Ask YC: What to do with repetitive strain injury problems?

That is what helped me when I got what sounds like pretty similar to you: Too much guitar playing causing left hand/wrist/arm problems. Unfortunately it still isn't entirely better, but fortunately typing doesn't seem to be a problem with it.

Sort out your posture, wrist/hand position when typing. I'm sure someone else can point you to decent information on this.

As far as getting better, I don't believe there is a magic trick. It all boils down to posture and taking appropriate breaks. There have been several discussions on HN about keyboards and desks [http://searchyc.com/keyboard] but it takes a while to find a keyboard that suits you well. I personally have gone through several keyboards and have come to the conclusion that I will have to spend the money to get a really good one.

The other issue, as I mentioned earlier, is taking breaks. Getting up from your desk at regular intervals is good both for your arms, and back as well as your eyes. There are a variety of exercises you can perform while at your desk [http://tinyurl.com/rttqm].

I haven't used any speech recognition software, so I am afraid I can't help you there. In all honesty though, catching this early and doing something about it helps.

Good luck and I wish you well.

ymmv.

I mean this quite seriously. I've consciously tried to make Arc easy to type.

If you are not use to typing on a split keyboard, I would switch to that first, and than to the Kinesis as it can take a few days to get use to. I also use a Logitech Wireless keyboard for gaming purposes, and due to numerous people trying to do a quick google search on my computer and spending half an hour trying to figure out the keyboard.

It's a bit expensive, although you can pick up a slightly used one on ebay for less (that's what I did). However if you think of the amount of time you spend typing and the fact that it is your career $300 is nothing.

Also, I stopped playing guitar for the most part :( because there's just too much overlap in muscles (I guess).

Really, the only answer that works long term though, it just get off the computer. If you're having withdrawl problems (I certainly did) order a whole load of good [computer] books.

I have continuing RSI myself, but I've gotten it to the point that it's manageable. Here's what helped me:

- Less stress, more happiness. This was probably the biggest issue for me. Stress made everything worse. Do whatever you need to do to get happy. I quit my job and went on vacation for a month. I also became less willing to do things that made me unhappy.

- Less typing. A lot of people just can't type 12 hours a day, everyday. Come to grips with it, and put yourself on a schedule. Find other things to do. Cut out non-essential typing like IM, etc. Take regular typing breaks. If you can, take some time off and don't even look at a computer for as long as possible.

- More exercise. I'm not sure it even matters if you're exercising the problematic muscles. Just improve your overall health.

- Goldtouch keyboards. These split into an A-shape, so I don't have to pronate my wrists while typing, which was a problem for me. I tried a lot of keyboards, and these are the ones that helped me. Go ahead and spend a bunch of money trying unusual keyboards and desk setups, it's worth it.

- Acupuncture seemed to help a little. I tried pretty much everything anyone suggested. Most other wacky alternative medicine didn't help.

- Tiger Balm. Excellent tingly sensation! Also seems to reduce swelling, which was causing problems for me.

Here's what didn't help me:

- Wrist stretches. I think these may have actually made things worse for me.

- Chiropractic. This made impressive popping noises, and produced no other effects I could discern. Also, it has an adjective for a name.

- Dvorak. The Dvorak layout is designed for speed, not necessarily wrist health. The independent finger movements needed to hit those home-row vowels hurt me bad.

- Doctors. I recommend you see one, but in my case they weren't very helpful. I was diagnosed with CTS, but reading about it, my symptoms didn't remotely match. Wrist braces did nothing. Physical therapy did nothing. Maybe I didn't see very good doctors.

- take frequent typing breaks -- even 10 to 15 second breaks work wonders.

- stay happy and relaxed, stress is bad. Also, RSI pain can increase stress. Breaks and a chill frame of mind help address this.

- massaging the fingers/wrists under hot tap water first thing in the morning and several times during the day. this feels great and helps focus your mind on relaxing the muscles.

- anti-inflammatory drugs (your doctor may want to prescribe one to help the healing)

- don't pound on the keys. My years using an "M" keyboard got me pounding them pretty hard. I've had to try to unlearn this technique and just use a softer touch.

They monitor your computer usage and lock you out at regular intervals, so you can have a break, and relax your arms/hands/fingers. Works for me.

http://www.workrave.org/ http://tech.inhelsinki.nl/antirsi/

1. Microsoft split keyboard

2. Dvorak

3. Wacom tablet instead of mouse

i would add Vim but i'm not sure it helps with those things. it's certainly more efficient for code editing. anyways, i haven't had so much as an inkling of pain in years

How much of your time in front of the machine do you spend thinking, as opposed to typing? You may find that you can drop your typing speed significantly while having a negligible effect on your overall productivity.

