RSI-Repetitive stress or strain injury

Musculoskeletal Disorders (MSD’s):



Musculoskeletal Disorders (MSD’s) are injury or disorder of muscles, nerves, tendons, joints, cartilage, or spinal discs. Not caused by slips, trips, falls, motor vehicle accidents, or other accidents. MSDs are considered work-related when the work activities and work conditions significantly contribute to their development or exacerbation but are not the sole determinant of causation (World Health Organization, 1985).


  • Prolonged repetitive, forceful, or awkward hand movements
  • "Static loading" or holding a posture
  • Poor conditioning of the heart and lungs, and poor muscle endurance
  • Direct mechanical pressure on tissues
  • Cold work environment
  • Poorly fitting furniture
  • Basic inadequacies of workstation design
  • Work organizational and psychosocial issues


High Risk Groups

  • Computer Users
  • Check out clerks
  • Musicians
  • Hair dressers
  • Health Professionals: Surgeons, Dentists
  • Nurses
  • Butchers
  • Massage Therapists. HCA
  • Sports Persons
  • Laboratory workers
  • Children
  • Teachers
  • Housewives
  • Manual Labourers
  • Assembly Line Workers
  • Assistant
  • Drivers

Early Warning signs and Symptoms


  • Discomfort, fatigue or pain.
  • Swelling, redness, coldness or warmth.
  • “Catching” or “snapping” with movement.
  • Loss of grip strength, heaviness or clumsiness of the hand.
  • Stiffness.
  • Burning, numbness, tingling.
  • Visual strain.
  • The injury accumulates slowly leading to difficulty in day-to day activities such as shaking hands, opening doors, holding newspapers, using a comb, or even holding a teacup.

Stages of WRMSD’s

Severity Stage of RSI Recovery period
Stage1: Mild 2 - 4 Weeks
Stage 2: Moderate 1 - 3 Months
Stage 3: Severe 3 - 6 Months
Stage 4: Complicated 6 Months

Non-Specific WRMSD's

  • Myofascial pain syndrome (MPS)
  • Fibromyalgia syndrome (FMS)
  • Complex regional pain syndrome (CRPS)

Recent Advances in the Management of WRMSD’s


It can be treated completely with a Skilled Hands on Manual Therapy Approach for Release of Muscle & fascia, along Joints, Nerves and other Soft tissue techniques. The effect of this technique proved by researches and the studies were published in indexed journals. This treatment has been given in four phases:

PHASE I (Severe Discomfort): Trigger Point Therapy (TPT) (Ischemic compression, PRT, INIT), Myofascial release (MFR), Relaxation & Breathing technique and Stretching exercises.

PHASE II (Moderate Discomfort):Moderate Discomfort: Soft- tissue (TPT & MFR), Nerves & Joints Mobilization, Self- Stretchins Mild Discomfort: Stretching exercises, Progressive Strengthening Exercises, Postural Retraining, Body Mechanics and Ergonomics Training.

PHASE III : In this phase continue with self-stretching exercises, free exercises and start of with progressive strengthening exercises followed by relaxation techniques.

PHASE IV (Maintenance): Further Strength Training, Aerobic conditioning and Yoga Therapy.

“The potential for a quick and complete recovery is enhanced, if the patient seeks competent medical interventions like manual Physical Therapy with Ergonomic Workplace Analysis at an early stage.”

SHARAN’S Protocol for RSI

Skilled Hands-on Approach for Release Of Myofascia, Articular, Neural and Soft-tissue mobilization Rehabilitation Protocol management of Physiotherapy been followed which has been graded into 4 phases which are interlinked to each other.

Phase 1 - Severe discomforts in the initial stage: Management - Myotherapy soft tissue mobilization, neural mobilization, rib mobilization, clavicular mobilization, scapula thoracic mobilization and physiotherapeutic modalities like IFT, US followed by assisted stretches.

Phase 2 - Moderate discomforts in the upper limb and neck region: Management -It is a follow up of phase 1 which includes more self-stretching exercises, range of motion exercises, relaxing techniques like breathing exercises, Alexander techniques and yoga therapy.

Phase 3 - Mild discomforts, Management: In this phase continue with self-stretching exercises, free exercises and start of with progressive strengthening exercises followed by relaxation techniques.

Phase - 4 - Maintenance phase: Management-This consists of postural maintenance, generalized whole body stretching and strengthening exercises in order to maintain the length and strength of muscle.

Adequate micro and macro brakes should be taken in between work: Do the stretches and strengthening exercise at least thrice a week.If there is any flare up of symptoms in this phase (phase 4) stop all the exercises and immediately consult a physiotherapist for further clarification.