In this highly computerized world, more and more people of all ages are experiencing aches and pains that come from sitting at a computer for long periods of time. These aches and pains are felt in the neck, shoulder, upper and lower back, wrist and elbow joints. In some cases, the nerves to the hand become compressed, causing weakness and/or tingling in the fingers. These symptoms can occur in the onset of Repetitive Strain Injury (RSI), which may include damage to tendons, muscles, nerves and other soft tissues from repeated physical movements over time.
There are a number of factors that contribute to the onset of RSI, including:
• Posture – is the most critical component. Slouching at the keyboard puts your spine and limbs in positions that contribute to increased strain and tension, as well as increasing the risk of eye strain;
• Office set-up – a poorly designed workstation, or one that does not fit you well, can contribute to the onset of RSI (i.e. reaching for the mouse or keyboard too high or low, wrists extended during keyboarding);
• Worker technique – pounding the keyboard, using your wrists to move the mouse, or gripping the mouse tightly increases the demands on the hand and wrist and can trigger or aggravate symptoms of RSI; and
• Work Habits – sitting for extended periods of time without changing position is hard on your whole body and is a factor in developing RSI.
Don’t ignore the early warning signs, such as weakness of your grip, numbness, and discomfort or pain in the arms, hands, wrists or shoulders. Early diagnosis and treatment are vital to ensure recovery from the symptoms of RSI. For more information on RSI please contact physiotherapist in person.
We have created the following S.M.A.R.T. guidelines for computer user that you and your family can follow at home, at school and at work. S.M.A.R.T. is an acronym for Stretch, Move, Add it up, Reduce strain, Talk to a physiotherapist:
• Stretch – Include regular stretching into your work routine. Every 20 to 60 minutes, do three or four stretches – for hands, shoulders, neck and trunk. The key is to move your joints through their normal range of motion. Inquire about computer software that is set to interrupt work at chosen intervals with appropriate stretches, or set your onscreen timer to remind you to take “micro-breaks” as needed to momentarily change your arm position or to shift your weight.
• Move – Get up from your work station for a short stretch or walk around to promote blood flow to fatigued muscles every hour. No one has ever become more fit by sitting at a desk. Get regular daily exercise, away from the computer. It could be as simple as a walk around the office or getting off the elevator one floor early and taking the stairs. Move out of the pattern that the work is creating (i.e. stretch the opposite motion). Ensure you are not putting pressure on the carpal tunnel; slow key strokes to allow the median nerve to move off the tendons.
• Reduce strain – Make sure you are sitting correctly with your back supported:
• Adjust your chair, as below, to support your back and minimize awkward postures that can lead to muscle tension, fatigue and soreness. Avoid slouching;
• Sit with your buttocks right back in the chair and your feet flat on the floor, or on a footrest or phone book. Your knees should be bent at a 90-degree angle, at the same level or slightly above your hips. Keep your shoulders relaxed; arms close to your body or resting comfortably on the armrests, which should be positioned close to your sides; elbows bent at approximately 90 degrees; forearms parallel to the floor; and wrists straight, which may involve adjusting the angle of the keyboard;
• Keep your eyes level within range of the top third of the screen. Don’t squint to see the screen (check for glare or enlarge the font);
• Keep your work, keyboard and mouse centered in front of the monitor and close to you, to avoid arching your neck or twisting your body;
• Use a good quality mouse that requires minimal pressure to click, and be sure to position it on the same level and as close to the keyboard as possible. Keep your wrist straight and move the mouse with whole arm movements;
• Use ergonomic computer accessories, such as document holders to encourage neutral neck postures, and head sets to avoid awkward neck postures (often seen as holding the phone in the crook of the neck) while interfacing with the computer and telephone;
• A wrist pad on the keyboard allows you to rest your wrists on the pad and reduces stress on the wrist; and
• If you’re working on a computer all day at work, you may want to limit your computer-time at home. Choose activities for leisure and recreation that will not continue to stress the same muscles / tendons (i.e. if you’re keying on the computer all day, hanging out on the internet at night, or knitting / crocheting throughout the evening, this is not providing proper rest for the muscles and tendons that worked all day).
• Talk to a physiotherapist


DR. RAJESH PAL (PT)
MPT, BPT, MIAP, MDCPT
9811265450