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Ask HN: RSI is getting really bad

3 points by wrong_variable ↗ HN
I have been having serious pain while typing:

Left Hand - Pinky - Middle Finger - Ring Finger

Right - Palm while moving mouse

Having read a lot of online stuff I am terrified of the prospect of losing my ability to type. My entire existence is dependent on being able to type.

I am not sure if its nerve damage ( carpel tunnel ), or joint and muscle inflammation.

Nerve damage sounds really bad. I have also read that doctors always push for surgery and it might make things worse and I might never recover my ability to type to my former glory :(

Since its RSI and related to computer usage - I realized that programmers would know the best solution.

I just purchased Microsoft sculpt and hopefully its a solution [1]

Questions:

Will it help or make things worse to go to the gym ? squats, deadlifts, etc.

What about stress balls and grip strength contraptions ?

The pain actually reduces when using them, It gets really bad when I am typing - pressing each key feels l like someone is poking my joints with a pin.

The keyboard I was using was the Lenovo Thinkpad Carbon X1 keyboard [2]. I recommed that keyboard to other HNs a while ago and am not regretting that decision to recommend. Sorry if any HNers end up getting RSI due to my advice :(

[1] http://www.peterbristol.net/wp-content/uploads/2014/08/Microsoft-Sculpt-Keyboard-Peter-Bristol-1.jpg

[2] https://cdn.arstechnica.net/wp-content/uploads/2014/01/thinkpad-x1-carbon-keyboard.jpg

9 comments

[ 3.9 ms ] story [ 32.0 ms ] thread
ebcode
I just recently went through an RSI flare-up and had to do something urgently, so here's what I did. I immediately went and bought a replacement mouse, with a trackball. Because it was my right hand/wrist that was experiencing the worst of it, I switched my mouse from the right side of the keyboard to the left. This has changed up my usual right-hand grasping/squeezing/clicking motions, and now the flare-up has died down considerably. The other thing I did was to get a split keyboard similar to the one you bought.

Ergonomics are extremely important for our profession (obviously). Examine how your elbows are situated in relation to the keyboard. If you're sitting at a desk, be sure to have a keyboard tray underneath the desk so that when your elbows are at a 90-degree angle, the keyboard is underneath your fingers and your wrists are straight and not bent. If you know anyone who plays piano regularly, ask them to show you their positions and posture, and try to replicate that at your desk. HTH

wrong_variable
I have noticed the elbow 90 degree advice a lot.

I am just confused how the elbow relates to the pinky.

The mouse thing is interesting. is there a software that I ca use to switch my right hand designed mouse to my left hand.

PS: wonderful advice !

qb45
Like, swap right button with left? There is an option for that in "accessibility settings" of most OSs. Left-handed people use it sometimes.

BTW, two possible sources of mouse issues I know:

1. Sharp angle between palm and forearm, happens when the mouse is too low and too close to the body. Put it elsewhere.

2. Palm forced to lie horizontally, while the natural position would be angled (lay your hand comfortably on the desk and see that the palm isn't flat at all). This is solved by putting mouse on angled surface or getting mouse/trackball with angled top. See Microsoft Trackball Optical (not sold anymore) for example of what I mean.

eip
1. Get a standing desk. Set so that your elbows make a 90 degree bend when typing. 2. The sculpt should be an improvement. I prefer the the Microsoft Ergonomic 4000 (http://compass.microsoft.com/assets/b1/12/b112ddfc-0541-4948...) 3. Switch to you other hand for mouse usage for a while. Takes a week or two to get used to but once you do you can switch back and forth easily. 4. Hit the gym 5. Never type directly on laptops. 6. Make sure you hands are never tilted back when typing. That will cause more irritation than anything. That is why I prefer the keyboard I linked above. It has a riser for the palm rest.
wrong_variable
Thanks for the wonderful advice !

Another question.

Have you tried Dvorak ? I have been thinking of buying the sicker and changing my keyboard to dvorak.

I have also read that keys with mechanical switch are better. But unfortunately the sculpt does not have it :( Is there a keyboard that combines mechanical switches with sculpt like design ?

ajsalminen
There are a number of ergonomic mechanical keyboards. Some that might be worth looking at are the Keyboardio (coming soon), Kinesis Advantage2, Maltron and the Ergodox which is a DIY solution not very ergonomic by default but possible to build to be. I've backed the Keyboardio myself and if you decide to get that one you can currently get a discount code from here: https://shift.newco.co/what-50-buys-you-at-huaqiangbei-the-w...

For mechanical keyswitches I've read that the most stressful part of typing for your wrist is when you hit the bottom and your fingers come to an abrupt stop. To avoid that you need tactile switches and additionally I find that for me they have to be fairly stiff (Cherry MX Clear is my current favorite). On the other hand I've also seen some people who already experience constant pain while typing comment that they find the light linear switches to be the least painful to use. If you have constant pain those might be a better choice possibly combined with O-rings for a bit softer bottom hit.

I use another QWERTY-alternative called COLEMAK. It's a newer one that is considered to be more of an improvement over QWERTY than Dvorak. This Geekhack post compares pretty much all of the different layout options in the running these days (of course it still just reflects the opinions of the author, the Carpalx & MTGAP layouts are the result of a similar analysis with emphasis on different aspects): https://geekhack.org/index.php?topic=67604.0

There is an easy 5 step approach called TARMAK for COLEMAK where you gradually change your layout. It's useful if you want to retain some typing ability while in the process of switching.

You might want to also post on Reddit's /r/MechanicalKeyboards, you'd probably get more answers there.

PaulHoule
The gym is good. I am all for squats and deadlifts but I have seen push-ups work miracles for hands. Also around 45 to 60 min of cardio will trigger the runner's high with endorphin production that fights pain. Also instead of popping Tylenol or nsaids pills that can destroy your liver and stomach try an SNRI like venlafaxine.
MikeTV
I've been doing these stretches a few times a day for the past several years, since I first felt RSI coming on. It's helped significantly. Whenever I start to feel wrist/hand pain, I know I've been slacking on them.

https://youtu.be/hUyMNyrOHJQ