Repetitive Motion Injury

“SIGNER-CISES”

General Considerations

• Avoid signing when hands are cold.
• Exercise and stretch in non-painful ranges (know the difference between “stretch” and “pain”).
• There should be no pain after stretching or exercising

Warm up Exercises

• Shoulder shrug 5 times forward, then backwards 5 times
• Hold arms at 90 degrees and turns palms over 5 times
• Open and close fists rapidly 5-10 times
• Circle wrists 5-10 times in each direction
• Spread and close finders 5-10 times each hand
• Sign alphabet at moderate speed once
• Shake hands out. This should be done anytime hands feel tight.

Stretching Exercising

• Line up head and neck over your shoulder then turn head to the left 5 seconds then to the right, drop chin to chest for 5 seconds, repeat the above.
• Place hands in prayer position with only finger tips touching, lift elbows and press fingers in backward direction.  Hold for 5 seconds and repeat 5 times.
• Arm out straight, palm down, bend at wrist and push down on back of hand with opposite hand.  Hold for 5 seconds and repeat 5 times.  Change hands.
• Arm out straight, palm up, push fingers downward with opposite hand (wrist should bend backwards).  Repeat 5 times with 5-second hold. Change hands.

 Remember, if an exercise or activity causes pain…..OMIT IT.

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WHEN RESUMING WORK ACTIVITIES

YOU MUST LOOK OUT FOR AND TAKE CARE FO YOURSELF

• See your supervisor to modify it – suggest creative scheduling to him/her
• Return to work on a trial basis - light duty may reduce stress temporarily, but unless the job is modified, odds are that the symptoms will return when the restrictions are lifted.
• Do not close you workers comp case
• You may be a qualified disabled employee under ADA.

2. Interpreting with a brace on may relocate the stress of interpreting.  Be cautious.
3. Have someone observe your interpreting style for any habits which may be aggravating the condition.
4. After the pain and inflammation have gone away, begin a reconditioning program under supervision   

*DO NOT EXERCISE IF YOU ARE IN PAIN*

 BE GOOD TO YOURSELF!

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REPETITIVE MOTION INJURY: POSSIBLE PREVENTION HINTS



1.   Do your signer-cises!!!

• Do at the beginning of each day and between jobs during the day

2.   Provide longer training periods for new interpreters to increase hand and wrist strength.

• Always warm up.  Think of yourself as a dancer or athlete.

• Never interpret when you hands are cold!

• Nuke a towel in the microwave

3.   Put hands under warm running water
4.   Maintain good general health
5.   Work on upper body strength
6.   Know your stress indicators
7.   Don’t sit under air conditioning vents
8.   Have someone look at your interpreting for posture, fingerspelling, rest position, sign position, etc.
9.   Try relaxation exercises, guided imagery, or meditation

• Interpreter relaxation tape

10. If you find yourself tensing up before or during a job, take several deep, cleansing breaths.
11. Don’t change dominant hands
12. When exercising, work on the opposing muscles groups
13. If you are a beginner now, work on your endurance
14. After an assignment or a full day of work, “Cool down”
15. After sitting for a long period your blood pools and shoulder and neck muscles tense up.  When you get up, do a few stretching
      exercises to “Cool down”
16. Require a team for any assignment over an hour that doesn’t include break(s) or don’t accept it.

• Many studies are indicating that to prevent RMI we need to switch off every 20-30 minutes

17. Keep warm during the winter before and between assignments
18. While you are interpreting , change positions

• Cradle your hands, put hands in pockets, quick massage, drop your arms, shake out hands

19. Keep a journal
20. Check out your chairs for posture
21. Increase sign vocabulary to decrease fingerspelling
22. After a two week break or more, warm up before returning to interpreting
23. Get your boss to buy a hot wax machine (or mittens for yourself!)

• Make a hot wax machine

24. Massage your hands while working
25. Schedule reasonable breaks for yourself, don’t accept bomber jobs alone

• HONESTLY!

26. Supervisors must learn how to schedule to avoid RMI
27. Use felt tip pens
28. Cool down using creativity

• Blue ice for wine bottles (clean with a towel)

• Frozen peas

• Keep ice packs at work

29. BREATHE!
30. Squeeze tennis balls or putty
31. Wear braces at night
32. Don’t practice fingerspelling day in and day out
33. Caffeine Constricts
34. What are your hobbies?
35. Look into workers comp now
36. Buy an electric can opener
37. Daily activities

• opening doors

• driving

• cleaning, yard work

• computers

38. Keep informed
39. Don’t exercise when you are in pain, you may cause more damage.
40. Heat before, ice after
 

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IF YOU HAVE REPETITIVE MOTION INJURY

DO NOT DENY IT!  DO NOT SAY THIS CAN NOT BE HAPPENING TO ME!

1.   Seek medical attention.

• Go in armed with knowledge

• many times women are treated differently than men

• keep your supervisor advised of your condition.

• File for workers compensation

2.   Rest. Rest. Rest. Rest!!!

• Rest means stopping any activity that causes pain i.e. signing, fingerspelling, knitting, writing, etc.

• Princess phase of the disease

3.   Surgery is a last resort

• Doctors will recommend surgery most of the time

• Ask for a referral to a physical therapist of chiropractor.  They have had success in treating RMI non-surgically.

4.   If your doctor does not prescribe pain medication you may take an anti-inflammatory take 2 tablets four times a day
      with food for five days.  Aspirin, like antibiotics, has a cumulative affect.

• For Tendonitis try tapping gently on the inflamed area.  For CTS, drop your hands to your sides then slowly open and close them.

5.   Use a wrist brace to restrict movement

• Tight braces reduce pain but cut off circulation

• Sleep with your brace on

• Prove to yourself and to others that you are “sick”.

6.   Discontinue any exercises until your doctor says to resume

7.   Do not shake your hands out

• This only causes more damage if you are in pain

8.   At this point you have control!

9.   Use ice for reducing swelling/pain

• 20 minutes for acute pain

• 15 minutes for chronic pain

• 7 minutes for ice massage

10.  Massage

• Try to get a doctor’s prescription

11.  Ultra sound

12.  Moist heat

13.  Hydro-therapy

14.  Develop a support system of interpreters and family

15.  Monitor your home activities and hobbies

• Include what you do to relax in this

16.  Monitor your sleep cycles.  If the pain wakes you up constantly then you don’t function as well and a cycle begins

17.  Cortisone injections are successful (although temporary) for CTS.

18.  CTS is sometimes treated with vitamin B6.  This must be monitored by your doctor as it can build up in the system.

19.  Try contrast baths

• 5 minutes warm water

• 5 minutes cold water

• Do two times each ending with warm

20.  Sports creams, Ben-gay, Icy Hot may make it feel better

21.  Interpreters relaxation tape

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