For millions of Americans, hand-held electronic devices are a source of convenience and efficiency. But, if used improperly, they can also be a source of chronic pain and injury, according to the American Physical Therapy Association (APTA.)

"Repetitive stress injury, also known as RSI, can result from the overuse of hand-held devices causing pain and/or numbness in the thumbs and joints of the hand," says Margot Miller, PT, a physical therapist with WorkWell Systems and president of APTA's Occupational Health Special Interest Group. Miller notes that the condition is caused by spending too much time checking and composing e-mails, instant messaging, and accessing the Internet for both work and personal use through a handheld wireless personal digital assistant or PDA.

"The use of PDAs is no longer limited to the eight hours spent in the workplace," observes Miller. "More and more, people are depending on these devices to stay in touch with friends and family before and after the work day and on the weekends, as well as having access to work when they leave the office; that is where the heart of the problem lies."

Miller points out users who abuse their PDAs -- those who use them for more than short intervals, several times a day -- are more likely to develop symptoms ranging from swelling and hand throbbing to tendonitis. Additionally, because so many PDA users are middle-aged businesspeople, overuse can aggravate underlying arthritis, she says. "Because the keyboard of a PDA is so small and because the thumb, which is the least dexterous part of the hand, is overtaxed (for faster typing), the risk of injury skyrockets."

According to the U.S. Bureau of Labor Statistics, musculoskeletal disorders, which include repetitive strain injuries, accounted for a third of all workplace injuries reported in 2003 - the latest data available. "There is a reason why ergonomic disorders are the fastestgrowing category of work-related illnesses," observes Miller. "We're going to continue seeing an increase in complaints resulting from repetitive strain injuries if users insist on using them for prolonged periods of time and in awkward positions."

What is the best solution to prevent RSI? "Listen to your body, be aware of your symptoms and take personal responsibility,” Miller says. Typical treatments include applying ice to the affected area, stretching, using a properly fitted thumb split, and possibly even a cortisone injection. In worse-case scenarios, some may need surgery to remove scar tissue that has thickened the tendons inside tunnels that sheath them. "But my first suggestion is that individuals who have these symptoms see a physical therapist," Miller concludes.

Tips to Avoid Repetitive Stress Injury Caused by Hand-Held Devices

* Take frequent breaks from your PDA. It's harmful to type for more than a few minutes at a time.
* Write fewer and shorter messages; learn to abbreviate your responses.
* Try to avoid thumb-typing; use your other fingers to type.
* If possible, place a support in your lap so wrists are in a more upright position and not flexed or bent.

Do simple exercises, such as the following:

* Tap each finger with the thumb of the same hand. Repeat five times.
* Alternate tapping the palm of your hand and the back of your hand against your thigh as quickly as you can. Repeat 20 times.
* Open up your hands and spread fingers as far apart as possible. Hold for ten seconds and repeat eight times.
* Fold your hands together; turn your palms away from your body as you extend your arms forward. You should only feel a gentle stretch. Hold for ten seconds and repeat eight times.
* Fold your hands together; turn your  palms away from your body and extend your arms overhead. You should feel the stretch in your upper torso and shoulders to hand. Hold for ten seconds and repeat eight times.

This Holiday Season, Physical Therapists Advise Parents to Be Aware of  Injuries Caused by Overuse of Video Games

Children who receive the must-have gifts of the holiday season, Sony's™ PlayStation 3 or Microsoft's™ XBox 360, may get something that they didn't wish for -- sore thumbs and hands -- says the American Physical Therapy Association (APTA.)

"Video Gamer's Thumb" is a very real condition that can have long-term effects on children's hands and upper arms if they don't take proper precautions, says Cindy Miles, PT, MEd, PCS, and owner of a pediatrics physical therapy private practice in Whitehall, PA. Continued stress on tendons, nerves, and ligaments in children's hands and arms can lead to long-term consequences such as tendonitis, bursitis, and carpal tunnel syndrome, explains Miles.

“Video Gamer’s Thumb” refers to a repetitive stress injury (RSI) that causes swelling at the base of the thumb due to overuse of video games. RSI is an umbrella term for a  collection of disorders most commonly affecting the hands, wrists, forearms, and shoulders, notes Miles. She adds that symptoms can range from fatigue and loss of strength to minor or acute aches and pains, burning, and tingling.

To protect against injuries, APTA also recommends the following:

Keep wrists straight; do not let them bend downward when holding a game controller.
Practice good posture while playing. Sit in a chair that provides solid back support with feet on the floor.
Stretch and move. Remember to stretch and get up and move every 20 minutes or so to give head, neck, and shoulder muscles a break.
Watch for problems. Look for warning signs such as headaches, fatigue, muscle pain or cramping and suggest a break or alternate activity.