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Wednesday, June 2, 2010

Adult Repetitive Strain Disorders, Part Two

Post provided by Barbara Bergin, MD

In the last post we discussed what repetitive strain disorders are, why we get them, and what you can do about them. Today's post continues with getting back to what you love after getting better and how to prevent repetitive strain disorders.

Once I get well can I go back to doing things like I was before?

- Probably not. Most people get these disorders because they are somehow anatomically predisposed to getting them, or because they are not put together to participate in certain activities. Frankly, most human beings are not put together to perform certain sports activities on a regular or high intensity basis. Our joints just will not tolerate repetitive strain for extended periods of time. Sometimes it is just a matter of conditioning ourselves to participate; like building up to run or swim long distances. But most of the time we get repetitive strain disorders because we are just wearing out our parts. We must make permanent changes. Again, that can mean minor alterations of the way we do things around the house, but it can also mean changing the way we participate in a sport or even discontinuation of that sport. I'm sorry to say this, but it's true. Most of these repetitive strain disorders occur in people who are 40+. I just don't see them in twenty year olds. If you refer to an earlier post, "Having Peace with Your Pain, " you'll understand a little more about my thoughts on that subject.

- Treating these conditions is kind of like treating hypertension. If your doctor says you have to take an anti-hypertensive medication, do you think you can just take that for a short period of time and your hypertension is cured? Can you stop taking the pill? Will your hypertension come back? Are you ever truly cured of hypertension? No. Occasionally there are people who will make major lifestyle changes and can lower their blood pressure but most people have to continue taking the medications for the rest of their lives. This is the same with most of these repetitive strain disorders. They will come back if you go back to doing things exactly the way you were doing them before. If you make 90% of the modifications permanent, you might be able to continue to enjoying some of the activities which previously caused you pain! You can live with that!

How can I prevent repetitive strain disorders?

- Some of them might be unavoidable, but general principles can always be applied: maintain a healthy weight, exercise in moderation, avoid extremes of high impact and high intensity exercises as you age, and maintain flexibility. It's also important to recognize repetitive strain pain and address it early, either by seeing your orthopedic surgeon (that's me) or your primary care physician, or by making the modifications yourself. It's common for people to try to "work through" the pain, thinking that it's better to work it than rest it. This kind of approach to pain probably stems from the idea that you have to "work through" the conditioning pain of getting into a higher intensity exercise like running. The first time you run a half mile, it hurts; your lungs, your feet, your legs. But as you continue to run and run longer distances, it gets better. This is not the philosophy to take with the pain you experience in a tendon or joint as the result of a certain activity or after that activity. Learn to recognize the difference and address it. Rest it. Ice it. Take Aleve or Advil (if your doctor says it's okay). Then modify it!

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