An RSI Success Story
by Nick Mellor
WHAT ARE RSI'S?
According to Pascarelli and Quilter, RSIs accounted for over 60% of workplace injuries at time of going to press in 1994.
"Repetitive Strain Injury" (RSI) is the most common name for a series of closely connected conditions of the back, arms and hands. They are sometimes called "work-related upper limb disorders" (WRULD) or, perhaps most accurately of all, "Cumulative Trauma Disorders" (CTD). Physical or emotional traumas, or, more specifically, Post-Traumatic Stress Disorder (PTSD) often predate the onset of RSIs. Overall diagnoses like Fybromyalgia Syndrome (FMS), Chronic Fatigue Syndrome (CFS) and Reflex Sympathetic Dystrophy (RSD) cluster around the RSI diagnosis. "Stress" is nearly always a factor, often workplace stress.
There are a large range of more specific conditions including Thoracic Outlet Syndrome, a range of Tendinitis symptoms, Epicondylitis (tennis elbow), de Quervain's (can't twist your wrist, hurts to move your thumb). "Carpal Tunnel Syndrome" (CTS) is also a frequent diagnosis, but recently it has become controversial (see, for example, Damany and Bellis, "It's Not Carpal Tunnel Syndrome!") The authors suggest that real Carpal Tunnel Syndrome is extremely rare and most diagnoses of CTS unsafe. Their approach to RSIs is through physical therapy and changing behaviours. See http://www.rsi program.com.
Work involving long hours in front of a computer, or long hours on an assembly line, or long hours at a musical instrument, are often implicated. More women than men have RSIs, perhaps partly because equipment and workplace are designed for an average man. Many women sufferers contract RSI shortly after giving birth.
There are a huge range of effects from the mild to the thoroughly intolerable and disabling. To understand how debilitating RSI can be, imagine often not being able to use your hands because they're too painful. Added to the pain, imagine that they are so weak and clumsy that quite simple acts become mortifyingly difficult, like holding a glass of water, doing up buttons on your shirt or dialing a number on a phone. Added to this the common symptom of being in chronic discomfort or even chronic pain a lot of the time.
Conventional treatments are rest from work, remedial massage, splints, the application of hot and cold, training in "good posture", ergonomic equipment and workplace modifications, and pain relief. The best-known book on the subject of computer RSIs is Pascarelli and Quilter, Repetitive Strain Injury: A Computer User's Guide.
Like most treatments of the subject, Pascarelli and Quilter give the Alexander Technique, and more importantly, the level at which it works for change in the individual, very little space, if any at all.
The symptoms I describe here are what would be called a "diffuse RSI", in that there are a very wide range of symptoms with no sharp focus. Other people have very painful injuries in their wrists, hands, or neck, for example, and aren't greatly aware of symptoms elsewhere in themselves, although they are probably there.
With hindsight, I think I was fast heading for Chronic Fatigue Syndrome, and I don't know how I was coping with that degree of chronic exhaustion: in short, not well. Constantly uncomfortable. Sleep disturbance most nights. Uncharacteristically, feeling awful in the mornings. Depression (small d): feeling dull, with a very narrow emotional range, usually feeling very little of anything except discomfort, pain and irritation and frustration with those around me. Beginning to feel a bit dependent and helpless. Very low energy levels. Emotionally drained. (I could hardly smile.) Finding it progressively more difficult to do creative work as a writer of fiction. Numbness and pain in hands, arms, shoulders, neck, back. Numb feet and burning sensations in my knees. Frequent bouts of tennis elbow. Clenched neck and shoulders, unable to let go. Chronic tensions throughout my body, from feet and crackling ankles upwards. Clicks and cracks and crunches, and sometimes intolerable pressure in my pelvic area. Unable to sit still for more than two minutes.
Dinner parties, sitting still for hours, were torture, and I found myself unable to focus on the conversation at all, and felt desperate for everyone to go home and leave me alone. I bumped into things regularly, and fumbled often. I could hardly get change out of my wallet-- that kind of manual dexterity simply wasn't available. After struggling to do so, my lower back and collar bone area would be numb and profoundly uncomfortable. Brushing my teeth was so daunting that I frequently didn't. I couldn't do anything, not even exercise, without discomfort.
Doors of opportunity seemed to be slamming shut on me almost daily, and my options for a career seemed to be dwindling almost to nothing. I was beginning to have real trouble with my voice from using speech recognition to save my hands. It felt very tense, tired easily, and sounded pinched and unnatural. I was no longer able to sing with any pleasure or skill. My breathing was laboured and increasingly noisy, and I was beginning to wonder if I wasn't a mild asthmatic.
I was in need of company in order to feel okay, but must have been terrible to have around. My friends were patient, but uncomprehending and embarrassed, not knowing what to say, or how to respond to the answer. The subject was mostly just dropped as compassion fatigue set it, and I was left to cope with it on my own.
