TerpHealth: Prevention and Management of Interpreting Related Injury

04/29/2026

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.

04/26/2026

https://www.instagram.com/reel/DXmG2aNgMBT/?igsh=dGt0NmJxbWZlaXdt

04/24/2026

In addition to being hard on the body, high-risk interpreting bio-mechanics and ergonomics can also skew the message. Here are some simple examples:

- Overly forceful sign production can add emphasis where none was intended. It can also make it seem as if there is anger or irritation behind the message.

- Consistently signing in too small or too large a sign space can compromise effective use of space.

- Poor posture can interfere with conveying mood and even register at times.

- Opportunities for pacing are lost if micro-rest breaks (putting the hands in the lap) during interpreting are not employed.

- Excessive hand/wrist deviations from neutral (constantly producing signs while bending the wrists) can make the message look "visually noisy" and harder to read.

- Signing with too much physical muscle tension can interfere with effectively conveying the proper mood and tone of the message.

04/22/2026

Taking time for self-care is not selfish.It is actually one of the most generous and responsible things we can do - not only for ourselves, but also for other people and those for whom we provide services.

If we are on an airplane, they tell us to put our *own* oxygen mask on first if it drops down. They don’t say that because they are encouraging selfishness. They aren’t suggesting that we take care of ‘number one’ and to heck with everyone else. They tell us that because they know that, not only will it help keep us safe and alive, but that it will allow us to help others should they need it.

Self-care is similar. We need to take the time to restore and regenerate our own energies so that we can not only care for ourselves, but so that we can be fully present for others.

Interpreters need to stay healthy in order to do their work for the long haul. It’s OK to take time out for yourself and to say no when considering an assignment that is going to push you past your healthy limit.

04/21/2026

It’s important to be mindful to the potential physical impact of unprocessed, painful emotions. The nature of emotions is that they are felt. If we disconnect from them, they may sublimate to the body and be felt as physical pain and illness. For an interpreter this can significantly influence health and levels of pain. This is especially true when interpreting in an environment where feelings of emotional stress may be triggered.


Studies have shown that your body can produce symptoms in response to your words and thoughts. I have found this repeatedly in my practice. Often people who frequently say - or think -, "That is such a headache!" develop chronic headaches. People who say, "That is such a pain in the neck...or butt..." often have neck or hip pain. “She/he boils my blood" often shows up as hypertension. "I can't take it”, or "It's too much to bear." often affects the shoulders. The list could go on... And the body is listening and willing to obey. This is extremely relevant for an interpreter.

A school of medicine called psychoneuroimmunology (PNI) focuses on the study of how the mind and body interact. It's based on the premise that mental or emotional processes affect the physiology of the body. So the body affects the mind, but the mind also impacts the body.

The literature has repeatedly demonstrated that thoughts affect neurotransmitters. These are the chemical messengers that help different parts of your brain communicate with itself and with the nervous system. Neurotransmitters control just about every body function. Your thoughts influence your body directly, because your body utilizes the messages it receives to prepare you for whatever it interprets as occurring.

Essentially, neurochemical transmissions in the body are significantly affected by your thoughts and emotions. This impacts physical levels of pain as well. It's not hard at all to demonstrate the impact a thought can have on your body - simply think about biting into a big, juicy, sour lemon! Your mouth waters of course.

A thought engenders a physical response. Studies have even shown that just thinking about a part of your body activates enough electrical and chemical changes to be measured.

Consider trying an interesting experiment: observe your language and thoughts today to see if your body symptoms of pain and symptoms are reflected in your words. Sometimes people don't even realize they are regularly using certain words because it has become so ingrained. Ask for your friends and family to help by providing you feedback if they notice you using these types of phrases. Look for, and replace with healthier choices, any language that could negatively affect you physiologically.

04/18/2026

Older interpreters are *not* relics - you are living bridges. You are not just growing older - you are living history.

Being an older interpret doesn’t make you irrelevant. Rather, your experience provides you with a depth and scope of insight and knowledge, as well as the perspective of the history of our field. We can build on this and find ways to utilize what we’ve learned.

What you know matters.

What you’ve learned matters.

What you have to offer matters.

YOU matter.

(Edited from a Substack article I wrote)

04/15/2026

The psychological aspect, along with the ergonomic, bio-mechanical and physiological risk factors, is one of the possible predispositions to injury for an interpreter. Years ago I assumed that ergonomic and bio-mechanical factors were the most significant for sign language interpreters. However, after almost 30 years of teaching workshops and performing diagnostics, I now see that the psychological actually is the most impactful.

The psychological factor determines how you take care of yourself physically, how the interpreting task is approached, how you manage your predisposing factors, whether you advocate for yourself or accept unhealthy work terms and conditions, and how you respond if you experience discomfort from interpreting. All of these can impact risk of injury. Some examples of high risk psychological predispositions to injury include:

- External locus of control: An external locus of control means to approach life as if it happens to you. An internal locus of control acknowledges that your personal choices determine how you experience life. An external locus of control increases risk of injury because an interpreter is unlikely to take needed action to take care of themselves and to address issues of concern if they view themselves as powerless.

