Writing in Lakartidningen, Dr. Mallmin introduces "Computer Arm -- a new kind of pain problem" (vol: 101, iss: 15-16, pg: 1402-07, 2004, PUBMED ID 15146669). The term "Computer Arm" is new, but repetitive stress ailments probably go back to the earliest forms of manual labor; whether hunter-gatherer-related, farm-related, craft-related, assembly-line-related, the stress is particular to the repetitive movement or posture involved. The term "Computer Arm" brings to the forefront what has become a common ailment of Technological Man.
A search of the electronic version of Index Medicus, www.pubmed.gov, brings many results on the topic of computer-related repetitive stress, such as:
Although much has been written on the topic, there is no consensus on how to treat repetitive stress ailments. A Cochrane systematic review: "Ergonomic and physiotherapeutic interventions for treating work-related complaints of the arm, neck or shoulder in adults" was unable to find any consistent evidence for the benefits of ergonomic vs. non-ergonomic keyboards, exercise vs. massage, taking breaks vs. no breaks, manual therapy and massage vs. exercises and manual therapy (Europa Medicophysica, vol: 43, iss: 3, pg: 391-405, Sep. 2007, PUBMED ID 17921965).
The Lancet points out that "Repetitive strain injury is not one diagnosis, but is an umbrella term for disorders that develop as a result of repetitive movements, awkward postures, sustained force, and other risk factors" (vol: 369, pg: 1815, May 26, 2007, PUBMED ID 17531890).
Even the term "Repetitive Strain Injury" is controversial, as The Lancet makes clear:
The term repetitive strain injury is controversial and other descriptive terms for the symptoms have been suggested, such as cumulative trauma disorders, occupational cericobrachial disorders, occupational overuse syndrome, upper extremity musculoskeletal disorders, upper limb disorders, and upper limb pain syndromes (vol: 369, pg: 1815, May 26, 2007, PUBMED ID 17531890).
The topic remains clouded in mystification. Perhaps this is because repetitive stress ailments usually develop so gradually; it is hard to locate an initial point of causation -- like watching a mountain erode: we understand intellectually that it is eroding, but we cannot actually stand by and watch it happening. To better see the erosion process we use "time-lapse" photography. To better understand the process of repetitive stress, we could look to instances when the stress happens under conditions of greater force and concentrated effort, as in athletics. For example, a repetitive stress ailment might appear in an office typist after 10 years at the keyboard, while a professional tennis player might develop "tennis elbow" in a much shorter time.
So, we could look to areas like Sports Medicine and Physiotherapy for clues on how to approach computer-related repetitive stress ailments:
Musicians, too, are known to suffer from repetitive stress:
In the social evolutionary quest to avoid manual labor, people sit for hours at computers with their bodies hunched over into misalignment. Our initial hypothesis as to a solution (from the perspective of a physical culturist) is to throw the posture into its opposite: from the "hunched-over the computer" posture to a deep back-bend on a back-bending bench (Plate 1). [NOTE: Please DO NOT try this at home!]
Plate 1: Back-bending on curved bench.
We are using a male model for these photos as a stand-in for our actual experimental subject: a 51-year-old female who suffers "Computer Arm" from decades of keyboarding on typewriters and computers, manifested in the left arm as weakness in the grip and a loss of finger dexterity [See CORRECTION/UPDATE below]. Besides the simple back-bend, she also handles small dumbbells (2-lbs each) while in the bent position, doing a variety of movements, such as pull-overs (Plate 2) and flys (Plate 3) -- as demonstrated by our male model using 5-lb dumbbells.
Plate 2: Pull-overs on curved bench (low position).
Plate 3: Flys on curved bench.
Even without the use of a back-bending bench, our experimental subject could do pull-overs while lying cross-wise on a flat bench to much the same effect (Plate 4).
Plate 4: Pull-overs across flat bench (high position).
Our experimental subject precedes the back-bending with a warm-up of dance movement, using a set of rattan Escrima sticks for leverage/resistance (Plate 5). [Escrima sticks, item #25-12, available from MartialArtsMart.net -- 800-824-2433.]
Plate 5: Movement warm-up with Escrima sticks.
After the back-bending, our experimental subject does bent leg lifts on a flat-bench, which has narrow uprights to grip onto (Plate 6). This not only helps the abs (which help the back), but it brings our experimental subject's back into a more normal posture after having done all the back-bending. Our experimental subject does this back-bending/bent leg lift sequence three times through, three times a week.
Plate 6: Bent leg lifts on flat bench with narrow uprights.
As this is a voluntary/experimental (and hopefully therapeutic) recreation, we hope to post some positive results in the future [See CORRECTION/UPDATE below]. In the meanwhile, we present this article as a starting point for others who are researching this all-too-human malady of the Computer Age: "Computer Arm" (and assorted repetitive stress or posture-related ailments).
5-March-2009
[Photos by Sara Willi. Postures by Ted Willi]
Dear Ted:
I think computer posture will wreak havoc on our bodies for many generations to come.
Regarding your site, the picture where the model is reclined with back arched over a floor apparatus with his arms spread-eagled with weights: . . . To me this pose looks like heaven (for the stretch). But adding the weights is another level.
I have been doing West African dance for years to counteract computer posture. There are many movements where the chest is opened and the arms are extended out to full reach and movement is done the full range circle. It feels wonderful!
The dance absolutely eliminates pain, and I have specifically gone to class to deal with pain. The movements are opposite from sitting at the computer plus there is the added benefit of cardio, circulation, cleansing, endorphins.
Good luck with your research,
Dee Dee Castro
Our experimental subject is no longer "experimental" -- she is now just a regular fitness trainee doing the above regiment for general flexibility and fitness to help counteract the years of bad posture at the keyboard. The symptoms that we thought were "computer arm" were actually a Parkinson-like side-effect of the drug Citalopram. Mena and de Yebenes point out that "Drug-Induced Parkinsonism (DIP) has been recognised for more than half a century as a common complication of antipsychotic therapy. ... DIP threatens to be the most frequent type of parkinsonism and a health problem of great importance in the near future. ... Once the treatment [with antipsychotics] has started, the patients need to be periodically examined for initial symptoms of DIP. ... As soon as deterioration of performance [of motor tests] is noticed, the drug should be discontinued. ... There is preliminary supporting evidence that vitamin E could be neuroprotective from DIP, but this information should be confirmed. Other antioxidants and free radical scavengers may also have a preventive value. Once DIP is diagnosed, the best possible treatment is discontinuation of the causative drug" (pg: 759,765-766).
Why didn't the prescribing doctor have a clue to the problem? Probably too many patients with too many prescriptions (with hundreds of potential side-effects) to keep track of. Patients need to do their homework. If a symptom occurs, first check closely the "Cautions" for any medications you are taking and express your concerns to your doctor.
Maybe there still is a connection between "computer posture" and Drug-Induced Parkinsonism. How many people get depressed from being hunched-over a computer for so many hours? Probably many of them go to their doctors for anti-depressants, putting themselves at risk for DIP. We urge you to consult your doctor for either of these problems, and also consider getting involved in a good movement program -- dance, exercise, yoga -- to work the kinks out of your body and help you keep a positive mental attitude.
References on DIP:
[Update 22-Oct-09: No diminishment of symptoms after discontinuing Citalopram leads doctors to disgnosis of Parkinson's, not DIP.]
tw
The Cleveland Clinic has published an article on a new technology-related ailment -- CELL PHONE ELBOW:
"Air Kenya" by Chris Minihane
http://blog.crocs.com/2009/09/11/photo-friday-air-kenya
Kenyan, lean muscles.
Red ensemble jumping high.
Noble levity!