RSI is one of those things (ADHD, autism and dyslexia are other examples) that start as a label some scientist puts on a specific set of symptoms that cannot (currently) be linked to a specific condition [1], becomes popular and then get used for a zillion things with more or less the same symptoms (Wikipedia lists edema, tendinosis, tendinitis, carpal tunnel syndrome, cubital tunnel syndrome, De Quervain syndrome, thoracic outlet syndrome, intersection syndrome, epicondylitis, tenosynovitis, radial tunnel syndrome, and focal dystonia as possible conditions underlying RSI)
Since 'RSI' may have many causes, it is unlikely a single treatment will help everybody. This article, in particular, looks like anecdata to me.
Having said that, the suggestions others give to sleep and exercise almost certainly can't hurt and if they may hurt you, you probably already know how fragile your body is.
Exercise breaks during work have the added benefit of introducing breaks. If I had to bet, those breaks are more important for RSI-like symptoms than the exercises themselves.
Reddit has arrived: a plausibly researched answer that's so far off base it pains me.
Physician here, and my wife is an occupational therapist. RSI is like saying you have a cold. Yes, there is a problem, no it's not specific, but it gets us to the right chapter of the book. Some of the things you list have very specific causes and treatments that have nothing to do with RSI.
The article would be more like a case report: an interesting, uncommon source of RSI. Anecdata? Yes, but the interesting data is often the edge cases.
When faced with these symptomatically classified issues without a case-specific identified root cause, it still is nice to have a stable of simple (and medically believable) options to try.
Even the methods that didn't work for the author might be more applicable to others, if they have different root causes. In a situation where there's typically no precise clarity as to the root cause, shotgunning solutions is reasonable self-experimentation.
In fact, that's often how doctors prescribe treatments; shotgunning starting from suspecting the most common root cause and working down, testing to see if that's the root cause by seeing if the treatment for said root cause happens to be working.
“RSI” from typing too much in an uncomfortable way or using bad equipment is too serious to brush off.
For anyone reading here, if you’re regularly feeling any level of pain while typing, take an immediate break to figure out what’s wrong. If you let it persist it can do you serious damage.
There are a number of ways you can relieve your symptoms. Scale back your typing and keep trying ideas until the pain goes away. If pain persists or if it is acute/severe, go see a doctor right away. A doctor can much better diagnose you than internet commentary.
(1) Make sure your wrists are in a straight and neutral position while typing. This is in my opinion (having talked to many people with RSI and watched their typing style) the #1 contributor. Other arm/hand/finger position problems can also contribute, but keeping the wrists relatively straight and relaxed is the first most important step to take. Try to pull your keyboard in close to your body and tilt it so that its top is parallel to your forearms (the right tilt to use will depend on the height of your desk and chair and the shape of your body) and stop resting palms, wrists, or arms on a palmrest whenever actively typing (leave your hands “floating” above the keyboard, with just fingertips resting lightly on the home row). If the keyboard’s flip-out feet won’t let you get to the appropriate angle, try propping books or something under the near or far side, as needed.
(1a) More generally, pay attention to your body, and try to notice any muscles/tendons which are statically loaded while you type. Ideally you should be able to be in a position where your muscles are mostly relaxed, and only being used to actually press the keys.
(2) Try to avoid typing for too many hours a day, or for too long at a stretch. (Take a break to stand up and walk around a bit once at least every 45m or so. Go to the bathroom, make yourself a coffee, walk around the block, whatever.)
(3) Examine your seat and desk. Try to make sure your back is as straight as possible and your arms are in a relaxed position. Consider switching seat positions at least a few times throughout the day. Most office workers have their desks set too high compared to their torsos (this is because standard office furniture was designed for medium-tall European males to write with a pen on paper, not for people of arbitrary size/shape to type on a keyboard). You can either lower your desk or raise your chair to compensate. Consider alternative types of chairs (e.g. saddle seats) or an adjustable-height (e.g. sit–stand) desk.
(4) Try to eat a balanced diet, get enough sleep, exercise a few times per week, and avoid too much stress in your life. Obviously you should try to do these things anyway, but they can absolutely contribute to typing pain.
(5) If those changes don’t help, consider changing your physical keyboard/mouse hardware. A split keyboard with sufficiently “tented” sides eliminates the need to pronate your wrists, as is required for one-piece keyboards. This allows the elbows to be brought closer to the body, the shoulders to be relaxed, and generally reduces static load on several tendons/muscles. Consider an “ergonomic” mouse, a trackball, a roller mouse, or similar, or try to eliminate extraneous mousing. Consider changing the keyboard layout to avoid awkward stretched chords (“emacs pinky”), or even get a Maltron or similar row-oriented keyboard. Get a keyboard with switches that actuate halfway through the stroke (not a standard rubber dome keyboard), and try not to smash the keys hard into the bottom of the stroke while typing – aim for a light, fluid “dancing” style of typing.
This article is totally missing the basics. Exercise. I promise it will make ALL the difference. Get yourself a pull-up bar, and if you're feeling extra fancy, a dip bar.
Push-ups, pull-ups, dips, and sit-ups. Every day. You'll be a coding machine. At the VERY least, push-ups. Every hour or two, take a break, knock off ten push-ups, walk around a bit, get some water, get back to work. I'll do this right at the office, often in the server room.
A good chair helps, but all of this other nonsense is unnecessary. Exercise, and nutrition is the key to basically everything in life.
Last year I got into lifting for the first time ever (I'm 35). I got on a program, just doing a couple of heavy compound lifts three days a week, and the change for me has been night and day.
It doesn't take much time to learn how to do it correctly, and it's a lot more fun than running. All those aches and pains have gone away. Seriously, I can't recommend enough getting into lifting.
Exercise has helped my back pain ( I exercise 3 times a week) and my wrist pain sometimes comes back but only if I have been playing video games in addition to coding for a full day. Even then its pretty rare now. I do use ergonomic mice and keyboard though.
