7/03/2008

We're All Assembly Line Workers: Repetitive Stress Injuries

By Cary Raffle
The idea of repetitive motion injuries - more recently referred to as repetitive strain injuries - is well accepted for assembly line workers, but we aren't quite as aware of it when thinking about executives, professionals, or even our workouts at the gym.

Carpal Tunnel Syndrome is probably the best know among office workers. This is prevalent among people who use a mouse; the nerve in the wrist become compressed from constant pressure and can cause a shooting or radiating pain up the arm. Avoiding pressure on the wrist and using a gel pad can help prevent this problem. People sitting all day frequently develop hip pain because the muscles are flexed all day long. People rounded over the computer keyboard have shoulder pain. Sometimes it is a repetitive movement, sometimes it is from being in a fixed position or posture like when you get up from sitting on a long air plane flight. Below I will share a few stories and solutions that have helped other people with these kinds of problems.

A judge complained to me of neck pain during our training sessions. We discovered that she turned her head to the left dozens of times a day to see a computer monitor, so she began to alternate the monitor position, be mindful of straining, and incorporated chest sand neck stretches into her routine. My co-worker Alfreda complained about a pain in the neck, and she wasn't referring to her boss or an irate customer. We moved the monitor closer to her and it got better.


I overheard a member doing chest press complaining to his friend about his shoulder problems and inability do certain triceps exercises or hold his shoulders straight for overhead exercise. He described his workout program - heavy chest, lots of shoulders, almost no back. When he stood up he was exactly what I expected - a huge weight lifter of a guy with a big chest and forward rounded shoulders. His workouts had become the equivalent of an assembly line, with nothing to counter the heavy emphasis on the front of his body. He needs to stretch his chest, increase the ratio of back to chest exercises, and work on strengthening the muscles that pull the shoulder back). His program would include rear flies, rotator cuff strengthening, especially the external rotators, and abdominal core training. Crunches could exacerbate the problem he needs to get deeper into the core.

An IT worker complains of chronic back pain, and has poor posture with an arched back. He carries a heavy back with a computer and books every day and keeps his knees locked while standing and waling. He needs to lighten that backpack but until he can, it will be helpful to bend the knees to relieve the arching, stretch the back, and strengthen the core muscles - emphasizing the deep abdominals and gluteals. The program includes single leg squats, leg lifts and lots of core training.

A very fit professor has tennis elbow. (Technically, its epicondylitis and it can affect the inside in tennis elbow or the outside in golfers elbow, with pain felt in the tendons of the forearm). Is it from his workouts or is it from writing on a blackboard - or a combination of both. He uses heavy weights with exercise gloves, has been doing the same workout for about a year, and now had a forearm and elbow braces, what's next to brace? We are in the process of unwrapping this problem, including physical therapy. The general course of training for this problem involves exercises to strengthen the wrist and also some rotator cuff work, especially external rotators.


The last newsletter discussed flexibility, stretching and strengthening, and stretching before exercise. These examples show how this approach can be beneficial in your training program. It is important to vary your workouts, and avoid doing the same thing over and over again - whether its strength training or cardio. With the warm weather, its easy to mix up your cardio routine with some cross training. When it comes to strength training, focus on changing the intensity - ie, if you been working in a range of 8-10 repetitions, take it to 15 at a lower weight or do the exercises in a unstable position - and give your muscles and joints a break. Of course, if you are experiencing serious pain or pain for an extended period of time, you need to get medical attention and avoid working those muscles. Any questions, feel free to let me know.