RSI Day 2021: pain in a pandemic

Yesterday, 28 February, was RSI Awareness Day. This year, even for those of us used to working from home, our work routines have been thrown up in the air and healthy working habits have gone a bit awry.  It's also been a fairly reflective sort of year, so I thought it might be time to talk about some of my pain-related ups and downs. To explain the past year though, I’m going to have to take you back a bit …apologies to those who’ve heard some bits of this story before.

1989:
I broke my right collarbone in a car accident. I was told it'd healed and was sent off to live fairly unbothered by it for the next 10 years or so.

1999:
After spending my 20s teaching abroad, I’d just switched to a desk-based job as a lexicographer when I suddenly started getting severe pains in my right hand, arm, shoulder and neck. I was initially diagnosed with RSI and after lots of appointments, discovered that my collarbone had never fixed properly but was wobbling around causing a generally unstable wonky top right corner and putting all kinds of stresses and strains on the nerves, tendons and muscles around it.

2000 onwards:
Having had lots of doctors more-or-less shrug their shoulders, I spent the following 20 years doing my best to live with increasingly debilitating chronic pain that affected my whole upper body. It limited my professional life significantly. Having gone freelance early-on to give me the flexibility to work how and when I could, I worked part-time hours, was careful not to take on too much and avoided jobs that would be too fiddly and computer-heavy. I tried various workstation set-ups, took lots of regular breaks, tried various forms of exercise and therapy.

Late twenty-teens:
By about 2018 though, things seemed to have hit a real low-point. The pain was getting worse and dominating my life more and more. I was taking bigger chunks of time off work between projects to recover and my personal life was getting narrower as I avoided more and more everyday situations that would cause me pain.

June 2019:
A chance comment on a Facebook thread about mindfulness apps led to a suggestion from Rachael Roberts that I take a look at Curable, an app aimed specifically at chronic pain sufferers. The results were pretty dramatic. It feels a bit silly to say that an app managed to ‘cure’ 20 years of pain in just a couple of weeks, but I think it was just the right thing at the right time and brought together a lot of ideas I’d been aware of for a while but hadn’t known how to act on. I won't go into the details, because we’d be here all day, but it basically centred around mindset and my attitude to pain. It didn’t fix my wonky shoulder, but I learnt how to turn the volume down on the pain that had started bouncing round my brain’s wiring out-of-control. I went from taking strong painkillers pretty much daily to maybe 3 or 4 times in 18 months.

Coronatimes: 
Despite everything goin on in the world, 2020 on the whole was actually okay in terms of both my physical and mental health. After a fairly busy few months in the spring, work dropped off a cliff through the summer and I had 4 months with pretty much no work at all. Of course, it was all a bit worrying, but thankfully, I got government grants that kept me going financially and the weather was fabulous! My partner was out of work and being cooped up at home together wasn’t great, but with the good weather, we could use the garden as an extra room, there was lots of walking and gardening and we rubbed along fine.

Come the autumn, my work picked up again and I’ve been more-or-less flat-out since October – which is great, but maybe not so healthy. As the weather got worse, the days got shorter and my partner got more bored and despondent, I found myself spending longer stretches at my desk, avoiding leaving my office for my usual regular breaks because I didn’t want to be disturbed. By mid-December, I was getting tweaks in my shoulder. I partly put it down to the cold damp weather, but I knew that too much desk-time and increasing tension (mental tension leading to physical tension) were to blame too. By the end of the year, I was exhausted and at the end of my tether with no reserves of energy to draw on to do the clever, pain-subduing mind trick.

2021:
So far this year has been a tough slog; ploughing on with work, going out for fewer walks because I’m really feeling the cold in my joints, and feeling generally resentful and low. Thankfully, I know that I’ve always struggled with winter and I also know that I usually start perking up in March, so I’m hopeful that the advent of spring, along with the gradual easing of lockdown here in the UK will signal an upturn. I’m also just coming to the end of one work project and it looks like the next project I have pencilled in might be a bit delayed. So, I’m planning a much-needed week off. Of course, I won’t be able to go anywhere or do very much, but a bit more walking, perhaps a bit of pottering in the garden. If I can relax and recharge just a bit, then I think I can get my priorities back in perspective - even in these weirdly out-of-perspective times - and get my health back on track.

Four things I’ve learnt from working with chronic pain

The last day of February every year is International RSI Awareness day. And this year, for me, marks 20 years since I was first diagnosed with RSI. So, it seemed like a good point at which to look back on how chronic pain has affected the way I live and work over the past two decades.

