Repetitive Strain Injuries: What Editors Need to Know

In late June 2017, after working a very long week and pulling a few all-nighters to finish two copyediting projects, my hands suddenly became so painful that even thinking about typing on a keyboard made me feel sick to my stomach. The low-level hand and forearm pain that I’d been ignoring and pushing through for weeks had finally become unbearable. I had to stop working immediately.

The burning, searing pain that ran up my fingers and into my forearms had me in tears—I couldn’t even hold a toothbrush to brush my teeth.  I had trouble opening doors, and I couldn’t drive. I couldn’t wash my own hair. But what devastated me the most was that I couldn’t even hold up a book or magazine to read, which robbed me of the very activity to which my whole identity—as an editor, book lover, and lifelong reader—was tied.

I was diagnosed with a severe repetitive strain injury (RSI) caused by overwork, poor ergonomics, and bad typing technique.

The collapse happened suddenly, although I look back now and see the many warning signs. During the weeks when I had almost zero use of my hands, I worried that clients would be angry and upset, adding even more stress to an already overwhelming situation. I worried that it would mean the end of my company, and that I’d have to shut everything down for good.

I ended up needing to shut down my business for six months while I rested and recovered. Even though two separate orthopedic surgeons recommended carpal tunnel and thoracic outlet surgery, I said no. Instead, I found a talented myofascial masseuse who slowly helped my muscles and facia loosen up and realign. I reopened Inkbot Editing in 2018 with a new schedule that gave me more breaks and time to recharge.

But as an editor in today’s tech-driven world, you are a fellow computer athlete—and that means you’re also at risk for developing RSI. Here’s what you should know about this sneaky, progressive condition.

WHAT IS RSI?

Put simply, RSI is cumulative trauma caused by prolonged, awkward, or forceful hand movements. When combined with aggravating factors such as poor posture, a heavy workload, or improper ergonomics, damage occurs to the muscles, tendons, and nerves of the neck, shoulders, arms, and hands. This damage can cause numbness, weakness, pain, muscle spasms, and even impairment or loss of motor control.

RSI isn’t new. Repetitive strain injuries such as “milkmaid’s arm,” were being diagnosed as early as the 17th century. “Glass arm” (a.k.a. “telegrapher’s paralysis”), another form of RSI, was a common affliction for Morse code operators during World War I.

Even though RSI has been around for centuries, it goes by many names and is still misunderstood. Some medical professionals are quick to diagnose patients with carpal tunnel syndrome or isolated tendinitis instead of looking for patterns of weak, spasming muscles and damaged nerves throughout the neck, arms, and shoulders and down the spine.

ARE YOU ALREADY EXPERIENCING RSI SYMPTOMS?

This survey has been adapted from the books in the resources section below. If you answer “yes” to more than two of these questions, it might be time to research RSI a bit further.

• Do your hands, arms, shoulders, or neck hurt when you type?
• Do you feel tingling, numbness, heaviness, or cold fingers?
• Do you find yourself shaking out your hands because they’ve gone numb?
• Do you find yourself stretching or massaging after a few hours of keyboard work?
• Have you switched hands for certain computer tasks?
• Do you notice any sharp pains in your hands, arms, shoulders, or neck after working on the computer?
• Have you ever experienced heaviness or sluggishness in your forearms after typing for a few hours?
• Have you been woken up at night by numbness or nerve pain in your hands or elbows?
• Do you find yourself dropping items or having trouble gripping things?
• Have you been typing for more than seven years?

RSI develops over months and years, but once it’s severe, it can be permanently debilitating. Don’t wait if you notice any worrying symptoms. See your doctor, and find a bodywork professional who has a lot of experience with RSI. (Personally, I found myofascial/medical massage more helpful than physical therapy, but do what works best for you.)

I made the mistake of believing that my early symptoms—nerve pain in my elbows, sore neck, tight forearm and shoulder muscles, inability to sit up straight—were all separate issues. Really, they were clear signals that I was developing RSI. I waited until the damage was so severe that I couldn’t use my hands. Learn from my mistakes, and listen to what your body is telling you.

HOW TO PREVENT RSI

If you work on a computer for hours every day, follow these best practices in order to avoid developing RSI (this list has also been adapted from the two books in the resources section below):

• Keep your wrists straight in all directions—don’t tilt your hands back toward your forearms (dorsiflexion), and don’t swing your hands from left to right (ulnar and radial deviation).
• Don’t rest your wrists on anything (no wrist pads!).
• Keep your elbows at your sides so you’re not reaching out toward the keyboard (but don’t squeeze your elbows into your sides!).
• Reach the keys by using your whole arm, not just your hand.
• Don’t “anchor” your hand on the keyboard.
• Don’t rest your elbows on armrests while typing.
• Keep your neck straight and avoid tilting your head down to look at the monitor.
• Avoid one-handed combination keystrokes—use two hands for these instead.
• Be wary of using a laptop on a table or your lap as your workstation; this is the most at-risk posture for developing RSI.
• Install a timer that prompts you to take a 5-minute break every 30 minutes.
• Keep your hands warm to the touch.

RESOURCES

Here are the two most helpful and comprehensive books I’ve found on RSI. They’re both a bit dated now, but the information is still excellent. If you’re concerned that you’re developing RSI, take a few minutes right now to check these books out from your local library—don’t wait until your symptoms are severe.

• It’s Not Carpal Tunnel Syndrome!: RSI Theory and Therapy for Computer Professionals, by Suparna Damany, MSPT, and Jack Bellis
• Repetitive Strain Injury: A Computer User’s Guide, by Emil Pascarelli, M.D., and Deborah Quilter

This piece was written using Macintosh’s built-in dictation software and TextExpander by Smile Software.