Hairstylists and wrist injury- A vicious cycle.

Everyone needs to work to live. We get this, but there are levels to this concept and I think the amount of comparison that happens in our society nowadays is very unhealthy to younger generations coming up in the workforce. For example; how can we feasibly compare the workload of someone who works at a desk all day, to that of manual labor? Both are strenuous in their own way. Neither career is more or less valuable to society, yet we compare these positions and try to rank them in quality. As a manual therapist who treats injuries, I see work as non- linear. Whenever I enter a session with an new person, I get context clues about ones injury from how they spend their time both at work, and in recovery when they have free time. Yes, there are similarities and crossover from those who work in the same career path, but ultimately we must remember to treat everyone as individuals. Individuals with unique stressors, and coping mechanisms for those stressors. Amongst the most overworked in our society are those in the beauty industry, specifically hair stylists, and skin care specialists.

If we focus on what hair stylists do on a daily basis for a moment, its not rocket science as to why they are the most common demographic of people I see coming through my clinic doors. For starters, hair stylists and beauty industry professionals often spend hours on their feet. Cutting, setting foils and performing micro-movements of the hand and wrist that is largely unsupported by the stronger muscle groups of the shoulders, back, and chest. When one overuses muscles (specifically weaker ones like wrist rotators, and finger flexors) with little to no rest or rehabilitation, a scary thing can happen. Repetitive strain injury, or “RSI” for short is the point at which a muscle group is maxed out, and the muscle becomes strained. The difference between a stuck muscle, and a strain is in the name. A strain is an acute injury, and a stuck muscle is a functional limitation that can be fixed through stretching, yoga, and movement. Normally with a strain the pain response is enough to alert the brain that you need to stop and take care of the injury. With hairstylists however, work is on the line, and taking time off is almost never a priority.

When first understanding if you have repetitive strain injury, follow the “Stop, look, and act” rule. This is the first assessment tool I use when deciding how to proceed with treating an injury in my practice. You need to determine whether you are working with a strain (injury), or a functional limitation that can be fixed through stretching. With a strain injury stretching will only aggravate the issue.

STOP- If you are unsure whether you are dealing with repetitive strain injury, but are experiencing pain especially sharp, throbbing, or burning in the wrist, elbow, or shoulder (typically a joint region); play it safe and take the rest of the day off. Continuing to aggravate the area will accelerate the injury. Make a list of your recent strenuous activities, and create a self care plan to lower your stress. If you are in fight or flight, sleep deprived, and dehydrated your body is not equipped for recovery.

LOOK- This portion of assessment applies both to what you can objectively see at the site of injury and the ability to test your own range of motion without pain. This part is really important. Pain, swelling, and other signs of inflammation indicate injury, not restriction alone. Many times with muscular injury, one wont always see obvious signs of swelling or injury on the surface, but that does not mean it is not there. Isolate the joint of suspected injury, and take the joint carefully through every means of external and internal rotation. For the shoulder this would be forward circles, backward circles, lifting the shoulder out away from you, and pressing the arm with pressure straight against the body. This test is testing the AROM (Active Range of Motion) which is most important when determining if you have a strain injury. With a functional limitation the joint will have difficulty performing the task, but without sharp pain, whereas with strain injury the task may cause shooting up the arm or in the wrist, and elbow. The area may feel hot, and create a feeling of stress or panic as the action is recalling the injury itself.

ACT- If it is self determined that you are suffering from a repetitive strain injury it is important to seek out a soft tissue (muscular) therapist as soon as possible to begin treatment. The longer the pattern of use is continued the worse the RSI will become. For hair stylists its the specific overuse of internal rotation at the wrist, and elbow without proper support from stronger muscles of the shoulder and chest. (ie: holding the round brush, blowdrying straight out in front of you). The same can be said about neck RSI. Excessive forward posture of the neck without the support of the thoracic spine. Eventually the neck becomes so strained, one can develop pain in the back, and shoulders.

The best way to correct RSI is to first rest, and secondly work with a neuromuscular specialist to create a plan to strengthen the muscles that arent engaging. With hairstylists for example with the internal rotation issue, creating a routine where the posture is being opened and external rotators are engaging and being strengthened regularly will eventually correct this issue. Take care of yourself. If you suspect yourself of being injured, don’t let anyone pressure you into continuing to work. Take the time you need to rehabilitate.

reefRX Medical Massage Therapy Clinic is located on the North Shore of Oahu, Hawaii. To schedule an in person session, or a free zoom consultation contact Myron at 518-344-0396, or email the clinic at reefrxmedical@gmail.com. We can see patients on zoom anywhere in the world.