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WHEN IT HURTS TO WORK

Coping with Computer-Related Injuries

© Marg Gilks

"How many hours a day do you spend at your computer?" my doctor asked when I complained of a constant, debilitating pain in my right shoulder. He grimaced when I told him.

Like thousands of North Americans, I'd fallen victim to RSI (repetitive stress injury)—damage to the muscles, tendons, and nerves in the hands, forearms, shoulders, or neck caused by a combination of poor computing habits, repetitive hand movements, and inappropriate equipment. The resulting pain can make even everyday tasks impossible to perform.

I was lucky—the pain in my shoulder subsided after three months. But now I listen to my body's warning signs, and I do everything I can to prevent another flare-up. If you're experiencing pain, numbness, or weakness, don't wait—see your doctor.

Preventing RSI

Prevention is the best way to avoid an initial injury or subsequent flare-ups. All the experts agree: eat right and exercise, practice good posture, and work at an ergonomic work station, stretching and taking breaks regularly.

A proper diet and regular exercise keep muscles and tendons strong and improve circulation. If you're already suffering from RSI, you need to strengthen underused muscles and stretch overused muscles. Ask your physiotherapist for appropriate strengthening exercises, rather than embarking on an overall strengthening program—attempting to strengthen overused muscles will only damage them further and interfere with their healing.

Everyone can benefit from stretching. See My Daily Yoga or Take a Break and Stretch for illustrated stretches you can do at your desk. Take a five to ten minute break every half-hour if you're not injured; more frequently if you've already been injured. Stand up and move around whenever you can.

Many RSI sufferers credit Tai Chi, yoga, Stott-Pilates, and other controlled movement exercise techniques with alleviating their symptoms and improving their posture and overall well-being.

"The biggest factor in injury prevention is posture—using your body correctly," says ergonomist Sharon Taylor, M.Sc., of ErgoSum Consulting. "It's fine to have fully adjustable furniture, but if you don't understand correct postures, you won't be able to use the furniture correctly."

A computer station that isn't user-friendly can not only contribute to poor posture, it can cause injury. I realized that my pinched nerve was caused by the position of my mouse—up on my desk, where I constantly had to extend my arm to reach it. I moved my mouse down beside my keyboard, so I'm only required to move my hand a few inches sideways to touch it, and I use keyboard commands instead of my mouse whenever I can. Taylor adds, "Probably the single most important, no cost, thing you can do at the work station is move the mouse to the left side. It takes only a few days to develop a comfortable level of control. Try it for two weeks of consistent use before rejecting it!"

Relocating my mouse was only one step in making my workspace more ergonomic. I purchased an articulating keyboard tray that I can adjust to the proper height and angle to keep stress off my shoulders, arms, and hands. I replaced my conventional straight keyboard with an ergonomic keyboard that allows my hands to rest in a more natural position. I also invested in a fully-adjustable chair that fit my dimensions.

"If you have any money to spend, start by investing in a good chair," says Taylor. A good chair should include a protruding lumbar support that can be adjusted for height, seat height adjustability, good upper back support, and correct seat depth. You should only be able to put three fingers between the back of your knee and the edge of your seat.

What else should you consider in setting up your computer and desk?

"Position the height of your keyboard," says Taylor, "so that when your body is well supported by your chair, your upper arms are hanging comfortably at the sides of the body, the forearms are parallel to the ground and your wrists are flat and straight when your fingertips are curved over to meet the keys." You may need to raise your chair and use a foot rest to achieve this posture. Learn to type with your wrists unsupported and use a split keyboard to straighten the wrists, she advises. If you habitually let your wrists fall below the level of the keyboard, a palm rest helps prevent your wrists from extending.

To prevent neck pain, make sure your monitor is set so you're looking slightly down at the area of the screen you look at most. Don't put it too low, though, or you'll end up hunching. "Bifocal and multifocal lens wearers need to start with the head in an upright and forward-looking position and then adjust the monitor height and distance according to their visual needs," Taylor advises.

And if you're injured? "For back injuries, try making computer work a standing task." For muscle, tendon, and joint irritation, apply ice. "This could be gel packs, bags of frozen peas or even popcorn. The general rule is that if the discomfort changes over the day or week, apply ice for twenty minutes three to five times per day. If the discomfort is constant and never changes, then heat helps. But applying heat to a new or changing injury will only increase inflammation. This is basic sports medicine—and work is just sports carried out over a longer time!"

