Pipetting Precaution

I never thought that I would be injured from working in a lab – let alone using a laptop computer. What’s strenuous about pipetting or merely typing and clicking a mouse? I had no idea these activities, which required so little effort, would lead to one of the most debilitating conditions I had ever experienced.

In my fifth year of graduate school at MIT, I woke up one morning at 4:30am to get ready for my training with the Masters Swim Club. As I poured cereal into my bowl, I felt a sharp pain in my arms. I saw that both of my elbows were swollen and tender. Later that morning in the emergency room I was diagnosed with a type of repetitive strain injury (RSI) called bilateral epicondylitis, which is characterized by inflammation of the tendons that join the forearm muscles on the outside of the elbow.Pipetting

Epicondylitis, common among tennis, golf and racquet players due to the repetitive motions in these sports, also affects people who work in the laboratory or on computers for extended periods of time.

I was only 26 years old at the time, and I had never played any of the sports that would have put me at risk. So what happened? First of all, I worked full-time in a cell-culture laboratory, pipetting samples for hours a day (without taking breaks), which put strain on my arms and back muscles. But the straw that broke the proverbial camel’s back occurred when I made one change in my lifestyle a few months earlier: I started using my laptop instead of my desktop to write my thesis.

After my diagnosis, an occupational health professional evaluated my workstation and determined that when I switched to a laptop I put my body in an unnatural position that caused excessive strain on my back, neck and shoulders and also restricted circulation to my arms and wrists.

Immediately after the diagnosis, I received steroid injections in my elbows to reduce the inflammation and started a rigorous regimen of physical therapy to strengthen my arms and regain mobility. For the next two weeks, I was not allowed to type, write by hand or do any activities (pipetting, as well as cooking, laundry and cleaning) that required the use of my arms.

I returned to work part-time after two weeks and set up my work-station ergonomically, but I had to continuously manage my pain with anti-inflammatory drugs and stretching exercises until I finished my thesis 2 years later.

While my symptoms became very severe soon after I switched to a laptop, I now realize that there were warning signs for years before I developed this debilitating condition. Prior to my diagnosis, I frequently experienced back and shoulder pain at the end of the day, but I did not take my symptoms seriously because I had not learned about the possibly devastating consequences of RSI. I could not imagine that my muscular aches would lead to a chronic inflammatory condition, and I just took over-the-counter medications to reduce my pain.

The most important lesson I learned during my recovery from RSI was that just a little bit of self-awareness and a few simple habits can help you to prevent this condition and save you from months or years of pain and costly therapy.

1. Be proactive about preventing repetitive strain injury and set up a comfortable workstation
The three most important factors in reducing the chances of injury are:

– Maintaining a healthy posture
– Keeping everything (keyboard, mouse, pen) as close to your body as possible
– Taking regular breaks.

Regardless of whether you have developed RSI, experiment with different keyboards and mice to make sure that they are right for your body type and that you can work with them comfortably.

2. Contact your primary care physician if you have recurring pain in your hands or arms
RSI can quickly deteriorate into a debilitating condition. According to Emil Pascarelli and Deborah Quilter, authors of “Repetitive Strain Injury: A Computer User’s Guide,” warning signs of RSI include the following symptoms in the hands and arms: pain, fatigue, lack of endurance, weakness, tingling, numbness or loss of sensation, heaviness, clumsiness, stiffness, lack of control or coordination, heightened awareness, hypersensitivity and coldness. Not surprisingly, these symptoms could worsen during times of stress because you might hold more tension in your body.

3. If you experience pain while pipetting, switch to ergonomic or electronic pipettes
The best way to prevent injury while working in a lab is to be in a comfortable sitting or standing position while working and to take frequent breaks. Ergonomic or electronic pipettes can significantly reduce injury to your arms and wrists. You can further reduce the risk of injury by holding the pipettes close to your body (i.e., keep the elbow of your pipetting arm near your waist).

4. Use a timer to help you enforce scheduled breaks
It is easy to tell ourselves that we will take a break every 45-60 minutes; it is much harder to actually stick to this schedule. If you have already injured your hands and arms, you might not feel pain until a few minutes or hours after you have stopped working or typing. Your goal should be to stop before you feel any discomfort. A timer can help you to enforce a schedule that will keep you comfortable and prevent injury.

5. Exercise and practice relaxation at least 3 times a week
Exercise improves circulation, strengthens your muscles and relieves stress. Stress has been shown to be risk factor for RSI, and regular relaxation is one of the most powerful therapies for relieving muscular tension. If you already have RSI, seek advice from your therapist about the types of aerobic and muscle-strengthening exercises that will help your healing process.

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