely to develop an RST injury. While these statistics can’t be denied, they also need to be taken into proper context. In my San Diego based chiropractic clinic, we see many patients with RST injuries. Most of the time, most of the trauma is related to work, more specifically to computer work. Additionally, many of these injured people spend upwards of six hours per day on their computers while at work only to come home, eat dinner, and then sit at their own computers for hours on end as well. It doesn’t matter where the stress comes from, the injury remains the same. That being said, in my 15 years of experience in dealing with RSTs I have found the primary source of irritation to be the work environment.
At this point I will go off on a tangent for just a moment … or more. One of the services that my office offers is ergonomic evaluations. Since most of my patients are in computer related occupations, most of my evaluations are on computer set-ups. Typically, when I question my patients about their work stations I hear the following, “Well, it is pretty good except for FILL IN THE BLANK.” At this point I usually suggest that I come to their place of work and evaluate their work station. They are usually way out of the ideal ergonomic set-up. I see keyboards, mice, monitors and phones positioned in ways that will certainly lead to a worsening of their condition.
RSTs, ergonomics and permanent disability are important topics. As such, I will end this article at this point and be back tomorrow or Tuesday with a continuation of what I have started. This topic will be covered over the next three or four posts. Stay tuned.
Writers Bio
Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.
Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.
Call Steve Jones at
(619) 280 0554
San Diego Chiropractic
Ergonomic Office Equipment Website to learn more about or Buy Ergo Nav, the Ergonomic Mouse Pad
or Visit Ergonomic Blog, "Ergonomically Yours" And read the latest News in the Ergonomic World.
Better Health Steve Jones
Dec 28, 2009
Dec 18, 2009
The Computerized Office and Its Effects on Workers
The Computerized Office and Its Effects on Workers
Hundreds if not thousands of books and articles have been written that deal with the short and long term negative effects of working with computers.
As a chiropractor practicing in San Diego, I see a constant flow of new patients who complain of neck pain, shoulder pain, arm pain, wrist pain and hand pain as a result of long work days that mostly consist of sitting at a computer. It doesn’t stop there. Because sitting is especially stressful for the lower back we see plenty of computer operators who complain of low back pain as well.
It seems that the computer spares no body part from pain, discomfort and sometimes disability.
The most damaging characteristics of computer work can be summed up in two related triggers that stimulate our bodies to react to this type of work.
The first of these triggers involves the way the muscles of our necks, upper backs, arms and hands are used during computer work.
Whenever we are working on our computers our fingers are moving a mile a minute while the rest of the muscles of our upper extremities are in a static contraction. Muscles are designed to move joints through an entire range of motion. When we work at our computers these muscles simply contract to hold joints in a fixed position. When muscles act in this way they build up lactic acid, become irritated and inflamed and eventually fatigue and become painful. The long-term effects of this process include tendonitis, carpal tunnel syndrome, trigger finger, etc, etc.
The second trigger involves postural stress. It is human nature to lean forward into our work. Leaning forward improves our ability to see what we are working on. This posture typically includes bending forward at the waist, rounding our shoulders forward and craning our necks forward. Each of these body positions by themselves is capable of causing pain and discomfort. When we are doing computer work it is not unusual to have all three of these postural stresses working on us at the same time.
Controlling these stresses is of utmost importance in order to prevent injury. Taking short one or two minute stretching breaks for the arms and hands every twenty or thirty minutes is very helpful. Icing the painful areas is helpful as well. Finally, becoming aware of your posture and doing what you can to eliminate postural stress will help.
There are other articles on this topic in this blog and in my chiropractic blog at www.jonespainrelife.com/blog that will give you more information on how to control the stresses of computer work.
Writers Bio
Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.
Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.
Call Steve Jones at
(619) 280 0554
San Diego Chiropractic
Ergonomic Office Equipment Website to learn more about or Buy Ergo Nav, the Ergonomic Mouse Pad
or Visit Ergonomic Blog, "Ergonomically Yours" And read the latest News in the Ergonomic World.
Better Health Steve Jones
Hundreds if not thousands of books and articles have been written that deal with the short and long term negative effects of working with computers.
