TerpHealth: Prevention and Management of Interpreting Related Injury

TerpHealth:  Prevention and Management of Interpreting Related Injury Dr. Diane Gross, DOM, L.Ac., CI/CT (retir
"Sign Safely - Interpret Intelligently"
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TerpHealth(TM) offers prevention and management strategies for interpreting related injury, including ergonomic, nutritional and oriental medical interventions. TerpHealth also provides interventions for emotional stress concerns, workplace analysis and improvement, business, profitability and morale, Life Coaching, and general health and well being.

06/02/2026

Interpreters need to be careful not to overwork. Bodies need rest. Emotions need decompression time. Minds need quietness. Spirits need nurturing.

05/31/2026

The most essential thing connecting knowledge, achievement and skill is practice. For an interpreter, this is important to remember when it comes to upgrading ergonomics and biomechanics.

There are six major bio-mechanical risk factors that are associated interpreting-related injury.
While each of these factors has an appropriate time and place (such as the increased use of force when interpreting an argument), they can become problematic when they cease to be used as tools and become an interpreter's interpreting style.

The risk factors are:

1. The level of force in the production of signs. Too much force (ballistic interpreting) increases risk of injury.

2. Excessive hand/wrist deviations (bending of the wrist in any direction) from neutral positioning. Some signs require a hand/wrist deviation to produce properly, however many interpreters bend their wrist unnecessarily while interpreting.

3. Lack of micro, or small rest breaks, during the interpreting process. Leaving the hands up in the air without small rests increases risk of injury.

4. Overly large or excessively small sign space. Both of these can cause specific muscles to over compensate or become stressed and increase risk of injury.

5. Too much physical muscle tension.

6. Poor posture.

It can be helpful to identify *your* individual risk factors and dedicate time to develop and practice healthier biomechanics.

05/27/2026

I like to post this once or twice a year. It’s important to remember that interpreters have a need, a right and an obligation to take care of themselves. This "Bill of Rights" is not intended to be approached with a belligerent or “zero sum” attitude that says, "I've got my rights and tough on you!!!" It’s simply about learning to engage in healthy self-care. It’s about recognizing ourselves as human beings with feelings, needs and boundaries. Our attitude toward ourselves, our work and our consumers should be approached with a confident and professional attitude that says, "I recognize that my needs as a person and a professional are important. I have the right and responsibility to take care of myself. In doing so, I am not only kind to myself, but I also show consideration for the community I serve since self-care enables me to do quality interpreting long-term"

The basic Bill of Rights is below, followed by a more detailed description of each.

INTERPRETER BILL OF RIGHTS

*I have the right to take care of myself as an essential aspect of my personal and professional responsibility

*I have the right to take reasonable breaks to allow my body to rest from interpreting.

*I have the right to acknowledge and communicate my limitations and needs to myself and other appropriate individuals.

*I have the right to refuse an assignment that I feel is unsafe for me or that is beyond my current ability to do with quality.

*I have the right to produce work that is consistent and of quality without the expectation that I must be perfect.

*I have the right to ask for what I need in order to do my work safely and with quality.

*I have the right to continue to grow and develop as a professional in my field.

*I have the right to make decisions about what is right for me, while maintaining the integrity and ethics of the field.

*I have the right to be treated with respect and as a professional. As such, I have the right to establish healthy boundaries with consumers and employers.

*I have the right to be a person and an interpreter at the same time.

*I have the right to find satisfaction in my work.


1. I have the right to take care of myself as an essential aspect of my personal and professional responsibility.

Taking care of yourself is not selfish. It is the most professional, responsible and compassionate choice. It allows you to not only take care of yourself, but also ensures that you have the physical and emotional resources to share your talents and gifts with others. It allows you to physically be able to provide quality interpreting services over a longer period of time. Putting self-care first is no more selfish than putting on your oxygen mask first on an airplane in the event of an emergency. They tell you to put in on first so that you CAN assist others as needed. If you didn't put yours on first, you wouldn't be able to help others because you would end up in distress yourself.

