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RSI

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My name is mat and I suffer from repetitive strain injuries. You don't want this shit to happen to you - believe me.

Here's some pointers I recommend you try if you ever get any aches, numbness, stiffness, pain or tingling when you're using a computer. In no particular order:

1. Read this book

2. Negative tilt your keyboard - lifting the rear of the keyboard (where
it has the little legs) will make you flex your wrists upward, often to
very near your anatomical limit (see how far back you can flex your
wrist, then compare that position to a typing position on a fully tilted
keyboard). This has provided me with the single best improvement in
wrist and shoulder pain, and it's dead easy - simply lift the front edge
of your keyboard so that it slopes away from you. I use my wrist rest as
a wedge, but some matchboxes taped with their largest face down will do
the job just as well.

3. Wrist rests. In the words of my australian physio - "shithouse".
Wrist rests are designed for resting your wrists on between
typing, and then for short periods only. Pressure on the tendons and
nerves running on the bottom edge of your wrists is plusbad.
never use a wrist rest while typing

4. Breaks. Take 'em. Regularly, even if it's just sitting back and
taking a deep breath for ten seconds every few minutes - that helps to
stop tension building up and causing problems. Get out of your chair
and go for a walk at least once an hour - keeps the blood moving, and
helps release more tension. I highly recommend that you use software to
force you take breaks. I use MacBreakz for my Mac (you can get WinBreakz as well)
and workrave for linux. Workrave is awesome.

5. Stretching. Related to taking breaks in that they're a good thing
to do during longer breaks (I currently use a 10 seconds every three
minutes and 2 minutes every fifteen pattern, with stretches during the 2
minute break). The software mentioned above all has handy illustrations
of useful stretches, I'm not about to start trying to describe them here
(too much typing!) Stretches should never hurt - if it hurts you're stretching
too hard and could hurt yourself more.

6. Workstation ergonomics - as with stretches, you really need diagrams
for this. Bit of googling should sort you out, but the basics involve
right angles - right angles at your knees and elbows, straight back,
etc. etc. Fairly straighforward, but well worth paying attention to -
your chair/desk/etc can cause you a lot of pain if incorrectly set up.
I've seen huge pain reductions in the past simply by changing my chair.

7. Efficiency - keep the number of keystrokes down - learn keyboard
shortcuts, turn on stickyKeys. The twisting motion of hitting
ctrl-apple-d or ctrl-c, ctrl-v is not good for finger and wrist strain.
StickyKeys will let you press one key then the other, eliminating a lot
of this strain. Personally, I find that, once I'd got used to it,
StickyKeys has actually sped up my computer use whilst reducing my rsi.
It's worth putting in the effort to learn them, and so are keyboard
shortcuts. Tip for learning keyboard shortcuts - when you move your
mouse over the tool/option/menu that has a shortcut, it should show you
that shortcut. However, you'll probably just click anyway, as you're
there - try not to do this, try to read the shortcut and then use it
right away - a big part of learning is actually doing..

8. Don't bang the keys! Use only as much pressure as you need to - the
shock waves caused by the impacts of keypresses might not be large, but
they all add up. I have no idea how many times I strike a key during
the average day, but it's a very large number. You can probably find
some software somewhere that will let you count, if you're really
interested.

9. Keep a diary. Note when you use your computer, what you were doing
and score the levels of pain, stiffness and so on in your neck,
shoulders, back, arms, wrists, fingers. Try to find out what's causing
the worst problems and when - change your work patterns to avoid
situations that will cause you problems. The diary will also let you
know how well you're recovering as time goes on. Don't forget that
activities other than computer may trigger symptoms - I for one find my
fingers ache from holding softback books open.

10. See a doctor - if you're in pain every day, something is wrong.
Your doctor can help. In my experience using the letters 'rsi' is not
useful, it's best just to describe the symptoms and then tell them why
it happened. Your milage may vary.

11. Acupuncture/Massage/etc. Alternative therapies are very good for
relieving tension, unknotting your painful hands/shouders/neck etc.
Some of the best symptomatic relief I've got has been from acupuncture
and massage. Yoga, Tai chi, qui kung and so on can all help provide
postural and relaxational support and techniques, as well as improving
all over fitness and strength (which will also help avoid injury)

Owch. My fingers ache - time for a break. : )
16th Sep 2004, 18:24   | tags:

Hotdog says:

thanks for the tips Mat

16th Sep 2004, 18:33

mat says:

Ms monkeypunk asked about it, and I've been meaning to write this up for other people for some time.

I should add that this list is far from a definitive rsi prevention strategy and that I am not a medical professional - if you suffer from chronic or extreme pain, periods of numbness or tingling, YOU MUST SEE A DOCTOR. Permanent nerve damage is Not Cool.

