Preventing computer-related RSI

Today  new type of  computer related workplace injuries are on the rise, and one of the most commonly reported injuries is elbow pain from computer use. Which is often called mouse elbow.  The second, less frequent disease is Carpal tunnel syndrome

When you work with mouse and keyboard eight hours or more each day it can cause problems for your health, especially for people after 40. Many people develop RSI in their mouse hand. This is a choric condition that restrict your activities. Pain typically is limited to certain movements. But the danger should not be underestimated.

The rules of avoiding computer-related RSI are very simple: Pay attantion to your tendons health by doing simple exersized during the day, do not overuse  computer, use optimal posture, improve your technique, use ergonomic equipment to the max, while limiting the load. 

Learn to use alternative hand as even a week of rest often produce dramatic ostive effect. Swimming also often help. Ping-pong also might be useful.  Tennis and gold are not: they can produce similar symptoms on their own.

Try alternative input sources such as speech recognition. But all of those advices are easier said that done, especially if you work in a stressful environments Unis system adminitrators and some categories of programmers often do.   Don't be afraid to ask about better accommodation. For example 1" think memory foam mats on which you can rest you elbows can be helpful, at least psychologically (and it is very important that you elbows are rested on a surface and are not "in the air" ).  Elbow support strip is also useful and does provide some relef id wered correctly. If you boss is scregy buy a pillow made from memory foam and cut appropriate slices yourself.

It is also important that computer should not be you primary hobby outside of work. So more healthy habits can help.

Here is a relevant quote from Repetitive Strain Injury How to prevent, identify, and manage RSI

The three primary risk factors are poor posture, poor technique, and overuse. These topics are discussed in depth in the section on prevention. In addition to these, there are several other risk factors to be aware of. While they may not cause RSI on their own, they can increase your risk if you already possess one of the three primary risk factors. The following list (adapted from Pascarelli and Quilter) lists several risk factors. You may be at risk for developing an RSI if you:

• Have arthritis, diabetes, or another serious medical condition
• Have poor posture
• Have poor technique
• Don't take regular breaks
• Use a computer more than two to four hours a day
• Have a job that requires constant computer use, especially heavy input
• Don't take frequent breaks
• Are loose-jointed
• Don't exercise regularly
• Work in a high-pressure environment
• Keep your fingernails long
• Have an sedentary lifestyle
• Weigh more than you should
• Don't sleep well
• Are afraid to ask for better accommodations
• Won't accept that you are at risk when you really are

Consult Pascarelli and Quilter for further information.

At the same time RSI is  a catch-all term that applies to several medical conditions including Mouse elbow (or golf elbor -- Medial Epicondylitis ) and carpal tunnel syndrome:

• Mouse elbow which is a variant of golf elbor -- Medial Epicondylitis is probably the most  common. It often does not typically produce much pain but it is very unconfirable as some  sypical hand  movement are now painful, and it is very difficult to get rid of, especially if it entered chronic stage (and that's unfortunately is the most typical case for programmers and system administrators, especially younger one).  As "nothing helps" people often stop doing anything about it. That's wrong. If you are a programmer or system administrator you really need to educate yourself about this disease as this is a "professional decease" so to speak.  Treatment is possible but requires a lot time, patience and determination on your part. Typically the disease  just does not want to go away no matter hard you try. But that does not mean that you stop trying. Gradually you will learn your hand better, and be able to determine which mucles and which tendons is affected (often index finger tendon is the only one that is badly affected and pain remain for a long time).  that will allow you to put compression strip more precisely. Also it will permit you to do self-massage which is another "must do". It is important to understand that as soon  as the disease entered chronic  state (pain is present for one month or more; or returns in short period of time after initial treatment) there is no any easy remedies. Here we are talking another several months of dedicated efforts, change in work style and work habits, physiotherapy and much more. Nothing can be done  in several weeks. The disease is really sticky. The first step is getting foam mats and elbow strip. Also you need to warm up your hand before work session in the morning and do some exercises and massage after lunch and in the evening, after you came home. That's a minimum regime. If you have more or less severe case you need more, much more efforts and determination. See  Mouse elbow for more details.
   
• Tennis elbow is a misleading term because a lot of people who have it did not get it from playing tennis. The True Tennis Elbow is more properly described as Tendonitis of the wrist extensor muscles. The primary cause of this condition is repetitive stress of your forearm, which leads to pain over the outer portion of your elbow, possible tendon tears, and reduced strength. this is another, less frequnt variant of  Mouse Elbow  and it is usually easier to cure.
   
