TerpHealth: Prevention and Management of Interpreting Related Injury

10/28/2025

When it comes to exercise, some level of activity is better than none, however, too much can be worse than none at all. The ideal lies somewhere in between. A balance is needed for optimal health. Below are some of the risk factors associated with interpreting-related injury.

Too little exercise: Sometimes I have patients who have a hard time getting started on an exercise regimen because they are so tired. But they are so tired because they need to get their body moving. When your body has too little movement it is like when water doesn't flow - things become stagnant and unhealthy. Too little exercise:

- Can increase risk of injury.

- Compromises strength and endurance for the interpreting task.

- Contributes to chronic fatigue, which increases susceptibility to injury.

- Increases vulnerability to feelings of stress. This predispose you to injury.

- Negatively affects blood circulation needed to nourish muscles and for healing.

- Compromises hormonal balance in body.

Too much or too aggressive an approach to exercise: Sometimes I have patients that overdo it to their own detriment. They exercise "to stay healthy", but are constantly injuring themselves due to the intensity or amount of exercise. Sometimes I have to remind them that exercise that produces pain and injury is undermining their health goals. Too intense or too much exercise:

- Can increase risk of injury

- Contributes to cumulative micro-traumas

- Can cause sudden traumatic injury due to sprain, strain or tear.

- Contributes to chronic fatigue, which increases susceptibility to injury.

- Can sap your body's healing resources.

Below are some clues that will indicate you’ve overdone exercise:
- You feel like crap the hours and days after a big workout.

- You’re suddenly falling ill a lot more often.

- Your joints, bones, or limbs hurt.

- You feel overly fatigued, sluggish, and useless.

- You feel restless, excitable, and unable to sleep in your down time.

- You’re losing leanness despite increased exercise.

10/26/2025

As an interpreter there is something insidious that can make you feel that:

- You interpret far worse than you actually do.

- Life and the upcoming day of work is just going to be pain and a struggle.

- The calls you interpret, or the situations you encounter as an interpreter are generally more negative than positive.

- People are just hard to deal with.

- The job is overwhelming.

What is it that can cause these perceptions? Lack of sleep. Studies show lack of sleep impacts the emotional memories you lay down. You tend to remember TWICE as many negative events and emotional things and only half as many positive ones when you don't get enough sleep. This affects your overall experience of life and expectations of what your upcoming day is going to be like.

While sometimes life circumstance (such as a new baby, a sick child, an illness, etc.) can interfere with our ability to get the sleep we need, it is vital that we make healthy sleep choices that *are* within our control whenever possible. For many years I had my patients follow the principles of sleep hygiene to help regulate their sleep. These are strategies taught by sleep clinics around the country to help people with their sleep issues.

10/09/2025

Traveling to see family, so posts may be very sporadic and limited to times when everyone in the house is still in bed or working/school.

10/08/2025

Sometimes interpreters can feel that they always fall short, no matter how hard they try. While some interpreters have, at times, behaved in ways that don't demonstrate professional integrity and respect for Deaf consumers, most try to be the "best" interpreter they can be and maintain a high level of professionalism.

I have noticed that some are starting to feel a kind of "guilt by association" - feeling badly just for BEING an interpreter! This becomes exacerbated by the fact that interpreters who DO care find themselves trying to do something perfectly (interpret) that cannot ever BE done perfectly. A sense of guilt, frustration, inadequacy and even shame can result. The resulting feelings of stress increases risk of injury.

It IS important to make sure the assignments an interpreter accepts matches their skill set. It is also imperative that interpreters behave as professionals who actually CARE about what they are doing. If those things are in place then remember:

- There is no shame in making a mistake.

- There is no shame in not knowing.

- There is no shame in having and caring for your physical needs.

- There is no shame in being a novice interpreter.

- There is no shame in having room to grow.

And most importantly...

- There is no shame in being an interpreter.

10/06/2025

Sometimes interpreters get caught up in trying to fit every interpreting request they can into their schedule. It can feel like there is pressure to make sure that every request is satisfied...every time. But that is a sure road to injury. And it compromises your potential to continue to provide quality services in the future due to overuse injury. Do not sacrifice your body on the altar of interpreting. Build time into your schedule to allow your body time to heal if that is what it needs. Taking care of your body is a primary professional, as well as personal, responsibility.

10/03/2025

Interpreters who work in emotionally triggering environments must be especially mindful of their breath - with a special focus on the out-breath. Many people unknowingly hold their breath and/or chest breathe when feeling stressed - which can increase the chance that the body will hold onto the stressful feelings rather than release them. Bringing the breath to the abdomen/diaphragm helps to lower the stress response.

Additionally, it is helpful to emphasize the out-breath rather than the in-breath. The out-breath is when you release physical and emotional tension. Breathing in stimulates the sympathetic nervous system and increases heart rate. Breathing out stimulates the parasympathetic nervous system, which slows heart rate and calms. Breathing in and out is kind of a ‘dance’ and balance between the alert and the calm state of being (breathing in = alert, and breathing out = calm). When you are feeling stressed, more attention on the out-breath is important to help calm your system. Starting with a complete exhalation, rather than taking a deep breath in, can help begin to release the tension being held by the body.

