Avoiding Repetitive Strain Injury

Dr Christine Hamilton M.B., Ch.B

Theoretically, repetitive strain injury (RSI) is inflammation of the tendons round a joint caused by repetitive movements of that joint. There is a school of thought, however, that RSI is not a disease entity in itself, but that it occurs where repetitive movements aggravate an already existing condition such as osteoarthritis, infection (eg virus) or a pre-existing injury. For the purposes of this article, we will consider any pain in a joint caused or aggravated by repetitive movements to be RSI.

The main repetitive movement performed in stitching is the transferring of the needle-holding hand from the front to the back of the work and vice-versa to pull the needle through the fabric. This is a particular problem if you hold your work in your hand, or on a hand held hoop or frame. A small project held in the hand or in a small hoop may not be too bad, but the bigger the hoop, the larger the movement you make which then may well involve elbow and shoulder joints as well as your wrist and fingers.

The principal treatment for RSI is rest, i.e. total avoidance of the movement causing the pain, but if the problem does not settle in a few days it is probably a good idea to consult a doctor. He or she will be able to advise whether anti-inflammatory drugs, heat treatment, physiotherapy etc are needed, but these treatments are not a substitute for rest; they merely help to accelerate healing. When the attack has settled down, it is important to try to avoid or at least minimise the movement that has caused the problem, in order to try to prevent the same thing happening again.

Even if you have not so far suffered from RSI, it is a good idea to take a look at the movements you make when you are indulging in your favourite hobby, and think about how you can reduce them to minimise the risk of joint problems. The obvious way of reducing the movements of your needle-holding hand is to share the work with your other hand by using a floor, lap or table frame, which does not require holding. This frees both your hands so that you can use one hand on top of your work and the other below, allowing you simply to pass the needle from one hand to the other through the fabric. This completely obviates any swinging movement in changing one hand from above to below the work.

Tension in the muscles and tendons can be a contributory factor in RSI, so you should also try to be as relaxed as possible when you are stitching. Make sure you are sitting in a comfortable position with your back supported and your neck only minimally bent. Working on a high-count fabric can make you tense up your hand, as it is more difficult to get the needle into the right place. New glasses or a magnifier can help here, or, better still, use a lower count where it is easier to see the holes.

Another tip, which might help to reduce the risk of RSI, is to use short lengths of thread to lessen the distance you hand has to travel to pull it all through. Alternatively, you could try pulling the thread through a little at a time. Tucking your elbow into your side as you work, or resting it on the arm of your chair, may also help to cut down movements. Be careful, though, that this does not generate tension in your arm if it is an unaccustomed position.

It really is worth making a conscious effort to reduce the amount of movement and tension in your joints as you stitch. Hopefully, you will by doing so ensure that you are able to carry on stitching safely for many years to come.