You didn't mention which hand you used to mouse. If you mouse left-handed, try switching hands. I did this - the first few days are hell, but after that you'll be able to mouse effectively enough with the other hand.

The body will handle a lot if it is well maintained.

But it needs a specialist, and the people who work with musicians are the top of the field.

Also I have been using (on and off) the DataHand keyboard, which is wonderful for English text, but unfortunately inconvenient for programming because symbols are a pain to type.

Also personally I'm one for using a laptop so you can get pretty comfy in a ton of positions - lying on bed, lounging on a sofa, lying on the floor, sitting at a table (Rarely).

1. Get a split keyboard and make sure your wrists are straight when you type. For best results, get a FingerWorks keyboard on ebay and learn to use it. Stop using laptops at all.

2. Type less. Seriously. Turn on dabbrev-mode in Emacs, use SLIME completion when coding Common Lisp. Find a solution. Code the hell out of your editor (Emacs exceeds here). And don't participate in silly online forums.

3. "RSI" doesn't mean anything. Go see a doctor. Your pain could be tendons, muscle, nerves, or joints. It was joints in my case. If you can, see a doctor that specializes in treating sports injuries.

4. Dictation works for E-mail and documentation, but not for coding. If you want to use it, buy Dragon NaturallySpeaking (or MacSpeech dictate, same engine), forget everything else. Then get a microphone that costs at least $100. I use a Sennheiser ME3 from emicrophones. If you can't spend that kind of money, forget dictation.

In my case, cryotherapy, anti-inflammatory medication and typing less helped. If I'm careful, I can now work normally, but I still have to be careful about the amount of typing that I do.

You'll also learn that when you type more slowly you can still get as much done because your mind has more time to think the problem over while you're typing the code you've already decided you are going to type.

You'll start to notice the little stresses you've learned to ignore and every time you notice a little bit of stress you'll adjust your movement into a more gentle way of interacting with your computer.

As you do this more and more you'll find that your shoulders start relaxing, your neck becomes more relaxed; your breathing slows down and you adjust your computer so that your arms feel featherlight and then your wrists start moving in more fluid movements and your fingers start moving across the keyboard with less resistance until the point at which you might notice that the only stressor left is the tactile pressure of your keyboard and the curvature of your wrists; and then you're ready to try out the keyboard that works best for you and your problems are gone.

When you do this it will become automatic and you'll learn to speed up and slow down back into this mode whenever you feel stress building up again.

Anyway, I tried everything, new keyboard, different chairs, vitamins, rubs, Dragon Naturally Speaking, you name it. I even had a kind of pulpit built for my computer so I could work standing up. Since not being able to work would have been a death sentence for me at that time, I spent well over $1000 on this stuff. But none of this really made any difference.

Then, I sat down and thought about how the body works, and all I knew about medicine and biology, and I worked out that the wrist pain was caused by poor muscle condition. So I started exercising my upper body, particularly my arms as someone else pointed out above. That nailed it!

Within a matter of days, all pain went away. I mainly concentrated on standing pushups. Because I'm a woman, I have almost no upper body strength, so I could barely even push myself off the wall on a 25 degree incline. But gradually, doing this very gently every hour or so, I started to increase the incline and get more movement back.

Now, I don't have any pain or problems at all unless I really spend 12 hours in front of the computer. Then, if I get even so much as a twinge, I do the above routine for a day or two and all pain goes away again.

-main thing is to force yourself to use a posture holding your shoulders back and your head / neck back. Laptops are the worst because they force you to look down. As I understand it, the wrist pain is actually neck pain, shoulder pain, arm pain and wrist pain. Your neck, shoulder and arms unconciously make adjustments to relieve pain and the wrist bares the brunt of it because it cannot adjust and pass the pain down the line anymore.

-indoor rock climbing (bouldering) about 20 times helped a ton. I don't go anymore, but the stretching and strength building helped a ton.

-going to yoga about 10 times help also.

-I still don't mouse with my right hand, left only.

The #1 thing for me is to not look down toward the monitor and hold your shoulders and head/neck back. When I read about holding my shoulders back, I did it for 2 days straight and had extremely sore back muscles the next day. The sore muscles got better in a few days and the difference was huge.