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Ask HN: Avoiding carpal tunnel / repetitive stress injuries

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

#31
I've had it, and it did get better slowly. It cost me many thousands of dollars of lost work. The doctors are pretty useless in many cases.

0. Proper sleep, exercise and nutrition are important.

1. Hit the keyboard more gently.

2. If you're a wide person, like me, your elbows are out to the sides and your hands come in from the sides. So get a split keyboard like the Microsoft Natural. There are plenty of other keyboards that are split and "Ergonomic".

3. I had to drop Emacs, as it overused the ^X and meta-x keys. I mapped them to Function keys but that wasn't enough.

4. Not all RSI is carpal tunnel. There are even other tunnels. The thing about tunnels is that both a nerve and a tendon will go through the same tunnel in bone. When the tendon inflames it enlarges and squeezes the nerve against the bone. Misery ensues. You're body has lots of tunnels. There's even a pair in the head.

5. The best voice software is or was from a company from "Dragon Systems". The business history of this company is fascinating. Their "Naturally Speaking" product might still be the best.

6. Find and talk to some people in your state who have been on Disability. In some states, your Disability claims get paid by the last company you worked for. This results in you being blackballed by the business community. The companies seem to share information on employees and this might be legal. That's what those industry organizations are for, among other things. People who go on Disability are likely to sue. They don't want that. In the US, it varies from State to State. Get local information.

7. In some times and places, Disability is a big con and the bureaucracy has learned to treat all claimants as crooks; you are guilty until proven innocent. This is an important psychological injury and leads to trouble.

8. RSI can cause people to hate their jobs, and hate computers, they become the enemy. Work attitude suffers. Some management knows this and will head of trouble by getting rid of injured employees at the first excuse.

9. Get three different styles of keyboard and two or three mice. You an actually plug them all in at the same time if they're all USB.

10. See a hand specialist and an orthopedist. There is also a chance that what you really have is some outlier; like cancer of the bone in the hands, or something weird. Nerve damage can also be caused by bone weakness or osteoporosis. Have it all checked.

11. Docs tend to look at bilateral problems (both hands) differently. The trouble might be in the common parts, the spinal cord or the brain. This could be good news if they're right, as some mental problems and neurological conditions are easier to treat than soft tissue injuries.

12. Physical therapy can be very annoying but also be very, very useful. Do whatever they say as if it is God Himself commanding you from the Mountain. Do it every day, if they say so.

13. Going Dvorak means a new keyboard for both home and work. Give up game-playing and some web surfing. TV is also bad for you. You need basic exercise, walk or run. No handball, racquetball, tennis, ping-pong, hammering. Make sure you have an electric screwdriver or don't do that at all. I found that swimming stressed my hands.

14. If you take as many breaks as the RSI experts say, your whole level of intensity will go down. I don't even know if it's possible to relax your body as you work your mind unless your a Zen master, or something.

15. If you research the subject, you can terrify yourself and be paralyzed with anxiety. If you research RSD/RSI together, you'll leave work and become a monk out on a mountaintop, and starve to death. Okay, I'm exaggerating, here.

16. Proper sleep, exercise and nutrition are STILL important.

17. You might checkout http://www.rsirescue.com/, I haven't looked that stuff for years...

18. The only way to sit up straight is to raise the monitor screens. If you raise them too high, you'll be looking up, which is just as bad.

19. The most expensive chairs, keyboards, and so on are worth it, financially, if they work. Lost work is more expensive than any of those.

20. In some states, employers have to assume that if you were out of work for a while, you must have been in prison. This is because prison records get sealed after a few years so that ex-prisoners can get jobs and rehabilitate. So if you've been out of work a few years ago and don't have a prison record, you look just like somebody who actually was in prison.

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

#32
post #8

Mind telling us which machines do you and your friends use? Are those MacBook Pro's by chance? I starteted having quite a bit of problems soon after buying one.

It's a 50/50 split between typical Win PC's, and yes, MacBook Pros. I use a MacBook Pro. Perhaps there is a correlation.

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

#34

Exact same age and symptoms as me - 3M ergonomic mouse fixed it right up. http://www.google.com/url?sa=t&ct=res&cd=3&url=h... Also using my left hand for touchpads and wearing a brace helped get through the worst of it.

Seconded. I was doing 3D work, which involves a lot of mousing. The 3M joystick-style mouse greatly increased the amount of time I could comfortably work. The middle mouse button gummed up on me after about two years... I couldn't figure out how to clean it out, so I just replaced it with the same model.

I also recommend learning the keyboard shortcuts for whatever environment you work in, to minimize switching between mouse and keyboard. If you find yourself doing a lot of text cursor movement with the arrow keys or mouse, you might want to try vim for a month or two. (I tried emacs, but found it ergonomically uncomfortable, although I did not remap the keys from their default positions, which I understand other people do. I have not heard any statistics on the matter, but it would not surprise me to learn that emacs users are more prone to RSI than vim users.)

Try to work in an environment that is not too cold (or wear fingerless gloves). I found the cold made my joints uncomfortable and was bad for circulation.

Also, install Workrave (or equivalent for your platform) in the most obnoxious configuration you can stand. Even though my wrists are pretty good now, I still keep it on in quiet mode in the corner of my screen, to help me keep track of my breaks.

