Whether typing a school report or
surfing the Internet
, kids often spend hours at the computer. So it's important for
parents to know about the causes of repetitive stress injuries
and how to prevent them.
About Repetitive Stress Injuries
Repetitive stress injuries (RSIs) are conditions caused by
placing too much stress on a
joint
, and they vary in type and severity. Most RSIs 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 like tennis.
An 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 are the result of RSIs include:
- 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.
Preventing RSIs
Preventive measures can help kids avoid RSIs altogether:
- Always remind kids to sit up straight. Slouching or crouching
over the keyboard can place undue stress upon the neck, back, or
spine and lead to an RSI.
- Tell kids to avoid tensing their 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 90-100 degrees) relative to the
spine.
Remind kids that pounding on the keyboard is unnecessary and can
hurt both them and the keyboard! Using a light touch to type is
best. Also, be sure that they don't reach for the keys; if
so, the keyboard should be moved closer. Kids should maintain a
90-degree angle between the wrists and elbows and the upper part of
the arms. Fingers and wrists should remain level while typing.
Taking frequent breaks is also a important to preventing RSIs.
Kids can lose track of time and forget to take breaks, so make
sure they rest their eyes, back, wrists, and neck every half hour
or so.
Stretching, getting a snack or a drink, or walking or taking a
bike ride can help kids 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 kids 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, set a good example yourself. If you stare at a computer
screen in dim lighting for hours without taking a break, kids will
get the message that it's OK.
Many times, RSIs are caused by using the wrong tool for the
job. Because most computer systems are designed for the body of a
25-year-old man, be sure to get chairs, monitors, input devices,
and keyboards that are suitable for your kids' size.
Getting Ergonomic
Proper computer placement, correct typing and sitting positions,
and well-designed furniture will make your computer environment
ergonomic (which means to make equipment use less fatiguing and
uncomfortable) and prevent RSIs.
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.
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.
Go for 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 - because kids come in all
different heights and sizes.
These 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 - you should
be able to adjust its 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
kids won't bend their wrists to the side when typing.
- Monitor position
: the top of the monitor screen should be aligned with the
computer user's forehead. Kids should sit about 2 feet from
the screen. If the monitor is used by the entire family, get
one 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 keyboards feature function keys arranged in a convenient
circular format, rather than on the side or top of the keyboard in
rows or columns. Many have 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 RSIs
Repetitive strain (also called cumulative trauma) symptoms
include tingling, numbness, and searing pain, which indicate the
presence of progressive nerve and muscle damage. If your child
complains of excessive fatigue or stiffness in the neck or back or
any of these other symptoms, a visit to the doctor is in order.
Treatments for RSI vary; your 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, the doctor may suggest a
rehabilitation program
to exercise the muscles slowly and prevent loss of movement in the
joint. Another part of treatment might 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 whole family.
Given the importance of computers in our everyday lives, parents
and kids should strive to make adjustments to their computer
environments to keep themselves healthy.
Reviewed by:
Steven Dowshen, MD
Date reviewed: November 2008
Originally reviewed by:
Kimberly S. Pierson, OTR/L
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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