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Repetitive Strain Injuries of the Wrist and Hand

The hand and wrist are very complex structures that consist of 29 bones, which are supported by over 120 ligaments. There are also many muscles that control your wrist and hand. All of these structures can be injured or experience pain. One of the most common injuries we see in the wrist and hand is a repetitive strain injury, often referred to as RSI.



Repetitive strain injuries are often a more chronic condition, which develop over time due to excessive forces through the hand and wrist. The risk of developing a repetitive strain injury is increased with repetitive activities, doing a prolonged high-intensity activity without rest, and doing activities that involve working in an awkward position or with poor posture. 


Symptoms of Repetitive Strain Injuries


  • Pain, aching, or tenderness

  • Stiffness

  • Weakness

  • Tingling or numbness


The most common repetitive overuse injury in the hand is tendinitis. This occurs when a tendon becomes inflamed as a result of stress or irritation. It will be tender to touch, and you will commonly have swelling of the surrounding soft tissues. Symptoms tend to worsen with physical activity. You may initially only notice symptoms when performing a particular repetitive action, however overtime it can gradually worsen and you can have constant pain. 


Treating RSI


In order to effectively treat this condition, you need to work out what specific activity is aggravating your symptoms. You may need to stop doing the activity altogether, or make modifications to reduce the force placed through the muscles and tendons. 


Anti-inflammatories can be taken for pain relief. Heat packs can also help to relax all the muscles, and restore blood flow to the area to aid in the healing process. 


Wearing a protective guard such as a wrist brace can help take the pressure off the affected area and give you some extra support. It may also provide enough support that you are able to continue to work with the injury.


Stretching of the affected muscles will need to be performed to relieve any tightness. You will also need to strengthen your wrist and hand muscles with specific exercises so that they are better able to cope with the demands of your daily activities. 


How Can Physiotherapy Help RSI?


Physiotherapy treatment will help through soft tissue massage and manual therapy techniques to loosen up the muscles and promote blood flow to the area. We also use ultrasound, heat packs and TENS for pain relief. We will provide you with a comprehensive exercise program that will consist of stretches and strength work, and we will progress these as your pain improves to keep challenging the muscles. We will give you valuable advice on how you can modify your aggravating activities to prevent this from recurring again. We can also provide you with protective guards such as a wrist brace that you can wear during the day for extra support and to take the pressure off the affected area. We will advise you on when to wear the brace and for how long so that it doesn’t cause weakness from long term use.


Example: De Quervain’s Tenosynovitis


An example of tendinitis in the hand is De Quervain’s tenosynovitis. De Quervain’s tenosynovitis affects the two tendons that travel along the edge of the wrist to the thumb. The tendons become thickened and inflamed, constricting movement and causing irritation. This inflammation can be caused by repetitive hand and thumb motions such as grasping, pinching or squeezing. Activities such as knitting, hand sewing, using a screwdriver, or even excessive video game playing involving small thumb movements, can aggravate the tendons and cause inflammation.This condition is common in new mothers, due to repetitive lifting of a baby, which can cause some underlying swelling in these tendons. You will often feel pain on the thumb side of your forearm near the wrist, and when left untreated the pain may spread up the forearm or further down into the thumb. You may also find it difficult to grasp objects.


Physiotherapy is very effective for De Quervain’s tendinitis. Soft tissue techniques are used to help relieve tightness as well as pain relieving modalities like ultrasound and TENS. You will be prescribed a range of motion exercises, gentle stretches and grip strengthening work. We will offer advice on how to modify any activities at work or home that are putting too much stress on your thumb and wrist. A splint may be necessary in the initial stages to allow the tendons to rest and begin healing. 


Top tips for preventing RSI


  1. Maintain good posture throughout the day

  2. Take regular breaks from repetitive tasks

  3. Ensure your work setup encourages good posture. Your seat, keyboard, and computer screen should be adjusted so they are sitting at the right height.

  4. Stretch before and after doing repetitive activities or exercise


If you are suffering from RSI in your wrist or hand, and would like some more information, feel free to contact us! Give us a call on 9875 3760 or email info@wphphysio.com.au. We would be more than happy to help you.



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