As a chiropractor practicing in San Diego, I see a constant flow of new patients who complain of neck pain, shoulder pain, arm pain, wrist pain and hand pain as a result of long work days that mostly consist of sitting at a computer. It doesn’t stop there. Because sitting is especially stressful for the lower back we see plenty of computer operators who complain of low back pain as well.
It seems that the computer spares no body part from pain, discomfort and sometimes disability.
The most damaging characteristics of computer work can be summed up in two related triggers that stimulate our bodies to react to this type of work.
The first of these triggers involves the way the muscles of our necks, upper backs, arms and hands are used during computer work.
Whenever we are working on our computers our fingers are moving a mile a minute while the rest of the muscles of our upper extremities are in a static contraction. Muscles are designed to move joints through an entire range of motion. When we work at our computers these muscles simply contract to hold joints in a fixed position. When muscles act in this way they build up lactic acid, become irritated and inflamed and eventually fatigue and become painful. The long-term effects of this process include tendonitis, carpal tunnel syndrome, trigger finger, etc, etc.
The second trigger involves postural stress. It is human nature to lean forward into our work. Leaning forward improves our ability to see what we are working on. This posture typically includes bending forward at the waist, rounding our shoulders forward and craning our necks forward. Each of these body positions by themselves is capable of causing pain and discomfort. When we are doing computer work it is not unusual to have all three of these postural stresses working on us at the same time.
Controlling these stresses is of utmost importance in order to prevent injury. Taking short one or two minute stretching breaks for the arms and hands every twenty or thirty minutes is very helpful. Icing the painful areas is helpful as well. Finally, becoming aware of your posture and doing what you can to eliminate postural stress will help.
There are other articles on this topic in this blog and in my chiropractic blog at www.jonespainrelife.com/blog that will give you more information on how to control the stresses of computer work.
Writers Bio
Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.
Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.
Call Steve Jones at
(619) 280 0554
San Diego Chiropractic
Ergonomic Office Equipment Website to learn more about or Buy Ergo Nav, the Ergonomic Mouse Pad
or Visit Ergonomic Blog, "Ergonomically Yours" And read the latest News in the Ergonomic World.
Better Health Steve Jones
Dec 9, 2009
Computer Ergonomics, Work Postures and Injury
Computer Ergonomics, Work Postures and Injury
My chiropractic clinic is located in San Diego, California. For whatever reason, we see many patients suffering from neck pain, back pain, shoulder pain, wrist pain and hand pain as a result of computer work. As we spend increasing amounts of time at our computer workstations, we need to be aware of how the design and arrangement of our equipment can impact our chances of injury. Computer ergonomics is the study and / or implementation of work station design with the purpose of reducing or eliminating physical stress.
My interest in repetitive stress syndromes began approximately 10 years ago when my practice started seeing a much greater number of people suffering from the effects of computer / keyboard work. Despite all of my training and continuing education related to these types of injuries, I quickly realized that traditional treatment for this type of injury was marginally successful at best.
Any type of therapy was going to have to include the application of basic ergonomic principals to the patient’s work environment.
I am of the opinion that treatment alone or application of ergonomic principals by themselves was not going to resolve a repetitive stress injury.
This article will address the implication of work station ergonomics and injury resulting from postural stress secondary to use of the computer mouse.
Specifically, the following will be addressed:
1) What repetitive stress injuries are
2) What role do work station ergonomics play in injury
3) How reaching for the mouse sets the stage for injury
4) What are the symptoms of repetitive stress injury
5) How one can avoid mouse reaching injuries
What Exactly is a Repetitive Stress Injury?
Repetitive Stress Injury is a kind of catch all phrase for many conditions. Carpal Tunnel Syndrome, Tenosynovitis / DeQuervain's Syndrome, Tendonitis, Thoracic Outlet Syndrome, Trigger Finger, Myofascial Pain Syndrome and Chronic Sprain / Strain are some of the actual diagnosis that are rendered in my office. All of these conditions are serious and in many cases can cause great pain, permanent disability and sometimes loss of employment.
