Ask HN: Trigger finger and tendonitis

1 points by odammit ↗ HN
I tend to get extremely painful forearm tendonitis and trigger finger from my Mac's trackpad to the point my finger will stop functioning and I have to get cortisone shots every year or so.

I generally use shortcut keys, but inevitably I use my trackpad when I'm in learning mode (scrolling through blogs, changing tabs, etc).

I purchased an Evoluent mouse to switch back and forth and ended up getting shoulder tendonitis. I bought a Wacom tablet and switch between all three. It helps, but I look like an input device diva.

If you get or used to get frequent tendonitis, how do you relieve it or avoid it?

9 comments

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Push ups
Really?! Do you do them throughout the day or before/after work?
I did them in the morning.

The theory behind it is that in action the fingers are part of a kinematic chain and that involves your arms and the rest of your torso. Push-ups work all of those muscles as a group and can improve function of the whole system.

Switch hands! Give your current hand some time to heal and then alternate hands day-by-day. This cuts the workload in half.
That's what I'm currently doing with the tablet and the vertical mouse. I have the tablet on my left side the mouse on my right and then it's just a matter of remembering to not use my trackpad :-)
I've intermittently had the same problem. Some basic habits you can change to help:

Cmd-Tab (and Ctrl/Shift-Tab) should not be done with one hand! Hold down Cmd with your right hand and hit tab with your left. This one change probably helped my "tendonitis claw" more than anything else. Similarly, other keyboard shortcuts should involve holding down the opposite modifier key from the key being pressed.

Let your fingers float above the keyboard. A lot of people rest their wrists on the wrist-rest and try to type; this puts a lot of pressure on the carpal tunnel, and means you have to curl your fingers more.

Two-finger scroll with your wrist & upper arm, not your fingers. It should be a really subtle movement, too, just a few millimeters displacement.

Editor wars aside, vim is better than emacs (& TextMate etc, though emacs is the worst offender) for RSI. Modal editing doesn't require that you hold down modifiers.

Take thinking breaks. When your code is compiling or you have a tough problem, get up and walk around instead of cmd-tabbing to a blog.

Don't let yourself get mad or frustrated at your code. Get up and take a walk or talk to someone instead. This is actually pretty challenging, because I've found that intensive coding tends to shut down the emotional processing parts of my brain. But that's also why it's dangerous: when you aren't consciously processing emotions, they can often get "stuck" as muscle tension; your back and shoulder muscles might remember that you were mad, or your fingers that you were frustrated, even though consciously you don't. Relaxation or meditation exercises can help get muscles un-stuck, but ideally you should be relaxed whenever you're typing.

If all else fails, switch to Dvorak. It's somewhat better for finger-movement than Qwerty, although I'm not sure the benefit outweighs the switching cost unless your fingers are really bothering you.

Thanks. I'm going to give these a swing. I'm definitely guilty of going into a k-hole when I work and generally only stopping once I'm hungry.

I've stopped resting my wrist. I made a little tack strip that I'd lay on my laptop while I was working to train me not to rest them.

Have you tried Dvorak? I've considered it multiple times but always worry about if I'll lose the ability to use a standard keyboard. Although - how often do you use someone else's keyboard :/

Been using Dvorak since college. I did lose the ability to use a standard keyboard for a bit but gained it back. (The switching process is actually quite fascinating from a cognitive POV...there was a point where I would type half a word in Dvorak and half in Qwerty, resulting in nonsense, and then a later period when the keyboard layout I would type in was conditioned by which app was on the screen.) I'd say the speed boost is about 10-15% and it helps quite a bit for RSI, but it was a good year or two before I was back up to my previous Qwerty speeds and fluent on both keyboards, so it takes a while to recoup your investment. A decade and a half later I can say it was worthwhile, but don't expect miracles.
Short list:

1. Wear warm clothing: I'm very serious, this really helped me.

2. Got a Kinesis Advantage keyboard. Use normal mouse, but in left hand since right hand does more work (I'm right-handed).

3. Standing desk helps encourage correct posture for me(90 degrees in elbow, arms straight down in shoulder), but can be done at desk.

Longer version: https://codewithoutrules.com/2016/11/18/rsi-solution/