I credit micro breaks and stretching as the main reason I got over my severe RSI [1]. Never really heard that surgeons had similar problems though, but I guess it is the same mechanism - too much fine motor action for too long without a break.

[1] https://henrikwarne.com/2012/02/18/how-i-beat-rsi/

This was an unexpected benefit of the Pomodoro technique for me. I ended up walking around during the forced breaks and it definitely reduced the physical stresses imposed by coding days.

Pomodoro technique definitely transformed my work experience. A few wrist stretches and brief walk definitely improved focus, and relieved the wrist strain most coders are familiar with.

I remember reading this blog. There doesn't seem to one good way to cure RSI.

There are tons of stories here with lots of different "solutions":

https://github.com/melling/ErgonomicNotes/blob/master/README...

The "one good way" to get RSI is repetitive action as the name already implies. So anything that breaks that repetition will help to some degree.

Once you get it, it's extremely hard to figure out how to treat it. Sure, if you avoid the repetitive stress in the first place, that's ideal. For some people, once it happens, they can't reduce the "repetiveness" enough.

http://looknohands.me/

You're right that there isn't one way to cure RSI because RSI is an umbrella term for many different problems.

Can you provide some examples?

By not being specific when discussing it, it's harder for people to learn, and to figure out how to treat it.

In my experience, tendinitis and carpal tunnel syndrome are hand and wrist examples, tennis elbow, there are neck problems, upper back problems, shoulder problems, general muscle balance problems.

I developed a click in my wrist from mousing for 10 hours a day at work, without a break. (Yeah, I know it is illegal, and so did they.) That took a few years to go away.

Since the outcome metrics (pain) are self-reported, this study was essentially unblinded, right? That may simply be an inherent limitation that can't be avoided in this sort of study, but worth noting it opens up the door for a placebo effect.

There are some objective measurements you can make on surgeon performance. Things like rate of infection or other complications have variability but do relate to surgeon competence in aggregate. Assuming, random patient selection.

Sure, but you probably have to collect a lot more data to tease our such a tiny effect. Pain could plausibly be reduced by 50% with the correct exercises, but the complication rate would presumably change by at most a tiny amount.

One solution would be to change the test to "perceived pain". It doesn't matter if the person feels pain or not, if they perceive that they don't feel pain and it is less of a mental burden on them, stretching worked.

To some extent, isn't the placebo effect good enough?

If my goal is to feel more focused, that's an inherently subjective thing. If I feel like I'm more focused, I am more focused. So the placebo effect and a more objectively observed result are essentially the same here.

> If I feel like I'm more focused, I am more focused.

But the end goal is almost never to feel more focused, the end goal is to (say) accomplish a task faster or more accurately. And there are definitely placebo interventions that make people feel like they are doing things better without actually doing anything better.

Likewise, in this case, the end goal is for the surgeons to have a longer career. It's easy to imagine a placebo intervention that makes one feel better, but doesn't actually reduce wear-and-tear on joints, and hence doesn't prolong one's career.

Also, like the other commenter said: placebo effects are often less reliable or generalizable outside the specific context of the study. They may be motivated by, e.g., a subconscious desire to please the experimenter which goes away in real-life circumstances. Actual physiological interventions are much less likely to do this.

Isn't part of the problem with placebo is that it's unreliable?

Eg, if you can give me a way to achieve some amazing pain relief as a result of placebo, every time, it feels to me like this crosses the line from placebo to medicine.

The mind can do some crazy things, but we need to make it do these things reliably. I don't want a placebo form of anesthesia only to have it not work mis surgery haha. If however you can replace anesthesia with a placebo (purely as an example).. i almost feel like it's real medicine then. A technique to replace chemicals sure, but testable and reliable.

Workrave is a great program for Linux and windows that creates a break timer, and shows exercises. Has certainly prevented a lot of pain for me

What do these 1.5-2m standardized targeted stretching micro breaks (TSMB's) entail exactly? What kind of stretching exercises?

They give quite a lot of detail in the article, including links to photographs of surgeons stretching.

http://www.aahs.org/medstaff/wp-content/uploads/aparkAnnSurg...

In case "hunt the link in a PDF" isn't your favourite game, here are the images:

http://download.lww.com/wolterskluwer_vitalstream_com/PermaL...

Micro breaks.. micro dosing.. micro.. kernels. What will the next micro implementation?

microboners

XD

I wish the abstract provided more details on the kinds of stretching and the nature of the breaks.

Related to RSI in computer workers?

I'm intrigued by these sorts of studies - not coming from a statistical background I'm amazed by how few samples they need to draw conclusions. If you told me you only had 341 events in your A/B test I'd be suspicious of the results you were claiming. (Note: I don't do A/B tests professionally so I may not know what I'm talking about...)

They do mention " Random coefficient mixed models accounted for surgeon variability" in the summary so maybe that's sufficient.