The Importance of Feeling

Repetitive Strain Injuries

Nick Mellor, Alexander Technique

RSIs are about pain, tingling and numbness in the hands, wrists, elbows, shoulders, neck and back, and sometimes other places too. The injuries usually happen as a result of highly repetitive or static activities. Sitting at a computer for long hours without adequate breaks is a classic example. Musicians can get RSIs; so can surgeons, knitters and meat factory workers. Dr Deepak Sharan, an orthopaedic surgeon and an authority on RSIs, has a summary of high-risk groups on his website.

RSI accounted for 66% of all work-related illnesses in the US in 2009. Children playing computer games and those of us using Smartphones (including the iPhone), ever-cheaper laptops and game consoles to conduct our business and personal lives are swelling the numbers needing treatment.

RSIs can be slow-growing, minor irritations or they can land on you suddenly, changing your whole life from one day to the next. Here's someone experiencing an RSI for the first time:

“I turned up at work that day as normal. Half-way through the morning I rang a number on the phone. It said 'the number you have called is not connected. Please try again.' I typed it again, and mistyped the number again. I got it right on the 3rd attempt. But later that morning another phone number took 8 tries. My head felt fuzzy and I had numb fingers. I remembered that I'd had a very stiff neck for the last 3 days. I took the rest of the morning off and went to see my doctor. He suggested painkillers, that I was in a stressful new job and and should just 'push through it.'

“The next day, I returned to work. Now, my fingers hurt. I couldn't type on my computer keyboard or my phone. When I found myself almost crying out with the pain of hitting the letter 'P', I left work and got in the car. I couldn't steer or change gear. The vibration of the gear stick hurt too much.”

"Pushing through it" is the worst thing you can do with an RSI. They are injuries of overuse and misuse, and to go on abusing your body in exactly the same way will make it worse, sometimes rapidly much worse. Painkillers are sometimes felt to be necessary for someone in a lot of pain from an RSI, but they're a short-term option. The problem with painkillers is that they can mask pain that is giving you a useful message. Often the message is to stop, but after taking a painkiller it's tempting to go on working and do more damage. You're no longer able to feel the pain so sharply.

Feeling is important-- it can tell you when to stop.

There's a rare genetic disease called CIPA-- Congenital Insensitivity to Pain with Anhidrosis-- in which children can't feel pain, and don't sweat because they can't detect heat or cold. It's an extremely dangerous disease and not many “sufferers” survive their childhood. Here's how it affects one little girl. RSI sufferers do not have this disease, but in my experience many of them have poor awareness of their own needs, a learnt loss of sensation rather than a congenital defect. This lack of awareness is potentially dangerous, even if not life-threatening. A CIPA patient burns himself badly on a hot stove without noticing, because his nerves are not working. An RSI patient overrides her body's signals (60% of people with RSI are women), suppressing her awareness so often that she ceases to feel her own discomfort. She is often a model worker, working unreasonably long hours without breaks. It's only when she begins to suffer quite severe pain that she might do something. At this point her response is often to dull the pain with drugs and to carry on working.

In the quotation above, RSI landed “like a ton of bricks.” One day, all fine; the next day, disabling pain. What the story doesn't tell is how often this person's body had whispered, murmured and spoken out loud before finally the damage was serious and the pain began.

The RSI patient in the story was me. Looking back, I'd had whispers and murmurs for several years. Over several months, the Alexander Technique gently helped me to relearn how to listen to myself. My teacher taught me to stop before any ordinary act (commit a thought to paper, respond to a request by somebody else, reach for the mouse, open a door, get out of bed) in order to allow creative new responses. To reach for the mouse is not repetitive unless it is executed repetitively. He also taught me how to allow length up my spine, width across my shoulders and hips, length down my legs and arms and into my fingers and toes, first demonstrating what is meant by "allowing length" with his hands, then giving me feedback that told me how well I was doing. Both stopping and allowing length bring a new openness to sensation.

My muscles seemed to notice how tight they were only when they had started to relax a bit-- a common theme in the Alexander Technique called "faulty sensory appreciation." What we feel is happening is not what is actually happening. Alexander Technique lessons would regularly put me in touch with discomfort, or a reluctance to explore further. My teacher knew this and was careful to help me over these moments when to close down was more pleasant than to open up.

Over weeks and months there was a gradual but obvious unwinding of my repetitive strain injury. And during this time I was learning skills, rather than having a treatment passively applied to my body. This meant that I knew how to respond myself when the symptoms threatened to return, rather than needing repeat treatment.

My process of recovery was through education and re-education, not treatment. It was simple, highly effective and had no side-effects. I relearnt how to feel, did less damage to myself and allowed healing to take place. The downhill slope towards pain, misuse of myself and more pain turned into a lighter, more resilient, more open feeling, with many fringe benefits besides my recovery from RSI. I recovered from long-standing chronic back pain and felt lighter, younger and freer than for many years.

To feel more helps to free us from pain, but more than that, it helps us to be free. Life is simply more fun when we allow ourselves to feel.

Wellness Tip: Take breaks, lots of them. 5 minutes every half an hour would be good to aim for. In fact, if you stop this often, research suggests your productivity will actually increase by 30%. Also, choose 3 things you do a dozen or so times each day-- picking up the phone, opening a door and eating spring to mind. As an exercise, stop for a few seconds each time you do one of these things, and notice your breathing.

Nick Mellor teaches the Alexander Technique at Healing Well on Thursday evenings (other evenings by appointment.) He teaches in Newstead at other times. To discuss anything in this article, or to book sessions, please call (1300) 485 114 in Australia. Calls cost a maximum of $0.30.

Other Sources of Information

A decent source of information about RSIs for computer users is the Typing Injury FAQ. The RSI and Overuse Association of the ACT has compiled a report after talking to many sufferers from RSI, which is available for a small fee, and which discusses the Alexander Technique among other options. The Sorehand and RSI-UK email groups are full of people with direct experience of RSIs, and you will find a lot of advice there, often of good quality. If you're in Australia, please feel free to join the rsi-au email group, which I founded recently.

Not everyone fully recovers from RSI, and some are left to face chronic pain. Here is an interesting podcast about the Alexander Technique used for pain management, an interview with a Harvard Professor of Medicine.

Dentists and surgeons might be interested in forthcoming research that suggests Alexander Technique can improve endurance and technical performance for surgeons performing laporoscopic surgery. Dentists, like surgeons performing keyhole surgery, may need to maintain awkward static postures for lengthy periods. Dentists are well known to suffer from a lot of back pain.