• Carpal tunnel syndrome. It is most serious and most difficult to treat condition. You may well know someone who has had it or is off on disability because of it, but don’t understand what it is, or even think you may get it too. The nerve that passes through this narrow tunnel to reach your hand is called the Median nerve. This narrow passage between your forearm and hand is what is called the carpal tunnel. The carpal tunnel is normally quite snug and there is just barely enough room in it for the tendons and one nerve to pass through it. If anything takes up extra room in the canal, things become too tight and the nerve in the canal becomes constricted or "pinched". This pinching of the Median nerve causes numbness and tingling in the area of the hand that the nerve goes to.

See some interesting discussion at Anyone else here have killer tendonitis in your mouse arm

There two standard path that help to prevent and reduce computer-related RSI:

• Changing work habits. for example just buying quars sand clock can help you to stand up and do one ot two exersises for you rwring periosdically.
• Improving your equipment, and using macros to lessen the load.  

Changing work habits

In many cases RSI is self-inflicted wound. For example cradling telephone between the shoulder and the ear so that you can talk while you work with your keyboard and mouse is "a recipe for disaster". Working with mouse only when  your elbow is firmly positioned on your desk or on the arm of your chair if it is level with your desk is also important.

Improving your equipment

As for improving your equipment there are several areas where you can get positive result with minimal investment:

• Reassign Left  Ctrl key to CapsLock  This is well known defect of PC keyboards and Windows allow to fix it in registry.  This gives you the ability to conveniently press combination ion like Ctrl-C, Ctrl-F, Ctrl-H and other.  Pressing them with much less efforts helps to diminish pain and inflammation.  On some laptops you need to move keys like Home/End and PgUp/PgDn to less retarded spots. You can do it with just Windows via registry using SharpKeys or similar  utility. Again, this is a well known design defect of PC keyboards
• Using gel mouse wrist pad is a a must. Switch to mouse that is comfortable to use with fingertip grip (challenging proposal if you have small hands). 
• Change your mouse pad. Thin cutting PCB board with a color picture (matte often does not work with less expensive mice (but works good with those that advertize working on grass), but it can be made OK by squeezing a paste from a ballpen on it ;-).  "Flexible" cutting boards with pictures are another option. Mouse slides smoother on PCB boards with much less effort. And they are cheaper then plastic gaming pads. For example Corsair Vengeance MM400 Hard Plastic Edition Gaming Mouse Mat. There are also special gaming mouse pads including some aluminum.  They cost more but also can be competitive with PCB boards. One example is SteelSeries SX Gaming Mouse Pad (Black) Electronics
• Change your mouse to a better, more convenient model. Often programmers use really ancient models that hurt their wrists and arms.  You might  considering buying more expensive but more capable mouse that will provide more help in doing your job. Industry produced really decent models for gamers. Logitech line of G-mice is a good start. Logitech Wireless Performance Mouse MX also can be considered to right handers.
• Changing your position while using mouse and keyboard. Select one that feels comfortable and allows you to keep your arm in a relaxed position. You might need to change your chair, table or both. Regulated high of the chair is now standard but many people do not use this capability. Use it and position your chair so the your arms are comfotable
• Use macros for typical operations to diminish number of keystrokes and clicks you do daily. Even a couple of simple macros can get dramatic improvement in this area.  Using macros is powerful way to reduce your stress load. It is possible only with programmable mouse and keyboards that are provided with special drivers, or by using a programmable keystrokes macro players like open source program AutoHotkey . The latter is less reliable (aka somewhat buggy), but much more powerful tool. Some Logitech keyboards like  Logitech G510s Gaming Keyboard allow to use LUA for creating macros.
• Get the second monitor. The number of keystrokes and clicks generally can be diminished by using two monitors instead of one.
• Get a countdown timer and put it before your keyboard. that will force you to do exercises each, say, 30 min.

Behavioral changes

• Avoid common bad habits. see 10 Simple RSI Prevention Tips

• There are three pieces of equipment that require special attention:
  1. Keyboard: positioned above your thighs, you shoulder be able to reach the keys with your elbows at your side and bent at 90 degrees, and your forearms roughly parallel to the ground. If your elbows are at more than a 90 angle, it will surely tire you out quickly.
  2. Mouse:  Learn to use macros and get  a good capable model, that may cost $20-$30 more but provides more and  better buttons and better macrocapabilities. See High End Programmable Multi-button mice
  3. Monitor: directly in front of you (not off to the side), such that your eye level is somewhere between the top of the screen and 20% from the top. The screen should be about 15-25 inches from your eyes.
   