I generally agree that exercise is the key, but pushups can be terrible for tendonitis in the shoulder/upper-arm area. Just wanted to warn people from my experience.
It took me way too long to realize that coding all day and games all night is a recipe for pain. Working out is not fun, but it's absolutely necessary for serious software work.
Working on large, compound muscles, like that I wouldn't recommend every day. I would spread it out to no more than 3 times per week where you can exercise without any muscle stiffness and pain.
If you have the stiffness and pain in your muscles, hydrate yourself well, take the day off from these exercises and substitute light stretching to work on your flexibility, but always always drink plenty of water.
Used to have serious wrist/arm pain. Used to spend a lot of keyboard time, but also used to exercise a lot.
Anecdotal, but what worked for me was stopping walking around with my hands in my pockets. Seriously! Must've been something to do with body tension - once I figured out that letting my arms swing freely when I walked places, instead of keeping them rigidly in my pockets, the pain went away and hasn't come back.
This. What I discovered from my own RSI pain was that RSI is not caused by bad computer posture or doing any thing too much. It's caused by not doing other things enough.
For me, it was not exercising my wrists in any way. When I'd code, my wrists would be in one position which would eventually start to hurt. But then I took up rock climbing. In climbing, my wrists were forced to strengthen and be put in many other positions. And my RSI pain just went away. I wasn't coding any less than before. But in the time I wasn't coding, I was doing the exercises necessary to keep my wrists healthy.
Also, as an aside, most people's pain tolerance is also terrible. They let their mind take minimal pain signals from their bodies and magnify it tenfold until its excruciating. Some basic meditation training will teach people to minimize what little actual pain they have, which could also allow most to continue working through the pain.
You sound like someone who has never been badly injured, nor lived long enough to deal with an aging body.
Exercise does work wonders. And will solve SOME problems. But some problems really do need their own solutions. And sometimes it does take time and effort to figure out exactly what that solution is.
I have a regime of dumbbell exercises plus at least 5x25 pressups spread through the day.
In this I'm lucky to work from home - not everyone has the freedom to knock out a set in their office environment.
Maintaining condition goes far in mitigating the stress of the particular motor repetitions required by our profession, but I also find that periodically firing up the physical engine calalyses problem solving too.
I used to have a lot of wrist trouble (carpal tunnel I assume) from drumming and computing incessantly, but as long as I stick to the regime, I have no issues.
Same for me. I am very thin, slim hands. My first smartphone nearly destryoed my hands.
1. Stopped using phone in subway. I used to look down - strain my neck.
2. 30 Pushups everyday
3. Once a week walk/run 5 km
Fixed it.
The best exercise, for myself, for the "RSI" (tendinosis most likely) in my right forearm is archery with recurve and longbow in particular, not so much with compound.
Any pain I have in it is halved, and it feels much looser and stretched out. And as a bonus my medium distance vision also gets a workout.
I bought a power tower for chinups and pullups earlier this year but unfortunately it contributed to aggravating both my elbows and forearm.
One note - you can't just do pushups and call it a day. You need to work your back muscles to keep balance between those muscle groups. Pushups alone will cause your shoulders to roll forward, exacerbate forward head posture, and lead to upper crossed syndrome, which is already a major cause of many computer related RSI issues. Personal experience speaking here.
I used to get mild wrist pain until I started going to the gym 3 times a week.
Last year I broke my arm, metal plates put in, then taken out, ended up with nerve damage and no feeling in half my hand, 3rd surgery to fix the nerve.
About 3 months ago pain started to come back. Doctor gave me the all clear to go back to the gym. Started 2 weeks ago. Pain gone completely.
TL;DR: Similar problems, fixed diet, lost a bunch of weight, started exercising daily after achieving normal weight, all problems thing of the past. True for > 5 years now.
Both of my wrists were broken in my youth, in separate incidents. To make matters worse, one didn't heal correctly and needed to be re-broken.
Until my late 20s I obsessively spent long sleepless days at the computer, all classic qwerty keyboards, either model M or classic thinkpads later. My wrists would bother me at the computer, but they also would hurt when it rained, or other random moments. When I would try do some push-ups, my wrists would hurt like hell before I got anywhere near the expected muscle fatigue. This was generally accepted as expected and how things would be forever (or worse) thanks to the broken bones, according to those I consulted (doctors and family).
Except I wasn't minding nutrition, physical activity, or sleep at all, and lived in an environment (fly-over state) with an unhealthy food culture and awful climate. Without making a conscious deliberate effort, the default outcome was to slowly become fat and sick.
Fortunately a startup relocated me to the bay area, where I discovered even walking up a mild hill had become a strenuous, exhausting activity. Having a great climate, accessible local produce that actually tasted good, and a newfound interest in enjoying a life beyond the keyboard with the abundant outdoor beauty and activities, improving these facets of life came easily and I dare say I played little role beyond cooperating.
For ~5 years now I've been doing 300-600 push-ups daily, two sets in the morning and two in the evening. My wrists never bother me, not during push-ups, not at the computer, my injuries are a forgotten memory that I'm only reminded of in threads like these. There's usually also some sets of ~12 hand-stand push-ups, and holding a hand-stand for a minute while doing leg-spreads against a wall.
The only reason I'm able to sustain this daily routine is my weight got down to ~165 (5'8") from ~225. This didn't result from exercise, just vastly improved nutrition fixed my weight. After my weight was normal, the activity started because it was easy, fun, and painless. Words can't describe the pleasure of doing calisthenics with a body 25% lighter than it used to be. My experience exercising now is a daily celebration of being alive and well, and the feedback these activities provide keep my life in check.
I've also noticed that as I became stronger and more adept at push-ups, I was less abusive to my wrist joints and instead distributed the weight across my fingers and even slightly elevated the heel of my palm rather than leaving the area inactive (letting the wrist joint just take up all the abuse as I repeatedly drove my weight into the floor through it.) This wasn't possible for a long time because all the other muscles had to develop and catch up to the chest which was always capable of doing 20-30.
