Preventing RSI
August 12, 2015 2:30 PM Subscribe
I am extremely prone to RSIs. Looking for resources (books, websites) on preventing injuries, as well as personal approaches taken by other RSI-prone people. Most of what I can find relates to ergonomics around computers; I am more interested in working out how to go about doing daily life things and staying fit/keeping the body in working order without injury.
I don't have a rheumatological disease, that's been excluded by two rheumatologists. All of my injuries (mostly tendinopathies, osteoarthritis in some places) are orthopedic. I have mild-moderate hypermobility, that's probably part of it, but that's it as far as any kind of systemic issues go (at least as far as I know and as far as anyone can tell me).
I go to a sports med and physiotherapist (when I can afford it) as and when injuries occur. What I can't work out - and don't have good guidance on - is how to prevent injuries from occurring, while maintaining function and relative fitness. They happen unpredictably - a couple of times, like recently happened, again, after doing ordinary housework.
I know that doing no activity is just as bad as too much. Right now, I do my physio stuff, selected bodyweight exercises, and stationary cycling (per physio). Wrt exercise, my physio advises doing what I can within the limits of pain, and adjusting or stopping when necessary.
The thing is that sometimes, I have transient pains that don't add up to anything, and sometimes I experience no pain at all before an injury just shows up. So it's hard to know how to use pain as an indicator/monitor. Also, I don't really have a grip on how much e.g. sweeping is going to be overdoing it. (I thought about maybe trying some objective measure, like time limits, but don't know really where to start with that.)
So, am looking for advice and book/web recommendations on planning and monitoring activity, and interpreting pain, in the context of frequent RSI. (Also, interested in thoughts/recs on fear of reinjury, and maintaining motivation to stay reasonably fit when there are frequent setbacks and when you are kind of goal-oriented when it comes to fitness.)
I don't have a rheumatological disease, that's been excluded by two rheumatologists. All of my injuries (mostly tendinopathies, osteoarthritis in some places) are orthopedic. I have mild-moderate hypermobility, that's probably part of it, but that's it as far as any kind of systemic issues go (at least as far as I know and as far as anyone can tell me).
I go to a sports med and physiotherapist (when I can afford it) as and when injuries occur. What I can't work out - and don't have good guidance on - is how to prevent injuries from occurring, while maintaining function and relative fitness. They happen unpredictably - a couple of times, like recently happened, again, after doing ordinary housework.
I know that doing no activity is just as bad as too much. Right now, I do my physio stuff, selected bodyweight exercises, and stationary cycling (per physio). Wrt exercise, my physio advises doing what I can within the limits of pain, and adjusting or stopping when necessary.
The thing is that sometimes, I have transient pains that don't add up to anything, and sometimes I experience no pain at all before an injury just shows up. So it's hard to know how to use pain as an indicator/monitor. Also, I don't really have a grip on how much e.g. sweeping is going to be overdoing it. (I thought about maybe trying some objective measure, like time limits, but don't know really where to start with that.)
So, am looking for advice and book/web recommendations on planning and monitoring activity, and interpreting pain, in the context of frequent RSI. (Also, interested in thoughts/recs on fear of reinjury, and maintaining motivation to stay reasonably fit when there are frequent setbacks and when you are kind of goal-oriented when it comes to fitness.)
I'm prone to RSI in my hands/wrists/arms/shoulders which ARE computer related, but I also get pain in my elbows and knees and feet/ankles from housework and strenuous activity like moving (house).
The only thing that has ever really helped me is taking lots and lots of breaks. Even when they seem intrusive, even when you don't think you're hurting at that moment. If you have an internal measurement of how much/how long it takes for you to feel pain, take a break at the halfway point and do some stretching/loosening. Keep cutting the time you do a repetitive task without a break until you can make it through a task you need to do without pain.
posted by petiteviolette at 6:34 PM on August 12, 2015 [1 favorite]
The only thing that has ever really helped me is taking lots and lots of breaks. Even when they seem intrusive, even when you don't think you're hurting at that moment. If you have an internal measurement of how much/how long it takes for you to feel pain, take a break at the halfway point and do some stretching/loosening. Keep cutting the time you do a repetitive task without a break until you can make it through a task you need to do without pain.
posted by petiteviolette at 6:34 PM on August 12, 2015 [1 favorite]
Response by poster: Thanks, both, for your great answers :)
I think tracking is an excellent idea, circular. I do track food and exercise, but all the rest will be very useful knowledge to have. BMI is right in the middle of the normal range, but I could stand to lose a few pounds - have gained a bit back after loss and maintenance. I like food, but can't work as much of it off as before :/ (Re exercise motivation - it's more that I like to push myself a bit, and am frustrated with / not really happy about time off, restricted activities, modifications - am kind of bored with what I'm doing.)
petiteviolette - Thanks so much for this. I am not good at taking breaks from activity (tend to do things in big bursts). I can't say I have a reliable measurement like that for areas that aren't already injured, but my physio did advise taking breaks more often (for computer use), and it makes total sense to do this in general.
