Does it hurt when you sit down at the computer? You're not
alone. Occupational repetitive strain injury (RSI) is one of the
fastest growing workplace injuries, according to the Occupational
Safety and Health Administration (OSHA).
industry personnel who are likely to suffer the most from RSI are
corporate travel agents, who are often more tied to their CRSs than
leisure agents, and supplier res agents. According to a speech
given by an OSHA official, "one large airline's flight reservation
facility, with 650 employees, had 250 cases of RSIs over a two-year
We at Travel Weekly do more than sympathize with the
computer casualties of the travel industry. We share your pain. As
journalists, we're also on the computer a good part of the day.
That's why we're leading off this guide to treating RSIs with the
story of one of our own who suffered through the syndrome, San
Francisco bureau chief Laura Del Rosso.
"Listen to your body" may sound like touchy-feely mumbo jumbo,
but it was the best advice I got in 1998. I was covering the ASTA
Tourfest in Dallas last January, scribbling notes while ignoring a
persistent pain in my right shoulder that shot down my arm and into
my hand. As it worsened, I could no longer grip my pen; carrying my
purse over my right shoulder became unbearable. I felt cranky and
I made an appointment to see my doctor, a general practitioner
who, suspecting RSI, suggested a call to my workers' compensation
insurance carrier, which referred me to an orthopedist. It was
difficult to find an orthopedist who would take me immediately, but
I finally found one who had a slot open. He gave me a perfunctory
look, prescribed a heavy dose of ibuprofen and recommended a
physical therapist, Bill Mattmiller, who specializes in
Mattmiller was the best person who could have entered the scene
at this point. He turned out to be warm, caring and an expert on
RSIs. It was Mattmiller who told me to "listen to your body" and
warned me at the start that RSI does not heal quickly. This was
advice I did not want to hear, especially with a full travel and
reporting assignment schedule ahead of me for the spring.
But Mattmiller was right. Even with strong doses of ibuprofen, a
week off from work and then a part-time schedule for two more
weeks, my pain was weaker but persistent. He believed the injury
was a result of 20 years' work as a reporter, taking notes in
longhand, telephone pressed to an ear, and long hours writing at a
computer, all the time with poor posture and a maladjusted
A visit to my office proved him right about my work space.
Mattmiller immediately saw the problem. My computer screen was
positioned at an angle that required me to turn my head to the
left, while the keyboard and the mousepad were placed too high on
the desktop. That forced my elbows out, putting pressure on my
shoulder and neck muscles.
I needed to install a pull-out drawer for my keyboard to bring
it lower than the desktop, and the computer screen had to be
adjusted so that I was looking directly at it. Within days, I had
made all these changes. But the pain was still there and on some
days it was just as bad as it had been, despite deep tissue massage
two days a week and other forms of physical therapy that went on
for nearly two months (fortunately for me, the cost was paid for by
the workers' comp carrier).
On top of that, I followed Mattmiller's stretching and
strengthening regimen, a variety of slow, repetitive exercises
involving wide rubber bands and weights. I also stopped work for 10
minutes every hour to rest my shoulders, hands and arm. Other
techniques I used to bring temporary relief included acupressure
massage and soaks in whirlpool baths at my gym.
Meanwhile, I heard scary stories about others suffering from
RSI. One neighbor, a computer programmer who was out of work for a
year due to the syndrome, lent me some books that told of reporters
who had not taken care of their injuries early on. They were
permanently disabled, unable to use their hands or work again.
In May (five months after my initial diagnosis), feeling better
but still hampered by pain that left me cranky and unable to work
for some periods, I decided I simply needed a break from it all.
The stress of the injury, compounded by the fear that I might have
to give up the work I enjoy, had made me anxious. I took almost my
entire vacation time at once -- three weeks- and headed to
The trip was a turning point. When I returned, feeling relaxed
and having been away from phones, computers and even pens, I was
free of much of the pain. In the weeks that followed I had one
relapse (common occurrence, according to Mattmiller) and took it
easy for another week.
Today, I'm relatively pain-free -- but I am careful to follow
Mattmiller's advice, stopping work when tingling sensations start.
