NET NOTES

RSI

Published in SOS February 2002
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Technique : Net Notes

Repetitive Strain Injury (RSI) could curtail your musical career, so it's well worthwhile taking a look at these web sites to find out how you can avoid it.

Musicians, especially those who use computers, have a comparatively high risk of developing Repetitive Strain Injury (RSI), a debilitating condition which can bring musical careers to a swift and painful end. RSI is the damage to muscles, tendons, nerves, and other soft body tissues which comes about when you perform the same small task again and again. 'Small tasks' include many of the seemingly innocuous activities involved in operating a typical desktop computer, or in practising a musical instrument.

It's easy to blame age, rheumatism, or 'overdoing it a bit' for the RSI symptoms (typically aching hands/fingers, increasing clumsiness, or loss of strength), which is why the condition is often not treated early enough. RSI is far easier to prevent than to cure, so it's worth knowing about ways to minimise the risks. With this in mind, here are some web resources which can answer typical questions about RSI, whether you're looking for prevention or treatment.

For a start, it's well worth finding out a bit about RSI. You can contact the UK RSI Association through its web site at www.rsi.org.uk — they sell an information pack, but the site itself has precious little information other than their contact details. Much more useful for web-based information is www.rsi-uk.org.uk, which is the home page for the RSI UK mailing list. Not only is there the facility to subscribe to the mailing list itself, but you can also read a selection of articles and an FAQ on the subject. US-based general information sites can be found at the US-based Cumulative Trauma Disorders Resource Network (www.ctdrn.org), and the Los Angeles RSI site (www.geocities.com/la_rsi).

If you feel so inclined, there are many ergonomic gadgets that can help ease the strain of using a computer. There are various keyboard designs that can help in avoiding awkward postures, but your keyboard location and your typing technique is as important as the keyboard design. A great general-purpose resource on keyboard selection and use is the Typing Injury FAQ site (www.tifaq.org), which lists a number of alternative ergonomic keyboard options, as well as offering advice on how to use them to their best advantage.

At the typing injury FAQ site, you can find out what may be wrong with your keyboard or typing technique and read about the alternatives to conventional computer keyboards.

In addition to giving information on keyboards, the site also provides detailed information on alternative pointing devices, if your mouse is causing you pain. These include touchpads, trackballs and graphics tablets, and are worth looking into, as are the many useful accessories which are covered, like wrist rests and foot rests.

If you're doing a lot of typing, you might want to consider an alternative way to input text, in order to cut down the time you have to spend at the keyboard. The C•Pen (www.cpen.com) is one option; this lets you scan printed text and transfer it as a file to your computer. Alternatively, if you already own a scanner, you could check out one of the Optical Character Recognition (OCR) packages, such as Abbyy Finereader (www.abbyy.com) or Adobe Acrobat Capture (www.adobe.com), which allow you to scan printed pages and convert them to editable files automatically. Voice recognition could also be worth considering if your hands are already causing you pain, although these usually require dedicated training, and the technology is very much in its infancy.

If you play an instrument, you should spend some time studying how you sit or stand when playing — a full-length mirror can help here — in order to identify any areas of tension or unnecessary pressure. You should always try to find the most comfortable way of achieving results. If your playing style is uncomfortable, or causes you pain, you should try to change how you do it.

The Alexander Technique is one of a range of 'body re-education' measures which some musicians have found helpful in combating strain injuries.

If you have difficulty analysing your own physical playing habits, or if you've discovered a problem but don't know what to do, don't despair. Try the Musicians & Injuries site, at www.engr.unl.edu/ee/eeshop/ music.html, to begin with, as this not only gives a reading list, but also provides loads of on-line information and links specific to musicians, broken down into sections covering individual instruments.

Although sites like this provide a great deal of information, sorting out performance problems can often involve in-depth postural reassessment, and there are a number of techniques available which can help you to do this. One of the most popular is the Alexander technique, which is concerned with re-educating your body to rid it of bad habits picked up over the years. It is based on a thorough knowledge of anatomy, as well as using Yogic relaxation principles. A large amount of information about the Alexander technique can be found at the Alexander Technique International site (www.ati-net.com), as well as lists of books, videos and periodicals which can be of use. The Alexander technique does take a certain amount of commitment to master, and if you're serious about taking it up you really need a teacher who can guide you. Fortunately, Alexander Technique International also has a large and up-to-date listing of Alexander technique instructors throughout the world, with 75 listed for the UK alone.

