Repetitive Strain Injury (RSI)
Discovery the causes behind repetitive strain injury, plus effective treatment and prevention strategies.
by Brad Walker | Updated November 4, 2021
Repetitive strain injury (RSI) is not a specific injury, but instead a loose grouping of similar injuries. These injuries are also called repetitive stress injuries, cumulative trauma disorder (CTD), repetitive motion disorders, and overuse syndromes. These are soft tissue injuries associated with long-term repetitive stress on an area of the body.
RSI is common in manufacturing work, computer work, and musicians are often susceptible to these types of injuries as well. RSI is also found in many sport activities that require the same movements, in similar planes and ranges of motion. Tennis, pitching (baseball and softball), golf, and distance running are a few of the sports associated with repetitive stress injuries.
What Causes RSI?
Repetitive strain injuries are usually a result of prolonged repetitions of a movement without adequate rest.
An overload of stress on muscles, tendons or joints over a period of time without adequate rest may lead to RSI. Movements done in an incorrect or poor posture, or misalignment of the joints involved can also lead to an RSI. Going beyond muscle fatigue in any activity may cause extra stress on tendons and bones causing a repetitive stress injury. Any movement done in an awkward or unnatural manner for multiple repetitions or long duration can cause an injury as well.
Where can an RSI occur?
A repetitive strain injury can occur in any muscle, tendon or joint that is impacted by a repetitive stress, although it is most commonly found in the shoulder, elbow and wrist. Below is a list of some of the more common repetitive strain injuries for each body area.
Hand and Wrist:
- Carpal Tunnel Syndrome (Pinching of one of the nerves that passes through the wrist)
- Tendinitis of the Wrist (Irritation and inflammation of the tendons around the wrist)
Elbow:
- Golfer’s Elbow (Irritation of the tendon attaching to the medial epicondyle)
- Tennis Elbow (Irritation of the tendon attaching to the lateral epicondyle)
Shoulder:
- Impingement Syndrome (Inflammation in the shoulder causing the rotator cuff tendons and the bursa to become impinged)
Hip:
- Snapping Hip Syndrome (Tendons that catch on bony prominences and cause a “snapping” sensation on movement.)
- Bursitis of the Hip (The bursal sac becomes inflamed causing pain when the tendon moves over it.)
Knee and Leg:
- Stress Fractures (A fracture of the bone due to prolonged stress placed on the bone without adequate rest)
- Shin Splints (The name given to symptoms of pain over the anterior portion of the lower leg)
- Chondromalacia (Irritation to the cartilage on the undersurface of the kneecap)
Ankle and Foot:
- Tendonitis of the Achilles Tendon (Irritation and inflammation of the Achilles Tendon)
- Tarsal Tunnel Syndrome (Similar in mechanism to Carpal Tunnel Syndrome, except in the foot)
- Posterior Tibial Tendinitis (Pain in the inside of the foot and ankle caused by inflammation of the posterior tibial tendon)
Signs and Symptoms
Initially pain may be felt only during an activity and stopping the movement may bring relief. Over time this discomfort carries into rest time as well. With prolonged use and lack of treatment the pain may become severe, even crippling.
Tingling and numbness, along with swelling and loss of strength and/or flexibility in the affected area may also occur.
Compression of the nerves and or blood vessels passing through the injury site is the common causes of the pain, tingling and numbness. The pain usually starts out localized to the site of the injury but over time may radiate away from the site along the extremity. The tingling and numbness will usually occur distally (away from the body) from the actual injury site.
The affected muscles may cramp at times and sensation may be lost or impaired to the affected part of the body.
Treating RSI
The first step in treating an RSI is to stop the offending activity. Resting from the activity will stop the repetitive stress applied to that area. Ice and anti-inflammatory medications may help the swelling and inflammation in the affect area. Stretching and relaxation exercises for the affected area will help relieve some of the muscle tension. Massage may also help alleviate the pain and muscular tension.
