Repetitive Strain Injuries

Repetitive strain injuries (RSIs), also known as repetitive stress injuries, are a group of musculoskeletal conditions caused by repeated motions, overuse, or prolonged and forceful exertion of a particular body part. RSIs commonly affect the upper extremities, including the hands, wrists, arms, shoulders, and neck, but they can also occur in other parts of the body. In Singapore, Upper limb and hand RSIs are treated by Occupational therapists who specialize in Hand Therapy. Examples of RSI are:

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- Trigger finger / thumb

- Carpal Tunnel Syndrome

- Cubital Tunnel Syndrome

- De Quervain's Tenosynovitis

- Tennis / Golfers' Elbow

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Hand therapy is an essential component of rehabilitation for repetitive strain injuries (RSIs). It focuses on improving the function and reducing pain in the hand, wrist, and forearm. Hand therapists, often occupational therapists with specialized training in upper extremity rehabilitation, employ various techniques and interventions to address RSIs. Here are some common approaches used in hand therapy for RSIs:

1. Education and Ergonomic Assessment: Hand therapists educate patients about the causes and risk factors of RSIs and provide guidance on ergonomic modifications to prevent further injury. This may include recommendations on proper posture, workstation setup, and appropriate use of tools and equipment.

2. Therapeutic Exercises: Hand therapists prescribe specific exercises to strengthen the muscles, improve flexibility, and restore normal range of motion. These exercises may include stretching, resistance training, and coordination activities to address specific areas affected by the RSI. Our Hand therapists at CARe are also trained in perform neural mobilisation to aide in nerve gliding to improve mobility and healing speed of the nerves.

3. Splinting: Custom splints or orthoses are often used in hand therapy to provide support, immobilize affected joints, and promote healing. Splints can help relieve pain, reduce inflammation, and protect injured structures during daily activities or rest. E.g. An Oval8 splint can be used for trigger finger, while a long thumb spica splint can be used for De Quervain's Tenosynovitis.

4. Manual Therapy Techniques: Hand therapists use manual techniques such as soft tissue mobilization, joint mobilization, and massage to reduce pain, improve circulation, and enhance tissue healing. These techniques can help alleviate muscle tension, release adhesions, and restore normal tissue function.

5. Activity Modification: Hand therapists work with patients to modify their daily activities and work tasks to minimize strain on the affected hand and prevent further aggravation of the RSI. This may involve adjusting work techniques, implementing rest breaks, and incorporating adaptive devices or tools.

6. Pain Management: Hand therapists employ various physical modalities, such as heat or cold therapy, electrical stimulation, or ultrasound to alleviate pain and reduce inflammation.

7. Patient Education and Self-Management: Hand therapists educate patients about self-care techniques, including proper posture, body mechanics, and exercises to continue at home. They also provide guidance on activity pacing, stress management, and pain management strategies for long-term self-management of RSIs.

It's important to note that hand therapy should be tailored to the individual's specific needs and guided by a qualified hand therapist or healthcare professional. We can assess the severity of the RSI, develop a customized treatment plan, and monitor progress to ensure optimal recovery.

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Sources:

1. American Society of Hand Therapists (ASHT)​

2. American Physical Therapy Association (APTA)​

3. PubMed​

4. Mayo Clinic​

5. OrthoInfo (American Academy of Orthopaedic Surgeons)