Alan Kogosowski explains the new epidemic of repetitive movement disorders that have hit the modern workplace:

The complex question of the hand's movement with the interaction of the muscles and nerves of the forearm have, until now, been primarily the concern of the concert pianist.

A pianist such as myself must practise a minimum of five hours a day in youth, frequently raising this to eight or ten hours at the height of his training. He must be able to play not only for long hours with difficult runs and movements, but he must be able to produce enough sound, and variations of sound, to carry over an 80-piece orchestra.

The hand and finger movements a pianist learns are known as 'technique'. It is a similar technique that is required for the computer keyboard.

The pianist who has not assimilated the 'technique' and made it instinctive by his teens has little chance of having a virtuoso career," Kogosowski says. "Even with this technique being long established, a great number of those who learn the piano do not assimilate it well enough to avoid RSI problems, tendinitis and carpal tunnel complications.

Repetitive Strain Injury, as it is officially known, has many names, but basically it is the pain and possible paralysis of the hand and wrist that is affecting thousands and thousands of PC users at home and in the work-place.

The New York Times recently claimed that the average person faces a one-in-ten chance of developing Carpal Tunnel Syndrome. This figure is greatly increased among those who work continuously with the modern computer keyboard.

There are many therapists working to help with this problem, and many surgeons who step in when it gets to a critical point, but what I can do is show how to prevent the problem from arising, or, after it has appeared, to stop it. Most normal people fall into the habit of employing the wrong muscles when they use their hands, thereby aggravating the carpal tunnel in the wrist.

Pianists have to get the use of their forearm, wrist and hand muscles right if they are to have an enduring career, but most pianists start so young that what they know about the anatomy and use of their hand is never fully intellectualized. Even most teachers will show a young pianist what works without really knowing why.

Just after my debut in London at the age of 21, I was involved in a car accident in which I broke all the bones in my right hand. The doctors told me that the only way to get the full use of my hand back was to exercise it. Not only did I find the most difficult music ever written, and begin to play extremely slowly while my hand was still pinned with metal screws, but I studied with the greatest care the muscles and tendons which should be used. This has ever since helped me in my playing, and in showing others, usually in master classes, how to overcome technical problems at the piano, but now I find that my knowledge is almost more valuable in helping those at computer keyboards.

There are basic principles about how to use the hand without straining the long muscles in the carpal tunnel. There are also important principles concerning the height each person should sit in relation to their desk or computer. There is also strain caused by clicking on the mouse, which can easily be addressed.

Computer keyboards cause the hands and fingers to stiffen in rigid positions which are a recipe for Carpal Tunnel Syndrome, tendinitis and RSI. The same is true of the common mouse. All computer users should be aware of these dangers.

There are various aids, such as the foam rubber rest, which do help people to limit the problem of RSI, but these aids are a superficial solution, and do not address the underlying dangers which are ever-present when performing a repetitive movement for many hours on a less-than-ideal mechanism with a less-than-perfect coordination of the muscles."