Splints and physical therapy may be needed in some cases to alleviate the stress on the muscles and tendons. Surgery is rarely needed, but may become necessary in extreme cases to alleviate the symptoms and prevent additional damage.
Preventing RSI
Prevention of repetitive stress injuries is much more important, and less costly, than treating them. Addressing the issues that can cause this type of injury helps to avoid it from happening.
- Warming up before an activity gets the muscles, tendons, ligaments and bones ready for the activity at hand. A general warm-up to get the whole body ready for increased activity is important, but specific warm-ups for those areas that will be used extensively in the sport or activity are just as important. This prepares the muscles and tendons for the stresses they will be facing.
- Avoid activities that cause pain or discomfort. There is a reason why they cause pain. Your body may not be suited for the activity or your posture or alignment during the activity may be incorrect. Stop doing those activities that cause pain, especially if it is a repetitive activity.
- Allow adequate rest time between the activities. The muscles, tendons and joints need time to recover from the stresses they were placed under. They will need good nutrition as well. The proper nutrients must be in place to make repairs to muscles, tendons, and bones as needed. Rest during an activity is often overlooked as well. If you participate in a repetitive activity, it is important to have adequate breaks to allow the area to rest between bouts of stress.
- Having good ergonomics and biomechanical efficiency means that the body moves in a way that puts minimal stress and strain on the muscles, bones and joints. Whether participating in a repetitive sport or spending hours typing at a desk, it is important that the body is positioned so that fatigue is minimized.
- It is important to pay attention to your body. When you start to notice muscle fatigue or tension you must back off. Get to know your body, and how it feels when in proper alignment. This will make it easier for you to notice when fatigue or other factors pull you out of alignment and you can make corrections immediately. Reading your body for cues that may lead to RSI is an important step in prevention.
- To make sure the muscles and tendons are ready for the stresses that may be placed on them, keep the muscles flexible and strong. Work the muscles through a full range of motion and gradually add resistance. Stronger, more flexible muscles can better manage those stresses applied to them during an activity. They are more resilient and bounce back easier.
Research and References
- Bahr, R. Maehlum, S. (2004) Clinical Guide to Sports Injuries, 1st Edition (ISBN: 978-0736041171)
- Hecht, M. (March 14, 2017). Everything You Should Know About Repetitive Strain Injury (RSI). Retrieved November 4, 2021, from https://www.healthline.com/health/repetitive-strain-injury.
- Martini, F. Tallitsch, R. Nath, J. (2009) Human Anatomy, 9th Edition (ISBN: 978-013432076X)
- O’Neil, B. Forsythe, M. Stanish, W. (2001). Chronic occupational repetitive strain injury. Canadian Family Physician, 47: 311-316.
- Ratzlaff, C. Gillies, J. Koehoorn, M. (2007). Work-related repetitive strain injury and leisure-time physical activity. Arthritis Care & Research, 57(3): 495-500.
- Tortora, G. Derrickson, B. (2009) Principles of Anatomy and Physiology, 14th Edition (ISBN: 978-1118866096)
- Walker, B. (2018). The Anatomy of Sports Injuries, 2nd Edition (ISBN: 978-1623172831)
- Wikipedia contributors. (2020, August 26). Repetitive strain injury, In Wikipedia, The Free Encyclopedia.
About the Author: Brad Walker is often referred to as the "Stretch Coach" and has even been called the Stretching Guru. Magazines such as Runners World, Bicycling, Triathlete, Swimming & Fitness, and Triathlon Sports have all featured his work. Amazon (author page) has listed his books on five Best-Seller lists. Google cites over 100,000 references to him and his work on the internet. And satisfied customers from 122 countries have sent 1,000's of verified customer reviews. If you want to know about stretching, flexibility or sports injury management, Brad Walker is the go-to-guy.
Disclaimer: The health and fitness information presented on this website is intended as an educational resource and is not intended as a substitute for proper medical advice. Please consult your physician or physical therapist before performing any of the exercises described on this website, particularly if you are pregnant, elderly or have any chronic or recurring muscle or joint pain.
