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Ask HN: Avoiding carpal tunnel / repetitive stress injuries

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Ask HN: Avoiding carpal tunnel / repetitive stress injuries

#1

Post by wensing »

I'm 26 and have been hitting keys since I was 6 or 7. For the first time in 20 years I now have a burning pain in my right hand and wrist. I think it has a lot to do with my mouse. I've switched to an ergonomic keyboard, and have also begun using a keyboard tray, placing it low enough so that my shoulders are relaxed when I work. But the pain persists. MacSpeech Dictate has pretty sweet accuracy and can replace typing for IM conversations and email, but I still have to type to code.

What are any of you doing to prevent such injuries? Do you think about the possibility? I have a feeling it could end up being something of an 'unexpected' pandemic (three co-workers of similar age have also begun to see their first symptoms).

Re: Ask HN: Avoiding carpal tunnel / repetitive stress injuries

#2

Post by adrianwaj »

My solution was to place a standard building sized block of wood measured to the length of my standard keyboard under the keyboard so the nearest edge of the keyboard sits up on the block, and the furthest edge of the keyboard sits on the table as usual. This way, the wrists can rest on the flat upside section of the wood with the fingers then drooping over onto the angulated keyboard. It's meant to simulate how your arms and wrists feel when you hang them down freely - no flexion of the wrists up or down, and relaxed.

Similarly, place a thick book near your mouse for your wrist to wrest upon, leaving your palm to drop onto the mouse which slides on the pad that sits on table. For me, smaller mice are better that can be moved with just the fingers and highly sensitized.

This solved the RSI in my forearms.

Note: The wood block must be the correct size so that the keyboard slants neither too high nor too low, and that the forearms do not touch.

I use: '2x4 (pronounced "two by four"), but few people realize that the actual height and width of a 2x4 is really somewhere close to 1 1/2" x 3 1/2"' http://woodworking.about.com/od/typesofwood/p/WoodSizing.htm

Re: Ask HN: Avoiding carpal tunnel / repetitive stress injuries

#3

Post by Stabback »

I just went to a physiotherapist about this very issue, here's what I was told.

First, I've been experiencing a dull pain shooting up the BACKS of my hands to my wrists, following the middle finger. This may or may not be what you have, and I recommend looking into this yourself. It cost me 80 CAD to visit a physiotherapist and it was worth every penny. If you are going to be typing for the next 5, 10 years or longer (here's hoping we get a better input system...) I urge you to visit at the first bit of pain.

Onto the diagnoses. A primer on the human body: the nerves and blood vessels that get to your hands come from your spinal cord. To get there they must pass under the collarbone and above the first rib. My problem is that I have a slight posture problem (no one has ever noticed it) where my shoulders slouch forward a bit. This is very common for people that use the computer a lot, and it was compounded by my height (6'3''). As I am a tall person, I slouch while talking to people, inspecting things, pretty much whenever I do anything in a world built for the average sized guy.

This posture problem results in a small constricting of the space between the collarbone and the first rib - putting pressure on the blood vessels and nerves going through there. This causes extra strain whenever you pull on these items (which you do while moving the fingers). To make matters worse I do not do a lot of upper body exercise. I run 3k a day and bike about an hour and a half, but none of these tasks work my back muscles. While typing for extended periods of time these muscles recognize they are not needed and 'shut off' to conserve energy. If they were used more they would not be shut off as quick. When they are shut off the shoulders slouch more.

I was recommended a series of stretches to help the constricting of the blood vessels and nerves. I was also recommended to start swimming regularly to build muscle. I have also started using the program "instant boss" (quick and dirty program) to have a 10 and 2 schedule - 10 minutes on and 2 off. I follow it religiously.

I'd define the stretches but my hands are hurting a bit and I need to stop typing. I do recommend seeing a physiotherapist yourself though to get customized stretches that fit your body type. Take breaks, really read up on ergonomics.

Hope this helps.