For those of you saying your wrists are ruined from daily push-ups, I'm dubious of your claims. My wrists seem to only become more resilient as I do more push-ups. If you're overweight, have gout, or something else caused by poor nutrition then you should probably address that instead of ceasing the activities altogether. There are more or less abusive techniques to push-ups, and if you're doing them daily in large quantities, you should be able to develop a painless technique, be nicer to your joints by activating the muscles in the area.
Nerve damage is serious business kids! If you feel it coming on, you need to pay attention and take action. Don't wait until you start randomly feeling needle stabs all day like I did while in the middle of a year long, high pressure, large code volume project. Doc told me to get surgery. I cured it myself the hard way instead. Huge inconvenience for many months. Very happy with that decision today. Here's what worked for me:
* Two keyboards and two mice. One set on my desk. The other keyboard on my lap and the other mouse on a pedestal at my side. I would switch up which keyboard/mouse I was using every 10 minutes or so.
* Typing like I couldn't move my hands. Literally letting them hang limp and moving my arms a lot.
* Pay attention. Take breaks. Notice what feels bad. Notice when you need to change up what you are doing --probably many times an hour. Take off your watch/rings. Watch out for resting your forearm/wrist on anything.
I had some pretty bad RSI that I thought was going to kill my career also.
Turned out, I managed to eliminate it by completely changing my keyboard technique to tuck my thumbs underneath my fingers when typing. I'm surprised no-one ever told me about this before.
The action of tapping the space bar with the corner of your thumbnail instead of smacking it with a big lateral thumb tap makes all the difference in reducing strain on your carpal tunnel.
If your arms are at rest beside your body while standing, the 'natural state' of your fingers and thumbs in this position is the exact same hand posture you should maintain when typing. If you are instead performing an up-down movement with an unbent thumb, that can lead to RSI problems.
I've made a few extensive posts about this here before too. Had 24/7 RSI paint for years. At the worst I couldn't hold a mouse.
Thousands of dollars of ergonomic chairs, keyboards, and so on made it so I could work but still had constant pain.
Started doing pushups (which I had avoided because I thought they made it worse.) Four weeks later I was using a laptop and suddenly it hit me I had been typing for 30 minutes with no pain. Life changing. Zero pain now and I can work 12 hours straight.
Definitely is some combination of the muscles and tendons tightening up in the arms and shoulders. The pain being in a different spot makes in misleading.
I've been saying this for years to my colleagues. Pushups is key to basic overall muscle health. A simple exercise, can be done anywhere, and works your entire body. You'll no longer have lower back pain either. Take a break every hour or so, bang out ten pushups, go get some water. Get back to work. No big deal.
I've dealt with RSI and carpal tunnel syndrome for almost two decades, off and on. Some of my triggers are chairs with arms (I almost can't help but lean on them, making my posture horrible and disrupting blood flow), bad weather (rain and cold), stress, depression (all pain is worse when you're depressed).
My first real recovery came when I got an Aeron and lowered the arms enough to where I couldn't lean on them, switched to a tiling window manager and stopped using the mouse (I am back to normal mouse and window manager these days, but when I feel the twinges of pain, I will sometimes switch back), and fixing the source of some of my stress (money was a stresser back then, and I took a contract job that paid well and got my debts paid off and some savings in the bank, so I could get back to working on the stuff I wanted to work on).
I don't know which of these things was the real cure, though I do know that using a chair with arms I can lean on is the fastest way to bring the pain back.
I suspect it is never "cured", it's just managed. Since figuring out my triggers it's been rare that I've experienced the pain for more than a few hours or days, and taking a walk, massaging my hands and wrists, etc. can usually get me back to work.
I was a bit paranoid about this in my mid 20's, so I learned touch-typing the Dvorak layout (well supported on all major OS's, so no problem using it everywhere), got myself a decent mechanical keyboard a few years later and I use vim for editing since forever (fewer key-combos is good against RSI, so modal wins out here). Most recently I have switched the Ctrl and Caps keys on my layout, which reduces a lot of stress on my pinky finger. People think I'm a total geek (which is OK considering I'm in IT), and this works quite well in my daily business.
Now in my mid-30's I have no problem and enjoy typing very much, so I guess the best thing to do is start with the precautions before the damage is done. Of course my conclusion might be very much premature, but I'm carefully optimistic.
I did the same. When I was in my 30s my hands were cramping while I was typing so I learned dvorak and then built up the skill to switch between them easily. Now it's dvorak at home and qwerty at work, and no cramping since. That was 20 years ago or so.
My pain started coming back this year. One thing that always helps my mouse hand, is to rest my arm on a raised surface (currently a portfolio), but I've used a textbook before. This caused my hand to drop down to touch the mouse, instead of being pushed up, and changed the body part that gets anchored and pivots when moving the mouse from my wrist to my elbow. That really helped a lot.
I still had issues with my left hand, and for me what has helped this time around is a ComfortBead Wrist Rest along the bottom of the keyboard. I'd used it years ago and wasn't convinced, but this time it's clearly and definitely helped a lot.
In the past, I've sometimes gotten some relief by switching which hand is the mouse hand. Every once in awhile I'll let my left hand control the mouse for a bit.
As already mentioned, everyone's RSI is different so no one solution works for everyone, and if you have RSI, you should try everything until you find something that works for you.
The two biggest wins for me have been a standing desk for posture improvement, and wearing wrist braces at night.
I got an RSI injury on my left hand and was unable to type normally for a few years. I went so far as to learn Dvorak RH which, even though I got reasonably good at it after a couple of years, was still crappy for programming.
After a very dark period of taking jobs that required less typing (Kafkaesque jobs at mega-corps involving mostly fixing other people's bugs), I'm better now because of:
1) Using an Apple keyboard, which even though it doesn't look ergonomic, the reduced key travel has helped immensely.
