Repetitive Stress Trauma or RST is described entirely by the words that make up the phrase. Repetition implies that the injury is the result of more than one exposure. Typical RSTs result from weeks, months or years of performance of a repetitive task with a specific body part. Stress is the result of inadequate recovery time in between exposures to the repetitious task. Trauma, of course signifies bodily injury as a result of the repetitive stress.

Health care workers primarily view Repetitive Stress Trauma as an occupational or work injury. This thought is based on government statistics which indicate that those who work are more likely to develop an RST injury. While these statistics can't be denied, they also need to be taken into proper context.
In my San Diego based chiropractic clinic, we see many patients with RST injuries. Most of the time, most of the trauma is related to work, more specifically to computer work. Additionally, many of these injured people spend upwards of six hours per day on their computers while at work only to come home, eat dinner, and then sit at their own computers for hours on end as well. It doesn't matter where the stress comes from, the injury remains the same. That being said, in my 15 years of experience in dealing with RSTs I have found the primary source of irritation to be the work environment.

At this point I will go off on a tangent for just a moment – or more. One of the services that my office offers is ergonomic evaluations. Since most of my patients are in computer related occupations, most of my evaluations are on computer set-ups. Typically, when I question my patients about their work stations I hear the following, “Well, it is pretty good except for FILL IN THE BLANK.” At this point I usually suggest that I come to their place of work and evaluate their work station. They are usually way out of the ideal ergonomic set-up. I see keyboards, mice, monitors and phones positioned in ways that will certainly lead to a worsening of their condition.

Part 2: Picking up On Repetitive Stress Trauma:

The reason that work is such a heavy contributor to these types of injuries is the frequency and consistency of the exposure to the aggravating activity. Most of us work at least 5 days a week, usually consecutive days and we do the same things each day for the most part. This kind of continual stress exceeds the body's ability to recover and heal. Without adequate rest / recovery, a portion of us are susceptible to developing a repetitive stress injury.

Typical activities associated with the onset of Repetitive Stress Trauma include repetitive gripping, reaching, twisting, pushing, pulling and the use of computer input devices including both the keyboard and the mouse. Often times, these activities are performed in ways that dictate the use of poor posture and awkward body positions.

Hence we have the perfect formula for the development of a Repetitive Stress Trauma. Forceful Movements + High Repetitions + Poor & Awkward Postures + Lack of Recovery Time = Repetitive Stress Trauma.

This is not rocket science but it takes some thought to putting the pieces together. It also takes some thought in unraveling the particular stresses that are or could cause you to develop symptoms.

Figuring out what is the root cause of a Repetitive Stress Trauma is of the utmost importance. Once you have figured out what the source of that stress is, you have figure out a solution. I provide treatment for many people who simply don't see the importance in controlling the stress that they impose upon themselves. Many of them are of the opinion that if they get some treatment that the aches and pains will go away. For a small percentage of people, this is true. For most however, resolution of the symptoms of a Repetitive Stress Trauma involves formal treatment with an experienced clinician as well as reducing the physical stress that their work environment imposes upon them.

You have to look at it this way, if you work in a physically stressful environment for 40 hours per week and receive therapy 3 times weekly with each session lasting 30 minutes, you are attempting to counter 40 hours of repetitive stress with 1 hours of therapy. This formula will not work for most people. Treatment must include workstation modifications.

I have taken the liberty of outlining some basic rules of setting up an ergonomically friendly computer workstation below. Trying to come close to these recommendations will go a long way in reducing your work stress.

1. Placing the input device directly in your immediate reach zone offers natural comfort and maximum hand-eye coordination. The use of a platform for the mouse is preferable.
   Your chair should have arm rests that are adjustable.
2. Your wrist should be either in a neutral position or flexed slightly downward when operating both your mouse and your keyboard. For this reason, if you select a mouse platform that attaches to your chair, adjustability of the platform is of primary importance.
3. Consider using a high quality office chair with adjustable armrests and lumbar supports. It should also allow some degree of recline. The angle of your hips should be open to about 115 degrees.
4. Make sure that the upper arm and elbow are as close to the body and as relaxed as possible for keyboard and mouse use - avoid overreaching.
5. Hold the mouse lightly, don't grip it hard or squeeze it. Place the pointing device where you don't have to reach up or over very far to use it. The closer you can place it to your body the better.
6. Your monitor should be directly in front of you and the upper 1/3 of it should be at eye level.

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