What is R.S.I. and What Causes It?


by Gail Dubinsky, M.D.
Repetitive strain injury, Repetitive stress injury, Repetitive motion syndrome, Overuse injury, Cumulative trauma -- all are terms used to describe many different injuries most commonly involving the hands, arms, shoulders, neck, and upper back. Various diagnoses given by medical professionals include: Carpal tunnel syndrome (probably the most recognized), Cubital tunnel and Radial tunnel syndromes; Tendinitis of the hands, wrists, elbows and shoulders; Cervical strain; Trapezius strain; and myofascial Thoracic Outlet Syndrome. Whatever you call it, the common denominator is too much of an offending activity, done for too long, without adequate rest and regeneration.

Our state of musculoskeletal health depends on the balance between the forces of injury and repair. If the rate of tissue damage exceeds our body’s capacity to heal itself, then we are going to experience ongoing or worsening symptoms of pain, numbness, tingling, weakness, and disability.

Very Basic Neuropathophysiology 1A:

The destructive forces of overuse and postural strain cause a cascade of insults: inflammation -->swelling and irritation -->muscle tension--> constricted blood circulation--> fibrosis(scarring). Injured nerves become hypersensitive and irritable, with drastically lowered "pain threshholds".
These maladaptive changes occur not just at the original injury ( for example the wrist in carpal tunnel syndrome), but can extend throughout the neural networks and connections in the spinal cord all the way to the brain. It is as if your body becomes "allergic" to the injurious activities:
typing, mousing, repetitive manipulation or gripping, bending your neck down, reaching your arms out. This is why you are unable to tolerate normal amounts of normal activities such as writing a short note, washing dishes, opening a jar. To state it simply, R.S.I. causes damage to both structure and function.

Our symptoms are a strong alarm system for us to

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pay attention. It is critical to "stop, look and listen" to the danger signs of imbalance in the body-mind, and make changes before tissue damage becomes permanent and irreversible. The constant low grade "fight or flight" response to chronic pain and stress is a key obstacle to healing, because it causes and perpetuates muscle tension, constricted blood circulation, and shallow chest breathing, all of which deprive our tissues of the oxygen and nutrients they need for optimum health and healing.

The good news is that we can reprogram our nervous systems, by practicing yoga and relaxation on a regular basis. The R.S.I.? Rx: Yoga! video/DVD program provides a special blend of breath awareness, modified postures to safely stretch and strengthen the entire body, and relaxation. The word Yoga means union, and throughout the R.S.I.? Rx: Yoga! video/DVD program we practice the integration of body, mind and breath. To heal from repetitive stress injuries we need to look beyond the upper extremities and consider our connection to the earth and our relationship with gravity, cultivate soft steady abdominal (diaphragmatic) breathing, and develop core strength and stability to support and nourish the movement of our arms, legs, and spine, so we can let go of unhealthy muscle tension patterns, especially around the shoulders. Most of all, we need to relax deeply!


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