But I Don't Remember Hurting Myself: Understanding Repetitive Motion Injuries
- Elizabeth Wells
- Oct 8
- 7 min read
“But I didn't do anything to hurt myself.” A computer programmer works long hours with debilitating wrist pain. A long-haul truck driver suffers from chronic low back discomfort. An office manager develops persistent shoulder tension. When asked about injury, they’re genuinely puzzled—there was no fall, no accident, no single traumatic event they can point to. What these individuals don’t realize is that they have injured themselves, just not in the way most people think of injury. They’ve sustained a repetitive motion injury, sometimes called a repetitive strain injury (RSI), and understanding this distinction is crucial for both prevention and recovery.
Microtrauma vs. Macrotrauma: Two Paths to Injury
To understand repetitive motion injuries, we need to distinguish between two fundamental types of tissue damage: macrotrauma and microtrauma.
Macrotrauma is what most people envision when they think of an injury. It’s the acute incident—the slip on ice that sprains an ankle, the car accident that causes whiplash, the lifting mishap that throws out your back. These injuries involve a single, identifiable event that exceeds the tissue’s capacity to withstand force, resulting in immediate structural damage. The cause and effect are clear and unmistakable.
Microtrauma, by contrast, involves tiny amounts of tissue damage that occur repeatedly over time. Imagine bending a paperclip back and forth. The first bend doesn’t break it. Neither does the second, third, or even the fiftieth. But eventually, after repeated stress to the same area, the paperclip fatigues and snaps. Your body’s tissues—tendons, muscles, ligaments, and nerves—respond similarly to repetitive stress. Over time they can't recover at a rate that makes up for the repetitive stress it is under. Over time that wear and tear outpaces rest and recovery. And that's how repetitive injuries occur.
Research published in the Journal of Electromyography and Kinesiology demonstrates that repetitive tasks can lead to cumulative microtrauma in soft tissues, causing inflammation, fibrosis, and eventual structural changes (Barbe & Barr, 2006). Each individual action—one keystroke, one mouse click, one mile of driving—causes microscopic damage that would normally heal during rest. However, when these activities are repeated thousands of times daily without adequate recovery, the damage accumulates faster than the body can repair it.
The Spectrum of Repetitive Motion Injuries: From Obvious to Insidious
Some repetitive motion injuries announce themselves clearly. Tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis) are classic examples where athletes or manual laborers recognize the connection between their activities and pain. The repetitive gripping, twisting, and impact inherent in these sports create predictable patterns of tendon inflammation and degeneration at the elbow.
Similarly, carpal tunnel syndrome—compression of the median nerve as it passes through the wrist—has become synonymous with computer work and assembly line jobs. Studies in Occupational and Environmental Medicine confirm that intensive keyboard and mouse use significantly increases carpal tunnel syndrome risk (Andersen et al., 2003).
However, many repetitive motion injuries are far less obvious to patients because the causative activity doesn’t feel strenuous or repetitive. Consider:
Posture-related injuries: Sitting at a desk with rounded shoulders and forward head position for eight hours daily places continuous strain on neck and upper back muscles. This sustained poor posture is actually a form of repetitive microtrauma—the “repetition” is the constant, unchanging position that creates persistent muscle tension and strain.
Driving-related injuries: Professional drivers often develop low back pain not from a single jolt or lift, but from prolonged sitting in a flexed position combined with whole-body vibration exposure. Research in Spine indicates that professional drivers have substantially higher rates of low back disorders due to these cumulative factors (Bovenzi & Hulshof, 1999).
Smartphone-related injuries: “Text neck” and thumb tendinitis emerge from the thousands of daily repetitions involved in smartphone use—activities so normalized they don’t register as potentially harmful.
Most Common Repetitive Motion Injuries
While any body part subjected to repetitive stress can develop problems, here are some of the most common conditions caused by repetitive stress:
Upper Extremity:
Carpal tunnel syndrome (wrist/hand)
De Quervain’s tenosynovitis (thumb/wrist)
Tennis elbow and golfer’s elbow
Rotator cuff tendinitis (shoulder)
Lower Extremity:
Plantar fasciitis (foot)
Achilles tendinitis (ankle)
Patellar tendinitis (knee)
Shin splints (lower leg)
Axial Skeleton:
Cervical/neck strains
Mid and lower back strains
Thoracic outlet syndrome (neck/shoulder/arm)
Tension headaches
Research published in BMC Musculoskeletal Disorders found that work-related musculoskeletal disorders, predominantly repetitive motion injuries, account for a substantial portion of worker disability claims across industries (da Costa & Vieira, 2010).
Home Management: The Foundation of Recovery
The good news about repetitive motion injuries is that many respond well to conservative treatment, especially when caught early. The cornerstone of home management involves several key strategies.
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Rest and Activity Modification: This doesn’t necessarily mean complete cessation of all activity, but rather identifying and reducing the specific aggravating movements. A computer user might need to reduce hours, take frequent breaks, or modify their workstation ergonomics. This “relative rest” allows tissues to recover while maintaining function.
Care tip: If you catch a repetitive motion injury early enough, modifications may help avoid it becoming a full flare up. Pay attention for the little signs that your body is not happy.
