We all know that exercise is good for us. Unfortunately, even a beneficial activity taken to an extreme or performed incorrectly can lead to trauma and injuries. That's why it is important to know what is overuse syndrome, how it develops, and how to avoid it.
Occupational overuse syndrome (OOS), also called Repetitive Strain Injury (RSI), is an umbrella term for conditions caused by repetitive movements, constricted posture, forceful movements or constant muscle straining. It is classified as a gradual process injury (GPI) developing over time and can cause pain, discomfort or stiffness in joints, tendons, muscles, nerves or other soft tissues. The term encompasses various diagnoses including habitual, occupational or recreational activities. Localised injuries such as tennis and golfer’s elbow, trigger finger, carpal tunnel syndrome as well as various diffuse pain patterns may be classified as OOS.
Early signs and symptoms
The very early signs of OOS may include tingling, soreness, or discomfort in the shoulders, neck, arms, wrists or fingers. These may progress if the body doesn’t have sufficient opportunity to recover and the stressor persists. The following may appear:
Tiredness, headaches, loss of concentration and anxiety may also start to appear at this stage. As the stress cycle continues the following symptoms may develop:
The various conditions falling under the umbrella terms OOS and RSI can be classified as follows:
Causes and development
There can be multiple causes for OOS but at their heart, they are about repetitively holding a muscle tight or tense for a long time. When the muscles are tight and tense their supply of nutrients and their capacity for detoxification is compromised due to constricted circulation. This leads to inefficient use of nutrients, fatigue, and build-up of pro-inflammatory acidic waste products. This causes further stiffness and perpetuates the development of debilitating conditions.
The muscles and tendons need regular rest and a variety of movements in order to be able to recover effectively and withstand fatigue. Problems start developing when they are strained and overused through some of the following:
Muscles and tendons sustain tiny tears whenever they are used. The body is in a continual process of repairing the micro damage in response to the localised inflammation. When the damage accumulates more quickly than healing, there may be formation of scar tissue and thickening over the torn soft tissues.
In the absence of enough rest, the cycle continues and the conditions worsen progressively. Collagen bundles may start looking chaotic and discontinuous under a microscope as opposed to their tight, parallel structure. Muscle fibres may loosen and decrease in diameter.
This increases the chances and can directly lead to more complex injuries. A tennis elbow, for example, can degenerate into a form of arthritis as the bone starts taking some of the damage from the repeated stressor.
Tingling, numbness or ‘pins and needles’ may be experienced when nerves are compressed in RSIs. The health of the muscles and the nerves is closely related so damage to one of the structures will affect the other as well. Furthermore, healing of damaged nerves takes very long.
The most common sites of OOS caused nerve damage are the neck, shoulders, and the wrists and hands. These nerves also go through the discs and facet joints of the neck. These nerves will then be unable to move freely in the arm if their surrounding soft tissues are tight or damaged.
Repetitive use and straining of these already compromised nerves will make them sore and inflamed. Continual insult without sufficient recovery will only worsen the condition. The progressive degeneration can make occupational and everyday activities like typing or lifting a cup very difficult or even painful to perform.
Pain, stiffness, and degenerative changes may start happening in the joints due to prolonged abnormal posture or movements. Over time the worsening of the muscles, nerves and other soft tissues can lead to detrimental effects for the bones as well.
The progressive nature of OOS means that the best form of care is prevention. The following habits and practices would greatly diminish the likelihood of such a condition when applied consistently:
Common sense would also dictate the following in order to reduce the likelihood of OOS:
Identification and treatment
It may sometimes be difficult to diagnose because of their complex and progressive nature. A full review of medical history and comprehensive lifestyle analysis may be required. Once the diagnosis is ascertained, the treatment plan may include rest, change in work habits, postural correction, soft tissue therapy, medication, relaxation, stretching and exercise, mediation and many other modalities. Individualisation and a consideration of the whole body and mind are essential for a truly effective approach.
Martin Stefanov Petkov