To quickly recap, I started suffering the classic symptoms of RSI, shooting pains in my right hand and wrist, not long after I’d switched from a career as a classroom EFL teacher to one working all day every day at a computer in ELT publishing. Over the period that followed, I learnt a lot about repetitive strain injury and how it’s caused by sitting in a tense awkward position, often with a poor desk setup, doing small repeated movements, especially with a mouse. 

I also discovered that my pain issues stretched far beyond my right hand and that initial crisis was a trigger for a whole load of underlying musculoskeletal problems. As well as the sensitisation of the nerves running through my right hand, arm, shoulder and neck, I discovered that an old shoulder injury turned out to be a permanently dislocated collarbone which was making my whole right side wonky and unstable. Then, added into the mix was a degree of hypermobility, a condition that means that my skeleton and the tendons attached to it are particularly loose and stretchy, meaning that my frame can’t take the strain of holding my body in one position for very long. All of which has led to a messy chronic pain condition that’s had a huge impact on my life and work. It’s a topic I could write about endlessly, but here are the top four things I’ve learnt.

#1 Pacing myself

I soon discovered that I couldn’t manage a regular full-time job. I have good patches and bad patches, I’m better at working in short bursts with breaks in between and I have to fit my work around what I can physically manage. So, being freelance gives me more freedom to manage how and when I work. For any freelancer though, trying to achieve a schedule that gives you a steady flow of work is an incredible challenge. Work comes in fits and starts, projects get delayed, they run over, and sometimes get cancelled altogether. Most freelancers end up agreeing to more than they’d like just so that if one thing’s delayed or cancelled, they have something else to cover the time. And then when it all comes at once, they put in extra hours, work evenings and weekends, and just juggle their time to fit it all in. For me, however, that’s not an option. I simply can’t afford to get into a position where I’m working extra hours because my body will break down and everything will grind to a halt. That means I have to be conservative about the amount of work I take on, only agreeing to as much as I can reasonably cope with; 15-20 billed-for hours a week is ideal, 25 for the odd week at a push. That leaves me really vulnerable to those delays and cancellations though. If I’ve only got one project in my diary and that suddenly disappears at short notice, then I simply have no money coming in. I’ve got used to having a significantly lower income than my peers, but at times, with bills to pay and nothing in the bank, it’s definitely a source of stress and frustration.

#2 Avoiding the fiddly bits

Contrary to many people’s impression of RSI, for me at least, straightforward typing isn’t particularly problematic. That’s especially true with ELT materials where you’re very rarely typing long stretches of text, it’s mostly short sentences with thinking time in-between and doesn’t put that much strain on my hands. What gets me is all the fiddly stuff navigating around documents and formatting text either using a mouse or repeated keystrokes (such as lots of paging up and down). Although I use a graphics tablet instead of a mouse because I find it more comfortable, there are still certain things that are really problematic. My biggest bugbear is anything that involves highlighting specific sections of text, in order to cut and paste, or change the format. Trying to highlight exactly the right words and characters involves a degree of tension and control in your hand and wrist no matter what device you’re using and it’s that focused tension that really causes me the most pain, especially if it’s repeated over and over again.

I’m perfectly happy just typing text into a straightforward Word document and even using a template with Word styles isn’t a problem once you get into the swing of it. The projects I hate are the ones, often for digital materials, that require you to fill in lots of different fields with codes for exercise types, that involve copying and pasting the same instructions numerous times, repeating the same text for answer keys and audio scripts and artwork directions. I’ve worked on a couple of projects where getting the initial content down “on paper” took up a fraction of the time compared with filling in field after field of text in what amounted to no more than data input. Those are the jobs that I now avoid.

#3 Not standing around

Perhaps the number one most frustrating aspect of my health though is something that affects me both socially and professionally. For me, standing around for any length of time gets really uncomfortable. It can be a tricky one for people who know me to get their head around because in many ways I’m quite fit. I walk a lot – I’m currently walking around 20 miles a week as part of a walking challenge – and I don’t look like a hobbly old lady. But for me, there’s a huge difference between walking along at pace and standing around or even mooching about slowly – it puts my body under a whole load of different strains. On a bad pain day, just standing about for a few minutes can leave me unable to think about anything other than sitting down in a comfortable chair. Add to that standing around holding a drink (really painful for my arm and shoulder) or standing around with a bag on my shoulder (so uncomfortable I now avoid it at all costs) and the prospect of any kind of social or networking event that isn’t going to involve comfortable chairs fills me with dread.

It’s a real killer, because I really enjoy being sociable and chatting to people, whether they’re friends or colleagues. But unless I’m going into a situation that I’ll be able to control, such as meeting in a café where I know we’ll sit down, I find myself avoiding situations where I might end up  uncomfortable, distracted and wishing I could leave. That gets amplified at events which I’ve had to travel to (another potential source of discomfort) and at which I’m going to have to spend extended lengths of time without any respite.  It makes me feel like an unsociable grouch which I’m really not … honest!

