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Repetitive Strain Injury: Definition & Types

Instructor: Amanda Robb
In this lesson we'll be learning about repetitive strain injuries. We'll go over what this injury is and common types including tendonitis, carpal tunnel syndrome, tenosynovitis and bursitis.

What Is a Repetitive Strain Injury?

How much time do you spend at the computer each day? For many of us, it could be nearly the entire day. Have you ever felt soreness in your wrists that comes with hours of typing? Although it usually goes away with rest, for some people the stress of keeping the hands engaged at the computer or other repetitive tasks can turn into a repetitive strain injury (RSI). Repetitive strain injuries are injuries that result from repeating a motion over and over.

Although hand RSIs are a common type, RSIs also frequently occur in other parts of the upper body such as the elbows and shoulders. Sometimes they can also occur in joints in the lower body, such as ankles, knees or hips. RSIs arise from overuse. People who work with vibrating equipment, or do repetitive movements such as construction workers, factory workers, or athletes are all at risk for RSIs.

Carpal Tunnel Syndrome

Place a finger just below the crease in your wrist. Open and close your fist. Do you feel something moving? The long, firm tubes that become more prominent as your manipulate your hand are tendons. These line the bottom of a passage called the carpal tunnel in your wrist. On the other three sides of this passage are the carpal bones. The space in the middle is called the carpal tunnel. Your median nerve runs through the carpal tunnel from your shoulder to your wrist. It is what allows nerve signals to move between the brain and hand.

During repetitive movement, such as twisting a screwdriver, sewing, typing, or any activity that uses the fingers, the tendons become enlarged and can press on the medial nerve.

Carpal tunnel syndrome is caused by compression of the median nerve
carpal tunnel syndrome

The more the repetitive movement is done, the more narrow the carpal tunnel becomes and the more the nerve becomes irritated and compressed. This condition is known as carpal tunnel syndrome. In the early stages patients may experience the numbness, tingling and pain in the hand and forearm. But, without reprieve from the repetitive movement it can turn into decreased range of motion and even complete locking of the fingers and thumb.

Tenosynovitis

Sometimes carpal tunnel syndrome can turn into tenosynovitis. The tendons in the wrist and ankle are coated in thick coverings called sheaths to protect them. Since the sheaths are in constant contact with the tendons, they produce a lubrication that allows them to glide past each other seamlessly. However, with repetitive movement the sheaths can't keep up with the lubrication demands and eventually the sheaths start to grind on the tendons. Movement becomes painful and the hand actually creaks as it moves. If left untreated the tendons and sheaths can scar permanently.

Tendonitis

Tendons exist all over our body connecting muscle to bone, not just in our hands. Similarly, repetitive movement in any joint can cause inflammation of the tendons, called tendonitis. Let's look at an example.

Julie is a painter and often spends entire days with her right arm overhead painting people's houses. She's a pro and has been doing this job for about ten years. However, recently she started having a dull pain in her shoulder, particularly when she is painting with her arm overhead. She notices herself subconsciously keeping her arm lower to reduce the pain. When she presses on the shoulder it hurts more. Julie goes to a doctor and he diagnoses her with rotator cuff tendonitis.

The rotator cuff is a group of tendons connected to muscle and bone in the shoulder. They allow for arm movement. When the arm is held in an overhead position, or moved in a repeated motion over and over, such as tennis swings, the tendon can become inflamed and painful. Rotator cuff tendonitis is common and can be treated by stopping the offending activity, ice, taking anti-inflammatory drugs, and doing physical therapy.

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