2) Using JetBrains' IDEs instead of vim. If you are a bash/vim/tmux (or equivalent) user like I was, try coding in your favorite language in a JetBrains IDE. Automated refactoring and code completion are your friends.
3) Try drinking red wine. The resveratrol in red wine is a natural anti-inflammatory.
I used Sarno's book to cure myself back in 2002 and this approach has been successful ever since. Occasionally I will have some issue (though rarely wrist pain), and I can make it go away quickly by addressing the psychological root cause.
I highly recommend reading his book "The Mindbody Prescription"
I had to quit programming for six years because of an RSI. In attempt to get around it, I even spent a year and half (painfully) writing a new kind of 'higher level' text editor better for use with motion sensors [1]. Now it's been ten years, and I still don't exactly know what the cause was/is, though I've got it to a point now where it's at least tolerable.
I think the most confusing factor here is the (potential) mental component to these injuries. I personally ruled that out as a possibility for the first five years or so just because it didn't really fit into my understanding of things that I could experience physical pain via something mental. The idea was tantamount to calling the pain artificial, which I knew was very much not the case.
The article (and others here) mention Dr. Sarno. I also read a couple of his books, and a couple more from others who think in the same basic framework. It helped. I'm certain there is/was a mental component—but I don't think Sarno et al's framework is good enough yet (don't get me wrong though—it does work for some people). Aside from results being imperfect, the fact that much of it is grounded in Freudian psychology is an obvious defect. I think they've hit on some techniques that can help, but the theory is bad (which prevents them from effectively refining the techniques).
My latest idea on what has caused all of this: I had some kind of physical injury early on (maybe tendonitis), and it eventually resolved itself. However, I developed this habit of very anxiously monitoring/testing the wrist/hand pain whenever using mouse and keyboard, which would cause the muscles to tense to the point of being painful. Unfortunately, my mind failed to distinguish between the original pain and that caused by tensing, so I continued operating under the assumption that I had some RSI, and continued vigorously worrying about it and attempting to solve it.
The only thing I can think of doing now (and which I am actively doing), is getting better at meditation so I can hopefully one day let go and not worry and tense up while using mouse/keyboard :/
(warning, anecdotal) I have been behind a computer full time (>= 8 hrs/day) (usually including weekend) for over 30 years now, I take breaks for exercise, cooking & parties and have done for most of that 30 years. I have found, for myself anyway, that RSI has zippo to do with the amount of typing, mousing or work I do. I have done years of 12 hr days full on typing and I have gotten beginning RSI symptoms from a few weeks of stressful meetings with very little typing in between.
As I was young then and did not want to waste time not being able to lift my arms or move my wrists, I experimented and found that, again for me, it's just 100% stress. Any exercise (none, too little or too much), working 20 hours or 2 hours are completely unrelated for the onset; if there is a stress factor (like; our new product is not selling!! back then) I would get symptoms immediately and they would get worse once started when typing/mousing more if the stress factor stayed constant.
After that and other health events triggered by (much heavier) stresses, I got my brain to not stress (took me a lot of years) and that worked. I can just work forever behind a computer (which I usually don't need anymore, as I found also that it's completely useless to work many hours / day) without any effects for the past 13-something years.
I got RSI some 26 years ago, due to entering a university CS environment where the workstations and terminals had very light action keyboards. I was used to hammering on stiff, long-travel behemoth keyboads, and of course continued that same pounding on the light ones which shocked the tendons, since I was basically tapping my fingers hard against the keyboard base with no shock absorption from the keys.
The fact that I was doing curls with 45 lb dumbbells in the gym didn't help the wrists, either, not to mention playing guitar.
I ended up with pain, tingling and numbness. The university sports med clinic prescribed a NSAID (naproxen). That did provide some relief.
I overcame the RSI by working exclusively through a DEC VT100 terminal (the actual DEC VT100). Its heavy-duty keyboard with stiff action and long key travel didn't irritate my wrists. Eventually I went over to the light-action/short-travel keyboards that are now ubiquitous.
This may help someone out there. I had chronic tennis elbow for years, tried a huge array of options to fix it and failed... until: I found a _vertical_ mouse.
I had problem with my right hand. Majorly due to mouse usage. I'm not typing much (even being software developer).
I have also tried different physical activities but it's only solving problem temporally.
So my lifehack: switch mouse to left/right hand from time to time (or at work left handed, at home right handed). That's it.
Yes, it's a bit awkward on beginning, but take that as challenge. And it will bring less harm than pills. In couple weeks you won't have problems to use mouse with any hand.
Of course if you're typing a lot and you have problem with both hands due to keyboard usage my solution will not work for you.
Go vertical, kids. For keyboard, I have used a Kinesis Freestyle w/ the Ascent explicitly designed for this purpose but now I just use the Matias Ergo Pro with some tripod parts to keep it vertical https://geekhack.org/index.php?topic=79810.0 (since the pic I have changed a bit but nothing significant, I have these four parts now forming an adjustible, 12" long column: 1/4" to 3/8" male-male spigot, Manfrotto adjustible column, Triopo Short Column, 3/8" female to 1/4" male adapter). The huge advantage of this vs the Kinesis is the super light weight so you can travel with this setup easily. And despite the end result is quite wide it actually collapses into smaller parts so I can just pack them in the same padded tablet bag as the keyboard. Alas, the same bag is now out of production and I honestly have no idea what to recommend. In the same forum you can find other solutions to keep it vertical.
For mouse, Evoulent is good and I have used many generations of it and I can tell you the difference is negligible so you can just go on eBay and buy an older generation for cheap. It is a b!tch to travel with as it is really oddly shaped. Oh well, nothing is perfect.
The thing about these pains is that they can come from, and be cured by all sorts of things.
