For anyone who read my previous article on Tennis Elbow and Golfers Elbow, you may have thought it a little short on detail. That was mainly because I knew that I was going to write this article next and these conditions are generally a repetitive strain issue.
Normally when you hear about RSI people think of wrist problems often from using computer keyboards and mouse. And people tend to be familiar with term ‘carpel tunnel syndrome’ which is wrist related RSI.
So what is it?
RSI stands for Repetitive Strain Injury and many conditions are the result of repetitive strain or over use. Generally either through a repetitive movement through a fairly limited range of movement or through a repetitive impact. In the case of an impact it could be like hammering but is most often an end of range movement where a joint snaps into extension. The classic example of this is tennis elbow which is usually in a tennis scenario from extension of the elbow on a backhand shot. Golfers elbow can occur in a similar fashion on the downward phase of the stroke as the trail arm extends at the bottom of the movement but can also be caused by excessive force return through the club if it strikes the ground.
These repetitive strains will usually result in either tendonitis or tenosynovitis or sometimes bursitis. In all cases a small area becomes inflamed because of excessive tension within a muscle or part of a muscle increasing tension also through the tendon or other connective tissues.
If you imagine you are pulling a rope with a weight on it up over a 90 degree edge. The sort of thing you might see in an action movie with the weight at the other end usually being a person. Anyway if the rope goes up and down smoothly through most of its length there isn’t a problem. If on the other hand the rope goes up and down through a short part of its length or rubs back and forth along the edge it starts to wear and fray.
Now in our bodies the difference comes in that they have built in protection and repair mechanisms, which create inflammation and tenderness firstly to stop you doing what you are doing to prevent long term damage, and secondly to help repair any damage done. However if you continue to try and work through these issues they can become chronic with long term changes taking place often with the only way to resolve them being surgery.
In carpel tunnel syndrome and various other conditions the tendon and or the sheath can thicken requiring the sheath to be cut open/split length ways to release the tension.
In shoulder impingement problems you can get frozen shoulder and calcification may occur in the tendon – the growth of bone which will need to be removed.
In plantar fasciitis you can also get calcification at the point the tendon attaches to the bone creating a ‘heel spur’.
Therefore it is obviously essential to get the problem treated early.
Your GP will tell you to rest and possibly to ice the area (which is good advice), possibly prescribe anti-inflammatory drugs and may refer you to a physiotherapist who will normally prescribe exercises and stretches and may give you ultrasound. If none of this works they or the GP may offer you cortisol steroid injections to try to reduce the inflammation and resolve the issue. Statistically these are not very successful long term.
Massage (sports massage) is generally the solution. You may remember earlier in this article I mentioned that these conditions are frequently the result of an area of tightness within the muscle and it is this tension that increases the tension in the connective tissue where the inflammation generally occurs. Treat the cause not the symptoms. Remove the muscular tension through sports massage and look at and alter any possible triggers to the tightness building up – repetitive movements through a small range of movement. Then
change equipment used if relevant, make time to work through a full range of movement between tasks and stretch your muscles regularly.