Who, what, why: Can politicians get RSI from shaking hands?

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Media captionOrthopaedic surgeon Tony Kochhar's tips on avoiding handshake strain

Scottish First Minister Alex Salmond has apparently been wearing a foam wrist support to cope with strain caused by shaking too many hands. Can meeting voters cause repetitive strain injuries, asks Justin Parkinson.

A handshake says a lot about a person. The positioning can be creepily over-friendly or offish. The grip can vary from limp and apologetic to python-like.

Most people only do it a few times a week, but politicians, when not waving or kissing babies, are encouraged to press the flesh at every occasion.

During the recent Scottish independence referendum campaign, Alex Salmond spent up to 15 hours a day on the trail, shaking the hands of "thousands and thousands of people", according to a party source. The damage is described as "not permanent". But could it be a repetitive strain injury?

"It's the first I've heard of it from hand-shaking," says Tony Kochhar, consultant orthopaedic surgeon at London Bridge Hospital. "But it definitely sounds like a case of RSI. It's been a sort of perfect storm for Alex Salmond, having to do so many handshakes in such a concentrated period. You have to have a good, firm, manly handshake as well, which adds to the strain."

This can inflame the tendons, meaning a splint is necessary until they have recovered sufficiently for the sufferer, via physiotherapy, to be able to write or brush their teeth in comfort. Kochhar expects the arm in a case like Salmond's to remain in foam for three or four weeks.

"It doesn't surprise me at all that Alex Salmond has this," says BBC Radio 2 doctor Sarah Jarvis. "It's very similar to the conditions suffered by cleaners and painters and decorators, who make the same movements many times a day."

Image copyright Reuters
Image caption Alex Salmond has shaken a lot of hands this year

During the 2004 US presidential election, the American Occupational Therapy Association offered the Democrats and Republicans advice on coping with "handshake fatigue". Techniques included alternating between left and right hands, putting arms around shoulders to avoid hand-to-hand contact, holding an object that couldn't easily be put down and wearing a pretend splint to warn off aggressive glad-handers.

Selfies with would-be voters, unknown in 2004, could now be added to the list.

But the need for handshakes, similar to greetings shared by chimpanzees, persists. In July 1977 Joseph Lazarow, Mayor of Atlantic City, set a world record by doing more than 11,000 in a day.

"It's a greeting which attempts to circumvent status difference," says author and former Oxford University experimental psychologist Peter Collett. "You could both bow to each other - that would fulfil some requirements. But the important thing about the handshake is the element of touch, showing the politician is connected."

Collett is surprised that Salmond, who is standing down as first minister and considering a return to Westminster politics, needs a foam support. "Shaking hands doesn't take that much out of you," he says. "I think the sling's a kind of palpable medal of his service. It's a visible reminder of how intimately networked he was with his supporters."

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