By M.A. Banfield
Repetitive strain injury — RSI — is often considered a "modern" syndrome. Indeed, in the early 1980s, and even today, sufferers frequently were not taken seriously by doctors (let alone by employers). Yet there is considerable evidence that RSI is nothing new.
During the industrial revolution, a large sector of the population moved from the farm to the factory. Their work changed from being active, intermittent and varied, to sedentary, constant and regulated. Faster machines, task specialisation and longer working hours resulted in many injuries.
The medical section of the 1908 edition of Jack's Reference Book, published by T.C. & E.C. Jack of London, suggested that repetitive injuries were often caused by workers not taking appropriate steps to protect themselves. But it also noted that "the second chief obstacle is the increased cost to the employer that precautionary measures so often involve, and which handicaps the capitalist in England in his competition with those on the continent, where the factory regulations are of the slightest, or are non-existent".
The book gave several examples of repetitive injury: "The frequent repetition of one movement causes the different craft palsies, e.g. writer's cramp, the treadlers cramp of the weaver, telegraphists cramp etc. In these afflictions the sufferer first becomes rapidly tired, and later loses the power altogether of carrying on the skilled movements of his trade."
Repetitive pressure on the abdomen appears to have caused intestinal cramps in clerical workers as they leaned forward all day over their desks. The book stated, "Sedentary occupations cause dyspepsia" (indigestion and colic), and "colic corresponds to cramp, but attacks the involuntary muscles instead of the voluntary".
Similar repetitive pressures appear to have caused intestinal cramps in shoemakers: "Attitude [meaning posture], as in cobblers, may be a cause of disease. In this trade, pressure is applied to the lower end of the chest for hours together with the result that the chest is often deformed, and indigestion and cancer of the stomach are common."
It is clear that in 1908 repetitive work was a well-recognised occupational hazard. Why then were doctors in the 1980s saying that such diseases did not exist?
A primary role of doctors is to keep people healthy and productive for as long as possible, and to return them to work as quickly as possible after illness or injury. This suits the capitalist, the economy and the country.
However, treatment for these injuries is unreliable and outcome is unpredictable. Rest always relieves symptoms, and one year's total avoidance of repetition gives a complete cure to some, but what employer or insurer would allow for that, when they also know that it can sometimes be many years before it clears up, or be a lifelong condition?
Also, quite often, the person may be able to perform tasks for a short time, but soon after returning to full-time repetitious work, is again crippled by cramp. This sets up
doubt, disbelief, resentment and morale problems in other workers. Furthermore, the problem cannot be verified by modern diagnostic methods, so it can be exploited by malingerers. It is therefore a considerable embarrassment and nuisance to doctors, who consequently have good reasons for sweeping the whole mess under the carpet.
However, this obscurity was upset in Australia, in the mid-
1980s, when the introduction of new keyboard technology resulted in an epidemic which hit typists, computer operators and journalists. The respectable label RSI reached the mass media, and the "all in the mind" nonsense was publicly condemned as a sham.
Moreover, the large number of skilled workers who were succumbing was costing industry by reducing productivity.
Realistic ergonomic studies were therefore undertaken to determine what equipment design, props, rest periods, task rotation, proper posture and specific exercises could prevent and manage the problem, which apparently disappeared again.
However, it didn't vanish completely. It is now called occupational overuse syndrome and occupational overuse injury. This slight and unnecessary change in terminology carries a new ambiguous element of ridicule designed to ease the RSI issue out of the public arena without fuss or notice.
RSI is a real physical condition caused by a person's occupation, yet businesses will treat the problem properly only when benefits exceed the costs; otherwise they will pressure the medical profession to distract attention from their liabilities.