“The main thing that has helped me was an eight-week intensive course which involved lots of stretching and strengthening. I have much more mobility than I had before. I would recommend the course to anyone, but I think you have to be prepared to put yourself through a lot of physical discomfort before you see the benefits. It didn’t exacerbate my RSI in any way, though there was a lot of muscle soreness.”
There’s scientific evidence to back up the health benefits of strengthening for people with RSI/OOS. “Strengthening exercises, particularly for eccentric strengthening, have been advocated as a treatment for tendon overuse conditions since the early 1980s. Clinical studies point to the efficacy of eccentric strengthening regimens.” (Khan, Cook, Bonar, Harcourt and Astrom, 1999).
Strengthening exercise should be combined with aerobic exercise as part of your treatment regime
Three benefits of strengthening exercise
When you exercise your muscles regularly:
- muscle fibres increase in diameter and number
- muscle fibres react faster and in greater number to messages from your nerves
- the number of capillaries increase by 20% after a few months of training, bringing more blood flow to your muscles.
However, there are times when strengthening exercise is not recommended:
- when your condition is acute
- when your normal daily life is taxing you to the limit.
However, at these times you can still benefit from:
- aerobic exercise
- strengthening exercises for the lower body
- core strength exercises, such as Pilates
- gentle stretches
It’s vital that you are supervised for a strengthening program, at least in the early stages. This is because correct technique is essential and you can easily forget how to do an exercise properly when you have a number of new exercises to learn.
Taking care of yourself with strengthening exercise
It’s essential you don’t injure yourself when you start a strengthening program. You need to have an assessment from a qualified instructor or therapist and you need to be supervised, at least in the early stages of a program.
Some ideas for making sure you take care of yourself are:
- start with no weights
- talk to the gym supervisor about any pain
- do repetitions slowly and evenly (not in a way that is shaky, fast or inaccurate)
- distinguish between good pain – pain that is just normal muscle fatigue and lasts less than 2 hours – and bad pain
- break up exercises into fewer repetitions, e.g. not 30 reps in one go but 10 repetitions each time, 10 minutes apart, three times
- use aerobic exercise to warm up before commencing strengthening exercise – this is essential
- be assertive about what you can and can’t do
- give it a try for a fixed period
- try hydrotherapy in warm water.
Strengthening can even work for older people. “When I retired I started playing the piano again to find that I could really only do it for about 10 minutes before I was in pain. Around this time I joined a gym and tried weight lifting, being very careful. I found that after a few weeks I could sit down and play for 20 to 30 minutes, which was wonderful.
Stretching for rehabilitation
There has been a lot of controversy about stretching in recent years, with studies showing that it has little or no benefit in preventing injury before sport. But does it have a useful role in rehabilitation after injury? And if so, what kind of stretching is most beneficial?
A recent review of research into muscle stretching in the International Journal of Sports Physical Therapy concluded that stretching can in fact be very useful in rehabilitation. According to the authors, “stretching is prescribed to increase muscle length and range of motion, or to align collagen fibres during healing muscle.”
However, like other therapies, its effects can take quite a while to see. For example, 12 months of stretching was just as effective as the same period of strengthening exercises or manual therapy for chronic neck pain. Don’t lose hope, though, as 6 to 8 weeks of stretching has been shown to increase muscle length when muscles are tight, as they often are in people with RSI.
When it comes to the type of stretching, it seems that “static” and “PNF” stretching are the most effective. You’re probably familiar with static stretching: it involves holding a muscle in the stretch for a period of time, then releasing it. It’s always best to do this on both sides of the body. “PNF”, “prioceptive neuromuscular facilitation”, stretching involves contracting the muscle as well as stretching it. You might start with a static stretch, then contract the muscle slightly, hold for several seconds, then breathe out and relax. Then release and allow the muscle to stretch further. You can contract and release two or three times before ending the stretch.
How To Stretch Your Neck
- Sit or stand comfortably.
- Drop your left ear toward your left shoulder.
- Use the weight of your left hand to assist the stretch. Hold here for a static stretch before releasing and repeating the stretch on your right side.
- To make this a PNF stretch, push against the pressure of your left hand and your neck muscle should contract slightly. Hold for 8 seconds.
- Take a deep breath out and relax.
- Allow the muscle to stretch further.
- Repeat two or three times, before repeating the stretch on your right side.
Kit Laughlin’s book “Overcome Neck and Back Pain ” is a good source of stretches for neck and shoulder pain, as are the classes he holds around Australia — for more information see www.pandf.com.au. Another excellent source of stretching exercises is “Conquering Carpel Tunnel Syndrome and other repetitive strain injuries” by Sharon J Butler, a book on stretching with clear illustrations and very good instructions.
YouTube search for stretches
Here are some useful videos available on YouTube:
A number of mobilisations and stretches for the arms; 10 minutes.
Very useful hand stretches to do in real time with the presenter; 10 minutes.
You need a towel or strap for these useful carpal tunnel stretches.
Four useful stretches for forearms and wrists; four minutes.
This short, three-minute clip has very clear demonstrations of some easy neck stretches, not in real time.
For lots of information and personal stories on how complementary therapies like massage, acupuncture, Alexander Technique and osteopathy can help your RSI, order our book RSI: A Self-Help Guide.
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