There’s one group of patients that shows up at Dr Christoph Eichhorn’s surgery with particular frequency.

“It’s young girls who write classroom tests with a fountain pen and have a very tense hand posture,” says the chairman of the German Association of Orthopaedic and Casualty Surgeons.

The girls have a sore wrist, and the pain radiates into their lower arm, so writing is out of the question for a while.

The diagnosis is often repetitive strain injury, or to be more precise, an inflammation of the tendon sheath where muscle connects to bone.

Typically caused by repeating the same motions, the condition can lead to permanent damage if the affected joint isn’t rested.

Risk groups include typists, people who work at a computer, musicians and athletes.

People who perform a strenuous, unaccustomed activity, such as a lot of garden work all of a sudden, can also develop this condition.

“It occurs when too much strain is put on muscles that are too weak,” orthopaedist Dr Rene Conrads sums up.

Tendons are fibrous, cord-like tissue that connect muscle to bone or another structure. At key sites, they’re sheathed in a membrane that produces a lubricating fluid, allowing them to glide without adhering to surrounding fibrous tissue. If there’s too much friction between a tendon and its sheath, the sheath becomes inflamed.

In his Cologne surgery in Germany, Dr Conrads has a four-pronged treatment for repeated strain injuries: resting the affected joint, moderate cooling for three to 10 minutes to bring down the swelling, compression and elevation.

An anti-inflammatory ointment that can be kept in a freezer compartment may be applied as well. Sometimes anti-inflammatory tablets from the COX-1 or COX-2 inhibitor drug class are prescribed.

But the injured area should never be allowed to become seriously inflamed in the first place.

“If it’s painful to the touch or swollen, it should be examined,” says Dr Joachim Grifka, director of an orthopaedic clinic.

The condition can become chronic if the pain is ignored.

A special massage technique called deep traverse friction massage helps relieve the pain for some people. The hardened tendon is kneaded until it becomes pliable again, but the massage itself is unpleasant.

Another popular treatment is acupuncture. The needles should be inserted twice a week in the beginning, explains Andreas Noll, a non-medical practitioner.

“Ten sessions – or a bit more – can be expected, depending on the duration of the symptoms and the individual’s responsiveness,” he says.

To prevent these kinds of injuries, people who work at a desk should always maintain good posture. A keyboard should be placed low enough so that the wrists are in a straight position, that is, level with the elbows and not bent up or down, Dr Grifka says.

Athletes should only gradually intensify their training sessions.

Dr Eichhorn also recommends doing regular stretching exercises, for example with yoga or Pilates.

Musicians benefit from extensive warm-ups.

As for Dr Eichhorn’s young female patients, they’re usually able to write again after a short period of rest. They’ve got to take a break if their wrist tenses up again, though.

There’s one trick to help maintain mobility when you’re doing repetitive motions: Take a quick break by shaking your limp hands back and forth for several seconds. – dpa