Repetitive / Continuous Injury


Seeking early treatment is important in minimizing the progression of any injury. At Nicali Sports Medicine and Associates, we successfully use a wide variety of physical modalities such as: TENS, Interferential Current, Ultrasound, Laser Therapy, Therapeutic Massage Therapy and Corrective Manual Manipulations to manage these type of injuries. With a proper examination and diagnosis, healing of these conditions can be achieved and return to normal pain-free activity can be expected.

What are Repetitive Strain Injuries?
Repetitive strain injuries (RSI) are a family of injuries affecting tendons, tendon sheaths, muscles, nerves and joints. They cause persistent or recurring pains most commonly in the neck, shoulders, forearms, hands, wrists, elbows and lower limbs.

The term “repetitive strain” injury is misleading. Unlike other diseases, RSIs are not easily classified because they have a variety of causes and include injuries to different parts of the body. A number of terms are applied to such injuries including: repetitive injury, repetitive motion injury, repetitive trauma, overuse injury, cumulative trauma disorder, occupational musculoskeletal disorder and cervio-brachial disorder. The different terms indicate that such injuries involve repetition, and can also be caused by force, rapid movement, overuse, static loading, excessive strain, uncomfortable positioning of limbs or holding one’s posture in an unnatural, constrained or constricted position.

Who is affected?
In the past, repetitive strain injuries were most commonly attributed to those persons involved in sports – hence the names, “tennis elbow” or “golfer’s elbow”. These injuries were generally not recognized amongst workers, although syndromes related to specific occupations such as “weaver’s cramp” and “threader’s wrist” were reported. However, RSIs are increasingly common among a variety of worker groups, from clerks to jackhammer operators, from maintenance workers to typists.

Many workers are unfamiliar with repetitive strain injuries so everyday aches and pains are overlooked and no connection is made between the injury and the workplace. Aches and pains warn that a serious injury may be developing. If the causes are not eliminated or the worker moved from the job immediately, the damage can be permanent and irreversible. Sometimes the injury is crippling, leaving the worker in pain and possibly immobile for life.

Although the number of RSI injuries reported is increasing, there are no regulations or standards covering them.
RSI: The Causes
The causes of repetitive strain injuries can be classified in the following ways:

1. Rapid movement injuries, caused by repeated rapid movements.
2. Forceful movement injuries, caused by the exertion of muscle movement.
3. Static loading injuries, caused by fixed position with unsupported limbs.

Such injuries can be caused by either too little movement or excessive movement while handling light as well as heavy loads.

Often, repetitive strain injuries have multiple causes. A maintenance worker using a screwdriver may get pains from repetitive use of force while working at an uncomfortable angle. VDT operators may sit in an uncomfortable position with no wrist support and use rapid finger movements on a poorly designed keyboard. These workers may develop a number of serious injuries because of effects on their musculoskeletal system.

Any work that forces a person into an “unnatural” position can lead to repetitive strain injuries. The forceful twisting of a screwdriver, repetitive finger movements without rest, sitting in an uncomfortable position, bending the wrists for long periods, working with arms above shoulder length, gripping tools forcefully, etc., strain tendons, ligaments, and muscles causing injury.

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