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.

If you are struggling with symptoms of overuse, then you have the right to pursue strategies for self-care. One important strategy is to not accept an assignment if you are in pain. I have seen interpreters accept assignments, even though they are in excruciating pain - sometimes just trying to help out the person doing the scheduling. But self-care has to be a priority.

2. I have the right to take reasonable breaks to allow my body to rest from interpreting.

Building rest into your interpreting schedule is an essential part of self-care. The body can cope better with physical stress when it is spread out. We know, for example, if someone tried to maintain a plank position while exercising for 15 minutes, it would be far more demanding and stressful for the body than if the 15 minutes was spread out over 5 sessions throughout the day. When we interpret non-stop for too long a period of time our muscles and joints can become extremely fatigued. Interspersing reasonable rest breaks throughout the day can prevent your muscles from becoming overly stressed.

3. I have the right to acknowledge and communicate my limitations and needs to myself and other appropriate individuals.

It's important to recognize and acknowledge how your current skills, attitudes and temperament might impact your ability to provide the services desired. For example, if you don't yet have the skills sets to interpret certain assignments well, then accept assignments you are able to do with quality, while continuing to work on developing and honing your skills. I'll discuss this more in a future post when I elaborate on our right as interpreters to interpret with consistent quality rather than with an expectation of perfection.

Communicating what we need in order to work safely is also vital. This includes requesting another interpreter for an assignment that needs it, ergonomic accommodations, appropriate breaks, etc. This will be addressed more fully in the next post.

It's also essential to acknowledge and recognize any physical limitations you might have. If you are struggling with an injury or symptoms, for example, it is important to communicate about any necessary accommodations you might need. Not doing so will often lead to exacerbated symptoms.


4. I have the right to refuse an assignment that I feel is unsafe for me or that is beyond my current ability to do with quality.

It's essential to recognize and acknowledge areas in which your skills might still need time to develop and broaden. This may include interpreting skills, vocabulary acquisition, communication skills, and cultural or subject knowledge that may need more time and attention in order to be able to provide the level of services required. To accept an assignment that exceeds your current skill sets can impact your risk of injury because it can increase stress hormones as well as muscle tension.

There is no shame in having areas where professional growth would be helpful. I have often seen novice interpreters berating themselves for not demonstrating the same level of skill as does a 30 year veteran. But there is no shame in being a novice. We all have room for growth and learning.

There may be certain environments or settings that create exceptional emotional challenges. They may even be emotionally unsafe. It is helpful to acknowledge that and make a conscious choice about if it is an appropriate venue to interpret at this time for you. Like any other field, there are interpreters that have specific emotional sensitivities due to their own personal history. Being mindful of what you are truly prepared to do emotionally is an important consideration when accepting an assignment.

Certainly if there are things in the physical environment in which you are interpreting that put you at risk, then know you have a right to speak up and do whatever is necessary in order to ensure your safety.


5. I have the right to produce work that is consistent and of quality without the expectation that I must be perfect.

“Perfectionism is self-abuse of the highest order.” Anne Wilson Schaef. It's essential to acknowledge as interpreters that our work will never reflect a "perfect" interpretation. Any single interpretation can never fully reflect every nuance, subtlety and cultural implication imbedded in the source message. To think otherwise is to court frustration. I'm not suggesting that we shouldn't strive for the highest level of skills to which we can attain. But there is a difference between consistent quality and perfectionism. Consistent quality is a reflection of professionalism and integrity. Perfectionism is dysfunctional and creates discouragement, increases feelings of stress as well as the likelihood of injury.

We can learn from our mistakes and continue to grow in skills and knowledge, but this is very different from beating ourselves up because what we did was flawed in some way. It is also essential to see the flaws within the larger perspective of what we are also doing that is skillful.