I once got a terrible pain in my right arm, couldn't click with my fingers, couldn't move my mouse. After a week I saw a doctor and he said I was tense in my shoulder, which wasn't causing any pain, and showed me a stretch.
Stretching for 2 days cured me, and I've never had the problem again.
The take-home message isn't that you should stretch, but that the cure for these things can be almost anything.
Here's my anecdote. I had painful but not debilitating RSI-like symptoms for a couple of years. For me, fixing this came down to a set of fairly simple things: the Kinesis Advantage keyboard mentioned in the article, setting a timer to force myself to take rest breaks, focusing on posture when working. At least in my case, the issue seems entirely mechanical, and I'm sceptical of psychological and emotional explanations like Sarno's.
I've found that there are a number of different prescriptions for RSI pain, and that you have to experiment until you find what works for you. But that's complicated by the fact that it's hard to run experiments on yourself because there are so many confounding variables.
In any event, to add to the anecdata, someone below recommends not resting your arms/wrists on anything and letting your hands float above the keyboard. I've tried this, and the small muscles in my back that keep the arms lifted would become sore bundles of fire that eventually would spread pain throughout my back/neck/arms/wrists.
I found, paradoxically, that totally resting my arms splayed wide on my desk combined with a Kinesis Freestyle so I can keep my wrists straight (this wouldn't work with a regular keyboard) is the ideal setup for me.[1]
Not saying this would work for everyone.
[1] I have a standing desk combined with a high chair oriented such that the desk comes a bit higher on my chest than a sitting desk would, such that I can just rest my arms on the desk. The keyboard is not elevated and is basically flat to the desk surface, and is separated and angled such that my wrists are not bent.
[+] [-] Someone|9 years ago|reply
Since 'RSI' may have many causes, it is unlikely a single treatment will help everybody. This article, in particular, looks like anecdata to me.
Having said that, the suggestions others give to sleep and exercise almost certainly can't hurt and if they may hurt you, you probably already know how fragile your body is.
Exercise breaks during work have the added benefit of introducing breaks. If I had to bet, those breaks are more important for RSI-like symptoms than the exercises themselves.
[1] A disease is a particular abnormal condition, a disorder of a structure or function, that affects part or all of an organism (https://en.wikipedia.org/wiki/Disease, via https://en.wikipedia.org/wiki/Condition#In_medicine)
[+] [-] niels_olson|9 years ago|reply
Physician here, and my wife is an occupational therapist. RSI is like saying you have a cold. Yes, there is a problem, no it's not specific, but it gets us to the right chapter of the book. Some of the things you list have very specific causes and treatments that have nothing to do with RSI.
The article would be more like a case report: an interesting, uncommon source of RSI. Anecdata? Yes, but the interesting data is often the edge cases.
[+] [-] white-flame|9 years ago|reply
Even the methods that didn't work for the author might be more applicable to others, if they have different root causes. In a situation where there's typically no precise clarity as to the root cause, shotgunning solutions is reasonable self-experimentation.
In fact, that's often how doctors prescribe treatments; shotgunning starting from suspecting the most common root cause and working down, testing to see if that's the root cause by seeing if the treatment for said root cause happens to be working.
[+] [-] jacobolus|9 years ago|reply
For anyone reading here, if you’re regularly feeling any level of pain while typing, take an immediate break to figure out what’s wrong. If you let it persist it can do you serious damage.
There are a number of ways you can relieve your symptoms. Scale back your typing and keep trying ideas until the pain goes away. If pain persists or if it is acute/severe, go see a doctor right away. A doctor can much better diagnose you than internet commentary.
(1) Make sure your wrists are in a straight and neutral position while typing. This is in my opinion (having talked to many people with RSI and watched their typing style) the #1 contributor. Other arm/hand/finger position problems can also contribute, but keeping the wrists relatively straight and relaxed is the first most important step to take. Try to pull your keyboard in close to your body and tilt it so that its top is parallel to your forearms (the right tilt to use will depend on the height of your desk and chair and the shape of your body) and stop resting palms, wrists, or arms on a palmrest whenever actively typing (leave your hands “floating” above the keyboard, with just fingertips resting lightly on the home row). If the keyboard’s flip-out feet won’t let you get to the appropriate angle, try propping books or something under the near or far side, as needed.
(1a) More generally, pay attention to your body, and try to notice any muscles/tendons which are statically loaded while you type. Ideally you should be able to be in a position where your muscles are mostly relaxed, and only being used to actually press the keys.
(2) Try to avoid typing for too many hours a day, or for too long at a stretch. (Take a break to stand up and walk around a bit once at least every 45m or so. Go to the bathroom, make yourself a coffee, walk around the block, whatever.)
(3) Examine your seat and desk. Try to make sure your back is as straight as possible and your arms are in a relaxed position. Consider switching seat positions at least a few times throughout the day. Most office workers have their desks set too high compared to their torsos (this is because standard office furniture was designed for medium-tall European males to write with a pen on paper, not for people of arbitrary size/shape to type on a keyboard). You can either lower your desk or raise your chair to compensate. Consider alternative types of chairs (e.g. saddle seats) or an adjustable-height (e.g. sit–stand) desk.
(4) Try to eat a balanced diet, get enough sleep, exercise a few times per week, and avoid too much stress in your life. Obviously you should try to do these things anyway, but they can absolutely contribute to typing pain.
(5) If those changes don’t help, consider changing your physical keyboard/mouse hardware. A split keyboard with sufficiently “tented” sides eliminates the need to pronate your wrists, as is required for one-piece keyboards. This allows the elbows to be brought closer to the body, the shoulders to be relaxed, and generally reduces static load on several tendons/muscles. Consider an “ergonomic” mouse, a trackball, a roller mouse, or similar, or try to eliminate extraneous mousing. Consider changing the keyboard layout to avoid awkward stretched chords (“emacs pinky”), or even get a Maltron or similar row-oriented keyboard. Get a keyboard with switches that actuate halfway through the stroke (not a standard rubber dome keyboard), and try not to smash the keys hard into the bottom of the stroke while typing – aim for a light, fluid “dancing” style of typing.
