Student - 31 januari 2019

Clarity and recovery in five steps: RSI... So then what?

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RSI is an often hidden and persistent problem among students. It can have far-reaching consequences, slowing progress or causing students to drop out temporarily. Students affected by it don’t always know where to go for help. Resource looked into it.

text Echica van Kelle  illustration Steffie Padmos

Your wrist hurts when you type or use your mouse. Or you neck aches whenever you’ve spent the day studying. In fact, the pain is getting worse and is in danger of affecting your results. It is quite a shock when this happens to you, WUR students Noa, Guus and Sascha told Resource. ‘I had been in pain for a while and I knew I had RSI, but you ignore it because you don’t want to have it,’ says Sascha. ‘You adapt to it all the time. If you can’t hold your yoghurt pot in the morning anymore, you put it on the table while you have breakfast.’

Confusion
What complicated the situation for the three students was the difficulty they had finding out where they could go within WUR to get the support they were looking for. They encountered several procedures, and people who gave advice they didn’t always agree with. This caused confusion and sometimes frustration, says Noa. ‘I was referred to a student doctor. He said I should stop everything, including working on a computer. I felt very dependent on his opinion because he signs the medical certificates with which you can get extra time during exams, for example. If he says you shouldn’t do an exam at all, it can be difficult to get extra time in the exam. I spent a quarter of an hour on the phone to him to convince him.’

Dropping out
Guus was shocked when he was advised to drop out for a while. ‘That is tough because you don’t get a student loan and you lose your student transport pass. You’d have to go back and live at home, really. I’d already talked to my physiotherapist about wanting to carry on doing some courses so I could keep up a routine, mentally. And in the end that’s what I did.’

After hearing the three students’ stories, Resource decided to investigate. The result is this ‘roadmap for RSI’.

1.      Go to your GP

If you have a medical problem the first port of call – for students the same as anyone else – is your GP, who can refer you to a physiotherapist. Suzanne van Dinther, GP at the busy Student Medical Centre on campus, says she always refers people with RSI symptoms to a physiotherapist. The therapist will help you identify the cause of the problems and give you exercises to relax and strengthen muscles, as well as give you information and advice about your work station and posture.

2.      Go to the dean

Sometimes the symptoms are so bad they affect your studies. In that case it is important to get in touch with one of the four student deans as soon as possible. Because if you get held up in your studies for health reasons, you might be able to apply for financial compensation through the ‘FOS’ system. But to do that you must report your problems in good time, says student dean Marc Uijland. ‘You have to report it within two months of knowing you will be held up. For example, if you don’t do certain exams and therefore know you won’t get those credits. We are fairly strict about that time limit, because if you only come to us later, it is hard for us to establish what impact the symptoms had on the way your studies went.’

3.      Ask for a medical certificate

In order to apply for financial compensation for a delay, or for extra time in exams (see 5), you need a medical certificate. This says that the symptoms are serious enough to make it difficult to study. You can’t get this certificate from your GP; in the Netherlands doctors can’t issue a certificate about a patient they are treating. The student deans at WUR send students to André Godkewitsch for a medical certificate. He was the student doctor at the university until 2011, and is now retired but works about eight hours a week as a student doctor. Students are free to go to another independent doctor for their medical certificate, but they hardly ever do so, says student dean Uijland. ‘The route via the student doctor is the most practical.’

4.      Decide whether you will continue studying, and how much

As well as possibly signing a medical certificate, Godkewitsch advises students on the appropriate work load. ‘This advice nearly always means taking a break from your activities,' he explains. ‘The biggest risk with RSI problems is of their becoming chronic. You’ve got to prevent that.’ If you lose a lot of time, the student doctor may advise you to drop out of university for a while. Up to last December, Godkewitsch had advised 16 students with RSI to do this. He has seen a total of 51.

People are resistant to the idea of dropping out, Godkewitsch confirms. ‘It is still a controversial point. For a lot of students, it feels as though they will be held up even more if they drop out completely for a while. Sometimes I have to protect students against themselves. You should see dropping out as no more than an administrative change. And if you drop out for medical reasons, you can register again at any point during the year. Dropping out takes the pressure off because your debt doesn’t get any bigger.’

Asked how you are then to pay your rent, dean Uijland says: ‘Sometimes you might get support from your parents. You can also apply to the municipality for social security if you are no longer a student, don’t have many savings, and can’t work for medical reasons. Unlike your student loan, you don’t have to pay social security payments back.’ Anyway, students are always free to ignore the student doctor’s advice to drop out, says Uijland. ‘He only makes a recommendation.’

5.      Apply for support

If you have a medical certificate and you do go on taking courses, the dean can apply to the examination committee for extra time in the exams for you. The dean can also lend you some aids such as an ergonomic mouse or keyboard.

One aid you can always make use of – to prevent RSI as well – is the computer programme WorkPace. This is freely available for everyone with a WUR account (via the start button on your computer). It reminds you to take a break at set times, and to walk around or do some exercises.

What is RSI and how do you get it?

About 50 students per year report to the WUR Student Service Centre with pain in their hands, wrists, arms, shoulders, upper back and/or neck. This complaint is generally known as repetitive strain injury (RSI), but also goes by the name of CANS (Complaints of Arms, Neck and Shoulders) or work-related musculoskeletal disorder.

The symptoms result from long hours of work at a screen, tension and incorrect posture. Sufficient relaxation and varied activity are important for preventing these problems. And prevention is crucial because it often takes months or years before symptoms go away entirely. The risk of getting RSI is particularly high when students are writing a thesis or serving on a board for a year.

This academic year, all first-year students are getting an online module about healthy habits when working at a screen.  It covers how to prevent symptoms and what to do once symptoms appear. The idea is to make the module available to all students and staff from this spring.

Correct work posture

Any day of the week in the library in the Forum, you can see examples of how not to do it. Many students sit hunched over their laptops, staring at their screens all day. Do you want to protect yourself from RIS? Make sure you sit up straight as much as possible, with your hips, knees and elbows at 90 to 100 degrees and your feet firmly on the floor or a footstool. Even better: switch between sitting and standing.


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