6. I have the right to ask for what I need in order to do my work safely and with quality.
Part of what interpreters are responsible for is making sure they professionally request and advocate for what they need in order to ensure they are able to interpret for meaning and comprehension with integrity, quality and safety. The needs will vary depending on the situation and venue. If an interpreter, for example, is interpreting in an educational setting, they have a right to expect an appropriate chair that doesn’t leave them in pain for days. If they are interpreting in a VRS environment, they may need to let the Deaf caller know they cannot see if there isn’t enough light. If they are interpreting in a welding environment, they may need to request goggles to wear when welding is taking place, etc.
To ask for what you need in order to work safely and with quality requires courage and the ability to professional address the situation. These are skills that every interpreter needs to foster so their communication is clear, assertive, professional and open.

7. I have the right to continue to grow and develop as a professional in my field.

I often tell beginner interpreters that there is no shame in being a novice. There is no shame in having lesser experience and time in the field than someone else. There is no shame in having things left to learn or areas that still require growth. We ALL have to go through a process of growth and learning. We will inevitably make mistakes, but hopefully we will learn from every misstep, grow in experience and then take those lessons forward with us into future situations.

Even those who are considered veterans in the field have the right to continue to learn and grow. We can be ‘experts’ and students at the same time.


8. I have the right to make decisions about what is right for me, while maintaining the integrity and ethics of the field.
We are not required to be sacrificial in our commitment to the field. While it is important to be flexible, it is also important to remain mindful and respectful of our own needs, limitations, and even preferences. There are times when the right thing to do for yourself is to decline the offer of an interpreting assignment. You may be feeling fatigued, or even burned out. You may have something important happening in your own private life that demands or deserves your attention. You may want to transition to another job or area of interpreting about which you feel more passion or interest. None of these need elicit feelings of guilt. You get to consider your own life and needs when making professional decisions about your career.

9. I have the right to be treated with respect and as a professional. As such, I have the right to establish healthy boundaries with consumers and employers.
Taking abuse is not part of your job description. It doesn’t matter if it is from the person or company that has contracted your services, from your employer, from a senior interpreter or from Deaf or Hearing consumers. Some interpreters seem to think that they have no voice in how they are treated. This just isn’t the case. You are a person deserving of respect. You are not required to just suck it up and keep your silence when being disrespected. You can professionally, yet assertively draw appropriate boundaries and speak up for yourself when lines are being crossed.

10. I have the right to be a person and an interpreter at the same time.

Remember, you are not your work! You are a living, breathing person who interprets sometimes. It is important to recognize and acknowledge that to yourself. Why? Because forgetting or minimizing that can cause you to feel diminished as a person and increases risk of injury.

If you overly identify yourself with your work, then if you make a mistake in your interpretation you feel diminished as a person as well. It undermines your self-esteem. If you feel your interpretation was awful, then you feel it reflects on you as a person. However, if you realize that you are not your work, then if you make a mistake in your interpretation you can separate your identity as a person from your work. Your work on any given day may even "suck", however you as a person are still kind, amazing and wonderful in many ways.

Of course, as an interpreter you must not insinuate your opinions and ideas into the interpretation, nor should you try to influence or steer what is happening in any way. You are simply to facilitate the communication process and serve in that capacity. However, you are still entitled to your thoughts, opinions and ideas as a human being. You just can't express them in your role as an interpreter.

Recognizing that you are an interpreter and a person at the same time also helps you remember and honor your right to take care of yourself while interpreting. Your needs as a person matter. So if, for example, you are getting a headache because you are interpreting with the sun shining directly into your eyes, your needs as a human being matter. You have the right to expect accommodations so that your needs are met.

If you forget, or minimize, you are a person who is doing the job of interpreting, then it is easy to also minimize your needs as a person and to keep yourself safe. It is also easy to judge yourself as "less than" when your interpretation is not up to par. This can create feelings of stress and that increases risk of injury due to muscle tightness and stress hormone production.


