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Why is RSI a Problem?

Chapter

3

What is a Repetitive Strain Injury?

What Causes a Repetitive Strain Injury?

How Prevalent is RSI?

What is the Economic Impact of RSI?

Finding a Viable Solution for RSI

Repetitive Strain Injuries (RSI) have become a major drain on our health care system. Loss of productivity caused by employees working while in pain cost companies over $61.2 Billion each year.

(Journal of the American Medical Association 2003)

Repetitive Strain Injury (RSI) is caused by repeated physical movements that cause ongoing damage to muscles, ligaments, tendons, nerves, fascia, circulatory structures, and other soft tissues. RSI sufferers come from many occupations ranging from musicians and meat packers, to computer operators and construction workers.

Repetitive Strain Injury caused by cumulative trauma has become the most prevalent cause of injuries within the workforce. RSIs are among the most misunderstood, misdiagnosed, and poorly-treated conditions in our health care system.

Common therapies such as medication, electric muscle stimulation, ultrasound, heat, ice, rest, and surgery have all failed to effectively resolve these repetitive strain injuries.

Active Release Techniques^® (ART^®) provides a means to effectively and rapidly resolve these repetitive strain injuries without surgical intervention, and, in most cases, allows you to quickly return to your normal activities. By combining ART with focused, specific exercises, 90% of RSI injury cases can be resolved.

Note: This book does NOT teach you how to perform Active Release Techniques (ART). ART can only be performed by a professional such as a Physiotherapist, Chiropractor, Occupational Therapist or some other type of musculoskeletal practitioner who is trained in these techniques. See www.activerelease.com for course details.

What is a Repetitive Strain Injury?

A repetitive strain injury is a soft-tissue injury in which muscles, nerves, ligaments, fascia, or tendons become irritated and inflamed, usually as a result of cumulative trauma and overuse.

Unlike strains and sprains, which usually result from a single incident (acute trauma), a repetitive strain injury develops slowly over time. Other names for such injuries include:

 Cumulative Trauma Disorder (CTD).

 Repetitive Motion Injury (RMI).

 Occupational Overuse Syndrome (OOS).

 Work-related Musculoskeletal Disorder (WMSD).

What Causes a Repetitive Strain Injury?

RSIs can occur in any occupation that requires repetitive action and can result through the overuse of some part of your body, in combination with any of the following factors:

 Repetitive tasks with many small, rapid movements.

 Insufficient rest time between the repetitive tasks.

 Working in awkward or fixed postures for long periods of time.

 Excessive and forceful movements, used repetitively, to move loads, or to execute accelerated actions such as lifting, running, hitting, or throwing.

Effects of Repetitive Actions on the Body

The development of a repetitive strain injury is often quite insidious. Most RSI injuries are the direct result of cumulative trauma, such as those experienced by computer users (who make up a large percentage of our RSI patients). Repeated keystrokes cause friction between tissue layers, resulting in small micro-tears and inflammation in the tissues of the hands, wrists, and forearms.

The body responds to this inflammation by laying down scar tissue in an attempt to stabilize the area. (This is somewhat like sewing a patch over a hole in our jeans in order to maintain the structure and integrity of the jeans.) This scar tissue binds these tissue layers together and inhibits the movement or “translation” of these tissue layers across each other. When this inhibition of movement is also accompanied by continued repetitive actions, it can cause even more friction between tissue layers, resulting in increased inflammation, and bringing about the formation of yet more scar tissue.

In addition, one often sees an increase in compressive force when soft tissues are bound together by adhesions. Tissues which are compressed together:

 Inhibit nerve function.

 Reduce lymphatic drainage.

 Cause a decrease in blood flow and oxygen transfer to tissues.

 Increase the production of fibroblasts (directly responsible for the formation of scar tissue).

Together, these create a multitude of additional circulatory, neurological, and musculoskeletal problems.

RSI: Who Suffers?

Repetitive strain injuries occur in all walks of life including:

 Assembly line workers

 Cashiers

 Computer Operators

 Computer Programmers

 Construction Workers

 Dental Technicians

 Dentists

 Golfers

 Hairdressers

 Homemakers

 Hospital Workers

 Massage Therapists

 Meat Packers

 Musicians

 Nurses

 Postal Workers

 Runners

 Tennis and Racquet Sport Players

 Triathletes

 Vehicle Operators

 Weight Lifters

How Prevalent is RSI?

Repetitive Strain Injuries account for over 67 percent of all occupational injuries.¹ Statistics show that the number of patients suffering from RSI has now surpassed those suffering from back pain. Repetitive Strain Injuries appear in all walks of life, in all types of occupations, and in all types of sports and physical activities.

