Helen Skehan specialises in the treatment of RSI (repetitive strain injuries). She is the owner of
clinic in Islington, a clinic that she built herself over 16 years, houses 9 therapists and also offers massage and ergonomic assessments in the work place.
KT: Helen, what is RSI?
HS: RSI stands for repetitive strain injury. It is a term given to work related non-specific upper limb injuries and does not always mean the injury has come from repetition or is a strain. Patients present with a number of symptoms that may not always be the same from person to person.
KT: What symptoms are common with RSI?
HS: I test for many things - often clients present with varied pain in the neck, shoulder and arm, tingling ,numbness, temperature changes, swelling. I look for specific tightness, muscular imbalance and postural misalignment. I may also send clients to be tested by a rheumatologist to eliminate other underlying conditions.
KT: How does RSI develop?
There are many different ways RSI can develop. It is often a combination of a poor workstation, poor posture, lack of exercise (although not always sometimes I see patients who are real gym bunnies),not taking enough breaks at work, high stress, lots of typing and ignoring initial symptoms.
KT: How does stress play a part in the development of RSI?
I would say stress exacerbates symptoms. Mechanically, stressed induces increased muscle tension in the neck and shoulders where the nerves exit the spine and pass through the shoulder joint down the arm. Also, breathing rate increases and during stressful times we tend to adopt a upper chest lead breathing pattern which utilises the accessory respiratory muscles surrounding the neck and shoulders. The nerves are supposed to glide through neighbouring structures but if the muscles are contracted it can squeeze the nerves causing pain, numbness and tingling.
KT: What is your opinion on exercise for RSI? Does it create more strain or can it help?
HS: I always try to get my patients to engage in some form of stretching, mobilization and exercises. There is always a role for graded exercise in the recovery of RSI. It is important to go by a tolerance factor - the patient should not work into areas of pain.
KT: What affect does posture have on the development of RSI?
HS: Sustained postures for long periods in poor alignment are definitely not healthy and can contribute to RSI. Typically patients that have RSI injuries have a rounded upper back, a forward head carriage and their shoulders are rotated inwards. It is very common to find neck an shoulder stiffness as well as a lack of mobility in the upper back. Some patients can suffer from headaches. Even more distally you find that patients often have hamstring and calf tightness.
KT: What impact does modern technology like smart phones and portable laptops and tablets have on the recovery of RSI?
HS: All these devices encourage a poor posture as you tend to look down at the device you are using. People tend to overuse their smart phones which stresses the fingers, wrists, hands and forearms. With tablets and laptops they can be heavy to carry around and we tend to look down when we use them which strains the upper back and neck.
KT: What advice can you give to people using smart phones and tablets for work?
HS: Modern technology is improving all the time. For smart phones you can use the voice activation system to cut down on your typing time. Try to avoid using your phone and tablet when you travel on the tube and bus to give your hands and arms a rest. At work place a tablet on a stand or a removable keyboard. For laptops and desktop computers invest in an ergonomic mouse or a roller mouse that sits at the front of your keyboard.
KT: What are the early symptoms of RSI?
Any hand symptoms that are related to desk work including pain, muscle cramps, tingling, numbness, swelling or feeling of swelling and restricted movement. Also be aware of any of these symptoms in the shoulder and neck area even repeated small episodes. We should be able to function without pain. I would recommend diarising your symptoms and check over a period of time whether the symptoms remain or get worse. If in 10-14 days the symptoms are still there then seek treatment.
KT: What other advice would you give to those suffering with RSI?
HS: For those with mild symptoms I would advise regular movement that is based on improving postural alignment and mobilising the upper back. Backstroke can be helpful and calming to some. Avoid cycling as the posture can encourage symptoms to get worse. RSI is an injury that develops over time and through the continual use of bad habits. The most important thing is educating yourself on how to minimise the risk of injury and taking responsibility for your health and wellness at work.
For more information please visit the website at
or to make a booking with Helen please contact her clinic, Physio Solutions, on
0207 713 7780
. For more information on how exercise can help you recover from RSI injury please contact me at