Ice Therapy: Applying ice for 15-20 minutes several times daily can reduce inflammation and pain, particularly in the acute phase. Cold therapy decreases metabolic activity in damaged tissues and reduces inflammatory mediator release.
Care tip: Using a velcro hip ice pack, back ice pack or shoulder ice pack, like these, allows you to ice on the go, and not have to hold the ice pack the whole time. They also make and ice roller specifically for plantar fasciitis
NSAIDs: Over-the-counter anti-inflammatory medications like ibuprofen or naproxen can help manage pain and reduce inflammation. However, these should be used short-term and with awareness of potential side effects. Consult with a physician before use.
Strengthening and Rehabilitation: Once acute symptoms subside, progressive strengthening becomes critical. Systematic reviews in Physical Therapy demonstrate that exercise therapy improves outcomes for various repetitive strain injuries (Woodley et al., 2007). Strengthening surrounding muscles helps distribute forces more evenly and improves tissue resilience.
Care tip: Start slow and build up. Going too hard, too quickly will make a repetitive motion injury worse.
Ergonomic Assessment: Evaluating and modifying how you perform repetitive tasks is essential for preventing recurrence. This might involve adjusting chair height, monitor position, tool handles, or movement patterns.
Care tips: Have a friend, family member or coworker take a picture of you while you aren't paying attention so you can see how your posture is regularly.
Physical Aids: Back braces, tennis elbow bands, and proper shoes are all examples of aids that can help take some stress off an area with a repetitive motion injury until the area heals enough to start doing active rehab.
Care tips:
Arch support insoles: provide cushion and support that allow more movement with less stress.
Back braces allow support during unavoidable activities that require prolonged standing
Elbow bands and patellar bands help support tendons during tendinitis
The Chiropractic Approach to Repetitive Motion Injuries
Chiropractors play a valuable role in managing repetitive motion injuries through a multimodal approach that addresses both symptoms and underlying biomechanical dysfunction.
Manual Therapy: Joint manipulation and mobilization can restore proper motion to restricted segments, which often develop secondary to repetitive strain patterns. Research in the Journal of Manipulative and Physiological Therapeutics supports manual therapy’s effectiveness for conditions like carpal tunnel syndrome and lateral epicondylitis (Heebner & Roddey, 2008).
Soft Tissue Treatment: Techniques including instrument-assisted soft tissue mobilization, trigger point therapy, and myofascial release address the muscle tension, adhesions, and trigger points that commonly accompany repetitive strain.
Functional Assessment: Chiropractors evaluate movement patterns and biomechanics to identify the root causes of repetitive stress. Often, poor mechanics in one area create compensatory strain elsewhere—for example, poor hip mobility contributing to low back strain in drivers.
Rehabilitation Exercise: Progressive therapeutic exercise programs restore strength, flexibility, and proper movement patterns, reducing the likelihood of recurrence.
Ergonomic Counseling: Chiropractors can provide specific recommendations for workstation setup, posture correction, and activity modification tailored to each patient’s occupational and recreational demands.
The Path Forward
Repetitive motion injuries represent a significant but often misunderstood category of musculoskeletal conditions. Unlike acute injuries with a clear moment of trauma, these conditions develop gradually through the accumulation of microtrauma—making them easy to miss until symptoms become severe.
Recognition is the first step. That wrist pain from computer work, that back ache from driving, that shoulder tension from poor desk posture—these are legitimate injuries deserving of attention and treatment. The second step is action: modifying aggravating activities, implementing home care strategies, and seeking professional guidance when needed. By understanding that repetitive activities can injure tissues just as surely as a single traumatic event—just through a different mechanism—patients can better advocate for their own health and take the necessary steps toward recovery and prevention.
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References
Andersen, J. H., Thomsen, J. F., Overgaard, E., Lassen, C. F., Brandt, L. P., Vilstrup, I., Kryger, A. I., & Mikkelsen, S. (2003). Computer use and carpal tunnel syndrome: a 1-year follow-up study. JAMA, 289(22), 2963-2969.
Barbe, M. F., & Barr, A. E. (2006). Inflammation and the pathophysiology of work-related musculoskeletal disorders. Brain, Behavior, and Immunity, 20(5), 423-429.
Bovenzi, M., & Hulshof, C. T. (1999). An updated review of epidemiologic studies on the relationship between exposure to whole-body vibration and low back pain (1986-1997). International Archives of Occupational and Environmental Health, 72(6), 351-365.
da Costa, B. R., & Vieira, E. R. (2010). Risk factors for work-related musculoskeletal disorders: A systematic review of recent longitudinal studies. American Journal of Industrial Medicine, 53(3), 285-323.
Heebner, M. L., & Roddey, T. S. (2008). The effects of neural mobilization in addition to standard care in persons with carpal tunnel syndrome from a community hospital. Journal of Hand Therapy, 21(3), 229-240.
Woodley, B. L., Newsham-West, R. J., & Baxter, G. D. (2007). Chronic tendinopathy: effectiveness of eccentric exercise. British Journal of Sports Medicine, 41(4), 188-198.
