Studio Mysteries

July 6, 2009

Draftsman’s Arm: RSI in the Arts

Filed under: Being a Professional Artist — Anya Galkina - Studio Mysteries @ 6:47 pm

RSI stands for Repetitive Strain Injury. Most people associate it with Carpal Tunnel Syndrome, but that particular set of symptoms is only one of many possible injuries. RSI is a dark beast familiar to folk in a huge variety of fields: carpenters and tennis players, factory assembly workers and butchers, piano players, graphic designers and yes, fine artists.

Human Engineering and RSI

RSI stems from the fact that human beings are too funky to work like robots. My RSI doctor explained it to me thusly: our bodies’ design was honed in the Pleistocene, when everyone’s workday was extremely varied. You had to multitask between running away from a saber-tooth tiger, climbing a tree to get some fruit, throwing a spear at a wild boar, rubbing together sticks to start a fire, and then taking a break from cave painting to play coconut soccer with your tribe to maintain morale.

In other words, people’s survival was closely tied in to being able to perform a huge variety of tasks during the day, which switched constantly between different muscle groups, and also switched between small and large muscle groups, performing small and large movements.

RSI develops under two types of conditions: when someone performs the same movement over extended periods of time, and when someone has to remain in the same position over extended periods of time. The repetitive movement injures muscles responsible for that movement. The repetitive stillness injures postural muscles required to keep the body in that position.

Muscle Response to Constant Fatigue

Muscle tissue is a marvel. It is almost a creature onto itself, and when it gets tired, and you ask it to keep going, and going, and going, it develops emotional problems and thinks you no longer love it. These emotional problems manifest as a number of things. The ones I often experience are trigger points, referred pain and loss of movement range.

Trigger Points

Trigger points, as I understand them, relate to the fact that muscle tissue can be in one of two states – shortened (tensed) and long (relaxed). When a muscle performs its contraction over and over, to the point of injury, the muscle fibers form spots where they remain in the tensed position, and also kind of stick together into a lump. Trigger points are knots to the power of ten. They pull on the surrounding tissue, inhibit normal movement, put pressure on nerves and reduce blood circulation and oxygenation. Basically, they are toxic swamps of dysfunction and can cause significant pain in their location. Untreated and inflamed, they also cause festive fireworks of pain elsewhere in the body, called referred pain.

Referred Pain

Referred pain can feel like flu-ey, diffuse aches. If severe, it can also feel sharp, hot, and vivid to the point of you having to check whether some unkind soul is actually stabbing you with things. When I had a bad bout of RSI in 2002, while working in a sweatshop ad agency, I felt as if my fingertips were sanded down to the bone, and as if I had ground glass in my wrists.

Imagine my surprise when it turned out that the problem originated in trigger points in my neck and shoulders. Referred pain can confuse the bejesus out of doctors as well as patients. Imagine being told to have surgery to deal with wrist pain when what you need is regular neck massage and a less insane job.

Loss of Movement Range

Permanently tensed, freaked out muscle tissue is contracted and inhibits the work of its opposite twins. Every movement is performed by something having to shorten, which means that the muscles responsible for the opposite movement have to let go and lengthen. If your forearm extensors are short, you won’t be able to use your flexors to their full capacity.

Eventually, muscles just go on strike and refuse to work altogether. Which is probably just as well, because if things are this bad, you should be removed from your body’s driver seat and take classes on responsible usage.

RSI Treatment and Prevention

RSI is kind of like polio, cholera and AIDS in the sense that prevention is a lot more effective, fun and easy to implement than dealing with the illness itself. It may sound crass to compare RSI to something as serious as AIDS, but what if your livelihood depends on your being able to perform the work? What if you become injured to the point where you can’t tie your shoes or pick up a glass of water, let alone perform actions resulting in paid employment?

RSI is a very serious injury and it CAN GET THAT BAD. The pain can become excruciating and constant, the loss of capacity profound and disabling to the point of precluding the simplest of tasks. Recovery from that degree of RSI is long and expensive, the treatments themselves are painful, and if nerves become compressed and inflamed, neurological damage can be permanent.

RSI prevention

Preventing boils down to paying close attention to the degree of symptoms. If you have been playing enthusiastic tennis, computering away or drawing for 6-7 hours, and you notice your shoulder is sore, it’s to be expected, and that kind of pain will probably go away if you rest. But what if you draw, play tennis or design on a computer for several hours DAILY?

First of all, try to limit the activity. Doing anything for several hours daily is a recipe for RSI.

Secondly, make sure you take regular breaks. Ideally, you shouldn’t perform the activity for more than 20-25 minutes without a break, but that frequency can interfere with concentration. But you definitely shouldn’t go for longer than an hour without taking a 10-15 minute break and stretching, moving differently or resting.

In that case, pay very careful attention to whether or not symptoms are gradually increasing.

  • If the “post-long-bout-of-work” pain is still there the next morning, you have a problem.
  • If the pain begins after  1 or 2 hours of work, you have a problem.
  • If pain flares up after an easy and habitual movement NOT related to the work, you have a problem.
  • If you spend a long time getting to sleep because you can’t find a position in which you don’t have pain or discomfort, you have a problem.
  • If pain wakes you up at night, you have a huge problem.

The difficult thing is how slowly these things begin to creep up. You don’t go from normal to howling in pain right away. These discomforts build up over a period of months, and you become habituated to them and no longer register them as alarming. By the time symptoms become truly alarming, to the point where injury is pronounced enough to notice, it’s too late.

If you have any symptoms that match the list above, you are already injured and need work/lifestyle changes and treatment.