16th Sep 2004, 18:41

Joe says:

I remember you posting about negative keyboard tilt in another post a while ago, I have since done it at work on both of my machines, and found that it's really helped with finger fatigue...I'm gonna try the software you suggest...as I have possibly the worlds worst short term memory, and always forget to take the breaks.
ta mat

16th Sep 2004, 18:44

mat says:

yes, only your fingers. But lots of small rests on the wrist rest between typing. Try to to let your upper arms and shoulders do most of the work, it's easier and less risky that way.

If your posture is right, it shouldn't be a tiring position - if you're getting tired, you might want to look at how you're sitting.

16th Sep 2004, 18:54

Afternoon(afternoon-at-uk2-dot-net) says:

My problem isn't my keys though, I have no problem with them despite typing arseloads. It's me frickin' mouse wot does it. It's the negative vertical bend in the wrist. Getting a smaller mouse ought to help. Hopefully.

16th Sep 2004, 19:52

mat says:

I want a thought-mouse. Mouse wheels utterly slaughter my knuckles, and clicking can get really painful. I do get wrist strain from mouse use, but it's not as bad as the finger pain I get from typing.

RSI prevention is more about identifying the worst causes and learning new techniques or changing patterns or equipment to avoid those problems.

I did say it wasn't a definitive list :)

16th Sep 2004, 20:14

pieceoplastic says:

dude, mat, you're teh bestest.
luckily my rsi is not as bad as when i used to try and learn how to scratch in my dj days. and failed miserably. the thought of writting this for dj's made me chuckle...

16th Sep 2004, 22:34

mat says:

hehe - rsi never really bothered me whe I was djing. I did lose quite a bit of hearing in my headphone ear, and I still have very mild tinnitus to this day.

One day, I'll be able to afford some decks again - then I can add another thing to my rsi-causing list. :)

6. Try to alternate between your mixer hand and your deckside hand during long scratch patterns to avoid building up tension in your fingers

16th Sep 2004, 22:49

wilsmeister says:

guy's all you need is to build up your wrist muscles. there are really satisfying ways to do it.......
or just buy a powerball and try to beat the world record
www.powerballs.com

16th Sep 2004, 22:50

mat says:

A few minutes with a powerball would probably put me out of action for a week. As I said, I have problems holding a softback book open for any length of time right now, although that will change as I get better.

Lots of muscles doesn't mean you won't devleop tendonitis, carpal tunnel syndrome, thoracic outlet syndrome, de quevarian's disease, athritis or any one of a huge list of other problems that are caused by poor ergonomic technique, bad posture, extended skeletal over-extension and full body tension, along with a whole load of other factors.

Don't get me wrong, I'm not weak and puny - I'm injured. Same way I would be if I was lifting weights down the gym using my back, or if I'd twisted my ankle playing football. I regularly spend 13 or more hours a day using a computer, and good practice is essential to avoid furthur injury.

As with most things in life, it's not about brute strength, it's about technique.

16th Sep 2004, 23:05

jiva says:

yay! thanks mat!
i'll try it!

16th Sep 2004, 23:07

wilsmeister says:

A powerball is not about brute strength see below:

Do you suffer from - Carpal Tunnel Syndrome - CTS • Arthritis • Repetitive Strain Injury - RSI • Wrist Injury / Break • Tendonitis • Tennis / Golf Elbow?

Introducing the unique new Powerball rehabilitation instruments
Powerball is a 4th generation hand gyroscope which has been so perfectly engineered and balanced, it can spin to over 15,000rpm - all powered simply by your arm and wrist.

The definitive rehabilitation device
Once activated, Powerball generates levels of gyroscopic inertia previously unheard of for its small size. The smooth, fluid action of spinning your Powerball when coupled to this inertia results in a unique therapeutic quality which will have a profound effect on Carpal Tunnel syndrome - CTS, Repetitive Strain injury - RSI, tendonitis, arthritis & all wrist related ailments while used for as little as just 5-7 minutes each day.

It's Pure Dynamic Therapy
Recommended by Chiropractors, Powerball is a fully dynamic training - rehabilitation product that takes your wrist through the actual ranges of its motion while simultaneously adding resistance.

Its unique 'non impact' properties gently stress damaged areas in a perfectly smooth and balanced manner which cannot be replicated by traditional exercise routines

Hope this helps man

16th Sep 2004, 23:14

mat says:

Thanks for the pointer, I had no idea - I thought they were just strength things. I might check it out when I've recovered a bit from where I am now.

16th Sep 2004, 23:17

wilsmeister says:

go for it mate, £17.99 from Play.com

16th Sep 2004, 23:18

monkeypunk says:

hey mat. thank you so much, that is all very helpful.
just testing the keyboard thing right now. i mostly have it in my wrist and the pain stretches all the way up to the shoulders. first time i had it was two years ago in my right arm. so i trained myself to just use the left arm to handle the mouse. that helped, but its not a solution in the long term, as i see now.
i also recommend to put comfrey balm on your hand or arm. its good!

