RSI Prevention Programme
Our aim is to provide the most up-to-date assessment, treatment,
and research of Work Related Musculoskeletal Disorders (WRMSD)
or Repetitive Strain Injuries (RSI) in India. We recommend a comprehensive,
multi-disciplinary approach to prevent WRMSD, since a
piece meal approach, e.g., sporadic lectures or sessions on stress
management, wellness, yoga, or ergonomics is considered sub-optimal.
This involves working as a team with representatives from human
resources, facilities, health and safety, chair and workstation
manufacturers. I am supported, in this venture, by a multidisciplinary
team of trained Doctors and Rehabilitation Personnel, working
closely together in a holistic environment. Through education,
training and treatment, we help our clients' to regain control
over their physical and mental well-being. We are also in close
collaboration with eminent WRMSD and Ergonomics experts in North
America, Asia, Australia and Europe.
What is Ergonomics?
Ergonomics is the science that studies the relationship between
work and human abilities, limitations and characteristics. An
ergonomic intervention involves the application of this knowledge
in selecting or designing tools, machines, systems, tasks, jobs
and work environments to maximize human performance without causing
injuries or detrimentally affecting performance.
Why an Ergonomics programme makes
good business sense?
There is a solid body of evidence to suggest that sound ergonomic
interventions prevent pain, suffering and a range of other social
costs directly associated with WRMSDs. Research from USA and elsewhere
has consistenty shown that for every $1 (USD) spent on appropriate
ergonomic intervention there is a return of as much as $17.80
(USD). However, setting up an effective ergonomics programme in
an organisation (including early reporting of symptoms) should
be seen as much more than just a means of maximizing profits!
Recently, several scientific studies have
emphasized the cost effectiveness
of establishing an effective WRMSD Prevention Programme
in organisations by:
- Reduction in work related injuries
- Reduction in absenteeism
- Reduction in errors
- Increased productivity and quality
- Maintaining high employee retention
An ergonomic intervention plan must include a core set of elements,
- Worker involvement
- Management commitment
- Identification of risk factors
- Development of solutions
- Implementation of solutions
- Ongoing review for effectiveness
- Training and education for workers
- Early reporting of symptoms
- Appropriate medical management
Good ergonomics programs are ALWAYS
cost-effective - they save more than they cost. Many studies
have shown this. A basic programme of educating workers
in Ergonomics and the prevention of musculoskeletal disorders
are in your company's best interests and will result in
more effective work practices.
(Reference: Cornell University Ergonomics Site: http://ergo.human.cornell.edu/)
There are no shortcuts in RSI Prevention
Many IT Companies approach us for conducting a "quickie"
lecture on RSI ("no more than 30 minutes, since our boys
are busy and would not concentrate on anything longer")
followed by a screening session to see how many are suffering
from RSI. Our humble opinion is that this activity is a complete
waste of time. We are aware that many private hospitals are
eager to send physiotherapists and junior doctors free of cost
(essentially to get referrals for their hospitals), to give
lectures on ergonomics, carry out workstation assessments and
advise people about what general exercises to do for various
ailments like back pain or neck pain.
We choose to steer clear of this approach
for the following reasons:
- It takes at least 20 minutes to assess an individual regarding
RSI, give advice about ergonomics and workstation arrangement,
and prescribe tailor made exercises and other therapy. Anything
less than that is of no value to the employee and remains a
- An important component of recovery from RSI is an ergonomic
assessment and correction of the employees' workstation and
posture. This is obviously not possible in a group setting.
- RSI usually takes weeks or months to recover and requires
a close follow up of treatment and modification of therapy occasionally.
|We have documented advanced,
debilitating RSI's in several Indian IT Professionals who
had already received "training" in ergonomics, exercises
from physiotherapists and doctors, and whose workstations
had already been "cleared by experts"!
Why have Ergonomic Innovations failed
to control RSI's in India?
"Ergonomic" chairs have been around since 1976, split
keyboards since 1926, and Indian office workstations have become
more sophisticated and flexible than ever. But Indian workers
seem to be getting stiffer all the time. Not only has the incidence
of RSI shown no signs of abatement, we are increasingly encountering
more and more advanced RSI's due to which people are unable
to work at all.
So, why are Indian IT companies not
benefiting from investments in ergonomics?
The word "ergonomics" has become a mere marketing
gimmick. There is hardly any chair or computer hardware manufacturer
in India who fails to call his product "ergonomic".
