Repetitive Stress Syndrome

Repetitive stress syndrome * occurs when a frequently repeated voluntary action causes pain, muscle strain, inflammation, and possible tissue damage. Repetitive motion problems, also called repetitive stress injuries, are the most common form of occupational (workplace) illness.

John's Story

As a member of the high school tennis team, John served with accuracy and overwhelmed his opponents with his backhand. He worked harder and practiced more than any other team member. Major college scouts were looking him over. During a major tournament, however, John felt pain and swelling where the tendons join the bones at the elbow. His repeated practice of straightening his elbow and extending his wrist— especially during his back swing—had caused small tears in the tendon and muscle. The doctor diagnosed epicondylitis (eh-pih-kon-di-LYE-tis), a classic case of tennis elbow.

Carpal tunnel syndrome affects people who overuse their hands on piano or computer keyboards.

Carpal tunnel syndrome affects people who overuse their hands on piano or computer keyboards.
Illustration by Frank Forney. © 2016 Cengage Learning®.

What Is Repetitive Stress Injury?

Tennis elbow and runner's knee are just two of the common names for a range of repetitive stress injuries (RSIs), which result from repeated movements that stress the tendons, ligaments, joint capsules, fascia (FASH-ee-a), and other soft tissues that surround or attach to muscles and bones. RSIs can cause inflammation * of the neck, shoulders, arms, wrists, hips, legs, and ankles.

People at highest risk include office workers using computer keyboards, factory workers using sewing machines or working on assembly lines, warehouse workers, athletes, and dancers who damage ankles and hips. Common RSIs include the following:

Although most RSIs occur in adults, young people who spend too much time on computer keyboards, playing sports, or practicing on musical instruments also are at risk.

What Happens When People Have Repetitive Stress Syndrome?


Warning signs of repetitive stress injuries include the following:


The doctor's physical examination and medical history usually will reveal the repetitive motion that has stressed the soft tissue and caused the injury. The doctor may recommend x-rays or blood tests to rule out other causes.


In 1964, at age 36, Leon Fleisher was one of the world's great pianists. When he noticed a weakness in the little finger of his right hand, he practiced harder to overcome it. During the following 10 months, however, the other fingers in his right hand curled under until he was unable to play piano at all.

At that time, not much was known about how repetitive movements cause carpal tunnel syndrome and other overuse injuries. Fleisher tried many different medications and therapies, but finally had to switch his performance repertoire to concertos written for the left hand alone.

In 1995, Fleisher began physical therapy and deep tissue massage, which taught him how to “de-contract” the overused muscles in his right hand. In 1996, he was able to resume playing concerts with both hands.


Prevention always works better than treatment. Proper warm-ups and cool-downs, frequent rests, and improved ergonomic rules for the workplace are important preventive measures. Ergonomics is the science of adapting tools and equipment to the human body—for example, chairs and desks that can be adjusted to fit the body of the user may help to prevent repetitive strain injuries. The National Institute of Occupational Safety and Health has created new standards for workplace safety to reduce the number of cases of repetitive stress syndrome.

See also Arthritis • Carpal Tunnel Syndrome • Knee Injuries: Overview • Shin Splints • Strains and Sprains • Tendinitis • Tennis Elbow (Epicondylitis)


Books and Articles

Jagga, Vinay, A. Lehri, and Satish Kumar Verma. “Occupation and Its Association with Carpal Tunnel Syndrome – A Review.” Journal of Exercise Science and Physiotherapy 7, 2 (2011): 68–78. (accessed November 15, 2015).

Johnson, Jim. Treat Your Own Carpal Tunnel Syndrome: Treatment and Prevention Strategies for Individuals, Therapists, and Employers. Indianapolis, IN: Dog Ear, 2014.

Websites (accessed August 12, 2015).

NHS Choices. “Repetitive Stress Injury (RSI).” National Health Services. (accessed November 15, 2015).

Typing Injury FAQ (TIFAQ). “Repetitive Stress Injury.” (accessed November 15, 2015).


American Academy of Orthopaedic Surgeons. 9400 W. Higgins Rd., Rosemont, IL 60018. Telephone: 847-823-7186. Website: (accessed August 12, 2015).

National Institute of Arthritis and Musculoskeletal and Skin Diseases. 1 AMS Circle, Bethesda, MD 20892. Telephone: 301-495-4484. Website: (accessed August 25, 2015).

National Institute of Neurological Disorders and Stroke. PO Box 5801, Bethesda, MD 20824. Telephone: 301-496-5751. Website: (accessed August 24, 2015).

National Institute for Occupational Safety and Health. Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30329. Toll-free: 800-232-4636. Website: (accessed August 12, 2015).

* syndrome means a group or pattern of symptoms or signs that occur together.

* inflammation (in-fla-MAY-shun) is the body's reaction to irritation, infection, or injury that often involves swelling, pain, redness, and warmth.

Disclaimer:   This information is not a tool for self-diagnosis or a substitute for professional care.

(MLA 8th Edition)