Consumers are feeling aches, pains and strains, but is there a remedy?
By Matt Miller
Only a generation ago, Americans gained new efficiencies by using computers at work and in their homes. But for some, advances in technology have been offset with repetitive stress injuries such as carpal tunnel syndrome, tendonitis and bursitis. Others suffer from low-back pain, neck pain and headaches. Today’s generation is currently experiencing a new kind of pain — high-tech pain — thanks in large part to personal digital assistants (PDAs), Wii video games and cell phones.
According to a Harris Interactive survey, almost nine in 10 (89 percent) adults now have a wireless or cell phone. Add in research conducted by Entertainment Association indicating the video gaming industry sold more than 296 million units in 2008, and it’s clear that today’s society is technology driven. Yet while these technological advances continue to happen, an underlying phenomenon of injuries — high-tech injuries — is occurring. While few serious injuries have been recorded, consumer aches, pains and strains are finally being diagnosed. But is there a remedy?
“As a doctor, it’s not a surprise to see the number of injuries increasing that are associated with these technological advances,” said Dr. Brad Chicoine, Iowa Chiropractic Society board of directors president-elect. “Technology is a great thing — it’s opening up new horizons, but the problem is that we’re stuck behind a computer or game, and we don’t realize how they’re affecting us.”
Today’s gizmos and gadgets such as PDAs, iPods and Nintendo Wii’s are everywhere and literally at people’s fingertips. Another PDA, the BlackBerry, has gained attention with its term “BlackBerry thumb,” a catch-all-phrase describing the repetitive stress injury to the thumb as a result of overusing its small gadget keypad. The BlackBerry debuted in 1999 and has a full QWERTY keypad for thumb typing to automatically send and receive e-mail. But health officials like Chicoine believe BlackBerries and other PDAs can cause tendonitis from working in such a small space with the thumbs.
“We began seeing cases of ‘BlackBerry thumb’ about four years ago,” Chicoine said. “People, specifically teenagers, are texting so much they’re developing a “trigger finger,” which causes tendonitis in the fingers. We don’t see it very often, but there are a lot more cases out there that haven’t been identified. People are just too embarrassed to seek medical attention for it.”
Ashley Brown, an owner of a BlackBerry, says she’s aware of “BlackBerry thumb,” but doesn’t believe she’s at risk for the injury.
“I try to keep texting to a minimum,” said Brown, who indicated she would rather call someone than type a message. “I purchased my BlackBerry for work to help me stay organized, but I found out that I don’t use it as much as I thought I would. I text occasionally, but I think society has a huge problem because they’re addicted to texting.”
In 2004, the American Society of Hand Therapists issued a consumer alert warning users of small electronic gadgets that heavy thumb use could lead to painful swelling of the sheath around the tendons in the thumbs.
Adding to the problem that many Americans potentially face are unlimited texting plans offered by carriers like US Cellular, AT&T Mobility and Verizon Wireless. According to the Nielsen Company, American teenagers sent and received an average of 2,272 text messages per month in the fourth quarter of 2008 — almost 80 messages a day, more than double the average of a year earlier. With such alarming numbers, doctors say injuries are bound to happen.
“We talk to kids regularly about the habit of texting,” said Dr. Chad Olson of Stadia Sports Medicine in West Des Moines. “Kids are using them all day long, and when they’re doing that, they’re going to have an overuse problem.”
Doctors also believe other parts of the body are susceptible to the overuse of PDAs. Poor posture, such as hunched shoulders and a forward-leaning head, put serious pressure on the cervical spine, which can lead to various musculoskeletal problems (acute or chronic and may include inflammation, swelling, pain, fatigue, weakness, joint noises and stiffness, limited range of motion and lack of coordination).
“There can be a lot of neck bending and head swooping forward, which is very hard on the body,” Chicoine said. “I don’t believe it is something that’s going to go away as long as these poor habits continue.”