09/29/2025

Sometimes people bring a very yang, forceful energy to what should be a more yin, gentle type of activity of stretching. The goal with stretching is to teach your body to relax, open, elongate and soften.

When you stretch, think of it as "moving into softness". Stretch until you feel a mild stretching sensation, then stop, hold and allow your muscles to completely relax - then you can move into the stretch a little deeper - then relax completely into that stage of the stretch, etc. This approach can take longer, but the payoffs are tremendous. Never take a stretch past the point where you can fully relax the muscles being stretched. If you do, then you are stretching in a tight manner - like a rubber band. And you can fray the muscle fibers if your stretch is too aggressive, like a rubber band that becomes weaker when it is overly stretched.

09/27/2025

Sometimes the tendency in our society (and field) to magnify problems and weaknesses and minimize assets and strengths can have a significant impact on health and overall satisfaction in life and work.

What you focus on is what dictates your experience in life. Here are some questions that can help keep your focus on health building and gratitude-inducing things today:

- What are my strongest interpreting assets?

- What do I love about my job?

- What is really working in my life?

- What is going right with my health and body?

- What is there to appreciate in my life and work that I have overlooked?

- What positive choices am I making in my life and work?

- What can I do today that will lift someone up today?

Add your own...

09/23/2025

Self-care is not selfish. It is actually the most loving, compassionate, and even professional, thing we can do for ourselves AND others. We can’t give from that which we don’t have. We must nurture the resources that enable us to feel healthy, strong and able to be present for ourselves and others as needed. Self-care helps us to be far more effective interpreters - for the long haul.

Think about what the airlines tell passengers to do when the oxygen masks drop in the case of an emergency. They advise people to put their own masks on first - not because they are promoting an ‘every person for themselves’ agenda, but because they know that if you run out of oxygen you will be rendered helpless to assist anyone else. Putting the oxygen mask on yourself first isn’t selfish, it is exercising wisdom and foresight.

Making time for self-care is a pro-active choice. Many people wait to take time until they are physically, emotionally and/or emotionally spent. Responsible self-care needs to be an ongoing, regular and active part of life. Imagine running a full marathon at the pace of a sprint. You wouldn't be able to finish, and would likely hurt yourself. Interpreting is like running a marathon. If you keep an unreasonable schedule, interpret assignments alone that should be teamed, accept assignments you know you should turn down because your body is screaming for rest - but nobody else is available and you feel guilty saying "no" - then you run the risk of exhausting yourself. This can actually limit the time and quality of the services you are able to provide. In the long-run it serves nobody for you to overextend yourself.

Putting self-care first is an act of healthy self-regard, but it also is a sound professional choice. It also demands that we do the powerful work of letting-go of any residual co-dependent or "savior" attitudes and behaviors. It pushes us toward a healthier relationship with ourselves and with those for which we provide services.

09/16/2025

Some high-risk biomechanics and ergonomics can influence, and be influenced by, your emotions. Current research in the fields of neurobiology and biochemistry demonstrates that there really is a mind-body connection. Your thoughts and emotions impact your body, and your body position and movements influences your emotional state.

- Forceful, or ballistic movements while interpreting (or performing other tasks) is often associated with feelings of stress, anger and aggression. Angry, stressful emotions can lead to forceful movements, but forceful and ballistic movements can also produce feelings of stress and anger! Harsh movements actually cause a cascade of stress hormones to enter your bloodstream, including adrenaline.

- Producing signs with a lot of physical muscle tension can also increase stress hormones in the body - spiking stressful, tense emotional feelings. Studies have also shown that people with slouching postures tend to experience more depressed feelings and less self-esteem. Just improving and "uplifting" the posture can positively impact emotions almost immediately - especially if the facial expression is also changed to an uplifted expression as well.

- Healthy bio-mechanics and ergonomics can do more than improve your physical health - it can also improve the quality of your life. I have had many interpreters report increased feelings of well-being as they improve their body mechanics and ergonomics.

09/12/2025

Please continue to spread the word. These author’s stories deserve to be heard. And, though not interpreting related, a number of them were written by your colleagues.

I’ll share the one about my journey with my eyes here:

Unseeable Light

“You are going to become blind, so start practicing getting around now.”

Though this wasn’t an actual voice I heard as I descended the darkened staircase that morning, this internal ‘knowing’ was something with which I was quite familiar. It doesn’t happen often, but I have experienced a number of these intuitive revelations in my life, all of which have come true. As a result, I was not quick to simply dismiss it.

I began to practice. For a couple of years, I practiced walking downstairs with my eyes closed. I learned to count steps. Other times I deliberately didn’t count, instead trying to get a sense of when the last step was approaching. When I took my morning walks, I practiced walking with my eyes closed. I tried to increase the number of steps I took before I started to feel an overwhelming need to open my eyes to check my position. I performed a variety of tasks with my eyes closed, often making a game of it.

I knew, even before it happened, but I still wasn’t fully prepared for when it did.