I also take more breaks, faithfully perform stretching exercises,
make sure my work area remains properly adjusted and use a
speakerphone on long phone calls.
In short, I "listen to my body," which for so long had been
giving me signals that I was not working in a healthy way.
Looking for Dr. Right
Once you've identified the pains you have as a possible
repetitive strain, you face the next hurdle: finding a doctor who
can diagnose your condition competently.
"A large number of my patients have expressed great exasperation
in connection with seeking treatment for RSI," writes Dr. Emil
Pascarelli in his book "Repetitive Strain Injury." "They tell me
the [first] doctors [they saw] treated them like children; the exam
was too short; the doctors were arrogant or cynical or told them to
do something inappropriate, such as go back to work when they were
in too much pain to touch a keyboard."
A doctor's prescription is a requirement before you can start
receiving physical therapy, which is the usual treatment for
In your search for the right doctor, Dr. Pascarelli suggests
looking to "knowledgeable friends, RSI support group members or
recommendations from a facility that is known for interest in
occupational medicine or one that treats musicians or athletes, who
often have problems similar to computer users. "Keep asking. If the
same name keeps coming up, chances are that person may be very
good," he said.
Also remember that many different kinds of doctors are qualified
to diagnose this condition, including orthopedists, hand surgeons,
neurologists, occupational medicine doctors, physiatrists,
rheumatologists, internists and family practitioners.
Besides physical therapy, another important factor in treatment
for RSI is setting up your work space so you don't have to strain
while using the phone or computer. One good Web site to check out
on this topic is www.pc.ibm.com/us/healthycomputing.
Two basic pieces of equipment for a healthy work space are a
comfy chair with enough support for your back and a phone headset,
essential if you often type while on the phone.
For more help, consider a consultation with an ergonomic
specialist such as an occupational therapist to really fine-tune
your work space.
Warning signs of RSI
According to the book
"Repetitive Strain Injury," the following are all signs that you
could have a problem with RSI and should be checked out with a
visit to the doctor's office:
l Chronic pain almost anywhere in the body's upper
This pain can be experienced as burning, aching or shooting,
restricted to small sites, such as fingertips, or settled over a
broad area, such as the forearms.
This pain can be there when you work or even when you're at
rest; it can even wake you up at night.Fatigue, lack of endurance and/or weakness in the hands or
These symptoms can make it difficult to do things most of us
never think twice about, such as lifting wet laundry out of the
washing machine or lugging a shopping bag.Tingling, numbness or loss of sensation.Clumsiness. If you find yourself continually dropping things,
or find yourself having to concentrate actively on something that
should be automatic, such as holding on to your coffee mug, you
might have RSI.Stiffness; difficulty opening and closing hands or using hands
at all.Lack of control or coordination of your hands or fingers; the
feeling that your fingers aren't doing what you want them to, or
that you've lost control of them could be a signal that you have
RSI.Hypersensitivity. Watch out for tenderness to the touch, the
feeling that you're wearing a bracelet when you're not or a burning
sensation.Chronically cold hands -- especially in the fingertips -- can
signal a distorted nerve function.
Published by John Wiley, "Repetitive Strain Injury" was
written by Dr. Emil Pascarelli and Deborah Quilter and costs
$16.95.Time for a name change?
Here is another of Richard Turen's marketing
ago, I listened to a dynamic speaker address a huge agent
gathering. He asked audience members to "close your eyes, reach
into your wallet or purse and extract a single business card." I
watched as 3,000 agents did this.
"Now, I want you to hold the card between your right thumb and
forefinger, then hold it two inches or so away from your eye," he
said. What is this guy's point, I wondered. "Now, I want all of you
to slowly open your eyes, read your card and look at the silly
names you have picked for your businesses."
The audience laughed, but the guy had a point. Go to any yellow
pages in any U.S. city and you will see the same interchangeable
names for the travel agencies listed. Is it time for you to think
of a better name for your business?
Richard Turen is managing director of the Churchill Group, a
sales and marketing consulting firm, as well as president of the
agency Churchill & Turen Ltd., both based in Naperville, Ill.
Contact him at [email protected]