Whether it's typing a school report or surfing the Internet, your child may be spending lots of hours at the computer. By learning about the causes and prevention of repetitive stress injuries now, you can protect your child from future injury.
What Are Repetitive Stress Injuries?
Repetitive stress injuries (RSI) are a group of conditions generally caused by placing too much stress on a joint, and they vary in type and severity. Most repetitive stress injuries are linked to the stress of repetitive motions at the computer or overuse injuries in sports. RSI in kids may occur from heavy computer or video game use, playing musical instruments, or the repetitive motion of sports such as tennis. RSI occurs when stress is placed on a joint, pulling on the tendons and muscles around the joint. When the stress occurs repeatedly, the body does not have time to recover and becomes irritated. The body reacts to the irritation by increasing the amount of fluid in that area to reduce the stress placed on the tendon or muscle.
Conditions that occur as the result of repetitive stress injuries include the following.
- Carpal tunnel syndrome: swelling inside a narrow "tunnel" formed by bone and ligament in the wrist; the tunnel surrounds nerves that conduct sensory and motor impulses to and from the hand, leading to pain, tingling, and numbness
- Cervical radiculopathy: disk compression in the neck, often caused by repetitive cradling of a phone on the shoulder
- Epicondylitis: elbow soreness often known as "tennis elbow"
- Ganglion cyst: swelling or lump in the wrist resulting from jelly-like substance that has leaked from a joint or tendon sheath
- Reflex sympathetic dystrophy: a condition characterized by dry, swollen hands and loss of muscle control; consistently painful
- Tendonitis: tearing and inflammation of tendons connecting bones to muscles
Fortunately, only a small percentage of kids have RSI. You can help prevent RSI by taking preventive measures and redesigning your home computer environment so that it fits your child.
Preventing Repetitive Stress Injuries
By taking some easy preventive measures, you can help your child avoid repetitive stress injuries altogether. One important step you can take to prevent RSI is to remind your child to sit straight in the chair. Slouching or crouching over the keyboard can place undue stress upon your child's neck, back, or spine and this can lead to a repetitive stress injury. In addition, help your child avoid tensing her shoulders. Legs should be positioned comfortably and feet should be flat on the floor or on a footrest with the legs and hips perpendicular (between 90 and 100 degrees) relative to the spine.
Remind your child that pounding on the keyboard is unnecessary and can hurt both her and the keyboard! Using a light touch to type is best. Also, be sure that your child isn't reaching for the keys; if so, the keyboard should be moved closer to her. In addition, your child should maintain a 90-degree angle between the wrists and elbows and the upper part of her arms. Fingers and wrists should remain level while typing.
Taking frequent breaks is also an important step in preventing repetitive stress injuries. Your child may lose track of time and forget to take breaks, so it's your job to make sure she rests her eyes, back, wrists, and neck every half hour or so. Stretching, getting a snack or a drink, or a fun physical activity like walking or taking a bike ride can help your child avoid future pain. Eye twitching; sore, tired, burning, itching, or dry eyes; blurred or double vision; and increased sensitivity to light are all symptoms of eyestrain, so tell your child to look away from the computer and focus on something far away every once in a while. Proper lighting of the workspace will also help to prevent eyestrain.
Finally, you can help your child avoid RSI by setting a good example. If you stare at a computer screen in dim lighting for hours without taking a break, your child will get the message that it's OK to abuse your body. Set a good example, and your child will follow your ergonomically correct lead. By informing your child of the dangers of incorrect posture and positioning, you can keep her aware of avoiding RSI.
Many times, repetitive stress injury is caused by using the wrong tool for the job. Because most computer systems are designed for the body of a 25-year-old man, you can help your child avoid repetitive stress injuries by fitting the tools, such as chairs, monitors, input devices, and keyboards, to your child's size.
Getting Ergonomic
Proper computer placement, correct typing and sitting positions, and well-designed furniture will make your child's computer environment ergonomic (which means to make equipment use less fatiguing and uncomfortable) and prevent future injuries.
"In computer usage - as with other equipment - the goal is to decrease both force and repetition, to ensure adequate rest breaks, and to achieve good positioning and good support," says Janice Trope, a certified hand therapist and ergonomic consultant.
Computer furniture can prove to be an ergonomic hazard if it does not adjust to promote good posture and hand positions. Don't put your new computer on a discarded desk with an old kitchen chair pulled up to it because these products don't give proper support to you or your child. "You want the maximum adjustability in the set-up - from the desk and chair height to the position of the keyboard relative to the elbows and trunk to the height of the monitor. This is necessary because kids come in all different heights and sizes," Trope says.
The following guidelines will help you make your family's workplace ergonomically correct:
- Leg position: legs should be positioned comfortably, feet should be flat on the floor or on a footrest, with the legs and hips perpendicular (between 90 and 100 degrees) relative to the spine.
- Chair position: if the computer is used by more than one person, a chair that's comfortable is not the only consideration - the chair should have the ability to adjust height, back angle, and armrest.
- Back position: the small of the back should be supported with an adjustable lumbar support.
- Wrist angle: wrists should be in a neutral position for typing or using the mouse, not overly flexed or extended. A wrist rest can keep the hands in the neutral position.
- Elbow angle: the angle of the elbows should be 90 degrees relative to the upper arms. The elbows should be close to the side of the body so your child won't bend her wrists to the side when typing.
- Monitor position: the top of the monitor screen should be aligned with the computer user's forehead. Your child should sit about 2 feet from the computer screen. If the monitor is used by the entire family, be sure to purchase a monitor that is easily adjustable.
- Keyboard height: the keyboard should be about 27 to 29 inches above the floor, and adjustable so it can be higher for taller people and lower for shorter people.
- Foot position: feet should rest comfortably on the floor. A raised footrest can help smaller people attain an ergonomically correct position.
Some alternative keyboards now feature function keys arranged in a convenient circular format, rather than on the side or top of the keyboard in rows or columns. Many keyboards now feature a "curved" or split design that promotes what ergonomists believe is a more natural position for hands and wrists, with the palms turned slightly toward each other (a position knows as pronation), rather than flat relative to the keyboard. In addition, a trackball can be substituted for a mouse.
Treatment of Repetitive Stress Injuries
Repetitive strain or cumulative trauma symptoms (the terms may be used interchangeably) include tingling, numbness, and searing pain, which indicate that progressive nerve and muscle damage may be present. If your child complains of excessive fatigue or stiffness in the neck or back or any of these other symptoms, you should take her to her doctor.
Treatments for RSI vary; your child's doctor may prescribe cold treatments to reduce swelling and pain and rest to reduce irritation and speed up healing. Once the swelling and pain has gone away, your child's doctor may suggest a rehabilitation program to exercise the muscles slowly and prevent loss of movement in the joint. Another facet of your child's treatment plan could be anti-inflammatory medication to reduce the pain.
Parents can install keyboard trays, pads, or alternative curved keyboards; change the location or position of seating, and the height of desks and keyboards; or adjust the height of computer screens and video monitors to create an ergonomically correct work station for the child.
Because of the increasing influence of computers on our everyday lives, it's important for parents and children to survey their computer environments and make the adjustments needed to keep themselves healthy.
Updated and reviewed by: Kimberly S. Pierson
Date reviewed: April 2005
