What Is a Repetitive Strain Injury (RSI)?

What is a repetitive strain injury (RSI)?

A repetitive strain injury, or repetitive motion injury, is a condition that results from repeating the same movement during physical activities, like sports or job-related tasks. Repetitive motion can cause injury to your muscles, nerves, and tendons.

“Whenever you repeat a movement as part of your regular routine, whether that be typing at a keyboard or swinging a baseball bat, you're working the same set of muscles and joints,” explains Sarah Eby, MD, PhD, a Mass General Brigham sports medicine physiatrist.

“While regular physical activity is vital for our joint (and overall) health, excessive repetitive motion may be harmful to our bodies,” she adds. “Too much repetition, particularly with unnatural movements or those involving strong forces, can wear down cartilage, tighten muscles, and reduce flexibility. This increases your risk of chronic pain or strain.”

On the other hand, Dr. Eby adds, low-impact repetitive activities in moderation don't contribute to arthritis and likely protect otherwise normal joints.

What are the symptoms of a repetitive motion injury?

Symptoms vary depending on the location and severity of the injury. These strains typically occur in the hands, wrists, forearms, elbows, shoulders, neck, and knees. Signs of a repetitive motion injury include:

• Mild to severe pain
• Inflammation (swelling) around the affected area
• Numbness and tingling
• Joint stiffness
• Muscle weakness
• Decreased range of motion
• Difficulty gripping objects
• Sensitivity to cold and heat

Risk factors for a repetitive strain injury

Specific activities and professions can put you at greater risk of an RSI injury. For example, a career involving repetitive movements at work can lead to injuries.

Actions linked to repetitive strain injury

Actions that contribute to developing a repetitive strain injury include:

• Performing the same motion over and over for extended periods
• Standing or bending in an unnatural position without rest, leading to poor posture and discomfort
• Lifting heavy objects that put added stress on muscles and tendons
• Using inadequate workplace equipment, such as poorly configured computer setups and non-ergonomic chairs
• Environmental factors like cold or hot work environments or jobs involving vibrating equipment

Careers that may increase risk of repetitive stress injury

People in these roles may be at increased risk of strain:

• Athletes: Many sports professions involve movements that can lead to an RSI injury. These include the overhead throwing motion of a baseball pitcher, the forceful swing of a tennis player or golfer, and the strenuous movements of a gymnast.
• Construction workers: If you perform repetitive tasks like hammering, drilling, or lifting heavy objects, your hands, wrists, and shoulders take the brunt of impact or vibrations.
• Barbers and hairdressers: Stylists stand for prolonged periods and perform repetitive movements throughout the day with various styling tools.
• Musicians: RSI injuries like tendinitis and bursitis are common in pianists, guitarists, and violinists whose instruments require the repetitive use of their hands and arms.
• Typists: Those using a keyboard for data entry or writing sit for long stretches. That makes their fingers, hands, forearms, neck, and shoulders vulnerable to injury.

Other repetitive activities that may lead to an RSI injury include cooking, needlepoint, and gaming.

Common repetitive motion injuries

You’re more prone to certain medical conditions when you perform tasks that repeat the same unnatural body movements. Some of the more common conditions caused by RSI injuries are:

Bursitis

Repetitive motion can lead to inflammation of the fluid-filled sacs that cushion and protect your joints and surrounding structures, also known as bursitis. When these sacs become irritated or worn down, you may experience pain, swelling, and limited range of motion.

Tendinitis

This condition is an inflammation of the tendons that connect muscles to bones. Repeating the same body movements puts stress on your tendons, causing swelling and pain.

Carpal tunnel syndrome

Carpal tunnel syndrome is a common repetitive strain injury to the wrists, fingers, and forearms. About 10 million people in the U.S. have this condition, which occurs when the nerves in your wrist get compressed. Data entry workers and writers often experience repetitive strain injuries from typing for extended periods. That can lead to stiffness and weakness in the hands and fingers. If you have carpal tunnel syndrome, you may be unable to make a fist or grip objects.

Repetitive strain injury treatment

Based on the severity of your injury, your health care provider may recommend various RSI injury treatments. These approaches include:

The R.I.C.E. method

You can relieve the symptoms of a repetitive strain injury at home. One avenue for immediate relief from sprains and strains is the R.I.C.E. method. The acronym stands for rest, ice, compression, and elevation. Using these recommendations together helps to reduce swelling and pain at the site of your injury.

The M.E.A.T. method

While R.I.C.E. therapy brings immediate pain relief, the M.E.A.T. method (movement, exercise, analgesics, and treatment) focuses on restoring function and promoting healing through a more active approach. Talk to your health care provider about this approach. Certain movements may worsen a repetitive strain injury that resulted from movement.

Medication

Over-the-counter medications, such as ibuprofen, acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs), can relieve strain injury soreness and swelling.

However, Dr. Eby cautions, it's important to listen to your body. If you feel pain when you perform an activity, it may be a sign to avoid that action. If you take medications and interrupt those pain signals, you may push your body too much through injury. This can prolong the healing and recovery process.

Physiotherapy

Physical therapy is the cornerstone of RSI treatment and aims to alleviate RSI pain and improve strength and mobility. Your therapy team puts together a program that includes:

• Stretching and strengthening exercises
• Tissue massage
• Education on how to self-manage your RSI injury, including guidance on proper posture

Steroid injections

If other repetitive strain injury treatments don’t ease your pain, your provider may recommend corticosteroid injections to help reduce swelling and discomfort. You may get injections as a last resort if you're unable to tolerate physical therapy due to pain. Injections may help you do the exercises your therapist recommends in order to treat the underlying cause.

Surgery

You may need surgery for a repetitive strain injury if other treatment methods don’t work. Specific conditions that could require surgery are severe tendon or ligament tears, nerve compression, and stress fractures.

How to avoid a repetitive strain injury

You can’t always prevent an RSI injury. However, there are things you can do to help reduce your risk. Whether you’re a professional athlete or working at a computer, there are steps you can take to lower your chance of having a repetitive strain injury.