Repetitive Stress Injuries occur from repetitive movements involving a specific set of muscles and joints. RSI injuries are the result of an accumulation of stress and strain that causes irritation, inflammation, and eventually pain or other disability. A good analogy used to characterize the onset of RSI would be the “straws on the camels back” saying.
Initially, RSI affects the soft tissues of the involved joint(s). Soft tissues include muscles, nerves, ligaments and tendons. However, if left untreated for long periods of time, the involved joint can become arthritic and form bone spurs resulting in permanent damage to the joint.
While various occupations ranging from meat cutters to construction workers develop RSIs that result from the typical duties of their professions, the most frequent cause of these injuries involve computer work. The constant demand of keyboarding and mousing combined with the postural stress of confinement in an office chair with one’s neck and back held in prolonged fixed positions has resulted in an epidemic of injuries that includes hand pain, wrist pain, arm pain, neck pain, back pain and shoulder pain.
Work Station Ergonomics
The study of workstation ergonomics tells us that the objects that are used most often should be located closest to your body and accessed easily, without awkward body positions. Repeated reaching or prolonged postures that involve leaning forward from your chair are particularly stressful and fatiguing.
Many people are aware of computer ergonomics and thus have an ergonomic mouse. An ergonomic mouse is of little use if it is positioned in an area that requires reaching and stretching in order to operate it. Limiting reaching and stretching for desk items is essential to maintaining a healthy ergonomic environment.
The most frequent complaint that I have seen in my office is due to computer work is the combination of mousing and its’ inherent postural stress.
Most computer stations are designed in a way that involves the worker operating the computer mouse on a pad on the desk. Reaching to the desk for the mouse places direct stress on the joints and soft tissues of the neck, shoulder, elbow, wrist and hand. Additionally, reaching forward for the mouse stresses the lower and middle back.
So How Does Reaching for the Mouse Set the Stage for Injury?
Reaching for the mouse causes you to lean forward in your chair, extend your arm and support the weight of your body through your extended arm. The following section will discuss the particulars of each of these positions.
The stresses placed on the human frame when reaching for the mouse are easily explained. Contrary to popular belief, sitting, which most people believe is relaxing, is hard on the back. Sitting for long periods of time can cause increased pressure on the intervertebral discs of the spine.
In recent years, ergonomisist have told us that proper sitting posture would have us sitting upright with our hips flexed at 90 degrees. As it turns out, the most up to date studies show that a slightly reclined sitting posture with the hips flexed at 100 to 115 degrees is ideal if you have to sit at a desk. If your mouse is not positioned close enough to your body, you will have to reach for it. Reaching for your mouse stresses your back by reducing the angle of your hips.
Next, we have to look at the effects of reaching on the neck and shoulder.
When the mouse is being operated at a distance that makes the operator reach, the shoulder extends forward and the shoulder blade abducts (rotates forward). This position stretches the muscle groups that connect the medial portion of your shoulder blade to your spine and the superior portion of your shoulder blade to your neck. In the short term, this stretch aggravates the affected muscle groups causing spasm, fatigue, headaches and stiffness in the neck and shoulder. In the long term, this position creates a condition called a “stretch weakness” resulting in muscular imbalance, trigger points and chronic variations of the conditions listed in the prior sentence.
Lastly, placing the mouse too far away, too low, or too much on one side can cause shoulder, wrist, elbow, and forearm discomfort. When the operator is forced to reach for the mouse, his / her body weight shifts forward and ultimately results in weight bearing stress on the extended arm. Spending prolonged periods of time leaning on an extended arm is an unnatural and destructive posture that will eventually lead to the development of a repetitive stress syndrome; likely resulting disorders would include tendonitis of the wrist, elbow or shoulder.
What are the Common Symptoms?
• Tightness, discomfort, stiffness, soreness or burning in the hands, wrists, fingers, forearms, or elbows
• Tingling, coldness, night pain or numbness in the hands, especially around the base of the thumb
• Clumsiness or loss of strength in the hands
• Pain in the neck, shoulders, wrists, hands or back that is associated with using the computer
How Can You Avoid Injuries Related to Reaching for the Mouse?
The following recommendations are applicable to both home office ergonomics as well as ergonomics in the office.