AFTER TWO YEARS' TEACHER TRAINING IN THE ALEXANDER TECHNQIUE
I'm not going to write another list. Every single aspect of my RSI has been addressed, even though the name of my condition has never been uttered by my teachers unless I mention it. They are NOT "treating" me.
All that's left is a very slight tendency to stiffness and a very mild numbness, in my forearms and the middle of my back, and only after I've been typing for a good couple of hours. I can type for three or four hours with only minor symptoms, but these days I am far better able to stop before I overdo it. I take change out of my wallet without even thinking about it: it has resumed its place as a normal activity in my life. I have no need of any support from ergonomic equipment, and have gratefully ditched my copy of Dragon Naturally speaking.
I use a laptop, a great deal, and have no fears for my health from doing so, although laptops are conventionally regarded as "dangerous". My back is once again the strong, resilient, flexible and utterly dependable structure I remember from when I was in my early 20s. This after an RSI that is largely back-related, and a long-standing and quite serious lower back/pelvic injury.
These changes are not directly sought in the Technique, as they would be in the medical model, but are the result of deep changes in your thinking and approach to all activities: in short, in the huge arena of human stimulus and response. You are simply far more able to choose, and far less likely to react on a semi-conscious or unconscious level.
I'm less manipulable, lose my temper far less easily, and my thinking has become more rational, imaginative, flexible and playful. I am physically far stronger than before my RSI attack, apart from a slight shortfall in finger grip which is not associated with any pain or discomfort. I still feel that I am improving at an enormous rate.
All sorts of things dropped off my agenda when I injured myself: career choices, hobbies, wishes, life goals. They're all back on the agenda, bar none. And these days, I procrastinate less, and find I have the energy to get stuck into them.
I am recovering from RSI as I train to teach the Alexander Technique. The training involves a great deal of one-to-one hands-on work, more than most "pupils" would get, and a supportive group atmosphere strongly conducive to self-application, choice and taking time to try things out. I am now wo-thirds of the way through the training, with a year to go.
Alexander teachers undergo a rigorous three-year, full-time training with never more than five students to one teacher. The training is overseen for most teachers by the Bristish-based Society of Teachers of the Alexander Technique (STAT), The American Society for the Alexander Technique (AmSAT) or, more recently, Alexander Technique International (ATI). You can find local and international teachers through the website "How to Find a Teacher of the Alexander Technique" at http://www.alexandertechnique.com/teacher
You might think that this training means I had a better chance than most of kicking my RSI injury with the Alexander Technique. You could well be right...except that during the training I have not stopped working between 4 and 6 hours a day in front of a keyboard, and, as I mentioned, that keyboard is invariably a laptop, which is notoriously bad for RSIs. If the Technique is able to keep (some) people at work, and healing at the same time, that might be welcome news on many fronts: in terms of of income, self-esteem, continuity, future job prospects, and not least, in finding that those doors that had seemed closed are actually still open.
Alexander himself said that 30 Alexander lessons, taken at regular intervals, were enough to bring about irrevocable change in a pupil's "manner of reaction" (Walter Carrington, A Time to Remember). One of today's teachers, who has taught people with RSI, recently told me that he thought 30 lessons taken close together did more for RSI-suffering pupils than it did for most people.
The Alexander Technique has startling and wide-ranging effects on the average pupil, so this is strong stuff. Times have changed, and this is perhaps not so easy, but in his day (died 1955) Alexander used to suggest to his pupils that they took the first month off work while they were having lessons, often one a day. This month away from normal activities presumably let the work sink in and integrate, and they were then to go back to their normal lives to apply what they'd learned and become less dependent on the teacher.
That seems to me, and an experienced colleague of mine, like quite a good regime to aim for if you have an RSI -- very regular lessons initially, and give the work a chance by having enough lessons. After a few lessons, I would hope there would be sufficient evidence of improvement or possibility to motivate RSI sufferers to take more lessons, and get deeper into the work and its benefits.
Nick Mellor was in the PC industry, the voluntary sector and the public sector for eight years as a technical editor, teacher and programmer, leaving to write full-time in 1996. His difficulties with RSI brought him to the Alexander Technique, briefly in 1996, then again in 1999, at which point he decided to train at NETCAT, the Northern England Teaching College for the F.M. Alexander Technique in Leeds, West Yorkshire, UK.
After graduation from NETCAT, he hopes to work with a wide range of application areas for the Technique, including creative writing, musical performance, public speaking, sports performance, efficient compensation for the effects of brain damage and physical impairment, Shock/Trauma and, as a result of his own experiences, Repetitive Strain Injuries. More than anything, he is interested in improving the range and quality of life choices available to his future pupils.
He fell-walks and plays Squash, and is a keen amateur pianist from a family of musicians.
He holds a B.Sc.(Hons) in Computer Science and an M.A. in Linguistics, both from the University of Leeds.
Click here to read a description of the Alexander Technqiue by the author
A comprehensive source of information about the Alexander Technique can be found at:
The Complete Guide to the Alexander Technique