Managing or preventing pain

As a writer and editor, I had no choice but to keep working, pinched nerve or no. I asked other sufferers of RSI what they do to prevent flare-ups, help their body mend, and manage pain while still earning a living. Many found relief with alternative treatments. (Note: Always consult your doctor before embarking on any alternative treatment.)

Massage therapy

An experienced massage therapist can ensure that muscle fibers scarred by micro-tears heal in their proper alignment. Further, regular massage can prevent injury or reinjury, according to registered massage therapist Joan Mailing. "Massage increases your range of motion," she says; "it decreases muscle spasms and increases blood flow to the affected area, thus ensuring the inflow of nutrients and the outflow of cellular byproducts." Regular massage keeps you supple and relieves pain and stress related to computer work.

What can sufferers do at home to relax stressed muscles? "Epsom salt bath," Mailing answers immediately. "Adding two to four cups of Epsom salts to your bath and soaking for twenty minutes draws waste products from your muscles and relaxes you, too."

Chiropractic adjustment

Dr. Gary Dix sees RSI patients complaining of posture-related headaches, shoulder injuries, and carpal tunnel syndrome. "My goal in treating any patient is restoration to normal health, which goes beyond just eliminating the symptoms," he says. "The chiropractic adjustment is a specific, controlled thrust aimed at the reduction and elimination of vertebral subluxations (misalignment in the spine). Restoration of normal joint play and improved biomechanics are part and parcel of the adjustment." Pressure on the nerves is often reduced as a result.

In conjunction with chiropractic adjustments, Dr. Dix also recommends soft tissue therapy. He practices a technique he calls Active Release Therapy: as he guides the patient through movements designed to contract and stretch the muscles, tendons, and ligaments, he works on adhesions in the tissues (similar to scar tissue) with his hands. "Muscles and joints work hand in hand so it's vital that both are dealt with during rehab or therapy."

Herbal supplements

"Supplements aren't meant to be the foundation of your diet," warns certified nutritional microscopist Barbara Dix. "They're meant to add to what we're already putting into our bodies." Ideally, they're used in a preventative capacity, but some herbs are natural anti-inflammatories or pain relievers, or they help prevent or slow further damage.

Grape seed extract, touted as an antioxidant, also acts as an anti-inflammatory and eases eye strain. Glucosamine sulfate protects and strengthens the cartilage around joints, and can also ease pain and inflammation. Combining glucosamine sulfate with chondroitin sulfate, a supplement with similar beneficial properties, will boost their effectiveness. Bromelain (found in pineapple) and turmeric reduce inflammation. For pain? "I love white willow bark," says Dix. "It doesn't upset your stomach, like ASA."

Herbal remedies usually have fewer side effects than synthetic medications, although reactions aren't unheard of. "I can't take grape seed extract with Advil," one sufferer told me. "I get kind of weird." Consult an expert or do your research before embarking on any herbal remedy.

Other coping strategies

RSI sufferers also cope with pain with acupuncture, which stimulates the body's manufacture of beta-endorphins, and so can be effective in relieving pain, and with TENS machines. TENS (Transcutaneous Electrical Nerve Stimulation) machines send electrical impulses through electrodes placed over nerve centers, blocking pain signals normally sent to the brain through nerve fibers. TENS also may activate the release of endorphins, used by the body to suppress pain naturally.

Rather than coping with symptoms, though, the best way to deal with RSI is prevention. "The single most important thing I learned," says one sufferer, "is that good routine maintenance is a lot better than medication. When I do my exercises faithfully, remind myself when my posture slips, take adequate breaks and don't overstrain the affected joints, there's a lot less pain and inflammation."


Marg Gilks is a writer and professional editor specializing in fiction. She's been working one-on-one with authors to help them prepare their work for publication for over ten years. Visit http://www.scripta-word-services.com/ to learn more about her editing services, manuscript evaluations, and FUNDAMENTALS OF FICTION, her 8-week e-mail course covering fiction-writing basics including point of view, showing instead of telling...all the way through to putting the final polish on your manuscript.

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