Excessive force imposed on muscles, tendons, joints and the nervous system by some job demands and working practises are the starting point to strain injuries occurring.Provided the forces exerted are of a short duration, with adequate rest periods, they will generally be within the physical capacity of the body sinews and tissues. However overloading of the tissues caused by very frequent exertions of forced static postures can be harmful, resulting in loss of capacity in the affected limbs.

Examples
Holding a tool with a bent wrist whilst having to apply pressure combines force and awkward posture, and having to perform the same task repeatedly adds to the frequency factor further increasing the risk involved, so in that movement you have got static load and repetitive movement.

Working overhead with the arms extended upwards, (wiring cable in) or having to work with the back bent and the arms extended horizontally in an awkward part of the building to reach the area needing attention, or holding a trowel and tray with mortar whilst plastering or pointing brickwork.

Painting ceilings, where the head and neck is extended at an awkward angle and one arm applying the paint with brush or roller, and the other arm holding on to maintain balance.

The Three Main Factors
FORCE – the application of excessive manual force

FREQUENCY AND DURATION OF MOVEMENT – including rates of working which are too intense and repetitive whether of a single or combined nature, and

AWKWARD OR RIGID POSTURE – of hand, wrist, arm or shoulder, and where kneeling or crouching posture is required there will be strain on the legs, ankles and feet.

The human body is designed to cope with a wide variety of movements, forces, pressures and stresses, but what is often not realised are the points in the body which give way under the strain, and that is where the limbs connect to the spine. At the top of the spine where shoulders and neck connect, this is known as the cervical spine area, and when damage occurs here pain can appear in the arms and sometimes the legs. This is known as referred pain, and is due to the damage in the discs, where a build up of tissue can cause pressure trapping the nerves. In the lower part of the spine, known as the lumbar area, again referred pain can occur in the legs, which is a pain similar to sciatica.

Prevention
When carrying out work which involves the three factors, it is important to take short rest breaks, particularly when working at a keyboard, to refresh the muscles/tendons, and perhaps incorporate a short exercise of flexing the limb, to remove the feeling of strain, stimulating the circulation, thereby refreshing the system and removing the toxins that build up in the system when you are still for too a long time. In the case of the head and shoulder stiffening, there are exercises available which again can correct the posture.

For anyone experiencing pain, tingling, numbness, it is important to recognise what is happening to your body, report symptoms, look at the risk assessment on your job, seek help from your General Practitioner and a physiotherapist who is suitably qualified to a postgraduate level and who is knowledgeable about treating RSI.

Named Types of Injuries
Most publicity these days is given to cases of computer-induced injury, due to the increased computer usage in working life, and which is the least understood injury. Research at University College Hospital London calls this “Diffuse RSI” which seems to be nerve injury. However it is well documented that many manual trades suffered from various types of repetitive strain injuries, (Washer woman’s wrist, telegraphist’s finger, etc.) and I use the term RSI as an umbrella term to cover various named medical conditions.

This collection of diseases and injuries, in itself a history of the afflictions that visit working people, shows the breadth and depth of illness and injury. In order to be recognised, for industrial injuries purposes, the medical condition must have been proved clinically beyond all doubt, and this is known as the epidemiology of the condition, and must have been approved by the Industrial Injuries and Advisory Commission, commonly known as IIAC.

A4 Cramp of the hand or forearm due to repetitive movements. For example writer’s cramp. Anyone involved in prolonged periods of handwriting, typing of other repetitive movement of fingers hand or arm, for example typists, clerks and routine assemblers. (So you see even that is not necessarily totally due to clerical work – a routine assembler usually works in the electronics industry where small components are assembled).

A5 Subcutaneous cellulitis of the hand (Beat Hand). Manual labour causing severe or prolonged friction or pressure on the hand, for example miners and road workers using picks and shovels. But this also could include gardeners digging, or even the use of a screwdriver causing pressure in the palm of hand.

A6 Bursitis (swelling) or subcutaneous cellulitis arising at or about the knee due to severe or prolonged external friction or pressure at or about the knee. (Beat Knee). Manual labour causing severe or prolonged external friction or pressure at or about the knee, for example workers who kneel a lot.

A7 Bursitis or subcutaneous cellulitis arising at or about the elbow due to severe or prolonged external friction or pressure at or about the elbow. (Beat Elbow). Manual labour causing severe or prolonged external friction or pressure at or about the elbow, for example jobs involving continuous rubbing or pressure on the elbow

A8 Traumatic inflammation of the tendons of the hand or forearm, or of the associated tendons sheaths. (Tenosynovitis). Manual labour, or frequent or repeated movement of the hand or wrist, for example routine assembly workers. (However it is common among keyboard and computer mouse operators, and those whose arms and hands are involved in jobs as varied as stirring large containers of soup, butchering meat, planing wood, using a manual screwdriver regularly, and other repetitive/static load jobs too numerous to mention.

A11 Vibration White Finger – the symptoms of episodic blanching (whiteness due to circulation seizing up) occurring throughout the year, in thumbs and fingers. Caused by handheld chain saws in forestry, or handheld rotary tools in grinding, sanding or polishing of metal, or the holding of material being ground or polished by rotary tools, or the use of handheld percussive (vibrating) metal working tools, are the use of handheld percussive drills or hammers, offer holding of material being worked upon by handling machines. (So you see this covers a wide range of tools).

A12 Carpal tunnel Syndrome – this is caused by the use of handheld powered tools whose internal parts vibrate so as to transmit without vibration to the hand, but excluding those which are solely powered by hand. (Excluded for example, are sewing machines, which do vibrate, and upon which the hands do rest, but are not classed as causing the injury, as the machine is not handheld).

Claiming Benefits
What also is not generally known is that claim for industrial injuries benefit can be made even if you are still working, but you are injured due to a work-related condition. Another thing that is not generally known when claiming for industrial injuries benefit, is that if you have an accident whilst on the way to work, travelling to and from work or at lunchtime and on the way home, you can also claim for industrial injuries benefit.

Therefore it is always beneficial to check via your union office, and then the citizens advice bureaux or local welfare rights advice centre, on whether or not you would qualify in the event of this happening to you. Useful leaflets, which can help regarding claiming benefits, are available from the Benefits Agency.

© 2011 RSI Action…