Michael started running track freshman year, gradually working
up to longer and longer distances. Now a senior, he recently took
up trail running and dreams of running the Marine Corps Marathon
someday.
Michael's love for his chosen sport made it really hard when
he started having some shin pain during his sophomore year. His
doctor told him to take a break from running for 6 weeks because he
had developed a stress fracture. But after a few weeks of rest,
Michael went back to running as if nothing had happened and he
hasn't had any problems since.
What Are Repetitive Stress Injuries?
Repetitive stress injuries (RSIs) are injuries that happen when
too much stress is placed on a part of the body, resulting in
inflammation (pain and swelling), muscle strain, or tissue damage.
This stress generally occurs from repeating the same movements over
and over again.
RSIs are common work-related injuries, often affecting people
who spend a lot of time using computer keyboards.
While most common in adults, RSIs are becoming more prevalent in
teens because they spend more time than ever using computers.
Playing sports like tennis that involve repetitive motions can also
lead to RSIs. You may hear sports-related RSIs referred to as
overuse injuries
. Teens who spend a lot of time playing musical instruments or
video games are also at risk for RSIs.
In general, RSIs include more than 100 different kinds of
injuries and illnesses resulting from repetitive wear and tear on
the body. These injuries vary from person to person in type and
severity.
In teens, overuse injuries most often occur at
growth plates
(areas at the ends of bones where bone cells multiply rapidly,
making bones longer as someone grows). Areas most affected by RSIs
are the elbows, shoulders, knees, and heels.
What Causes Repetitive Stress Injuries?
Most RSI conditions found in teens are linked to the stress of
repetitive motions at the computer or in sports. When stress occurs
repeatedly over time, the body's joints don't have the
chance to recover, and the joints and surrounding tendons and
muscles become irritated and inflamed.
Certain jobs that involve repetitive tasks - such as scanning
items as a supermarket checker or carrying heavy trays as a waiter
- can lead to RSIs. Sometimes, playing musical instruments can
cause problems from overuse of certain hand or arm movements. Any
repetitive movement can cause an injury - even text messaging!
Using improper equipment while playing sports is another
important factor in RSIs. For example, running in athletic shoes
that don't provide enough support can lead to shin splits and
foot and ankle problems. Improperly fitted tennis rackets can
contribute to a condition called tennis elbow.
Teens may be susceptible to RSIs because of the significant
physical growth that occurs in the teen years. The growth spurt
(the rapid growth period during puberty) can create extra tightness
and tension in muscles and tendons, making teens more prone to
injury.
Nutritional factors also come into play in RSIs. Proper
nutrition is essential for developing and maintaining strong
muscles and bones - and to keep up the energy levels needed to play
sports and perform other physical activities well.
What Happens When Teens Have Repetitive Stress Injuries?
Symptoms of RSIs include:
- tingling, numbness, or pain in the affected area
- stiffness or soreness in the neck or back
- feelings of weakness or fatigue in the hands or arms
- popping or clicking sensation
If you notice any of these warning signs of RSIs, make an
appointment to see a doctor. Even if your symptoms seem to come and
go, don't ignore them or they may lead to more serious
problems.
Without treatment, RSIs can become more severe and prevent you
from doing simple everyday tasks and participating in sports,
music, and other favorite activities.
What Kinds of Repetitive Stress Injuries Can Teens Get?
RSIs that can develop in teens include:
Bursitis.
Inflammation of the bursa, which are fluid-filled sacs that act as
cushions for the joints, is known as bursitis (pronounced: bur-
sye
-tis). Signs of bursitis include pain and swelling. It is
associated with frequent overhead reaching, carrying overloaded
backpacks, and overusing certain joints during sports, such as the
knee or shoulder.
Carpal tunnel syndrome.
In carpal tunnel syndrome, swelling occurs inside a narrow
"tunnel" formed by bone and ligament in the wrist. This
tunnel surrounds nerves that conduct sensory and motor impulses to
and from the hand, causing pain, tingling, numbness, and weakness.
Carpal tunnel syndrome is caused by excessive bending of the wrist
during typing, playing video games (using joysticks), and other
activities. It is rare in teens and is more common in adults,
especially those in computer-related jobs.
Epicondylitis.
This condition is characterized by pain and swelling at the point
where the bones join at the elbow. Epicondylitis (pronounced:
eh-pih-kon-dih-
lye
-tis) is nicknamed "tennis elbow" because it frequently
occurs in tennis players.
Osgood-Schlatter disease.
This is a common cause of knee pain in teens, especially teen
athletes who are undergoing a growth spurt. Frequent use and
physical stress (such as running long distances) can cause
inflammation at the area where the tendon from the kneecap attaches
to the shinbone.
