Repetitive Strain Injury (RSI)

Download our leaflet on Repetitive Strain Injury (RSI)


RSI is a broad term and it may be applied to any part of the body. Muscles, joints, tendons and ligaments can all suffer a repetitive strain injury. RSI can affect arms, legs or back. RSI can happen suddenly or over a long period of time. It normally happens with improper sustained posture such as when using a computer and a mouse. RSI can also be sustained while playing sports such as rugby or dancing. Doing the same routine in the gym can cause the same results so it’s important to vary your routine.

  1. 1 in 50 of all workers in the UK have reported RSI symptoms
  2. 5.4m working days are lost to RSI each year in the UK
  3. Every day six people leave their jobs due to RSI
  4. RSI costs the UK economy between £5bn and £20bn per year
  5. RSI conditions affect the best workers
  6. Musicians and sports people are vulnerable


Bones & muscles make up the musculoskeletal system which provides support & strength, keeps the body moving and protects internal organs. The bones, connected by joints, serve as levers for the muscles to move. Muscles attach to bones by tendons (some are enclosed in sheaths). Ligaments connect two or more bones, cartilages or other structures.

Any activity that wears away at this system may cause a repetitive strain injury.


  • doing repetitive actions, too long, too often without sufficient breaks or with vibration
  • repetitive activities e.g. computer/machine work, playing a flute - for long periods,
  • constant forceful movements e.g. screwing forcefully, playing tennis, football, lifting and moving furniture or people.
  • working in an awkward, static posture e.g. painting ceilings, joinery, children writing
  • imbalances from previous injuries or poor posture: tissues are more vulnerable
  • feeling under pressure or competing issues as seen at work, sport, school or college
  • overwork – we aren’t designed to work over quickly or without rest or change of position
  • stress already within a person makes them more likely to develop RSI - even more so when he/she finds it difficult to relax

Injuries affect muscles, tendons, sheaths, joints and nerves and by the time pain is felt, a lot of damage has been done. Repair in the body usually involves scar tissue which can restrict a joint and its movement even more.

RSI can affect the neck, arms, wrists, lower back, shoulders, hips, knees, ankles and feet! Yes, any area can be affected! And anybody.

The more common injuries are labelled e.g. carpal tunnel syndrome, bursitis, tennis elbow, low back pain, ‘frozen shoulder’, tenosynovitis, tendonitis, strained cruciate ligaments and so on.

Carpal tunnel syndrome refers to inflammation of the tendons of the wrist which are enclosed in sheaths as they pass through a very small bony tunnel on the way to the hand and fingers. These sheaths secrete synovial fluid, lubricating the tendon so that damage and injury from rubbing, friction and pressure are prevented. Rest periods are needed to replenish the fluid. In RSI, this lubrication is depleted causing friction, which then stimulates increased production of the fluid. Excess fluid in a small area will cause pain. If this is insufficient, the tendon and sheath rub against each other and become inflamed. Pain ensues on motion or flares up in the night.

Other muscles try and splint the area to prevent further damage.

Other similar painful conditions are not labelled: pain can be difficult to diagnose specifically as it may radiate to other areas causing great distress and may be labelled as ‘chronic pain syndrome’ when the doctor can’t think of anything else.

Labels are not as important as seeking relief. The pain can be very severe and life changing. RSI can be helped or treated successfully with Swedish or Remedial Massage. Therapists will look at your whole structure and work to improve and bring it into balance as well as working on the affected area to ease pain and congestion and improve motion.

Signs and symptoms can include: pain in the area or shooting elsewhere (can be severe and interfere with sleep), swelling, numbness, tingling, weakness, muscle spasms, cramps, fatigue, muscle wasting, clumsiness and tremor.

Pain comes from inflamed tissues, increased fluid in the area causing pressure on nerves, congestion, muscle spasm. Compensating movements at other joints further complicate the problem. Healing chemicals cannot get to the area as the circulation is not as it should be.

Remember the real pain producer is muscle spasm. Muscles get tighter for many reasons including stress and also to splint an overused or injured area or in response to disease or imbalances elsewhere. Tight muscles pull on the inflamed tendons – with MORE pain.

The explanation here about Carpal Tunnel Syndrome can be applied to other areas of the body affected by RSI. Many soft tissues are pain sensitive.


RSI conditions are commonly seen and treated effectively with Osteopathy and/or Remedial Massage. Regular Advanced or Remedial Massage helps so much in keeping the joints moving which is what we need to ‘oil’ the joint.

Bodywork also encourages the body to release its own pharmacy of anti-inflammatories and feel good hormones. Changes to diet (the more alkali the better) and lifestyle (fresh air and exercise) will also help.


  • A regular Massage will relax, increase awareness and reduce stress.
  • Areas of congestion can be massaged BEFORE the pain kicks in.
  • Breathing muscles can be worked helping overall energy levels and circulation
  • Vulnerable areas can be massaged before there is a problem keeping the muscles, tendons, ligaments, soft tissues and joints supple and in peak condition.
  • Warm up before you start the activity
  • Check your posture – relax!
  • Don’t hunch your shoulders
  • Ensure that you know how to work the machine and that you and it are at the optimum height – take advice.
  • If seated make sure that the seat suits you
  • BREATHE it is easy to forget!
  • Take frequent breaks – a quick stretch and shake – regular stretching is fab!
  • Change activity or at least position when you can – even a few minutes will make a difference – awareness keeps you safe
  • Good nutrition: no more junk food really aim to nourish your body
  • Drinking enough water to keep tissues hydrated and able to repair
  • Regular exercise aerobic and anaerobic
  • Identify stressors and work with trying not to get stressed by them
  • Improving lifestyle: take time for yourself

Pain and swelling CAN be reduced and movement then becomes easier. As a result there is less reliance on drugs and consequently fewer problems.


  • Eases muscle spasm relieving pain
  • Reduces inflammation and congestion
  • Restores mobility
  • Improves circulation
  • Increases awareness


As above PLUS

  • Releases trigger points and hot spots
  • Mobilises joints improving function
  • Works more deeply to reduce adhesions and scar tissue, aligning healing muscle fibres
  • Works with the chain of associated joints and tissues involved in the RSI
  • Imbalances in the body’s structure contribute to RSI. If the muscles are pulling abnormally on one side then the effects of repetitive use of that area are more likely to cause pain.

Osteopathy is the science of human mechanics.

Osteopaths have a toolkit of techniques which can be ‘custom built’ for all ages to work specifically to ease pain by correcting spinal nerve stress using manipulation. This will help RSI.

The body has a natural healing ability – we work with that. All these therapies work well alongside orthodox medicine as well as on their own.