Once it started, my eyes quickly worsened. In the beginning, they felt so strained and tired it became difficult to keep them open. Over the next few months, it began to feel as if I had an eyelash under my eyelids all the time. This quickly progressed to a constant sensation of gravel and ground glass. It was extremely painful. My eyes began to reflexively blink nonstop. Sometimes too, it felt as though one or both of my eyeballs were shriveling up in my head.

Though I wasn’t considered legally blind because my acuity was not yet severely affected, I was functionally blind. I could no longer do many of the things that had previously been an integral part of my life. I couldn’t read, which had always been a great love of mine. I couldn’t write, which was how I often processed my world. I couldn’t edit the last book I had written. I couldn’t drive, which meant I was often homebound. I wasn’t able to engage with people on social media with any frequency. I began to avoid in-person social interactions because it was so taxing. A significant way in which I had always connected with people was through eye contact and reading body language. These essential tools for how I gauged and adjusted to the tenor of my interactions were substantially impacted.

My world shrunk dramatically.

Over the next few years, several eye doctors treated me. Their initial diagnosis was severe dry eye disease. However, I didn’t respond to even the most innovative treatments for dry eye. Eventually more intensive testing revealed my severe dry eyes were a symptom, not the root cause of my eye issues. I had an underlying condition that had been missed. As time went on many of the lubricating glands in my eyes became scarred, depriving my eyes of much needed moisture. The severity of dryness resulted in abscesses on the surface of my eyes and corneas.

I was functionally blind, since I had to keep my eyes closed most of the time due to the constant and excruciating pain.

Over the next year I underwent a total of five surgeries. With each surgery, I clung to the hope my eyes would get better. That did not happen. I was despondent and consumed by fear. The idea of spending the rest of my life in pain and with severe visual functional impairment was devastating. I wanted to die.

This emotional period of darkness lasted about four days. Then, I had a moment of clarity. I suddenly realized I could focus on my limitations, or I could focus on ways to do things I love. Many people before me, with far worse visual impairments - in some cases total blindness - lived joyful, meaningful lives. Many have even changed the world. I realized my challenge was to also find a way to live a life of joy and contribution.

I thought about the impact of people like Helen Keller, Andrea Bocelli, Stevie Wonder, Joseph Pulitzer, Galileo, Monet, and Harriet Tubman. Their examples inspired me and left me without excuses. I decided I could wallow or follow. I could wallow in my pain and misery, remaining mired in feeling helpless, or I could follow the example of their courage.

So, I considered how to continue to do the things I loved, even if nothing changed with my eyes. I spoke with the companies for whom I had provided workshops and webinars for decades. They offered to provide a Communications Facilitator for every webinar I taught for them to provide support by assisting me with tasks my eyes would not allow me to do. I developed strategies to continue to provide some services to my patients. I listened to my favorite movies. I ‘read’ via audio books. I now utilize a ride service for people with disabilities. I travel internationally with my sister, arranging for special accommodation as needed. I hired two editors to finish editing the book that had been languishing for almost three years. I put in place the resources necessary to compile the book you’re reading right now. And I started working with a therapist to help me process the enormous impact my visual impairment has had on my life.

In short, I decided to live with purpose and joy instead of waiting and praying for death.

At this point, I am still unable to drive. I can read for a few minutes now, but my eyes quickly become strained, so I still depend heavily on audio versions of information. I can, however, keep my eyes open more, which has made day-to-day activities much easier. I have to get regular treatments designed to calm the eye spasms that became hardwired due to blinking so much, for so long. While the discomfort is still constant, I take solace in the fact that the pain is no longer excruciating.

Sometimes I still feel overwhelmed by my limitations. In those moments, I seek to treat myself with tenderness and compassion. I honestly don’t know if my eyes will ever return to anything resembling normal, but regardless of what happens, I am committed to living my best life.

My mantra has become a line I heard in a movie a few years ago - “The most important light is the light we cannot see.” This inclusive, larger light has expanded my world dimensionally. I am learning to access and trust my insight and deeper intuition more skillfully. I see the value of nurturing a rich internal world, not just an external one. And while I can more easily see through façades, pretenses, and inauthenticity, I also see kindness, empathy, generosity, courage and other intangible qualities in myself and others much more readily.

This unseeable light has illuminated much beauty in life I had previously missed seeing. It has given me the gift of greater insight. It has certainly shown me that real hope isn’t predicated on getting a specific, desired outcome. There are, after all, some things beyond our ability to control. Hope, rather, is an active response to life’s difficulties. It is a choice to believe in and work toward a positive outcome, despite adversity. It's a way of engaging with life’s challenges with optimism and positive action to create a brighter future.

You see - hope is an unseeable light.

© Diane Gross

‘When All Hope is Gone - What Then?’ gives a voice to the authors’ lives and stories. It is a testament to their courage and ability to and hope during times of overwhelming despair. Their stories are a light to others who find themselves walking a dark and seemingly hopeless path.

09/09/2025

My author page.
Note: Only two are specific to interpreters.

Follow Dr. Diane M. Gross and explore their bibliography from Amazon's Dr. Diane M. Gross Author Page.