Specific Yoga stretches can help prevent and ease RSI. Check them out, with useful animated examples, at www.mydailyyoga.com.

Yoga is another technique that can help you take control of your own body. You don't need to be able to twist your feet around the back of your head, but some of the Yoga stretching techniques are of particular interest to anyone concerned about RSI. A good site to visit is www.mydailyyoga.com, which has a whole section dedicated to RSI stretches, complete with animated pictures showing them in action. Once you have found a few favourites that suit you, try to include them in your daily routine and you'll soon feel the benefit. Bear in mind, as well, that the relaxation and meditation elements of Yoga can also reduce your levels of stress, which will in turn decrease your risk of developing strain injuries.

T'ai Chi also has an excellent reputation as a good form of relaxation, as well as a gentle form of exercise consisting of a series of movements performed slowly and methodically. You can find lots of information about the many applications of Tai Chi at the UK's Tai Chi Union site (http://dspace.dial.pipex.com/taichi), and there is a good list of books, videos and links at www.thetaichisite.com. Like the Alexander technique, however, Tai Chi is also best learned from a teacher, because trying to learn 'The Form' (as the series of movements are called) from books, videos or web sites can be very difficult. Locating a teacher couldn't be easier, though, using the world map at www.airtel.net/hosting/fjvelasco/mapindex.html. I found 77 teachers for the UK alone.

And these aren't the only techniques available which are known to aid prevention of, and recovery from, RSI. There's also the Feldenkrais (www.feldenkrais.com) and Trager (www.trager.com) methods, Rolfing (www.rolf.org), Hellerwork (www.hellerwork.com), and Pilates (www.pilatesfoundation.com), so you ought to be able to find something to suit you.

If you would prefer a more passive form of body awareness, hypnotherapy can be very effective, not only at reducing the pain of any existing RSI, but also for instilling good postural habits, relaxation techniques, and stress management. Surf to the British Society of Clinical Hypnosis web site (www.bsch.org.uk) to find a reputable practitioner in your own area.

Homeopathic remedies will be popular with some musicians, and there is a list of RSI-specific suggestions at www.homeoint.org/site/price/workers.htm. It's also worth mentioning that cod liver oil (when coupled with rest or moderation) is known to help your body to return to normal functioning after RSI symptoms have developed. You don't have to drink it and have that awful taste in your mouth all day — you can buy it in capsule form. And, speaking of oils, a low-fat diet can intensify the symptoms of RSI. It would be wise to consult a doctor or dietician if you suspect that your diet might be aggravating RSI.

The main thing to remember from day to day is that you have to pace yourself and take breaks regularly. At least every hour or so, take a couple of minutes and have a stretch. It's worth bearing in mind that even perfect working ergonomics can cause problems if you stay too still for long periods of time, so shift position frequently. Your hands are one of your most important work tools, so respect them, don't overstretch them, and make life as easy as possible for them.

RSI Newsgroups     • misc.health.injuries.rsi.misc • misc.health.injuries.rsi.moderated

RSI Symptoms To Watch Out For     Dealing with RSI early is critical to limiting the damage it can cause, so it helps to be able to spot symptoms in yourself or others. They include general soreness, numbness, coldness, tingling, loss of strength, tightness and clumsiness. The symptoms can all manifest themselves in the hands, wrists, forearms, fingers, shoulders and neck. These symptoms can easily be mistaken for symptoms of localised fatigue (aches, pains, trembling, and loss of strength), but fatigue symptoms increase as the activity increases, and disappear shortly after activity stops, whereas RSI symptoms often persist after resting. If you are experiencing a tingling and numbness of the thumb, index, and middle fingers, you may be experiencing an RSI-related condition known as Carpal Tunnel Syndrome. These sensations are often more pronounced at night and can wake you up. Carpal Tunnel Syndrome can progress to developing a burning sensation, cramping and weakness in the hand. You may find yourself frequently dropping objects and experiencing sharp shooting pains in the forearm. Chronic Carpal Tunnel Syndrome can also lead to wasting of the hand muscles. Tendonitis is another common RSI-related condition caused by inflammation or irritation of a tendon, and is often mistaken for arthritis. If you are experiencing any of the symptoms described above, pick up the phone and book yourself an appointment to see your doctor. By the time RSI symptoms are apparent, damage is already being done.