Too much of a good thing
The evolution of video games has been well documented over the years. While games like “Mario Bros.,” “Duck Hunt” and “Punch-Out!!” were some of the originals, today’s video gaming industry has changed all perceptions of the multi-billion dollar hobby. Consoles like Xbox 360, Playstation 3 and Nintendo Wii are the newest systems that have taken hold, and they popped up on health specialists’ radars for risk of injury, too.
“I’ve always been a gamer, and I can see where doctors are now becoming worried about injuries,” said Justin Neubauer, a 24-year-old West Des Moines resident who owns a Xbox 360 and Nintendo Wii. “The industry continues to create new things that capture games, but when a consumer purchases an item like an Wii, there are risks involved.”
The Wii, which was introduced in November 2006, features a wireless controller, which can be used as a handheld pointing device. The Wii boasts one of the most popular-selling video games, “Wii Fit,” an exercise game that encourages users to stand on a board and go through a series of exercise/games that fall into one of four categories: strength, balance, aerobics and yoga. The “Wii Fit” exercise program sold more than 6.5 million since it was introduced in May 2008. While games like “Wii Fit” and others free-swinging games that involve baseball, bowling, boxing, golf and tennis have changed sedentary videgaming to an active one, health specialist say games like the aforementioned may be too much of a good thing.
“We’ve seen Wii problems including injuries to thumbs, ankles, knees and shoulders,” Carlson said. “It’s not a highly documented phenomenon, but it does happen.”
Pain felt by videogamers originally coined the term “Gamer’s thumb,” but terms like “Wii Shoulder,” “Wii-Knee” and “Wii-itis” are now commonly used. Consoles like the Wii have been built with warnings about prolonged use, and electronic alerts interrupt players regularly to urge them to take a break. The Nintendo DS Instructional Booklet states, “Warning — repetitive motion injuries and eyestrain. Playing videogames can make your muscles, joints, skin or eyes hurt after a few hours. Follow these instructions to avoid problems such as tendonitis, carpal tunnel syndrome, skin irritation or eyestrain.”
Another misconception about the Wii’s handheld devices is that a full swing in these types of games is necessary. But that isn’t the case — a simple fluid motion of the wrist will generally do the trick.
“I’ve played baseball and boxing, and I was super sore the next day,” said Brown, who plays occasionally with her nephew. “I guess I didn’t realize that I used those muscles so much. It’s not a surprise to me — those games seem kind of dangerous.”
“When I played a lot, I used to be gaming up to four hours a day on average,” he said. “The most I’ve experienced is a strained neck and sore eyes. I like to get up and stretch, take a break and rest my eyes.”
Kenny Enterline, an employee at Jay’s CD and Hobby in Des Moines, says the on-screen prompts by the Wii can be a nuisance, but believes officials do get their safety message across.
“The messages are annoying and come up frequently in my opinion, but it’s good for younger youth,” said Enterline, 25. “It’s easy to get caught up in the fun of the games, but it’s important to take a break.”
Wii injuries can even be compared to those sustained by athletes. Pete Butler, athletic trainer for the Des Moines Buccaneers, says the injuries can be similar.
“Our players do a lot of stretching before and after practices and games,” he said. “Stretching is a key component, and video gamers should take that into consideration, too, when playing the Wii. Make sure your muscles are warmed up before you get the controller in your hand.”
A different perspective
While Web sites like www.blackberrythumb.com and www.wiiinjury.com tell the misfortunes that consumers are experiencing when it comes to injuries caused by technology, doctors are using their popularity for good, too. Doctors have used Wii’s for patients recovering from broken bones, strokes and surgery, making rehab fun and exciting for thousands.
“Although we don’t incorporate Wii exercises into our rehabilitation, doctors are finding that the motion associated with Wii videogames can be beneficial,” Carlson said. “Video games have been around a number of years, and it’s nice to know that although they can create pain, they can also be used to help those in need.”