[+] [-] overcast|9 years ago|reply
Push-ups, pull-ups, dips, and sit-ups. Every day. You'll be a coding machine. At the VERY least, push-ups. Every hour or two, take a break, knock off ten push-ups, walk around a bit, get some water, get back to work. I'll do this right at the office, often in the server room.
A good chair helps, but all of this other nonsense is unnecessary. Exercise, and nutrition is the key to basically everything in life.
As mentioned below. SLEEP.
[+] [-] BeetleB|9 years ago|reply
After I had my tennis elbow due to overwork at the computer, and many months in PT, I learned my lesson: Go work out regularly.
It's worked out great. Better health metrics, stronger muscles, etc.
And then I had ergo pains again. And again.
So I unlearned my lesson.
Exercise does great things for me. Solving my ergo related pains? No.
I promise you that exercise is not much of a cure. By all means, go do it because you should anyway. But don't go to sleep thinking it is a solution.
[+] [-] r_smart|9 years ago|reply
It doesn't take much time to learn how to do it correctly, and it's a lot more fun than running. All those aches and pains have gone away. Seriously, I can't recommend enough getting into lifting.
[+] [-] mrexroad|9 years ago|reply
ehhhh... years of daily pushups contributed to the slow shredding of cartilage in my wrist and two operations before i could type again.
but
> walk around a bit, get some water, [...] SLEEP.
this. can't stress enough.
[+] [-] zitterbewegung|9 years ago|reply
[+] [-] weerd|9 years ago|reply
It took me way too long to realize that coding all day and games all night is a recipe for pain. Working out is not fun, but it's absolutely necessary for serious software work.
[+] [-] johndubchak|9 years ago|reply
If you have the stiffness and pain in your muscles, hydrate yourself well, take the day off from these exercises and substitute light stretching to work on your flexibility, but always always drink plenty of water.
[+] [-] brianwawok|9 years ago|reply
Thought I had RSI. Got x-rays etc. Started lifting heavy weights. No more RSI.
You can't do nothing but code, or your body will rot. Go swim, run, lift some heavy stuff. Body works better.
[+] [-] melling|9 years ago|reply
https://github.com/melling/ErgonomicNotes
There's an extensive checklist of things people have tried but there doesn't seem to be one answer that works.
[+] [-] chair6|9 years ago|reply
Anecdotal, but what worked for me was stopping walking around with my hands in my pockets. Seriously! Must've been something to do with body tension - once I figured out that letting my arms swing freely when I walked places, instead of keeping them rigidly in my pockets, the pain went away and hasn't come back.
[+] [-] curun1r|9 years ago|reply
For me, it was not exercising my wrists in any way. When I'd code, my wrists would be in one position which would eventually start to hurt. But then I took up rock climbing. In climbing, my wrists were forced to strengthen and be put in many other positions. And my RSI pain just went away. I wasn't coding any less than before. But in the time I wasn't coding, I was doing the exercises necessary to keep my wrists healthy.
Also, as an aside, most people's pain tolerance is also terrible. They let their mind take minimal pain signals from their bodies and magnify it tenfold until its excruciating. Some basic meditation training will teach people to minimize what little actual pain they have, which could also allow most to continue working through the pain.
[+] [-] codingdave|9 years ago|reply
Exercise does work wonders. And will solve SOME problems. But some problems really do need their own solutions. And sometimes it does take time and effort to figure out exactly what that solution is.
[+] [-] psynapse|9 years ago|reply
I have a regime of dumbbell exercises plus at least 5x25 pressups spread through the day.
In this I'm lucky to work from home - not everyone has the freedom to knock out a set in their office environment.
Maintaining condition goes far in mitigating the stress of the particular motor repetitions required by our profession, but I also find that periodically firing up the physical engine calalyses problem solving too.
I used to have a lot of wrist trouble (carpal tunnel I assume) from drumming and computing incessantly, but as long as I stick to the regime, I have no issues.
[+] [-] e40|9 years ago|reply
[+] [-] ajkjk|9 years ago|reply
[+] [-] Rallerbabs|9 years ago|reply
I started working out with machines. It helped.
I started working out with barbells. It helped more.
I started working out with free weights. It helped even more.
I started boxing. It fixed my RSI right up.
The pattern: the most intensive and freeest exercises have the greatest effect.
[+] [-] whyagaindavid|9 years ago|reply
[+] [-] Snowe|9 years ago|reply
Any pain I have in it is halved, and it feels much looser and stretched out. And as a bonus my medium distance vision also gets a workout.
I bought a power tower for chinups and pullups earlier this year but unfortunately it contributed to aggravating both my elbows and forearm.
[+] [-] npunt|9 years ago|reply
One note - you can't just do pushups and call it a day. You need to work your back muscles to keep balance between those muscle groups. Pushups alone will cause your shoulders to roll forward, exacerbate forward head posture, and lead to upper crossed syndrome, which is already a major cause of many computer related RSI issues. Personal experience speaking here.
[+] [-] philliphaydon|9 years ago|reply
Last year I broke my arm, metal plates put in, then taken out, ended up with nerve damage and no feeling in half my hand, 3rd surgery to fix the nerve.
About 3 months ago pain started to come back. Doctor gave me the all clear to go back to the gym. Started 2 weeks ago. Pain gone completely.
Gym may not work for everyone. Works for me.
[+] [-] duaneb|9 years ago|reply
If that's not correct, I can't follow why you just discarded the entire article.
[+] [-] greendragon|9 years ago|reply
[+] [-] cncneieidlslap|9 years ago|reply
My post became longer than I expected to write
TL;DR: Similar problems, fixed diet, lost a bunch of weight, started exercising daily after achieving normal weight, all problems thing of the past. True for > 5 years now.
