An increasingly common problem among computer users, and in particular bloggers and developers, is repetitive strain injury (RSI). While most people who use a computer have heard the term RSI and are aware that it exists, it is still very little understood by the public and even the medical community. The result is that when someone does get it, it can be hard to know what to do or who to turn to.
Few people know that I have had RSI in various degrees for around 10 years and it has taken me until recently to really start to get a good understanding of it, and better than that I am successfully getting it under control. So this article is intended for any blogger (or computer user in general) who is suffering from RSI or who is worried that they may be experiencing the first symptoms.
I can only tell you what I’ve learned from experience, and if you have more experiences I encourage you to share them in the comments.
What is the Cause of RSI?
It would be easy to assume that RSI is simply the result of ‘repetitive strain’, such as typing and mousing. To some extent this is true, but it doesn’t explain why some people use a computer a little bit and get RSI, and others type day and night and never get it. Most medical practitioners blame poor ergonomics, but again it doesn’t tell the whole story. So what is the full story?
Firstly, we need to come to terms with a hard fact. RSI is a lifestyle injury. There is a cause, and RSI is the effect. Eliminate the cause(s) and you can prevent and cure the problem. Easier said than done!
So let’s look at the causes one by one:
- Skeletal Misalignment – I’ve put this first because it took years before I figured this out, but when sports massage therapist Sarah Murray at No More Knots in Brisbane identified that my hips were significantly out of alignment, it in turn revealed the corresponding misalignment of my spine, shoulders and neck that were ultimately causing the restriction of nerves and blood vessels to my arms and hands. The lesson here is that the symptom is in your hands, but at least part of the cause is probably somewhere completely different. Start at the feet and work your way up to identify any issues in your body’s alignment.
- Ergonomics – The way that you position and use your body while on a computer (and at ALL other times) will have a big impact on the condition of your body. As computer users we tend to sit in the same, unnatural position for hours on end and our bodies start to build fascia tissue to help us sustain these unnatural positions. That tissue in turn starts to strangle our nerves and blood vessels. The problem is that sitting at a computer for hours is completely unnatural, and almost all ergonomic advise is based on a completely flawed concept that we should sit at a desk with all of our joints at 90 degrees.
- Lack of Muscle Tone – If you are going to put your body under strain, the weaker you are, the harder it will be to cope with that strain. So if like me, you start out with minimal muscle tone but a very high level of flexibility, then your body is going to seriously struggle to hold the unnatural positions that you ask it to, accelerating the development of that strangling fascia tissue.
- Posture – This is similar to ergonomics and also requires a degree of muscle tone, but poor posture puts strain on your body, tiring it out and encouraging the development of that emergency fascia tissue. With good posture, your body is all nicely stacked up like a Jenga tower and can support itself without anyone needing to hold it up. Tilt the table however, and the Jenga tower starts to topple. That is how poor posture affects your body.
- Stress – This is controversial because a lot of RSI sufferers don’t like the implication that there is a psychological element to RSI, but in my experience, stress is one of the single biggest factors. When you think about it, the reasons are obvious. When you are stressed, you sub-consciously tense your body, putting strain on your muscles for hours on end. When you are stressed, you feel more tired and so you have less energy and strength to maintain good posture. When you are stressed, you are more sensitive to pain and so are more easily affected by the physical problems in your body. When you are in pain from RSI, it causes you stress, and so the cycle continues.
- Unnatural Use – There is nothing that you can do to escape the fact that we spend far too much time at desks and on computers. It isn’t natural and our bodies don’t like it. Force your body into an unatural position to do unnatural tasks all day, every day and you can’t really blame it for eventually shouting WTF!!!! Stop f***ing torturing me or I’ll scream even louder!
I’d bet that there are very few, if any, RSI sufferers who can put their hand on their heart and say that none of the above apply to them. A lot of people can get away with one or more of the above and not notice a problem, but it is the combination that is really dangerous. In my opinion, that is why some people suffer problems when other don’t, because it requires that perfect storm to occur before you notice an issue.
So how can we cure RSI?
Before I go into details, I should state that I have spent 10 years and a lot of time and money trying to find a definitive cure. I’ve seen GP’s, chiropractors, physiotherapists, sports massage therapists, RSI “experts”, a rheumatologist, an Alexander Technique teacher, acupuncturists and a whole host of other professionals in search of the answers. I’ve had MRI scans, nerve conduction tests, blood tests and x-rays. I’ve tried wrist splints, ergonomic chairs, anti-inflammatories, digital pens and voice command software. And most of it (not all) was a complete waste of time.