17th Sep 2004, 07:46

afternoon says:

Mat: Yeah, sorry, I was talking about the negative keyboard thing. New mouse doesn't look like it's changed a whole lot, but it's more pocketable as well. It's all in the body of my hand, I need to find a way around it.

17th Sep 2004, 10:47

jiva says:

I HAVE POWERBALL! and tis fun.

26th Sep 2004, 10:18

SWMBO says:

HI

I like you Mat suffer from RSI, I did the physio thing, yes it helped, but the biggest help of all to me was my mouse specifically designed to be ergonomic and for RSI sufferers,

I got mine last year, and though it takes some getting used to, more like a joy stick, it really does work and doesn't need the wrist twisting a normal mouse does.

I was look for one for a guy at work yesterday and found some newer models which might even be better.

Check these out:-

http://www.ergoplus.co.uk/group.html?GroupID=107
/>
http://www.homeworkingsolutions.co.uk/catalog/ergonomic_mouse.cfm
/>
http://www.computingplus.co.uk/mice.htm
/>
The last one is the one I have.

I will also try the negative tilt, so thing so thanks for the good advice.

9th Jun 2005, 07:30

marcus says:

hi Mat,

I get pain in the joints from my thumb and index. originally thought it was my mouse, tried a sideways one, did'nt work. now the pain has spread slight to my left too.

have you heard of that before ?

16th Aug 2006, 17:23

mat says:

could be De Quervain's tenosynovitis (a form of arthritis), but as I've said - I'm no doctor, please go and see a professional.

Whatever you do, don't do nothing about it. It won't go away on it's own, and working through it will only make it worse.

16th Aug 2006, 17:28

bob says:

try using a (product name removed) www.(url removed).com. Works best with a slippy gaming mouse mat - see tha FAQ's.

eases mouse effort - very good.

9th Jan 2007, 00:51

mat says:

Wow, what a staggeringly stupid product. Why don't I just hack up my wrists with a rusty razor and be done with it?

To put it another way, get your spam off my moblog.

9th Jan 2007, 14:23

hildegard says:

What follows is general info & only prophylactic;

My mum's a pianist & I know a lot of pro musicians, all of whom have daily exercise programmes specifically designed to keep them playing by minimising the risk of RSI injury.
There are lots of exercises for pianists that regular computer users ought to be looking at too, you can find them easily enough with any search engine.

Keeping the wrist high, the spine upright & the chest open (this draws the shoulders back, pushing the shoulder back is the wrong way to open one's posture) will all help at the computer keyboard too.

A pianist has a far greater range of movement than us, so the sort of excercises a pro pianist does ought to be even more important to us as we are probably more likely to develop injury.

If you go to a decent music school, you will find that Alexander Technique is part of the curriculum. We put our bodies throught many of the same strains as pro musicians - tiny repetetive movements, difficult postures, too long in one position, etc.

It's true that once the damage is done, building muscle is hard & exercise can do little for inflammation, but building strength in muscles that support joints will, obviously, have the effect of reducing the load on the tendon itself & protecting it from further injury. So doing things like powerball can help to keep RSI style injuries at bay, as well as rehabilitate damaged tissue.

Single biggest factor - general posture; don't spend every penny on the computer & then stick it on a cheap desk, in front of a nasty chair. Look up a few sites on ergonomics, measure yourself, & spend money on a desk & chair that fit.

One last point - breathing. Shallow breathing & anxious holding of the breath when working mean that tissues are under-oxygenated & thus more prone to injury, as any athlete will tell you. Basic breathing meditation, 10 mins a day, will help with this, reduce tension generally, give you space to focus on positive posture and improve concentration without going down the tension-inducing focus aids route like coffee.

Do hope none of that was staggeringly stupid, know I've mentioned some to you before, Mat but this seems like a general info session. :)

9th Jan 2007, 15:12

mat says:

You didn't see the thing that guy linked to. It was basically a mobile wrist-rest, that would increase pressure on the vulnerable inner wrist, and promote Bad Mouse technique as well as CTS and other hellish things.

Good tips though, and I'm impressed that AT is being taught at music schools. It really should be taught as part of IT courses too.

9th Jan 2007, 16:07

hildegard says:

Not a comment on you editing just in case there's new data flatly contradicting me. ;)
Agree on AT & IT & wonder when will be the first class action against a company for not training staff in something like Alexander as part of H&S; requirements?
One can hope...

9th Jan 2007, 18:14

mat says:

I've been told I could probably do something like that with my former employers. I wouldn't want to though - it would be upsetting and stressful for me, and not very fair on them either. They did help make me worse, but I did most of it.

9th Jan 2007, 18:29

kadamontaga says:

Thanks a lot for the advice mat!

Just to clarify one thing - you said that using a wrist-rest whilst typing is a no-no. Does that mean that when you type, only your fingers should be touching the keyboard - not any other part of the hands?

It's gonna take me a while to get used to that. It sounds knackering.

8th Jun 2008, 18:16