RSI Treatment

1. Trigger point release massage. This is not fluffy, friendly, relax until you drool massage. The therapist puts manual and constant pressure on the knot of muscle fibers until they give up on the permanently contracted position and relax. The key to treatment of trigger points is to get this to happen. Once the fibers go limp, blood floods the area, washes out toxic byproducts of activity and inflammation, and the surrounding tissue is no longer pulled on and can go have a beer in peace. Improvement is almost immediate, in terms of pain reduction and movement range.

2. Trigger point release acupuncture. Western medicine has an iffy relationship with acupuncture, and the latter’s effects in healing the body via manipulating empirically undetectable energy flow have not been *scientifically* proven to exist, so it’s generally a buyer beware health market. However, trigger point release is different – it’s a more extreme form of the manual release through massage. When a needle is inserted into the trigger point, the point relaxes instantly, whereas during massage release, the therapist has to keep constant pressure for about 15 minutes per point to get the same results. The improvement in the overall symptoms and capacity is also quicker and much more pronounced than with massage therapy. I was able to recover from a staggering level of pain and disability in about 3 weeks.

However: this therapy is unbelievably, horribly, torturously painful. Essentially, the trigger point release happens because of the shock and pain the needle insertion causes to the muscle. I used to break pencils in my teeth during treatment, and my doctor told me stories about a patient who was an opera singer and would belt out arias on top of her lungs to cope with the shock and pain.

3. Stretches and timed rest. Rest cures are problematic for people with RSI because while they rest, they improve, but as soon as they go back to the activity, the symptoms return. The key is, again, taking breaks and stretching, stretching, streeeeeeeeeeetching. If the problem the muscle is having has to do with being asked to contract too long, too often, then the cure is the opposite – let it stretch out, wiggle its toes and experience relief. Stretching also helps with constricted circulation which is the second problem in RSI besides sheer muscle fatigue.

Timed rest means that you keep doing your activity, but you take breaks that are regular as clockwork. Set a timer and take a break when it goes off. For a lot of people, taking breaks is hard because they simply become too absorbed in what they are doing, especially graphic designers, writers, musicians and the like. A timer is a good tool to keep on track.

Here are some resources for stretches:

http://www.will-harris.com/yoga/rsi.html

http://www.rsi.deas.harvard.edu/preventing.html

http://www.rsiwarrior.com/stretches.html

4. Regular exercise. Yoga is a fantastic tool to help with RSI. Doing yoga, swimming and general gym workouts is extremely helpful in prevention, and if done carefully, in recovery. My word of caution is to avoid exercises that call on the muscles you are already overusing, or duplicate the position you have to hold for long periods of time. In my case, I don’t do any yoga positions that recquire me to support my body’s weight on my hands. For example, when it’s time for the plank position, I do it off my knees if at all, and instead of upward dog, I do a mellow, “old people” version of cobra. I also swim on my back rather than the regular way, because keeping my head out of the water requires a tense, compressed trapesius, one of my workhorse muscles.

5. Ergonomics and posture. For computer users, it’s relatively easy to achieve. Your back, upper arms and lower legs should be at a 90-degree angle to the ground. Your upper arms should hang next to your body, not extend in front of it. Your upper legs and forearms should be parallel to the ground. Your back should be supported. Your monitor should be at a height that has your line of eye sight at a 30-degree downward angle. You don’t need a fancy set-up – all this can be achieved with things like a box under your monitor. I do find that a chair that doesn’t let you sit in exactly this way will cause problems. Note that it doesn’t have to be an expensive chair, just one that lets you sit in the correct position.

For other professions, things are a bit trickier and have to be adjusted through trial and error. I’m still trying to figure out the best ergonomics for drawing with a small board and drawing a large piece mounted to the wall. Hairstylists have some leeway with height, but they HAVE to keep the working arm extended outward, which is very, very hard on the neck and shoulder muscles. Room for improvement seems to be infinite.

6. Job variation. Is there any way to vary the tasks? Today, I am too sore and fatigued to keep working on my large drawings. Instead, I am making clay sketches for a new piece, which I will use to study the lighting on the things I will eventually draw. I also have some small compositional sketches to make, materials to prepare and anatomy books to study. Is there anything you can switch to, or work on things in 1 or 2 hour increments instead of 4-5-6-7-and-up increments?

These are all the things that I know to be effective in treating muscle overuse injuries. I don’t have a lot of experience with tendon and ligament problems related to RSI, but it also makes sense to me that those problems are secondary, because the original issue is muscle injury due to unrelieved fatigue. Treat the muscles right, and they will serve you happily. Treat the muscles like sweatshop factory employees, and I guarantee you will eventually have to spend a lot of time putting out the fires of revolution.

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3 Comments »

  1. Ghaa! That’s a lot of knowledge about one injury!

    RSI is so common for computer graphic artists – being a fine artist can’t exactly help the condition. I’m trying to assume the correct computer-user position as I type, but it’s not easy following your recommendations

    This post will be very helpful to those who don’t yet have RSI – there’s so much useful information. You’ve certainly done your research.

    I have Carpel Tunnel Syndrome and was so relieved that the numbness and pins & needles in my fingers wasn’t an early heart attack. I just cut salt out and put up with it.

    Aaand streetch!

    Comment by InkSplodge! — July 11, 2009 @ 4:14 pm

    • Wait, that’s bad – the whole point of ergonomics is to set up your seat and table so that your most natural position is the right one. If you are having to make an effort to be in the right place, it means you should adjust stuff until you don’t anymore.

      Aaaaand streeeeetch… I am really bad at taking breaks, so if I practice what I preach, it will be a snowy day in hell a very good thing.

      Comment by studiomysteries — July 11, 2009 @ 7:12 pm

  2. […] Studio Mysteries – Draftsman’s Arm: RSI in the Arts […]

    Pingback by Artists and Repetitive Strain Injury (RSI) | Trips & Tricks — April 26, 2016 @ 9:02 am


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