I have learned that:
- There is no magic cure
- Most experts have absolutely no idea what they are talking about (however confident they might sound)
- Fixing your body is a long term process
- The answers are staring you in the face in the list of causes above!
So I want to give you a head start and tell you what I have found works, and hopefully it will help you figure out a solution to your own case.
We’ll address the causes one by one:
1. Skeletal Misalignment
While much of the solution is in your own hands, you might want some professional help identifying the imbalances in your body, and releasing the muscle spasms that are causing the misalignment. I found that deep tissue sports massage therapists tend to me the most helpful, but try out professionals near to you and if you feel they are blagging, move on. No professional can ‘fix’ the problem, but they can kick start the recovery by releasing the worst muscle spasms and helping to straighten things out.
If you don’t want to go to a professional, Yoga is also a great way to develop awareness in your body and identify and rectify the imbalances. Nearly everyone has one side of their body tighter and less flexible than the other and this can contribute to the problems.
- Identify areas of misalignment
- Get a massage therapist to release the worst areas
- Do Yoga regularly to align your body and develop greater awareness
Good ergonomics is one of the biggest challenges, because sitting on a computer is just not natural. The most ergonomic thing to do would be to stop working on a computer and live a more active lifestyle, but in reality that isn’t possible for most people. So what can you do?
Firstly, try to spend less time on the computer, or regularly switch between working on paper and working on the computer. Variety is your friend, so keep changing things up and get up and move around as often as you can. Some people use a timer to remind them to get up and move their body. These are tiny tweaks though.
The best thing that I have found is to completely redesign my “desk”. I have had lots of different “ergonomic chairs”, some bought and some prototypes that I knocked up myself, but most turned out to have an inherent flaw, which in most cases is that they are not well suited to long periods of use. I most chairs, as soon as you start getting a little bit tired, your body collapses and starts being put under strain. Then there is nothing the chair can do to save you. After years of experimentation, the best option that I have found is… wait for it … an Ikea Poang chair! Yes, it is one of those bouncy arm chairs. Needless to say, you cant sit at a desk in an armchair, but using an LCD monitor attached to a extend-able arm, and a small wireless keyboard on my lap, it works an absolute treat. The reason this works is because you are sitting in a relaxed comfortable position and then fitting the computer around you. I recommend that you experiment with the same principle and see what you can come up with.
The downside is that you cant always get away with such bizarre arrangements in an office enviroment. So I have the poang at home and a coventional desk in the office. I find that as long as I spent a good proprotion of my time working from home, my body can cope better with the time that it does spend at a regular desk.
One final thing. Ergonomics doesn’t just apply to your desk. Your body is under strain when you drive, ride a bike, do the washing up, even sitting on the sofa. Make changes to reduce strain on your body and keep it well aligned at every opportunity.
- Identify activities that put sustained strain on your body
- Redesign those activities around your body to reduce the strain
- Take regular breaks
- Mix things up – variety is your friend
3. Lack of Muscle Tone
The solution to lack of muscle tone is kind of obvious, but there are a few important things to note.
Firstly, you don’ need big bulging muscles. What you need is even and balanced control throughout your body. It’s all these tiny muscles that you have never heard of that keep you upright and balanced. In fact, developing big “gym muscles” can make problems worse because they are out of proportion with the rest of your muscles and so contribute to imbalance.
The best solution to this to do exercise that works all of your muscles in sync with each other and promotes alignment. Yoga is the obvious answer as it tones stretches and aligns the body, but some people I have heard find clinical pilates very effective. Finding the time to do these though can be really difficult. I find that if I do Yoga 5-6 days a week then I can keep things under control, but anything less and the pain starts coming back. The solution for me is to do DDP Yoga, as you can do it at home and the “dynamic resistance” concept means that you can get a really good workout in 20-25 minutes. Yes, it is cheesy, but it works so who cares. Pro Ironman Brendan Brazier also explains a similar concept in his book Thrive if you want an alternative to Yoga.
- Try to do stretching and toning exercises everyday
- You need even muscle balance in all parts of your body, not a few big muscles
- Yoga is ideal
This is closely related to the above 3 items. The key is to be aware of your posture at all times and make an effort to bring yourself back into alignment. For me, one of the biggest problems was that:
- I didn’t have enough core strength to maintain good posture
- My muscles were so jammed up that I physically couldn’t stand completely upright.