According to www.lifesceience.com, surgeons in training are using the Wii to improve their fine motor skills and performance in a surgical simulator. In an experiment, eight trainers were asked to play the Wii for an hour before performing virtual laparoscopic surgery with a tool that simulates a patient’s body and tracks the surgeon’s movements while operating. Wii-playing residents scored 48 percent higher than those without the warm-up with the Wii, working faster and more accurately.
Doctors at NewYork-Presbyterian Hospital/Weill Cornell Medical Center use the Wii to help scan through patient X-ray and MRI images. Without the Wii, doctors would be at risk for carpal tunnel syndrome, which is caused by repetitive motion injuries. Doctors can now cycle through images quickly, something that would take hours to complete.
Therapists have also incorporated using the Wii to help burn victims. For some burn victims, stretching and moving the skin in painful, specifically near joints where the healing process is critical.
For those who feel they need to give their hands a break from PDAs, many spas around the country now offer massages to relax those digits. In 2005, Hyatt Hotels creatively invented the “BlackBerry Massage” for those with overworked hands. For $30, users could get a 30-minute massage that began with heat treatment and “BlackBerry” balm. The massage focused on counteracting tension on various hand and arm muscles, specifically in the thumb and wrists.
The future of high-tech injuries
Although technology continues to change, the reality is that there will always be a risk for injury.
“I think these types of injuries are here to stay,” Neubauer said. “They’re not going go be going away anytime soon. People just need to look for the symptoms and act accordingly.”
Dr. Carlson agrees.
“In the years to come, videogames are going to mimic sports more and more,” he said. “The more that this happens, the injury rate among gamers is going to continue to increase. As for PDAs and texting, at some point, someone will come up with a better way of texting.”
For Brown, she says she plans on keeping her texting to a minimum and will be careful around the Wii.
“I like playing Wii and using my phone for the right reasons,” she said.
In the years to come, Dr. Chicoine says he will continue to do his job and help those who have been injured from today’s technology.
“Technology isn’t going to go in reverse,” he said. “Injuries are going to become more prevalent as time goes on.” CV
Caption: Dr. Brad Chicoine of the Iowa Chiropractic Society says he began seeing cases of “BlackBerry thumb” four years ago. Photo courtesy of Iowa Chiropractic Society
Caption: Health specialists believe the option of unlimited texting plans will only increase cases of “BlackBerry thumb.” Photo by Matt Miller
Caption: Sean Maxwell, front, and Kenny Enterline enjoy playing Wii’s sports games but admit risk of injury may occur. Photo by Matt Miller
Caption: Justin Neubauer, who used to play videogames up to four hours a day, believes he is not at risk for repetitive motion injuries. Photo by Matt Miller
Staving off repetitive motion injuries
- Fold your hands together and turn your palms away from your body as you extend your arms forward. You should feel a gentle stretch all the way from your shoulders to your fingers.
- Fold your hands together and turn your palms away from your body, but this time extend your arms over your head. You should feel the stretch in your upper torso and from your shoulders to your hands.
- Extend an arm in front of you, making sure the elbow is completely straight. With your palm down, take the opposite hand and bend the hand on the outstretched arms down toward the floor. Then turn the palm up and stretch the hand up toward your body. This stretches the forearm and wrist muscles.
- Open the hands and spread the fingers as far as possible.
Source: American Society of Hand Therapists
Facts and terms associated with high-tech injuries
Repetitive motion injures are among the most common injuries in the United States.
Two of the most common repetitive motion injuries are tendonitis and bursitis.
Tendonitis: is the inflammation of the tendon; common sites include the shoulder, biceps and elbow.
Bursitis: is the inflammation of a bursa sac, which is found over areas where friction may develop and serve to cushion or lubricate the area between tendon and bone.
Carpal tunnel syndrome: medical condition in which the median nerve is compressed at the wrist. This condition can lead to numbness and muscle weakness in the hand.