Both of my wrists were broken in my youth, in separate incidents. To make matters worse, one didn't heal correctly and needed to be re-broken.
Until my late 20s I obsessively spent long sleepless days at the computer, all classic qwerty keyboards, either model M or classic thinkpads later. My wrists would bother me at the computer, but they also would hurt when it rained, or other random moments. When I would try do some push-ups, my wrists would hurt like hell before I got anywhere near the expected muscle fatigue. This was generally accepted as expected and how things would be forever (or worse) thanks to the broken bones, according to those I consulted (doctors and family).
Except I wasn't minding nutrition, physical activity, or sleep at all, and lived in an environment (fly-over state) with an unhealthy food culture and awful climate. Without making a conscious deliberate effort, the default outcome was to slowly become fat and sick.
Fortunately a startup relocated me to the bay area, where I discovered even walking up a mild hill had become a strenuous, exhausting activity. Having a great climate, accessible local produce that actually tasted good, and a newfound interest in enjoying a life beyond the keyboard with the abundant outdoor beauty and activities, improving these facets of life came easily and I dare say I played little role beyond cooperating.
For ~5 years now I've been doing 300-600 push-ups daily, two sets in the morning and two in the evening. My wrists never bother me, not during push-ups, not at the computer, my injuries are a forgotten memory that I'm only reminded of in threads like these. There's usually also some sets of ~12 hand-stand push-ups, and holding a hand-stand for a minute while doing leg-spreads against a wall.
The only reason I'm able to sustain this daily routine is my weight got down to ~165 (5'8") from ~225. This didn't result from exercise, just vastly improved nutrition fixed my weight. After my weight was normal, the activity started because it was easy, fun, and painless. Words can't describe the pleasure of doing calisthenics with a body 25% lighter than it used to be. My experience exercising now is a daily celebration of being alive and well, and the feedback these activities provide keep my life in check.
I've also noticed that as I became stronger and more adept at push-ups, I was less abusive to my wrist joints and instead distributed the weight across my fingers and even slightly elevated the heel of my palm rather than leaving the area inactive (letting the wrist joint just take up all the abuse as I repeatedly drove my weight into the floor through it.) This wasn't possible for a long time because all the other muscles had to develop and catch up to the chest which was always capable of doing 20-30.
For those of you saying your wrists are ruined from daily push-ups, I'm dubious of your claims. My wrists seem to only become more resilient as I do more push-ups. If you're overweight, have gout, or something else caused by poor nutrition then you should probably address that instead of ceasing the activities altogether. There are more or less abusive techniques to push-ups, and if you're doing them daily in large quantities, you should be able to develop a painless technique, be nicer to your joints by activating the muscles in the area.
My $.02.
[+] [-] corysama|9 years ago|reply
* Two keyboards and two mice. One set on my desk. The other keyboard on my lap and the other mouse on a pedestal at my side. I would switch up which keyboard/mouse I was using every 10 minutes or so.
* Typing like I couldn't move my hands. Literally letting them hang limp and moving my arms a lot.
* Stretches and massage before, during, after typing. This "Essential Hand Stretches for Guitarists" video helped me a lot https://www.youtube.com/watch?v=TSrfB7JIzxY
* Pay attention. Take breaks. Notice what feels bad. Notice when you need to change up what you are doing --probably many times an hour. Take off your watch/rings. Watch out for resting your forearm/wrist on anything.
[+] [-] cornflake|9 years ago|reply
Turned out, I managed to eliminate it by completely changing my keyboard technique to tuck my thumbs underneath my fingers when typing. I'm surprised no-one ever told me about this before.
The action of tapping the space bar with the corner of your thumbnail instead of smacking it with a big lateral thumb tap makes all the difference in reducing strain on your carpal tunnel.
If your arms are at rest beside your body while standing, the 'natural state' of your fingers and thumbs in this position is the exact same hand posture you should maintain when typing. If you are instead performing an up-down movement with an unbent thumb, that can lead to RSI problems.
Learnt about this from: http://www.kogosowski.com/product/prevent-rsi-ebook/ * This e-book was written by a really smart concert pianist and the thumb positioning was the main take-away for me
[+] [-] AJ007|9 years ago|reply
Thousands of dollars of ergonomic chairs, keyboards, and so on made it so I could work but still had constant pain.
Started doing pushups (which I had avoided because I thought they made it worse.) Four weeks later I was using a laptop and suddenly it hit me I had been typing for 30 minutes with no pain. Life changing. Zero pain now and I can work 12 hours straight.
Definitely is some combination of the muscles and tendons tightening up in the arms and shoulders. The pain being in a different spot makes in misleading.
[+] [-] overcast|9 years ago|reply
[+] [-] hugozap|9 years ago|reply
[+] [-] SwellJoe|9 years ago|reply
My first real recovery came when I got an Aeron and lowered the arms enough to where I couldn't lean on them, switched to a tiling window manager and stopped using the mouse (I am back to normal mouse and window manager these days, but when I feel the twinges of pain, I will sometimes switch back), and fixing the source of some of my stress (money was a stresser back then, and I took a contract job that paid well and got my debts paid off and some savings in the bank, so I could get back to working on the stuff I wanted to work on).
I don't know which of these things was the real cure, though I do know that using a chair with arms I can lean on is the fastest way to bring the pain back.
I suspect it is never "cured", it's just managed. Since figuring out my triggers it's been rare that I've experienced the pain for more than a few hours or days, and taking a walk, massaging my hands and wrists, etc. can usually get me back to work.
[+] [-] skriticos2|9 years ago|reply
Now in my mid-30's I have no problem and enjoy typing very much, so I guess the best thing to do is start with the precautions before the damage is done. Of course my conclusion might be very much premature, but I'm carefully optimistic.