- “Savior” mentality: Sometimes interpreters find themselves constructing their lives and schedules around what they believe their consumers need – to their own detriment. It is not healthy or helpful to work from a martyr stance, Doing so may result in personal injury.

- Stressful thinking: When you engage in chronic stressful thinking it affects every bodily system. In addition to inhibiting blood circulation, upsetting your body’s hormonal balance, and causing physical muscle tension, chronic stress can also affect the ability of your cells to receive nutrition from the food you eat! The cell receptors can actually get “hijacked” by the stress hormones. Obviously this impacts the ability of your body to repair and nourish itself.

- Perfectionism: I think an “Achilles heel” of many sign language interpreters is demanding perfectionism in their work. This is not to imply that your goal should be anything less than producing work of the highest quality. However, perfectionism is an unfair and unrealistic demand. Approaching the task of interpreting with a need for perfection increases stressful feelings and increases risk of injury.

04/14/2026

In case you missed it. Calm FAST. This simple technique can help calm your nervous system between assignments. I’ve taught this method to patients for years.

https://www.instagram.com/reel/DXG_IbmgM9b/?igsh=bWpkem43b3Fpc3Rr

04/12/2026

This is very relevant for interpreters. Recovery - physical, mental and emotional - is essential. Here’s a great write-up by Dr. Tim Patel on how self-sabotage can mask as self-care:

“I've had a long day."

That's how self-sabotage starts sounding like self-care.

It sounds harmless.

Even deserved.

A drink. Takeaway. Scrolling. Skipping movement. Staying up late for "me time."

All reasonable.

That's the problem.

Because your body doesn't hear: "I deserve this."

It only receives the signal.

Poor food. No movement. Bright light at night. Less sleep. More stress.

And it responds accordingly.

After 30 years in medicine, here's the truth most people miss:

Self-care is not what feels good in the moment.

Self-care is what helps your biology recover.

Those are not always the same thing.

Most "recovery habits" aren't recovery at all.

They numb. Distract. Sedate. Delay.

But delayed discomfort doesn't disappear.

It shows up later. Usually in the body.

↳ Worse sleep
↳ Higher blood sugar
↳ More cravings
↳ Low energy
↳ Poor mood
↳ Increased visceral fat
↳ Rising blood pressure

This is how health declines.

Not through chaos.

Through "reasonable" decisions, repeated daily.

So the real question isn't: "What do I feel like?"

It's: "What would actually restore me?"

Often, the answer is:

↳ Walk over wine
↳ Protein over processed comfort
↳ Dim light over scrolling
↳ Sleep over stimulation
↳ Stillness over sedation
↳ Connection over consumption

That's real self-care.

Not reward. Recovery.

The most dangerous habits aren't the ones that feel destructive.

They're the ones that feel deserved.

"I've had a long day."

Be careful what that sentence gives you permission to do.

♻️ Self-care that numbs is not recovery. Real recovery restores your biology.

💾 Save this for the next time a hard day has you reaching for a habit that doesn't actually help.”
Dr. Tim Patel

04/11/2026

For Stress-related insomnia.

Check out Diane M Gross’s video.

04/10/2026

Hand Acupressure for pain.

Check out Diane M Gross’s video.

04/09/2026

In the interpreting field we tend to overly focus on what we think we need to fix about our interpretation. This can lead to an overall sense of never being good enough, or never being able to get it right. Over time, this can sap the joy and satisfaction from the work we do. It can also increase risk of injury since it contributes to emotional and physiological stressful states.

There are three ways in which to develop professionally:

- Focus on what needs improvement.

- Focus on what is working well - and optimize it.

3. A combination of 1 and 2.

Even so, the Capitalization model (identifying and capitalizing on strengths) is far superior to the Compensation model (identifying and fixing weaknesses) in skill development.

I believe interpreters often focus too much on what they (or their colleague) did ‘wrong’, or what could have been improved. This hyper-focus on the negative can create fear of failure, as well as a constant sense of not ever being good enough. This mindset can be demoralizing, and even stunt professional growth, since the internal dialogue that results from feelings of inadequacy can interfere with the ability to understand and process information with clarity.

Years ago I was assigned to interpret a class for a full quarter. When my team partner arrived the first day, she asked me, "Do you want feedback?" (We all know "feedback" is code for critique...). Since I was struggling with feelings of discouragement at the time, I told her that I really just wanted to know if she saw anything I was doing ‘right’ in my interpreting work; what I was doing well. She loved the idea! For a full quarter we only commented on what the other person was doing "right" - unless it was something of great import (like signing the wrong date for the final exam...). Interestingly, both of our skills as interpreters grew more that quarter than any other time in our careers!

Ask yourself today:

"What do I do really well as an interpreter?"

"What are my strengths as an interpreter?"

"What interpreting choices did I make that 'rocked'?"

Be a ‘Strength Advocate’ today. Tell at least one interpreter today (in addition to your own self) what they are doing that excels; an area of interpreting in which they shine; an outstanding skill they exemplify...

Focusing more on building ourselves and one another up benefits everyone.