RSI - Repetitive Strain Injury

Alex Clarke Ashgrove Physiotherapist

Article by Alex Clarke

What is RSI?

RSI (or Repetitive Strain Injury) is a descriptive term for an overuse injury. Occupational Overuse Syndrome (OOS) is another name used to describe RSI.


Repeated use of the same movements causes inflammation and damage to the soft tissues (muscles, nerves, tendons and tendon sheaths etc.) In particular, RSI has been attributed to upper limb and forearm pain.

Repetitive Strain Injuries (RSI) includes many localised injuries such as trigger finger, golfer’s and tennis elbow and carpal tunnel and also more diffuse pain syndromes (those spread over the body) which may be diagnosed as cervicobrachial pain syndrome or chronic pain syndrome.

Common RSI Symptoms

Symptoms of RSI or an overuse injury can be any of the following:

  • Burning, aching or shooting pain.
  • Tremors, clumsiness and numbness.
  • Fatigue or lack of strength.
  • Weakness in the hands or forearms. It is often difficult to perform even simple tasks.
  • Difficulty with normal activities like opening doors, chopping vegetables, turning on a tap.
  • Chronically cold hands, particularly the fingertips.

Early Signs of RSI

The first signs of RSI may be soreness, tingling or discomfort in the neck, arms, wrists, fingers or shoulders. These symptoms may come on when you do something or appear after a repetitive task.

Symptoms may disappear when you stop the aggravating activity. It may take only a few hours for the symptoms to settle, or it may take as long as a couple of days. Unfortunately, over time a minor RSI can turn into a nasty chronic injury. Extra stress in your work , or taking fewer breaks can make your symptoms much more severe and long term.

What Causes RSI?

RSI can be caused by many factors. They include:

  • Repeated arm use for too long
  • Working with equipment that doesn’t fit your body
  • Working too fast
  • Not having enough recovery breaks
  • Holding your muscles in the same position for a long time
  • Lack of training in the safest way to carry out a task
  • Lack of variety in the type of work you do
  • Working in cold conditions

What's Injured by RSI?

RSI potentially damages your muscles, tendons,  nerves and joints through repeated micro-trauma.

Muscles & Tendons

Whenever muscles or tendons are used, tiny tears can occur in the muscle or tendon tissue. The local area becomes inflamed for a short time as the body attempts to repair the damage.

Thickening and scar tissue form over the torn muscle or tendon tissue. At this stage, the area will feel painful. Normally, the body would repair the damage and the pain would go away. However, without enough rest, more activity causes further damage and more inflammation, thickening, scar tissue and pain.

This cycle gets progressively worse if sufficient rest is not taken. Under the microscope, changes can be seen in the structure of a muscle or tendon damaged by overuse. Collagen bundles that are normally tight and parallel instead look disorganised and discontinuous. A number of other changes have been noted as well, including a decrease in fibre diameter and fibre loosening.


Nerves are also damaged by RSI. Tingling feelings are caused by the compression of nerves. Nerves run through muscles, and if muscle health is poor, so is nerve health. Damaged nerves can heal but the process is extremely slow.

Most cases of persisting RSI have their basis in the nerves that run from the neck, down through the shoulders, and into the wrists and hands. These nerves pass by many other structures, most notably the discs and facet joints in the neck. If the discs or muscles become damaged or tight - often due to a poor posture - then the nerves cannot move freely in the arm.

If these tight nerves are then used repetitively, such as when typing or process working, they naturally become sore and inflamed. If this process is repeated before the nerve has recovered, the problem worsens. Before long it can be difficult to perform any task, even lifting a coffee cup, without feeling pain. Many different nerves course through your arms.

This diagram illustrates some areas covered by the main branches, any of which can produce symptoms of RSI.

RSI can be complicated. Because you have so many nerve fibres that exit from your neck and travel through your arm, the symptoms of this problem can vary wildly. Pain can be felt almost anywhere.

Nerve-related pain is often misdiagnosed as a variety of conditions, including rotator cuff tendonitis, carpal tunnel syndrome, tennis elbow, golfer's elbow, de Quervain's Tenosynovitis (thumb) and fibromyalgia.

Nevertheless, by assessing both the nerves and the structures that they cross, your physiotherapist can usually determine the exact cause of RSI. This much-maligned problem is no longer a mystery. A cure may be close at hand.



In the long-term, your joint posture and movement may become abnormal and result in joint pain, stiffness and premature degenerative changes. 

Please contact your physiotherapist for your specific individual assessment.

RSI Treatment

Whereas acute RSI is relatively simple to assess and treat successfully, is difficult to cure chronic RSI. Chronic RSI is multifactorial with some RSI sufferers eventually developing a chronic pain syndrome that affects many aspects of their life. 

However, the good news is that RSI is usually very receptive to treatment in its early stages, so it’s vital that you get medical help early and that you proactively manage this condition.  

Early intervention is the key.

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Common RSI Treatments

  • Early Injury Treatment
  • Avoid the HARM Factors
  • Soft Tissue Injury? What are the Healing Phases?
  • Acupuncture and Dry Needling
  • Sub-Acute Soft Tissue Injury Treatment
  • Scapular Stabilisation Exercises
  • Biomechanical Analysis
  • Proprioception & Balance Exercises
  • Medications?
  • Soft Tissue Massage
  • Brace or Support
  • Dry Needling
  • Electrotherapy & Local Modalities
  • Heat Packs
  • Joint Mobilisation Techniques
  • Kinesiology Tape
  • Neurodynamics
  • Physiotherapy Instrument Mobilisation (PIM)
  • Prehabilitation
  • Strength Exercises
  • Stretching Exercises
  • Supportive Taping & Strapping
  • TENS Machine
  • Video Analysis
  • Yoga
  • FAQs about RSI

  • Common Physiotherapy Treatment Techniques
  • What is Pain?
  • Physiotherapy & Exercise
  • When Should Diagnostic Tests Be Performed?
  • Massage Styles and their Benefits
  • What Causes Post-Exercise Muscular Pain?
  • Can Kinesiology Taping Reduce Your Swelling and Bruising?
  • How Much Treatment Will You Need?
  • Rotator Cuff: What is it?
  • What are the Benefits of a Standing Desk?
  • What are the Common Massage Therapy Techniques?
  • What are the Early Warning Signs of an Injury?
  • What Causes Rotator Cuff Impingement & Bursitis?
  • What is a TENS Machine?
  • What is Chronic Pain?
  • What is Nerve Pain?
  • What is the Correct Way to Sit?
  • What is the Shoulder Impingement Zone?
  • What's the Benefit of Stretching Exercises?
  • When Can You Return to Sport?
  • Why Kinesiology Tape Helps Reduce Swelling and Bruising Quicker
  • Helpful Products for RSI

    RSI (Repetitive Strain Injury)

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    Related Injuries

  • Carpal Tunnel Syndrome
  • Cramps
  • de Quervain's Tenosynovitis
  • DOMS - Delayed Onset Muscle Soreness
  • Fibromyalgia
  • Hand or Wrist Arthritis
  • Muscle Strain
  • Neck Arm Pain
  • Overuse Injuries
  • Pinched Nerve
  • Rotator Cuff Tear
  • RSI - Repetitive Strain Injury
  • Shoulder Impingement
  • Shoulder Tendinopathy
  • Tennis Elbow

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    Last updated 14-Feb-2019 10:56 AM

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