#4 Perspective

If all that’s sounding a bit negative, there is one major positive to having a chronic health condition and that’s the perspective it gives you on life. For me, work-life balance isn’t a luxury add-on, it’s absolutely essential. If I’m overdoing it, my body will tell me so in no uncertain terms and I have no choice but to listen. I’ve learnt not to let my working life get out of perspective. That’s not to say I don’t ever get annoyed and frustrated by stuff, but I’m pretty good at stepping away from my desk, taking a break, going out for a walk, then coming back and dealing with the problem before it gets out of hand. Over the years, I’ve got better at standing my ground, speaking up when expectations are unrealistic and if necessary, just walking away. I love my work and I want to do a professional job, but you know, sometimes there are just more important things.

... like a cup of coffee in the sunshine ...

Seasonal working

For the past few months, my morning routine has been much the same:

• Get up and have breakfast
• Head upstairs to my office, switch on my computer, check my email and have a browse through social media
• Get dressed (no, I don't work in my PJs, but I do enjoy the luxury of slow start!)
• Then I head up the garden for 10 minutes before I make my second cup of tea and settle down at my desk to start on the day's writing.

I live right in the centre of the city, so I don't have a large garden, but I love my morning garden tour. I see how everything's looking, dispatch a few slugs and snails, and usually come back in with a handful of home-grown goodies ... most recently that's been raspberries and French beans. It helps to clear my sleepy head and gives me a few minutes of 'me time' before I face the demands of the day.

This morning though, it was absolutely heaving with rain and there was no way I was stepping out the back door. So I made my tea, switched on the lamp on my desk and tried to get my head back into an exercise practising emotion adjectives. Personally, I couldn't help feeling a bit sad (A1) at the passing of summer and a distinct sense of gloom (C2) at the prospect of the long autumn and winter to come.

Thankfully, this afternoon the rain has stopped and the sun's reappeared. I've just had a trip up the garden, hefted a dozen snails over the back wall and come back in with a handful of beans. And now I'm sitting with a cup of tea in the sun on the front doorstep before I fit in one more hour at my desk. Maybe it's not time to give up on summer just yet ...

The view from here ...

Men at the top of ELT?

Okay, so I'm going to jump on the International Women's Day bandwagon like everyone else seems to be today ... And my question is, why do so many of the movers and shakers in the world of ELT seem to be men? Now, before you jump down my throat with examples of influential, talented women - of which I know there are many - I'm talking relatively here. Considering language teaching is such a hugely female-dominated profession at grass roots level, it seems to me that there are a disproportionate number of men in positions of power and influence - whether they be managers or just 'names'; men who write books, speak at events and are just generally known and respected within the ELT community. Try and come up with 5 names in ELT (without consciously trying to think of women!) and I bet more of them will be men than women. Just taking this year's IATEFL plenary speakers as a random, unrepresentative example - four out of five are men.

It's something I often think about in relation to my own career. Generally, I tick along fairly quietly, trying my best be competent at what I do, but without really creating any waves. I'm known amongst my, mostly female, colleagues as being fairly proactive; I do a bit of networking, I go to the odd conference and event, I give the odd talk. In short, I put myself out there and I'm quite happy to talk enthusiastically about what I do and what I'd like to do. But when I occasionally cross paths with those male movers and shakers, I suddenly feel terribly unambitious. Instead of waiting for work to come to them, for others to recognise their talents, for opportunities to come along, they go out and actively make stuff happen. They start up their own projects, they promote their ideas, they take risks. Some do it from the comfort of an established base (with a publisher, a university or other organization), others are more entrepreneurial, going out on a limb.

So why don't I do that? I don't think it's about discrimination and I don't think it's as simple as confidence. I think it's more subtle than that. I guess that largely it's about motivation. I love my job, I have lots of ideas and opinions, and I'm not shy about sharing them, but somehow I just don't take that next step - it's not my whole life. As in any area of life, I think the people at the top, the big names, are those people who've thrown themselves into it completely. Those guys work hard, they put in the hours, they give it their all. Does that make me lazy? Maybe, but I prefer to think of it in terms of balance. My health has already made me think about how many hours I work - I just can't afford to throw myself into a project that sees me working 18 hours a day. But also, I value the rest of my life - at the end of the working day (usually around 6), I like to switch off, to do other things, to forget about work. You won't find me on #ELTchat at ten o'clock in the evening discussing the latest apps for use in the classroom!

Do I feel guilty or frustrated? Occasionally. Do I want to be a 'big name'? No, not really ... especially if it means giving up my cup of tea and afternoon cake sitting on my roof terrace in the sun. Is that to do with being a woman or is it just me?