The first issue was dealt with through regular Yoga, and he second fixed itself with deep tissue massage. The amazing thing was that my neck straightened out after the muscle spasms in my hips were released. That is why it is so important to look at your whole body, and start from the feet and work your way up.
Speaking of feet, they are literally the foundation of good posture. Most shoes have a big heel cushion, meaning that your foot slopes forward. This screws up your posture for your whole body. Wear shoes that have “zero rise” from front to back and it will make it way easier to maintain good posture. If you are feeling adventurous, take it to the next level and try barefoot running/walking. It might sound crazy, but it has massive benefits to your posture and core strength – quite the opposite of what many people find with “conventional” running.
- Be aware of your posture at all times and make an effort to correct yourself
- Improve your muscle tone and core strength
- Identify and fix any imbalances from the feet upwards
- Wear flat shoes or walk/run barefoot
As mentioned, I think this is one of the single biggest factors, and probably the most ignored. There are whole books and courses about how to manage and reduce stress, but here are my preferred methods.
There are really two elements to stress – triggers and reactions. Triggers are those external factors that upset you, while reactions are you own response to these triggers. This is important because stress itself, is the reaction, NOT the trigger. That means that whether or not you get stressed is controlled by you, and you alone, no matter how unpleasant the triggers.
To reduce stress therefore you should firstly learn to step back and take a look at your own reactions. Make a conscious decision about how to react to different situations. This is much easier if you look ahead and see the triggers coming, so that you are mentally prepared, rather than being taken by surprise. Also, don’t forget to breathe. Just stop, breathe and and remind yourself that inflicting stress upon yourself will only make the situation worse. Keep things in perspective, be positive and always remember that your number one goal is to be happy, healthy and relaxed, and that stress fights against all 3. Once I faced up to the fact that stress is self inflicted, my ability to deal with stressful situation improved massively as I was now in the driving seat with full control over how I react.
But it isn’t always easy if you’re being constantly hammered by stressful situations, and so the second phase is to reduce the triggers. Write a list of the things that stress you in life and see if you can eliminate any of them. It might even mean changing your job, but if that is what it takes then maybe that is what you need to do. People play a big part in this too, so try to spend your time with people who make you feel good about yourself and avoid negative people that drag you down. As Jeff Walker says, hanging out with negative people is like injecting poison into your brain.
Finally, there is a physical aspect to stress. Exercise has amazing stress busting properties, so get out and get that blood pumping regularly. Converse to that, make sure that you are getting enough rest so that your body and mind can recover from the constant abuse being thrown at them.
- Take control of your own emotions – only you control how you react
- Anticipate stressful situation so that they don’t catch you by surprise
- Avoid stressful people and situations wherever possible
- Exercise regularly
6. Unnatural Use
Maybe this is the hardest one of all, because this is the one that says:
- Using a computer is NOT what your body was designed to do
- Driving a car is NOT what your body was designed to do
- Riding a bike is NOT what your body was designed to do
- Using a phone is NOT what your body was designed to do
- Texting is is NOT what your body was designed to do
- Writing is NOT what your body was designed to do
- Watching TV is NOT what your body was designed to do
To truly get a handle on RSI, you need to face up to the above facts. It doesn’t matter how “ergonomic” the products you buy are, the above statements are still true, and the more you do these types of activities, the more your body will suffer.
Try to redesign your lifestyle to minimise unnatural activities, vary activities as much as possible so that you are not doing too much of one thing (at least not all in one go), and when you are doing unnatural physical activity, constantly research and experiment to find better, less strenuous ways of doing them.
- Live a more natural lifestyle (so far as it is practical)
- Take breaks
- Vary activities throughout the day and week
- Experiment with better ways of doing things
There is no magic cure for RSI, but if you open your mind, take responsibility for your own actions and address the causes of RSI, then you can both prevent and cure the symptoms.
Having had the problem for 10 years and been through some seriously low points, I am now at a point where I am in control. To say I am cured would be to miss the point, as I it takes daily effort to implement the points above and keep things on track. When I slack off, things start to slide downhill, so you need to prepare yourself for the fact that preventing and reversing RSI needs to be integral to your everyday lifestyle. Just as your lifestyle caused it, so too can your lifestyle solve it.
Remember, only a mad man will keep doing the same thing over and over and expect to get different results!
If you have experience with RSI and want to share ideas and techniques that have worked for you, please do leave a comment.