RSI is particularly prevalent in activities where repetitive, high-force action is required. Nearly two-thirds of all reported occupational injuries are caused by the exposure of the upper body to repeated traumas. Individuals who are at high risk for RSI include those who have occupations that:

 Combine force and repetition of the same motion, for long periods of time, especially in the fingers and hands.

 Require work in awkward or unnatural positions.

 Involve static work positions, while using the hands, arms, and shoulders, torso, or neck in an awkward position.

 Combine continuous, precise muscular movements with the above-listed factors.2

In stressful economic times, it is common for employees to worry about whether they may be in danger of losing their jobs. This can result in workers putting in extra hours in an effort to make themselves look less expendable. In such situations, employees often expose themselves to increased risks of RSI injuries.

What is the Economic Impact of RSI?

With skyrocketing incidences of RSI, the health-care costs for RSI in the U.S. are now surpassing the costs for low-back pain as the largest health care expenditure.

According to the U.S. Bureau of Labor Statistics, approximately 260,000 carpal tunnel release operations are performed each year, with 47% of these cases considered to be work-related.³ Repetitive strain injuries cost over $110 billion per year in medical costs, lost wages, and decreased productivity. Several years ago, the U.S. Occupational Safety and Health Administration (OSHA) predicted that 50% of the workforce would incur repetitive strain injuries during the year 2000.⁴

As staggering as these statistics are, the National Institute for Occupational Safety and Health (NIOSH) and a University of California study concluded that they likely understated the actual number of cases. They cite that only 44% of work-related injuries are actually reported and the incidence rate may be 130% higher. ⁵

Look at these Statistics!

 In 1981 (when the IBM PC was first released) only 18% of all illnesses reported were RSIs.

 In 1984, RSI cases grew to 28% of all occupational illnesses.

 In 1992, RSI cases grew to 52% of all occupational illnesses.

 In 2000, 70% of all occupational illnesses reported were expected to be due to RSI.

 RSI cases account for one out of every three dollars spent for workers’ compensation.

 The average cost of traditional or conventional treatments and disability payments for one injured worker is over $40,000.

This rapid increase in repetitive strain injuries coincides with the increase in the use of personal computers.

Finding a Viable Solution for RSI

Repetitive strain injuries cause major problems for both the person suffering from the injury and for the employer who is trying to minimize company health care expenses. Because of their complexity and multi-factorial nature, soft-tissue injuries (such as RSIs) require extremely specific and individualized solutions. Until now this has been a very difficult objective to achieve.

In my opinion (based on both my own clinical experience and upon the amazing results that ART has achieved after implementing treatment programs at several major corporations in the United States) Active Release Techniques provides just such a solution.

In 2003, Active Release Techniques began delivering on-site care to corporations that were experiencing significant expenses caused by repetitive strain injuries. ART practitioners were brought on location and treatment was initiated to treat and prevent soft-tissue conditions (such as RSIs) from developing. A key point is that ART was not just used to treat injuries, but used on-site to prevent them from occurring.

On-site treatments started with an initial pilot program at Sanmina-SCI, a corporation with 1,100 employees in Fountain, Colorado. The Workers’ Compensation costs at this facility were approximately $1 million per year and most of these costs were primarily attributed to soft-tissue injuries. Twice a week, ART practitioners conducted hour-long sessions with affected employees.

The results were astounding! After just one year of ART treatments, soft-tissue injuries were reduced by 80%. In addition, 90% of the RSI injuries that did develop could now be treated on-site. Also remarkable is that this corporation has been able to keep their soft-tissue injury costs down to this level for the last three years.

Over the last eight years, these significant results have been repeated again and again at a variety of different corporations. At the present time, ART is achieving similar results by working with over 150 corporations in the United States. If you would like more information about ART Corporate Solutions – On-Site Care, then visit their web site at www.artcorpsolutions.com.

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^1. U.S. Department of Labor, Bureau of Labor Statistics, Days away from work highest for Carpal Tunnel syndrome, April 02, 2001, http://www.bls.gov/opub/ted/2001/apr/wk1/art01.htm

^2. U.S. Department of Labor, Bureau of Labor Statistics, Days away from work highest for Carpal Tunnel syndrome, April 02, 2001, http://www.bls.gov/opub/ted/2001/apr/wk1/art01.htm

^3. U.S. Department of Labor, Bureau of Labor Statistics, Days away from work highest for Carpal Tunnel syndrome, April 02, 2001, http://www.bls.gov/opub/ted/2001/apr/wk1/art01.htm

^4. U.S. Department of Labor - Occupational Safety & Health Administration, http://www.osha.gov

^5. NIOSH - National Institute for Occupational Safety and Health. http://www.cdc.gov/niosh/topics/ergonomics