However, there is no such thing as an "ergonomic"
workstation, chair, keyboard, etc. What will make the
product ergonomic is if it is selected and adjusted according
to the user's body dimensions and nature of work, and the
user is trained to use it and is willing to use it correctly.
Out-of-date or incorrect ergonomic information provided by
untrained "trainers" or worse, salesmen of furniture and ergonomic
equipment! Ergonomics is a rapidly changing and controversial
field and it needs special training and experience to sort
out what is relevant to Indian workers.
Many Indian IT/ITES organisations rely on a "company
doctor" (usually a general practitioner or a physician
with no training/qualifications in Ergonomics/RSI treatment)
to provide ergonomic advice or to select office furniture.
The result is that most RSI's remain undiagnosed and untreated
till a stage comes when the employee is unable to work at
It is difficult to make asymptomatic computer users accept
and implement sane advice about safe computing techniques;
people start listening to you only after they become vulnerable
(read injured)! But grade 2 or more advanced RSI does not
respond to ergonomic modifications alone and specialised medical
intervention is required to reverse chronic muscle inflammation
or tethering of nerves.
Blind adherence to American or European Standards/Policies
on Ergonomics, especially by multi-national companies in India,
ignoring research specific to Indian workers. Indian office
tables are usually fixed at a height of 2 ½ feet irrespective
of the body dimensions of the user. Most chairs do not permit
adequate adjustability of armrests and back rests, and are
too large for shorter individuals and females, due to which
workers are unable to support their backs while typing.
Hazardous design and arrangement of furniture: M0st Indian
IT professionals sit in corners of L-shaped workstations (in
order to accomodate more workers in offices), with either
no tray or only a small tray for the keyboard with the mouse
placed on the table top. Often, computer users are provided
with a hard wrist rest, fixed to the tray. This set up constrains
arm movements of computer users and encourages hunching up
of shoulders and placing wrists/forearms on the edge of the
table, putting an enormous amount of strain on the neck and
shoulder muscles. Offices employing this set up have a disproportionately
high incidence of Thoracic Outlet Syndrome: one of the most
dangerous and severe forms of RSI.
Many Indian HR/Facilities Managers are known to obdurately
deny an Ergonomics/RSI problem in their organisations. Their
usual claim is that since the company has spent an astronomical
amount of money in "ergonomic" furnishing and design,
and since every single employee is not complaining vociferously,
there must be something wrong with the individuals who are
reporting pain. The problem is that most companies have no
reporting mechanisms for musculoskeletal symptoms and there
are huge disincentives to report ergonomic issues, especially
for junior workers. With this Ostrich-like attitude, there
are losers all around. Studies have shown that employees who
continue working in pain lead to hidden Corporate losses amounting
to thousands of dollars every year, even in companies employing
only 25 workers.
Major IT Companies in India are often found to be insensitive
to injured employees and it is often impossible to obtain
even relatively inexpensive workstation modifications (e.g.,
keyboard tray, footrests), time off work to recover from an
- In our experience, putting up ergonomic check lists on company
web sites or using software to make mass ergonomic recommendations
is a waste of time and money.
The Bottomline with Ergonomics
- Ergonomics has primarily a preventive
- Ergonomics will not compensate
for inefficient management or ineffective practical training.
- Once workers develop RSI, Ergonomics
will not relieve pain: Specific
- Western ergonomic recommendations
are not always appropriate for Indian office workers.
- Ergonomic recommendations vary
wildly from source to source, indicating several controversial
areas. Listen only to qualified experts with a proven
track record, otherwise your ergonomic intervention might
turn out very costly (and painful) indeed.
It is essential to raise public awareness about risks of RSI,
to prevent the next generation of workers (i.e., today's children
and adolescents) from entering the industry while already injured.
The computer and classroom furniture in schools is usually inappropriate,
and worse, children, teachers and parents have little or no knowledge
of ergonomics, RSI prevention and warning signs.
How can you help?
- Organise RSI Awareness lectures
at your child's school or college, or at your social
club. We would be happy to provide you the necessary
- Sponsor RSI Awareness Posters/Pamphlets
for School and College students.
- Ask your HR Manager to organise
programmes in Ergonomics/RSI Prevention and have
your workstation assessed.
- Share your experience or knowledge
of RSI with other injured workers and help others recover.
- If you come across an injured
co-worker, urge him/her to seek early, competent medical
me if you wish to help in spreading
awareness about RSI in the community.