Just want to add, for anyone interested, that I've just discovered that a useful search phrase is "joint protection". Stuff comes up about rheumatoid arthritis, mostly, but I think the advice (about using leverage to your favour, and being mindful of movement in particular ways) is probably equally helpful for anyone concerned about this.
posted by cotton dress sock at 10:17 PM on August 12, 2015 [1 favorite]
I think tracking is an excellent idea, circular. I do track food and exercise, but all the rest will be very useful knowledge to have. BMI is right in the middle of the normal range, but I could stand to lose a few pounds - have gained a bit back after loss and maintenance. I like food, but can't work as much of it off as before :/ (Re exercise motivation - it's more that I like to push myself a bit, and am frustrated with / not really happy about time off, restricted activities, modifications - am kind of bored with what I'm doing.)
petiteviolette - Thanks so much for this. I am not good at taking breaks from activity (tend to do things in big bursts). I can't say I have a reliable measurement like that for areas that aren't already injured, but my physio did advise taking breaks more often (for computer use), and it makes total sense to do this in general.
Just want to add, for anyone interested, that I've just discovered that a useful search phrase is "joint protection". Stuff comes up about rheumatoid arthritis, mostly, but I think the advice (about using leverage to your favour, and being mindful of movement in particular ways) is probably equally helpful for anyone concerned about this.
posted by cotton dress sock at 10:17 PM on August 12, 2015 [1 favorite]
For upper body RSI prevention and treatment, get BOTH books by Dr. Emil Pascarelli and BOTH books by Deborah Quilter. (Really only three books: one of the books they wrote together.) Pascarelli has a background in music medicine, and ended up focusing on soft tissue disorders (e.g. tendinitis); there's actually data on RSI disorders going back a century in music medicine and even longer than that in various trades that required repetition. Despite that, in the book he authored alone, he notes that he is baffled by the issue of RSI and doctoring, as it's a soft tissue injury, but there exists no specialty trained in treating it. This has precisely been my experience. In fact, I've seen many doctors and physical therapists who were downright idiots about it, as well as one or two (especially physical therapists) who were worth their weight in gold.
I was first struck by RSI (tendinitis) about 15 years ago, and ended up on an exercise regimen largely based on Pascarelli's book with Quilter. Between the exercise, good ergonomics, treatment for thyroid disorder, and strict attention to things like posture and hand usage, my RSI issue resolved, which is to say I feel no pain or discomfort, and can do most anything, so long as I don't cut off the circulation in my arms for extended periods of time.
I was able to stave off another attack for 15 years. The new attack was partly about me doing a few stupid things I knew I shouldn't be doing (e.g. human nature) AND a slow attack of thyroiditis, which is now being treated. On balance, the new injuries and resulting discomfort are very, very, very minor, and it's forced me to refresh myself on RSI health and safety tips, which isn't bad as I make a living at the computer.
p.s. Sudden symptoms can be a sign of autoimmune disease; I, too, was tested for rhematoid disorders, and came back negative. Also, if you live near NYC, memail me if you want the name of a superlative physical therapist. And, finally, whatever you do, don't get cortisone shots. Cortisone takes away immediate pain, but causes more damage.
posted by Puppetry for Privacy at 10:50 PM on August 12, 2015 [2 favorites]
I was first struck by RSI (tendinitis) about 15 years ago, and ended up on an exercise regimen largely based on Pascarelli's book with Quilter. Between the exercise, good ergonomics, treatment for thyroid disorder, and strict attention to things like posture and hand usage, my RSI issue resolved, which is to say I feel no pain or discomfort, and can do most anything, so long as I don't cut off the circulation in my arms for extended periods of time.
I was able to stave off another attack for 15 years. The new attack was partly about me doing a few stupid things I knew I shouldn't be doing (e.g. human nature) AND a slow attack of thyroiditis, which is now being treated. On balance, the new injuries and resulting discomfort are very, very, very minor, and it's forced me to refresh myself on RSI health and safety tips, which isn't bad as I make a living at the computer.
p.s. Sudden symptoms can be a sign of autoimmune disease; I, too, was tested for rhematoid disorders, and came back negative. Also, if you live near NYC, memail me if you want the name of a superlative physical therapist. And, finally, whatever you do, don't get cortisone shots. Cortisone takes away immediate pain, but causes more damage.
posted by Puppetry for Privacy at 10:50 PM on August 12, 2015 [2 favorites]
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Why not start by tracking the timed quantity of each injury-causing activity are doing, and rate your ferocity in e.g. sweeping on a scale of 1 (one radial inch per second) to 10 (say, 120 radial inches per second)? It'd be better than nothing and you'd soon have a spreadsheet full of data. It might even sound ridiculous, but again, there's the data; can't argue with it.
I'd also track your physical exercise activities for each day, length of time spent on each activity, and rate your pain before vs. pain after using the pain scale.
Then I'd have another spreadsheet to track injuries. Today's date, what was injured, what were you doing when injured (even if nothing), pain scale rating, and maybe note your total recovery time.
If you really want to get to the bottom of this, throw another sheet in there for your diet. Date, food consumed, before/after ratings on the hunger scale, weight, and so on. You could build a BMI calculator in there. While I'm not a huge BMI fanatic, reducing my BMI by about 8 digits so far seems to have reduced my proneness to pain. I no longer suffer from RSI pain, which really got to me in the past.
My hunch after reading your post is that you have hunches, which you can explain quite well, but now is a great time to hold onto the hunches and start recording solid data to help you taper and filter your conclusions a bit.
Edit: Regarding fitness motivation, I found the highest amount of motivation in the physical activity that was as thoughtless and effortless as possible to me, walking. As I slowly ramped up the exercise activity in the span of a year from 20 minutes (sweating like crazy at the beginning) to a couple of hours max, I found it comfortable and enjoyable the entire way. I couldn't claim that with the other activities I tried, like running, cycling, martial arts, etc.
posted by circular at 2:54 PM on August 12, 2015 [1 favorite]