Patellar femoral syndrome.
This is a softening or breaking down of kneecap cartilage.
Squatting, kneeling, and climbing stairs and hills can aggravate
pain around the knee.
Shin splints.
This term refers to pain along the shin or front of the lower leg.
Shin splints are commonly found in runners and are usually
harmless, although they can be quite painful. They can be difficult
to tell apart from stress fractures.
Stress fractures.
Stress fractures are tiny cracks in the bone's surface caused
by rhythmic, repetitive overloading. These injuries can occur when
a bone comes under repeated stress from running, marching, walking,
or jumping, or from stress on the body like when a person changes
running surfaces or runs in worn-out sneakers.
Tendonitis.
In tendonitis, tearing and inflammation occur in the tendons,
rope-like bands of tissue that connect muscles to bones. Tendonitis
is associated with repetitive overstretching of tendons from
overuse of certain muscles.
Preventing Repetitive Stress Injuries
Preventing Computer-Related Injuries
To prevent injuries from computer use, make sure your computer
equipment and furniture fit you properly and that you use correct
typing and sitting positions. If your parents are shopping for new
computer furniture, suggest that they buy pieces that can be
adjusted for each family member.
Here are some tips:
- Make sure the top of your computer screen is aligned with
your forehead.
- Sit up straight with your back touching the back of your
seat. Chairs that provide extra support, especially lumbar (lower
back) support are helpful. Avoid slouching over your keyboard or
tensing your shoulders, which can place unnecessary stress on
your neck, back, and spine.
- Let your legs rest comfortably with your feet flat on the
floor or on a footrest. (To test whether your legs are in a good
position, try placing a pencil on your knee - the pencil should
roll toward your waist, not off of your knee.)
- Use a light touch when typing. Place the keyboard close to
you so that you don't have to reach for it.
- Fingers and wrists should remain level while typing. Try a
wrist rest for extra support. Your wrists and forearms should be
at a 90-degree angle to the upper part of your arms. Elbows
should be placed close to the side of the body to prevent bending
the wrists side to side.
- It's easy to lose track of time when you're surfing
the Internet or immersed in a homework assignment. Be sure to
take breaks (to stretch or walk around) about every 30 minutes -
even if you don't feel tired or feel any pain. (If you lose
track of time, use a timer so you know when you're
due for a break.)
- Try an ergonomic ("ergonomic" means specially
designed for comfort) keyboard that has a curved design, and use
a trackball instead of a mouse.
Preventing Sports-Related Injuries
Begin any sports season with a full physical exam from your
doctor so that any problems or concerns can be addressed before you
begin workouts and competitions. More tips:
- Always warm up and cool down with appropriate stretching
exercises before and after playing.
- Wear the proper clothing and equipment for your sport. For
example, tennis players should be fitted for rackets that allow
for a good grip on the handle. Wear appropriate safety gear for
your sport, such as kneepads and wrist supports.
- Drink plenty of water before, during, and after your
workouts. Listen to your body and rest when you feel tired.
- Vary your day-to-day activities. Alternate distance running
with bicycling or swimming, for example.
- If you are experiencing symptoms such as pain, swelling,
numbness, or stiffness while playing your sport, stop playing
right away and see your doctor as soon as possible.
What Do Doctors Do?
The sooner an RSI is diagnosed, the sooner your body can heal,
so be sure to see your doctor if you have symptoms.
The doctor will try to assess how the injury occurred and what
motions cause pain. Your doctor may perform X-rays, blood tests, or
other tests to make sure there are no other health problems. In
addition to doing a physical examination, the doctor may ask you
about any concerns and symptoms you have, your past health, your
family's health, any medications you're taking, any
allergies you may have, and other issues. This is called the
medical history
.
If you are diagnosed with an RSI, resting the affected area is
the key to getting better. Your doctor may recommend that you take
anti-inflammatory medication (such as ibuprofen) for a period of
time. Ice packs are sometimes recommended to reduce pain and
swelling.
After the swelling and pain have gone away, your doctor may
suggest a rehabilitation program with a physical therapist to
exercise your muscles and prevent loss of joint movement.
Taking Care of Yourself
Prevention is the best medicine when it comes to RSIs. Overall
flexibility and strength can help to prevent RSIs, so exercise
regularly and stay active (remembering warm-ups, cool-downs, and
stretching, of course!).
To avoid overusing muscles and joints, be sensible about the
amount of time you spend doing any repeated motions. If an activity
is repetitive, take breaks and do something different every 30
minutes or so.
Reviewed by:
Larissa Hirsch, MD
Date reviewed: October 2006
Originally reviewed by:
Michael Alexander, MD, and Doug Huisenga, PT, ATC
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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