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

#35
see keyboard review threads:

http://news.ycombinator.com/item?id=185743

http://developerlife.com/reviews/?p=46

http://news.ycombinator.com/item?id=221434

http://news.ycombinator.com/item?id=199493

http://news.ycombinator.com/item?id=104977

That's about 3 days' reading material: some bullets as i dimly remember:

1. laptop keyboards: avoid, especially for emacs/textmate control/alt/command key combo's. These 2-key to 4-key combo's are hell on your wrists if you always have to do them on the left side. If you do COntrol_C and X and V to cut/past in windows, same deal. I think it helps to use both short-travel scissors mechanism keyboards, like the new aluminum mac KB's and older-style long-travel sprung keyboards taht logitech , Matias and kensington make. I especially like the Matias' feel.

2. hourly breaks and wrist exercises: wrist curls, reverse wrist curls, the Dyno-flex ball , powerWeb exercises. The latter is expanding your semi-closed fingers out against resistance, which is one that I rarely read about, but it's important.

http://www.fitter1.com/Catalog/Category/35/HandWrist.aspx http://www.amazon.com/Roller-Strength-Gripper-Forearm-Stainl...

3. always have your elbows and heels of hand supported weight-wise when mousing and keyboarding (kinda like Formula 1 designers trying to minimize unsprung weight). Try to mouse with undominant hand (I'm not too good at this)

4. consider other factors: cocking your wrists when you drive or ride a bike or work power tools, shovel snow, brush your teeth, sleeping on your side. The combination of weight-bearing, pressure/shock/vibration and closing off the outside or inside of wrist joint is insidious .

5. Aside: i think JFred has enough material for a book. all my upmod points to him/her!

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

#36
One thing cured my RSI carpal tunnel problems: the dyna-flex ball. You can find it in sports shops and sometimes golf or tennis pro shops.

Edit: found a mention of dyno-flex ball above. This thing is awesome! Plus the usual things of course. I recently bought a Dvorak keyboard but haven't yet started using it. I always use a trackball (Logitech thumb-trackball, the only REAL trackball on the market). Joystick mouse sounds about right too.

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

#37

Get religion about ergonomics. I've spend close to $1k on my workstation's ergonomics at home (decent desk, chair, keyboard, tried a bunch of different mice, adjustible monitor arms, etc...) I probably need to invest another $500-1000 just to get it tuned even further. A small price to pay, to not have to quit coding. Is the pain in your R hand on your wrist (palmar side?) or is it in the back of your hand? It' makes…

Thank you for the questions. I realize now that I have been resting my wrist on the chair armrest in an attempt to keep my wrist and arm and hand straighter (thinking this was healthier). But now I realize that even if that whole unit is straight, the resting itself is damaging. Thanks.

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

#38
post #25

For me, I was starting to get wrist pain with my mousing. I purchased 12 different mice, tried them all out, keeping note of how I felt in my hand. I eventually found out that really large mice is what work for me. The M$ intellimouse explorer specifically. The MX revolution, and all the other fancy mice weren't as good as the huge honking intellimouse explorer. The huge thumball mice were also good, but I didn't hav…

This is really interesting, because right now I use a very small wireless travel mouse.

Actually, I've ditched it and have begun mousing with my feet: http://www.bilila.com/foot_mouse_slipper_mouse

From 2000-2006 I used the MS Intellimouse. I should have stuck with it. Perhaps now if I must use a traditional mouse again I'll purchase another. Great tip.

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

#39
post #31

I've had it, and it did get better slowly. It cost me many thousands of dollars of lost work. The doctors are pretty useless in many cases. 0. Proper sleep, exercise and nutrition are important. 1. Hit the keyboard more gently. 2. If you're a wide person, like me, your elbows are out to the sides and your hands come in from the sides. So get a split keyboard like the Microsoft Natural. There are plenty of other keybo…

4. Not all RSI is carpal tunnel.

It's funny, but the RSI book a friend recommended to me is titled "It's Not Carpal Tunnel Syndrome!":

http://www.amazon.com/Carpal-Syndrome-Therapy-Computer-Profe...

Contrary to the title, the book doesn't rule out the possibility of carpal tunnel, but it correctly points out that carpal tunnel only applies to a small set of RSI-related symptoms. I found the book helpful.

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

#40
http://www.jwz.org/gruntle/wrists.html

Step one is to see a doctor about it. Or as jwz puts it, "Do not fuck around. If you are experiencing any kind of pain, get to a doctor and get it diagnosed." Your hands are your livelihood and you do not want to be cavalier about this. Nobody here is qualified to diagnose you from across the Internet. Quoting jwz again, "... think what your life is going to be like if you can't type at all. I have friends this has happened to. You seriously do not want to go there."

Mice with high click resistance have caused me the most tendon pain in my right hand. They seem to be getting much worse in recent years -- I had to replace one recently that took a feather-light touch, and I haven't found anything that comes close. The best one I've been able to find unfortunately doesn't have all the features I would like, but hands that aren't crippled are more important than features:

http://www.amazon.com/Logitech-MX518-Gaming-Optical-Mouse/dp...

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