1) Placing the input device directly in your immediate reach zone offers natural comfort and maximum hand-eye coordination. The use of a platform for the mouse is preferable. Some models of mouse platforms attach directly to your chair.
2) Your chair should have arm rests that are adjustable.
3) Your wrist should be either in a neutral position or flexed slightly downward when operating both your mouse and your keyboard. For this reason, if you select a mouse platform that attaches to your chair, adjustability of the platform is of primary importance.
4) Consider using a high quality office chair with adjustable armrests and lumbar supports. It should also allow some degree of recline.
5) Make sure that the upper arm and elbow are as close to the body and as relaxed as possible for mouse use - avoid overreaching.
6) Hold the mouse lightly, don't grip it hard or squeeze it. Place the pointing device where you don't have to reach up or over very far to use it. The closer you can place it to your body the better.
Writers Bio
Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.
Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.
Call Steve Jones at
(619) 280 0554
San Diego Chiropractic
Ergonomic Office Equipment Website to learn more about or Buy Ergo Nav, the Ergonomic Mouse Pad
or Visit Ergonomic Blog, "Ergonomically Yours" And read the latest News in the Ergonomic World.
Better Health Steve Jones
My chiropractic clinic is located in San Diego, California. For whatever reason, we see many patients suffering from neck pain, back pain, shoulder pain, wrist pain and hand pain as a result of computer work. As we spend increasing amounts of time at our computer workstations, we need to be aware of how the design and arrangement of our equipment can impact our chances of injury. Computer ergonomics is the study and / or implementation of work station design with the purpose of reducing or eliminating physical stress.
My interest in repetitive stress syndromes began approximately 10 years ago when my practice started seeing a much greater number of people suffering from the effects of computer / keyboard work. Despite all of my training and continuing education related to these types of injuries, I quickly realized that traditional treatment for this type of injury was marginally successful at best.
Any type of therapy was going to have to include the application of basic ergonomic principals to the patient’s work environment.
I am of the opinion that treatment alone or application of ergonomic principals by themselves was not going to resolve a repetitive stress injury.
This article will address the implication of work station ergonomics and injury resulting from postural stress secondary to use of the computer mouse.
Specifically, the following will be addressed:
1) What repetitive stress injuries are
2) What role do work station ergonomics play in injury
3) How reaching for the mouse sets the stage for injury
4) What are the symptoms of repetitive stress injury
5) How one can avoid mouse reaching injuries
What Exactly is a Repetitive Stress Injury?
Repetitive Stress Injury is a kind of catch all phrase for many conditions. Carpal Tunnel Syndrome, Tenosynovitis / DeQuervain's Syndrome, Tendonitis, Thoracic Outlet Syndrome, Trigger Finger, Myofascial Pain Syndrome and Chronic Sprain / Strain are some of the actual diagnosis that are rendered in my office. All of these conditions are serious and in many cases can cause great pain, permanent disability and sometimes loss of employment.
Repetitive Stress Injuries occur from repetitive movements involving a specific set of muscles and joints. RSI injuries are the result of an accumulation of stress and strain that causes irritation, inflammation, and eventually pain or other disability. A good analogy used to characterize the onset of RSI would be the “straws on the camels back” saying.
Initially, RSI affects the soft tissues of the involved joint(s). Soft tissues include muscles, nerves, ligaments and tendons. However, if left untreated for long periods of time, the involved joint can become arthritic and form bone spurs resulting in permanent damage to the joint.
While various occupations ranging from meat cutters to construction workers develop RSIs that result from the typical duties of their professions, the most frequent cause of these injuries involve computer work. The constant demand of keyboarding and mousing combined with the postural stress of confinement in an office chair with one’s neck and back held in prolonged fixed positions has resulted in an epidemic of injuries that includes hand pain, wrist pain, arm pain, neck pain, back pain and shoulder pain.
Work Station Ergonomics
The study of workstation ergonomics tells us that the objects that are used most often should be located closest to your body and accessed easily, without awkward body positions. Repeated reaching or prolonged postures that involve leaning forward from your chair are particularly stressful and fatiguing.
