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Greetings

Happy New Year from all of us at State Of The Art Physical Therapy.  We hope that you had a great Holiday season and we wish you all the best for 2016.

Welcome to the January edition of our State Of The Art Physical Therapy's newsletter.

In this newsletter we are exploring repetitive strain injuries.

Are you suffering from recurring pain in one of your joints? You may be experiencing a repetitive strain injury and this painful ailment may become chronic if it is not treated properly. Your joint may also suffer long-term effects if it does not heal correctly. If you’re experiencing chronic joint pain due to a repetitive strain, the licensed Physical Therapists at State Of The Art Physical Therapy may be able to help you experience less pain and better manage your discomfort.


The Basics of Repetitive Strain Injuries

Repetitive strain injury is a collective term that is used to describe pain in the tendons, muscles, or nerves of a joint that has been overworked due to repetitive movements. It is also referred to as non-specific upper limb pain or work-related upper limb disorder.

The hands, wrists, forearms, neck, shoulders, and elbows are most commonly affected. Furthermore, the following conditions may develop due to repetitive strain injuries:

  • Carpal tunnel syndrome – abnormal pressure on the main nerve in the wrist which causes discomfort in the hand.
  • Cubital tunnel syndrome – pressure on the nerve in the elbow joint that causes discomfort in the forearm, wrist, and fingers.
  • Guyon’s canal syndrome – the pinching of an important nerve in the wrist that extends through a tunnel called the Guyon’s canal.
  • Lateral epicondylitis/epicondylosis – also known as tennis elbow, is inflammation or breakdown of tissues at the elbow that is caused by overuse.
  • Tendonitis/Tendinosis in the wrist or hand – inflammation or degeneration of the tendons that is caused by overuse.

The typical symptoms of repetitive strain injuries include: pain, numbness, burning or tingling sensations in the affected joint or surrounding muscles. Muscle weakness, cramping, stiffness, and decreased mobility often develop as well.

Poor posture, or almost any posture that is sustained over long periods and over many months or years can lead to adaptation in your tissues (shortening or lengthening) that can lead to muscle imbalance.

Individuals who repeat specific movements such as those who perform manual labor (e.g., stockers, assembly line workers, cashiers), work at computer desks for long periods, or play certain sports (e.g., baseball, golf, tennis) are highly susceptible to repetitive strain injuries. These types of activities result in the overuse of tendons and muscles in the joints or the irritation of nerves. Temporary pain may be treated with heat or ice and relative rest, but if the condition persists longer than a couple of weeks, a Physical Therapy assessment is indicated to address the issue before the condition becomes chronic.

Pain Management Strategies

If a repetitive strain injury is suspected, resting the affected joint by avoiding the movement that is causing the pain (relative rest) is an important step that starts the healing process. In addition, exercises that are guided by a Physical Therapist have been shown to help improve repetitive strain injuries by helping nerves, muscles, or tendons that have been injured to heal properly.  Guided exercises are also useful at restoring the mobility and strength of the affected joint. Furthermore, certain strategies are usually more effective than others depending on the type of strain that has occurred.

For example, hand braces are typically beneficial for relief with carpal tunnel syndrome, while eccentric resistance exercises are more helpful in lateral epicondylosis/epicondylitis. Clinicians and Physical Therapists often recommend the use of a brace to help support and rest the joint and promote healing of the nerves, muscles, or tendons. When repetitive strain injuries are treated early on, most people can avoid having to undergo invasive procedures such as surgery.

Allowing a Physical Therapist at State Of The Art Physical Therapy to conduct a thorough assessment of your physical state is an especially helpful way to gain a better understanding of how your daily activities and lifestyle may be contributing to your repetitive strain injury. In addition, an individualized program can be designed for you in order to reduce your recovery time, while ensuring that you will regain mobility and strength in the injured joint.
 
Ways to Prevent Repetitive Strain Injuries

The licensed Physical Therapists at State Of The Art Physical Therapy recommend the following strategies in order to prevent repetitive strain injuries from occurring:

  • Maintain good posture while working, exercising, or sitting at your desk. This includes using proper lifting techniques, appropriate form during physical activity, and sitting with the back pressed against the chair along with the forearms placed horizontally on the desk while seated at the computer.
  • Take regular breaks when repetitive movements need to be performed for long periods. This means taking short, but frequent breaks in addition to a longer break (e.g., lunch period). Brief moments of rest prevent stiffness and tension by allowing your muscles and tendons to relax.
  • Get moving! Perform stretching and strengthening exercises regularly. Stretching exercises help improve blood flow to the joints and prevents stiffness. Strength training can help reduce the occurrence of muscle or tendon injuries. However, it is important to maintain the right posture and form while engaging in such exercises.


If you are concerned about performing these types of activities properly, contact a licensed Physical Therapist at State Of The Art Physical Therapy who can show you how to lift objects properly, maintain proper form while playing sports, and stretch tendons and muscles in the joints without causing further injury. The Physical Therapists at State Of The Art Physical Therapy can also assess your condition and create a pain management plan that will improve your recovery. Call State Of The Art Physical Therapy today to learn more about how our services can help you.

References
1.    van Tulder M, Malmivaara A, Koes B. Repetitive strain injury. Lancet. 2007; 369(9575):1815-22.
2.    da Costa JT, Baptista JS, Vaz M. Incidence and prevalence of upper-limb work related musculoskeletal disorders: A systematic review. Work. 2015; 51(4):635-44.
3.    Tjepkema M. Repetitive strain injury. Health Rep. 2003; 14(4):11-30.
4.    Van Eijsden-Besseling MD, van Attekum A, de Bie RA, Staal JB. Pain catastrophizing and lower physical fitness in a sample of computer screen workers with early non-specific upper limb disorders: a case-control study. Ind Health. 2010; 48(6):818-23.
5.    Ratzlaff CR, Gillies JH, Koehoorn MW. Work-related repetitive strain injury and leisure-time physical activity. Arthritis Rheum. 2007; 57(3):495-500.

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