Re: Ask HN: Avoiding carpal tunnel / repetitive stress injuries

#4

Post by DenisM »

1. Ergonomoc evaluation by a specialist to set up your desk, monitor etc. Ask your employer, they should provide it.

2. Inquire about work-place injury laws in your state. Your employer will likely have to pay the expenses.

3. Record all expenses no matter who pays for them. If you become disabled reciepts may help to make employer shoulder part of the weight.

4. Physical therapy. It's important to continue excersizing until, well, forever.

5. If mouse is source of your problems try using two mouses alternating left and right hands. You'll get used to it.

6. Carpal tunnel and RSI are two very different things. It's important to see specialist to tell one form the other. Carpal tunnel is actually quite rare, but consequences are severe.

Re: Ask HN: Avoiding carpal tunnel / repetitive stress injuries

#5

Post by tortilla »

1) Get a mouse that's flexible enough to use with either your left or right hand. It might feel weird at first, but switching sides every hour will reduce a lot the pain. Takes a bit to get used to but you'll eventually adjust.

2) Try to use the keyboard as much as possible for everything. Go into your Keyboard & Mouse settings and enable full keyboard access (or ^fn F7 to toggle on/off)

3) Use either Firefox/Camino for you main browsing because you can enable "find as you type" which you can use to navigate the links on a web page.

4) Take regular/breaks. I use http://tech.inhelsinki.nl/antirsi/ to remind me at set intervals.

5) Exercise regularly (running, walking, golf, something to get you away from you computer).

6) Meditate, relax, listen to music. Whenever I feel like I'm tired or overstressed, I listen to this for about 20 minutes. I'll feel refreshed and much more focused. http://www.pzizz.com/ (Energizer track)

Re: Ask HN: Avoiding carpal tunnel / repetitive stress injuries

#6

Post by andrewf »

See a medical professional! That said, anecdotal not-medical-advice:

I had mousing-related pain, and I fixed it by mousing left handed. The first couple of days were incredibly frustrating, but after a week I had probably 80% of my right handed dexterity.

To prevent the same issue from building up in my left hand, I started alternating between left handed and right handed mousing every couple of weeks.

I guess the worst case outcome here is severe damage to both hands, so proceed with caution.

Re: Ask HN: Avoiding carpal tunnel / repetitive stress injuries

#9

Post by smanek »

There was a thread a few years back on comp.lang.lisp about this very topic.

Peter Seibel (of 'Practical Common Lisp' fame) replied:

"Okay, here's how I do it. Of course I tend to overdo things--how do you think I dorked up my wrists in the first place so I can't say this is necessarily recommended practice:

a. Fill one pitcher with cold water and a tray or two of ice cubes, leaving room for you to immerse you hand and wrist without overflowing.

b. Fill another pitcher with scalding hot water, again leaving room for as much of your hand and wrist will fit into pitcher without bending your wrist at some weird angle.

c. Stick affected hand in ice water. Scream in agony until the numbing takes the edge off. Leave in for 1-4 minutes.

d. Move affected hand to hot water. If you timed it just right the water has cooled just enough that you avoid parboiling your hand. Leave in for 1 minute. Move your fingers around some.

e. Go to c until you get bored or the water in both pitchers has gone tepid.

I also periodically freshen up the hot water by filling a mug from the hot-water pitcher and microwaving it for a minute while I'm soaking in the cold water and then putting it back in the hot pitcher when I'm ready to switch. But I'm pretty weird.

-Peter"

Or you could just get a reasonable keyboard. I've been lusting after a Kinesis Contour for some time now ...

Re: Ask HN: Avoiding carpal tunnel / repetitive stress injuries

#10

Post by yummyfajitas »

First thing: figure out where your problem is. Next time you feel pain, try to determine exactly where it is. Also useful when you talk to a doctor about it.

Then find a map of the nerves in your hand (Grey's Anatomy has one). Find the joints that that nerve goes through, probably one of those is squeezing it. Adjust your position/workspace to avoid stressing that particular nerve.

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