Editor's note: This is the fifth part of a series for Ph.D. students with hands-on advice on how to handle the hurdles and challenges of the Ph.D. project, written by Herman Lelieveldt. The Ph.D. Doctor is based on excerpts from his book Promoveren--Een wegwijzer voor de beginnend wetenschapper.

R epetitive Strain Injury

Repetitive strain injury (RSI) is an umbrella term for a whole range of ailments of the hand, wrist, arm, elbow, shoulder, and back. For most Ph.D. students, these afflictions are related to extensive use of the computer. Symptoms of RSI range from a tingling or lame feeling in parts of your body to outright cramps and pain. At first these are transient, but eventually they will last longer and become more intense. At its most drastic, RSI not only prevents you from using the keyboard but essentially affects all daily activities. RSI patients are in many cases unable even to open a bottle of soda!

Below I will give you my insights on the causes and cures of RSI, which are based on my own experiences. Please take note, however, that this is only one perspective on a problem that is the subject of fierce debate both inside and outside the medical profession.

RSI is ultimately a problem of bad physical posture. The problems in the neck, arms, and hands are a result of using one's body improperly, most notably the back, which is permanently too curved and often imbalanced. This imbalance carries over and leads to an imbalanced and improper use of the rest of the body. Shoulders come under permanent tension, wrists make movements that the elbows should make, and thumb and pointing finger are forced to do all the gripping work that once was done by all the fingers of the hand. Quite naturally the misused body will start to protest against these abuses by becoming lame or painful or both.

Treating RSI consists of two steps. The first, short-term action is to immediately reduce the activities that cause complaints. Shift part of your work back onto paper, by writing first drafts by hand and doing redrafts on printouts instead of on the screen. This should seriously reduce the amount of time you have to spend in front of the computer, and by the way, you may discover that this old-fashioned working style may in fact be much more effective. Still, this does not remove the root of the problem. Once your work intensifies, the problems will return, hope as you might that a 3-week holiday would definitely kill RSI.

Your longer term strategy should be to work toward a better posture and the proper use of your body. Ann McNeil in A Little Book About Your Back (Thorsons 2000) gives four basic rules:

1) think straight,

2) think close,

3) think supple, and

4) keep moving.

Basically, the back should always be in a stretched position, while the rest of the body should be used to reach, see, and do the things you need to do. So don't bend your back; bend your knees when you need to pick something up. Carry heavy items close to your body; carrying them at a distance just increases their weight. In fact, if you want to know how to use your body, take a close look at toddlers, who still behave as nature intended and exemplify the four rules stated above.

Physical therapies such as Caesar's or Mensendieck enable you to fundamentally realign your body, as do yoga, swimming, and simple fitness classes such as body shape and low-impact aerobics.

Improving your posture, of course, also means that it's essential that your working area doesn't work against it. Make sure that there is sufficient and separate space for the computer, and use a document holder for your papers when typing to encourage you to keep your head up. (Remember: Think straight!) Learning to touch-type will obviate the need to look at your keyboard and enable you to look at the screen and the documents on your document holder.

Sticking to the rules also requires outright discipline. Shortcuts, such as keeping a book open with your left arm to copy a quote, or eating lunch with your right hand while answering mail with your left, are not allowed. And please throw away all those magical devices such as wrist pads, odd-shaped keyboards, mouse balls, and timing software.

If you learn to use your body properly again, you can really work as much as you like. But be prepared to invest large amounts of time in doing this: Your body is as important as your brain.


Burnout is a second problem that may plague the hard-working researcher. Especially in the final phases of the project, the research may be so exhilarating that it leads to shortsightedness and the neglect of everything else on this planet. When partners start to complain that you are married to the research project instead of them, you have created the perfect conditions for burnout, particularly when you cease getting a return on your investments in this other relationship. Symptoms including apathy, emotional instability, indifference, and extreme fatigue are a sure sign that you are getting overworked and overstressed. And of course such symptoms carry over to life outside the office.

The basic recipe against such burnout is rest, but in the proper dose. A prolonged period of doing nothing may only make matters worse. Call in sick and consult your family doctor as well as the university doctor: The latter sees dozens of people like you every year. You may also want to call your department and explain what's wrong, but do not feel obliged to go into great detail. In many countries, you are not obliged to inform your employer about the details of such health matters but only need to inform the company doctor.

Use this rest to do just that, rest. You may even consider getting away from it all by taking a cheap flight to some warm destination that doesn't have much to offer except the sun. This is exactly what you need: Read a novel, drink a coffee, and take a swim. No, this is not a holiday, this is simply the first step in getting back on track.

The second step is to make up your mind about yourself and your project and diagnose its prospects. In most cases, after a week or two you will feel much relieved and will already have gained the confidence needed to restart the work.

The third step is actually getting back to work, ideally after no more than 4 to 6 weeks: The longer you are away from it, the harder it becomes to revamp your research. You will soon enough discover whether you really only needed a rest or whether there are more serious problems that will frustrate your work again. In the latter case, you will have to go back to your doctor and probably also talk to your supervisor to see whether the problems can be eased by making changes in your working environment.

Just as with RSI, preventing burnout is better than curing it. Therefore, take at least 1 day a week off, even when you feel you should be working 24/7. From time to time, you simply have to recharge your batteries by doing something else. It may be cool to tell your colleagues that you spent the whole weekend toiling on this or that paper, but your first day after weekend will probably be a blue Monday because you are exhausted. Moreover, such weekend working in many cases ends up in reality as an unproductive and frustrating twilight of a little bit of work mixed with a little bit of other things (shopping, cleaning your house, drinking a beer).

For a fundamental recharge, make sure you go on holiday once a year for at least 3 weeks. Tight budgets and working schedules make it easy to skip these, but in the long run it may take even longer to finish your work if you have not got seriously away from it from time to time. Don't get sick of the research that you love so much!

Herman Lelieveldt holds a postdoc position in the Faculty of Business, Public Administration, and Technology of the University of Twente and is the executive director of the Netherlands Institute of Government. He is also author of the book Promoveren--Een wegwijzer voor de beginnend wetenschapper (Aksant, 2002, ISBN 90-5260-002-3).