11. I have the right to find satisfaction in my work.
We are all unique people with varying interests. This is true regarding interpreting venues as well. Some interpreters enjoy VRS – some don’t. Some like court interpreting – some don’t. Some like elementary school interpreting – some don’t. We are all different people, with different interests. Sometimes the venues we are drawn to reflect those interests. There is nothing wrong with that. I chose to work in a lot of post-secondary, medical and drug and alcohol rehabilitation programs. I always loved it. I didn’t enjoy working in grade schools, legal settings or performance arts venues. There is nothing wrong with that. At times, if there was a significant, pressing need, I would make an exception, but those were not the areas that were most enjoyable for me, so I didn’t do a lot of those kinds of assignments. I had friends in the field, though, who absolutely loved interpreting in those venues. They did a great job, in part because they were interested in, and enjoyed, those kinds of interpreting situations.

12. I have the right to produce work that is consistent and of quality without the expectation that I must be perfect.

It's essential to acknowledge as interpreters that our work will never reflect a "perfect" interpretation. Any single interpretation can never fully reflect every nuance, subtlety and cultural implication imbedded in the source message. To think otherwise is to court frustration. I'm not suggesting that we shouldn't strive for the highest level of skills to which we can attain. But there is a difference between consistent quality and perfectionism. Consistent quality is a reflection of professionalism and integrity. Perfectionism is dysfunctional and creates discouragement, increases feelings of stress as well as the likelihood of injury.

Copyright ©2010 Diane Gross, All Rights Reserved: no part of this material may be copied by any process, including but not limited to fax, photocopy, computer scan or any other means for any purpose without the express written consent of the author or the author’s designated representative.

05/25/2026

The Four Agreements for Interpreters
(Based on Miquel Ruiz's "The Four Agreements")

I love The Four Agreements for Interpreters because I believe it encapsulates the RID Professional Code of Conduct in four simple to remember and easy statements.

1. Be Impeccable with your Word:

- Interpret with integrity. Sign for comprehension only what you know was meant.

- Avoid using your interpreting as a vehicle with which to practice
co- dependent behaviors or to 'save' Deaf consumers from experiencing what is occurring.

- Refrain from breaking confidentiality.

- Remember to respect your consumers and that to speak against or to gossip about them also diminishes your own reputation and character.

- Use your skills as an interpreter in the direction of integrity and respect.

2. Don’t Take Anything Personally:

- Because you know that you are not your work, you understand that even though your work may suffer from time to time because of fatigue, physical challenges or just how the wind blew that day, but YOU are still a person of value and worthy of respect.

- When you realize that YOU are not your work it frees you to accept and correct areas in which your interpreting skills need improved. It removes the emotional barriers that keep you stuck in mediocrity.

- A consumer's lack of kindness is a reflection of their own state of being, not a reflection of you.

- When you stop personalizing the opinions and actions of consumers, you won’t be the victim of needless suffering.

3. Don’t Make Assumptions:

- Find the courage to ask questions and to express what you really need to do your work safely and with quality.

- Communicate with others as clearly as you can to avoid misunderstandings, sadness and drama.
With just this one agreement, you can completely transform your career.

4. Always Do Your Best:

- Your interpreting best is going to change from moment to moment; it will be different when you are healthy as opposed to sick.

- Remember to focus on your strengths as an interpreter, not just where you need to improve. Overly focusing on the negative can create discouragement and stymie your growth as an interpreter.

- Under any circumstance, simply do your best.

- Avoid self-judgment and self-abuse after an assignment. Don't beat yourself up for mistakes - learn from them, correct them and move on.

- Continually develop your skills. This demonstrates professional and personal integrity.

From ‘The Best of TerpHealth.’ Copyright ©2020 Diane Gross, All Rights Reserved: no part of this material may be copied by any process, including but not limited to fax, photocopy, computer scan or any other means for any purpose without the express written consent of the author or the author’s designated representative.

05/22/2026

What could I do next time to take care of myself better?" can be an important question for an interpreter.

There may be times when we find ourselves in a situation that results in post-interpreting pain. Learning to navigate those situations in a healthy manner can be a learning process.

While we may never encounter the exact same situation in the future, gleaning principles from our experiences to apply to other situations with similar aspects can be helpful.