Many people are aware of computer ergonomics and thus have an ergonomic mouse. An ergonomic mouse is of little use if it is positioned in an area that requires reaching and stretching in order to operate it. Limiting reaching and stretching for desk items is essential to maintaining a healthy ergonomic environment.
The most frequent complaint that I have seen in my office is due to computer work is the combination of mousing and its’ inherent postural stress.
Most computer stations are designed in a way that involves the worker operating the computer mouse on a pad on the desk. Reaching to the desk for the mouse places direct stress on the joints and soft tissues of the neck, shoulder, elbow, wrist and hand. Additionally, reaching forward for the mouse stresses the lower and middle back.
So How Does Reaching for the Mouse Set the Stage for Injury?
Reaching for the mouse causes you to lean forward in your chair, extend your arm and support the weight of your body through your extended arm. The following section will discuss the particulars of each of these positions.
The stresses placed on the human frame when reaching for the mouse are easily explained. Contrary to popular belief, sitting, which most people believe is relaxing, is hard on the back. Sitting for long periods of time can cause increased pressure on the intervertebral discs of the spine.
In recent years, ergonomisist have told us that proper sitting posture would have us sitting upright with our hips flexed at 90 degrees. As it turns out, the most up to date studies show that a slightly reclined sitting posture with the hips flexed at 100 to 115 degrees is ideal if you have to sit at a desk. If your mouse is not positioned close enough to your body, you will have to reach for it. Reaching for your mouse stresses your back by reducing the angle of your hips.
Next, we have to look at the effects of reaching on the neck and shoulder.
When the mouse is being operated at a distance that makes the operator reach, the shoulder extends forward and the shoulder blade abducts (rotates forward). This position stretches the muscle groups that connect the medial portion of your shoulder blade to your spine and the superior portion of your shoulder blade to your neck. In the short term, this stretch aggravates the affected muscle groups causing spasm, fatigue, headaches and stiffness in the neck and shoulder. In the long term, this position creates a condition called a “stretch weakness” resulting in muscular imbalance, trigger points and chronic variations of the conditions listed in the prior sentence.
Lastly, placing the mouse too far away, too low, or too much on one side can cause shoulder, wrist, elbow, and forearm discomfort. When the operator is forced to reach for the mouse, his / her body weight shifts forward and ultimately results in weight bearing stress on the extended arm. Spending prolonged periods of time leaning on an extended arm is an unnatural and destructive posture that will eventually lead to the development of a repetitive stress syndrome; likely resulting disorders would include tendonitis of the wrist, elbow or shoulder.
What are the Common Symptoms?
• Tightness, discomfort, stiffness, soreness or burning in the hands, wrists, fingers, forearms, or elbows
• Tingling, coldness, night pain or numbness in the hands, especially around the base of the thumb
• Clumsiness or loss of strength in the hands
• Pain in the neck, shoulders, wrists, hands or back that is associated with using the computer
How Can You Avoid Injuries Related to Reaching for the Mouse?
The following recommendations are applicable to both home office ergonomics as well as ergonomics in the office.
1) Placing the input device directly in your immediate reach zone offers natural comfort and maximum hand-eye coordination. The use of a platform for the mouse is preferable. Some models of mouse platforms attach directly to your chair.
2) Your chair should have arm rests that are adjustable.
3) Your wrist should be either in a neutral position or flexed slightly downward when operating both your mouse and your keyboard. For this reason, if you select a mouse platform that attaches to your chair, adjustability of the platform is of primary importance.
4) Consider using a high quality office chair with adjustable armrests and lumbar supports. It should also allow some degree of recline.
5) Make sure that the upper arm and elbow are as close to the body and as relaxed as possible for mouse use - avoid overreaching.
6) Hold the mouse lightly, don't grip it hard or squeeze it. Place the pointing device where you don't have to reach up or over very far to use it. The closer you can place it to your body the better.
Writers Bio
Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.
Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.
Call Steve Jones at
(619) 280 0554
San Diego Chiropractic
Ergonomic Office Equipment Website to learn more about or Buy Ergo Nav, the Ergonomic Mouse Pad
or Visit Ergonomic Blog, "Ergonomically Yours" And read the latest News in the Ergonomic World.
Better Health Steve Jones
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