If your job, hobby, or recreational activities involve repetitive movement patterns you may develop a repetitive strain injury, or RSI.  Also known as overuse injuries, cumulative trauma disorders, and musculoskeletal disorders these types of conditions are characterized by pain, inflammation, swelling, and reduced joint movement.

Some of the more well-know causes of RSIs include:

• typing/data entry (wrist tendonitis, epicondylitis)
• hair styling (wrist tendonitis)
• using vibrational tools (wrist, hand tendonitis)
• carrying small children (deQuervain’s syndrome)
• tennis (lateral epicondylitis; i.e. tennis elbow)
• golf (medial epicondylitis; i.e. golfer’s elbow)
• running (achilles tendonitis)
• bowling (medial epicondylitis, wrist tendonitis)

RSIs mostly affect tendons, ligaments, bursae, and neural sheaths but they can affect muscle fibers as well.  What happens is the offending activity places unusually high demand on these structures resulting in microscopic tears to the tissues. A very gradual inflammatory response follows, which then takes a life of its own.  At this point the patient notices that the pain is more frequent and doesn’t go away with rest, and he/she may reach for an over the counter non-steroidal anti-inflammatory like Motrin.

What makes repetitive strain injuries so persistent is that they are caused by an activity the individual needs ( job) or loves (favorite sport) to do, and essentially he/ she “re-injures” the condition with the activity until it gets to an advanced stage.

Most of the time a repetitive strain injury is transient; i.e. it appears for several weeks then disappears.  The patient resorts to icing, rest, temporary discontinuation of the offending activity, over the counter meds, massage therapy, bracing, and in some cases, cortisone shots.

In some people, the pain turns chronic; i.e. doesn’t entirely go away even after weeks and months since the onset.  If you are experiencing this, it can be due to improperly healed microtears causing abnormal muscle and tendon performance; and perhaps trigger points which are believed to be concentrations of nerve endings at an old injury site.

When the condition is chronic, you can attempt to do the therapy in the video above.  You use a flat edged massage instrument to “strip” the muscle close to where it attaches to the joint.  This can help loosen any fibrous adhesions (“stickiness”) that may be interfering with muscle and tendon movement.  It also mildly agitates the area (be careful not to overdo it) and increases blood flow, which can stimulate repair by fibroblasts, special cells that synthesize collagen.

This therapy is not to be done when the condition is acute (recent onset, hot, red, swelling).  Doing so will make it worse.  Try it only when it has reached a chronic stage and inflammation is absent.  If it causes an unusual increase in pain, discontinue and apply ice.