Exercise Helps Combat Repetitive Stress Injury

As a sports medicine specialist, Dr. Rosemary Agostini often treats patients with “tennis elbow,” an inflammation of tendons caused by repetitive overuse of that joint.

But surprisingly, “most patients I see with tennis elbow don’t even play tennis,” the Seattle physician writes in a recent issue of the American College of Sports Medicine’s Health and Fitness Journal. “More often than not, their malady is related less to sports than to their long hours at the computer. I’ve come to call the injury ‘mouse elbow’ because it’s often caused by using the computer mouse.”

Mouse elbow is a newly identified form of repetitive stress injury, a disabling malady that’s been called the workplace epidemic of the Computer Age. RSI is an umbrella term for an array of ailments whose symptoms include pain, numbness and loss of strength, usually in the hands, wrists, arms, shoulders or neck.

These injuries are typically linked to spending long hours operating computers, switchboards or other types of equipment that require repeated “hand intensive” motions--such as clicking a mouse.


In response to the explosion in reported cases of RSI has come a flood of “ergo-gizmos,” such as wrist supports and split keyboards, designed to fit the job environment to the worker. But some health professionals say shaping up the workplace is only a partial solution. They say there is also a critical need to shape up the worker.

“It’s very shortsighted to give people a splint and medications and send them back to work without also giving them exercises that can help prevent these problems,” says Houshang Seradge, an Oklahoma City orthopedic surgeon who has developed a series of 13 stretching and strengthening exercises designed to combat carpal tunnel syndrome, the most common form of RSI.

In a study of 102 hands of 92 patients, 81 with carpal tunnel syndrome and 21 serving as a control group, Seradge found that these exercises significantly relieved pressure in the carpal tunnel of the wrist. After presenting his findings at the American Academy of Orthopaedic Surgeons’ annual meeting in 1996 and publishing them in the Journal of Hand Surgery, Seradge was so inundated with requests for information that he and his colleagues recently formed the Orthopaedic & Reconstructive Research Foundation to educate others and further explore the effect of exercise on RSI.

“I’ve had carpal tunnel patients scheduled for surgery cancel their operations after doing the exercises,” says Seradge, who has taught his program to a wide variety of groups. He also recommends aerobic exercise to help prevent RSI because he says, “there is evidence that aerobic exercise enhances oxygenation, which improves the body’s ability to repair itself.”



Physically fit people are better able to handle the deceptively difficult task of sitting in a fixed position all day, says Robert Gamburd, a physical medicine and rehabilitation specialist in the Silicon Valley, home in the Bay Area to many leading computer companies.

“Poor posture, weak and inflexible muscles can all contribute to these injuries,” says Gamburd, a team physician for the San Francisco 49ers and the Stanford University Athletic Department.

Gamburd treats patients with RSI in the same way he treats athletes with overuse injury. “It’s no different if you hurt your elbow swinging a tennis racket or pushing a mouse,” he says. Both result in inflammation from microscopic tears in the tissues that the body doesn’t have time to repair.


Treatment includes “relative rest"--resting the injured part while allowing the patient to keep working other body parts so they don’t become deconditioned. Typically anti-inflammatory medication, plus use of ice and / or heat, is also prescribed.

Once healing has begun, “therapeutic exercises can help the tendon heal properly, so it doesn’t become shortened and weakened,” Gamburd says. “Exercise is also essential to correct the problems that led to the injury in the first place.”

For example, Gamburd recommends a program of upper-body strengthening exercises to all “computer athletes,” and advises them to take frequent stretch breaks to relieve tension and boost circulation in overused muscles and joints.

But since most people don’t remember to stretch throughout the workday, Gamburd designed a software program called “Stretch-ercise"--a pop-up screen appears at regular intervals to lead the user through stretches.


Other companies also have begun marketing software to shape up computer users. Jazzercise, the international exercise fitness program, released its Cyber-Stretch software in January.

Colorado flexibility guru Bob Anderson, whose classic guide to stretching has been translated into 18 languages, just released stretching software this month.


* Seradge’s carpal tunnel exercises: Send a self-addressed, stamped envelope to the Orthopaedic & Reconstructive Research Foundation, 1044 S.W. 44th St., Oklahoma City, OK 73109.


* Gamburd’s Stretch-ercise ($59.95), from Ergonomic Sciences Corp.: Call (650) 964-3134 or visit the Web site

* Cyber-Stretch ($70): Call toll-free, (888) 79-STRETCH, or (760) 434-2101 or visit the Web site

* “Stretching at Your Computer or Desk,” by Bob Anderson (Shelter Publications, 1997). You can also download a free demo of his new Stretchware software (the software is $29.95) at