[+] [-] godshatter|9 years ago|reply
[+] [-] kzisme|9 years ago|reply
While I feel no pain at all I'm pretty paranoid about getting any pain/RSI in the coming years (recent graduate now working full time)
[+] [-] cableshaft|9 years ago|reply
I still had issues with my left hand, and for me what has helped this time around is a ComfortBead Wrist Rest along the bottom of the keyboard. I'd used it years ago and wasn't convinced, but this time it's clearly and definitely helped a lot.
In the past, I've sometimes gotten some relief by switching which hand is the mouse hand. Every once in awhile I'll let my left hand control the mouse for a bit.
[+] [-] nateberkopec|9 years ago|reply
The two biggest wins for me have been a standing desk for posture improvement, and wearing wrist braces at night.
[+] [-] pmcollins|9 years ago|reply
After a very dark period of taking jobs that required less typing (Kafkaesque jobs at mega-corps involving mostly fixing other people's bugs), I'm better now because of:
1) Using an Apple keyboard, which even though it doesn't look ergonomic, the reduced key travel has helped immensely. 2) Using JetBrains' IDEs instead of vim. If you are a bash/vim/tmux (or equivalent) user like I was, try coding in your favorite language in a JetBrains IDE. Automated refactoring and code completion are your friends. 3) Try drinking red wine. The resveratrol in red wine is a natural anti-inflammatory.
[+] [-] nileshk|9 years ago|reply
I highly recommend reading his book "The Mindbody Prescription"
[+] [-] westoncb|9 years ago|reply
I think the most confusing factor here is the (potential) mental component to these injuries. I personally ruled that out as a possibility for the first five years or so just because it didn't really fit into my understanding of things that I could experience physical pain via something mental. The idea was tantamount to calling the pain artificial, which I knew was very much not the case.
The article (and others here) mention Dr. Sarno. I also read a couple of his books, and a couple more from others who think in the same basic framework. It helped. I'm certain there is/was a mental component—but I don't think Sarno et al's framework is good enough yet (don't get me wrong though—it does work for some people). Aside from results being imperfect, the fact that much of it is grounded in Freudian psychology is an obvious defect. I think they've hit on some techniques that can help, but the theory is bad (which prevents them from effectively refining the techniques).
My latest idea on what has caused all of this: I had some kind of physical injury early on (maybe tendonitis), and it eventually resolved itself. However, I developed this habit of very anxiously monitoring/testing the wrist/hand pain whenever using mouse and keyboard, which would cause the muscles to tense to the point of being painful. Unfortunately, my mind failed to distinguish between the original pain and that caused by tensing, so I continued operating under the assumption that I had some RSI, and continued vigorously worrying about it and attempting to solve it.
The only thing I can think of doing now (and which I am actively doing), is getting better at meditation so I can hopefully one day let go and not worry and tense up while using mouse/keyboard :/
[1] http://westoncb.com/projects/tiledtext
[+] [-] tluyben2|9 years ago|reply
As I was young then and did not want to waste time not being able to lift my arms or move my wrists, I experimented and found that, again for me, it's just 100% stress. Any exercise (none, too little or too much), working 20 hours or 2 hours are completely unrelated for the onset; if there is a stress factor (like; our new product is not selling!! back then) I would get symptoms immediately and they would get worse once started when typing/mousing more if the stress factor stayed constant.
After that and other health events triggered by (much heavier) stresses, I got my brain to not stress (took me a lot of years) and that worked. I can just work forever behind a computer (which I usually don't need anymore, as I found also that it's completely useless to work many hours / day) without any effects for the past 13-something years.
[+] [-] kazinator|9 years ago|reply
The fact that I was doing curls with 45 lb dumbbells in the gym didn't help the wrists, either, not to mention playing guitar.
I ended up with pain, tingling and numbness. The university sports med clinic prescribed a NSAID (naproxen). That did provide some relief.
I overcame the RSI by working exclusively through a DEC VT100 terminal (the actual DEC VT100). Its heavy-duty keyboard with stiff action and long key travel didn't irritate my wrists. Eventually I went over to the light-action/short-travel keyboards that are now ubiquitous.
Haven't had a problem since.
[+] [-] tom_wilde|9 years ago|reply
Turns out it was a micro-injury thing...
[+] [-] batter|9 years ago|reply
Of course if you're typing a lot and you have problem with both hands due to keyboard usage my solution will not work for you.
[+] [-] chx|9 years ago|reply
For mouse, Evoulent is good and I have used many generations of it and I can tell you the difference is negligible so you can just go on eBay and buy an older generation for cheap. It is a b!tch to travel with as it is really oddly shaped. Oh well, nothing is perfect.
[+] [-] wodenokoto|9 years ago|reply
I once got a terrible pain in my right arm, couldn't click with my fingers, couldn't move my mouse. After a week I saw a doctor and he said I was tense in my shoulder, which wasn't causing any pain, and showed me a stretch.
Stretching for 2 days cured me, and I've never had the problem again.
The take-home message isn't that you should stretch, but that the cure for these things can be almost anything.
[+] [-] cortesi|9 years ago|reply
[+] [-] msluyter|9 years ago|reply
In any event, to add to the anecdata, someone below recommends not resting your arms/wrists on anything and letting your hands float above the keyboard. I've tried this, and the small muscles in my back that keep the arms lifted would become sore bundles of fire that eventually would spread pain throughout my back/neck/arms/wrists.
I found, paradoxically, that totally resting my arms splayed wide on my desk combined with a Kinesis Freestyle so I can keep my wrists straight (this wouldn't work with a regular keyboard) is the ideal setup for me.[1]
Not saying this would work for everyone.
[1] I have a standing desk combined with a high chair oriented such that the desk comes a bit higher on my chest than a sitting desk would, such that I can just rest my arms on the desk. The keyboard is not elevated and is basically flat to the desk surface, and is separated and angled such that my wrists are not bent.
[+] [-] wingworks|9 years ago|reply