Deciding what our approach will be before we go into an interpreting assignment is an important key to working more safely.

Some helpful considerations might be:

- Next time could I ask for help?

- Next time could I ask for adjustments in the physical environment (temperature, where I stand/sit, etc.?

- Might I arrive earlier next time so that I can set-up better?

- Could I advocate for my own needs more assertively next time?

- Might more preparation for the assignment have been helpful?

- Is it possible that I might need to use more discretion in accepting assignments in the future?

- What might I do differently next time that could create a different outcome?

It’s not about self-blame. It’s about learning from the situation so we can better protect our health.

05/20/2026

When you try to control everything while interpreting, you pursue an impossible goal. As a result, you lose the joy of interpreting and increase your risk of injury. Relax, breathe, let go and just interpret. I have observed that interpreters often place a tremendous amount of stress on themselves to produce a "perfect" interpretation. But the need for perfectionism is not realistic, or even healthy. A goal of consistent quality is more appropriate and fair to oneself. Pursuing perfection can rob you of joy and peace, while increasing your risk of injury due to increased muscle tension from stress, changes in bio-mechanics, and increased production of stress hormones.

For what are we as interpreters responsible and not responsible?  This is a question that I see implicit in many of the ...
05/15/2026

For what are we as interpreters responsible and not responsible? This is a question that I see implicit in many of the issues and choices with which interpreters sometimes struggle. Being clear about this can clarify a great deal and make an interpreter’s job less frustrating and guilt-ridden.

05/09/2026

Commonplace and normal:

It's important to understand that just because the vast majority of people are experiencing something that doesn't mean it reflects what is normal - if the body is being provided what it needs for optimal health. To accept something as "normal" that is actually in a state of dysfunction can lead you to living a lesser quality of life than you may desire.

There is a difference between what is "normal" and what is "commonplace".

- It is commonplace for interpreters to experience chronic pain...not normal.

- It is commonplace for interpreters to experience chronic insomnia...not normal.

- It is commonplace for people to experience regular food cravings and addiction...not normal.

- It is commonplace for women to experience hormonal difficulties...not normal.

- It is commonplace for people to experience frequent depression and/or anxiety...not normal.

- It is commonplace for people to become chronically sick and have cognitive decline as they age...not normal.

Recognizing that our symptoms reveal a state of imbalance in the body is the first necessary step to correcting it.

05/08/2026

A gentle reminder…

The Blue Dot experiments are interesting. Essentially they showed that the more people look for something, the more they tend to see it - even/especially when the incidence reduces. In other words, when people are actively looking for something, as it diminishes, perception of it tends to increase because they unconsciously tend to narrow their criteria of what defines it.

I started interpreting in the mid 1970’s and started providing training for interpreters in the early 1990’s. I’ve been told by myriad interpreters over the years that they just don’t ever feel like they are good enough; like the quality of their work is constantly subpar - even when I and others are in awe of their work. It makes me wonder if this is a Blue Dot phenomenon.

Striving to do the best work that we can is important - but what if the current approach and focus on ‘fixing’ that which we perceive as ‘wrong’ with our work is actually backfiring and causing us, as a field, to feel constantly dissatisfied with ourselves and our interpreting? What if we are often seeing ‘mistakes’ in our work that aren’t mistakes at all, but simply a choice we made in the moment among many other choices that we might have made - some of which we believe may have been a marginally ‘better’ choice. But we call it a ‘mistake’. This phenomenon happens with interpreters more often than we realize regarding mistakes. Our field tends to focus on errors and what could have been improved in an interpretation.

Other research also shows that, across fields, adapting the Capitalization model for skills development (identifying and optimizing strengths) is far superior and more effective than utilizing a Compensation model (identifying and fixing deficits and weaknesses). Those who focus on and develop their skills tend to improve and do better than those who focus on and work to repair their deficits. Maybe the Blue Dot experiments can help us understand why.

Start looking for what you and other interpreters are doing well today. Start noticing and looking for what you are doing that is working. Build on that. Grow that.

05/06/2026

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.

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