• Spread the load from the injured hand to another, use your non-dominant hand more frequently. You may try to use mouse by other hand some days a week. It's actually pretty easy to learn to use mouse with your left hand. Just not overdo it.  Create two working places in your house and change from one to another. if you work a lot form home.
• Change shopping habits because you can't carry as much you used to in your dominant hand.
• Play less tennis or golf

NEWS CONTENTS

• 20130621 : No More Mouse Meet the Future of Computers Oldest Sidekick ( No More Mouse Meet the Future of Computer's Oldest Sidekick, Jun 21, 2013 )
• 20120315 : 9 Tips for RSI Prevention ( May 30, 2010 )
• 20100530 : The Handshoe Mouse - First Impressions ( The Handshoe Mouse - First Impressions, May 30, 2010 )

Old News ;-)

[Jun 21, 2013] No More Mouse Meet the Future of Computer's Oldest Sidekick

Anyone with a smartphone or tablet, of course, can tell you that the end of the mouse is nigh. Consider Mycestro, the new Kickstarter-funded "3D mouse" from entrepreneurs David Greenspan and Nick Mastandrea. The Bluetooth-enabled device clips onto your index finger, letting you control your cursor with simple gestures. Imagine Tom Cruise in "Minority Report" flipping through screens with a flick of his hand; that's essentially what you would look like giving a presentation on your laptop or an Internet-enabled TV. Setting up the Mycestro isn't much harder than setting up a wireless mouse.

It's also extremely mobile. Even people who prefer not using trackpads are loath to bring a mouse into their local coffee shop. The Mycestro, which weighs about as much as a wireless earpiece, solves this problem by fitting easily in your pocket. Yes, it's convenient, but will consumers want to look like they're conducting an invisible orchestra while web-browsing? Early signs are positive: the Kickstarter project looks poised to smash its goal of raising $100,000 by Friday, March 29.

At only $79 during pre-order, it's in the same ballpark as a high-end wireless mouse - not cheap, but easily affordable for the motivated early adopter.

... ... ...

Mycestro is only one of the many nails in the mouse's coffin.

The Kinect, a motion-sensing device originally sold as an accessory to Microsoft's Xbox 360, has found robust demand among computer researchers and roboticists. It's not hard to imagine a variation of it interpreting voice and motion commands for all PCs in the future.

Tobii's Gaze technology wowed reporters at CES as they controlled an asteroid-blasting spaceship - with their eyes. Just attach a small bar to the bottom of your Windows 8 PC monitor and shift your gaze, stopping to concentrate on whatever you want to open or enlarge. Currently selling for $995, the Tobii Rex is meant mainly for developers, but that doesn't mean a more-affordable version isn't on the horizon.

[Mar 15, 2012] 9 Tips for RSI Prevention

May 30, 2010

You've read a dozen times about good posture & wrist position, but else can I do? We put together a short list of [creative] tips.

1. Swap out your keyboard & mouse 3 times a day. This one comes from some Google engineers who have a daily rotation of peripherals. This forces your hands into more of a variety of hand positions which is quite beneficial. Remember, we're trying to make what you do all day less repetitive.
2. Stretch more than just your forearms. A lot of problems higher up in the arm & shoulder areas manifest in other areas like your wrists (think about how acupuncture needles are placed in other parts of the body than the area in pain). A full range of stretching [yoga is excellent] in the upper body can make a big difference.
3. Non-smoking smoke breaks. You don't have to be a smoker to have an excuse to step outside!
4. Pay attention to your posture when you go to sleep. Are you curled up into a ball or stacking 3 pillows for your head at night? Good posture increases circulation, which [in theory] helps you extremities heal. Sleep accounts for 1/3 of your day, so give it thought around the clock.
5. Create macros for two-key keyboard combinations. The fewer keys you press, the less stress on you fingers right? For example ctrl-C [copy], ctrlX [cut], ctrl-V [paste] can all be made single keystrokes by various keystroke macro programs out there, or by specialty keyboards such as the logitech g13/g15. We did a writeup on using the g15 to consolidate key combos to a single button here.

[May 30, 2010] The Handshoe Mouse - First Impressions

The buttons are very solid and have a nice click to them. If you have severe 'trigger finger' then you might want something with a softer click. I will say the right button is softer than the left, so it might be a manufacturing inconsistency. The scroll wheel is the same story. While it's has an excellent feel and is very high quality, it doesn't exactly glide like butter like some mice. This is a mouse oriented towards relieving wrist pains & hand aches more so than trigger finger. For people with both trigger finger and wrist problems, you might consider this mouse in conjunction with perhaps a foot pedal for the mouse click.The verdict? I like it a lot. The build quality is excellent and it has a nice weight to it. The downside is that it costs $130

... ... ...

Update: It's now been 3 months since I initially wrote this post. So far I think this mouse takes the crown in effectiveness against RSI. My wrist pains have mostly subsided and my fingers aren't cramping like they used to. It strikes a great balance between a vertical & horizontal mouse. I'm starting to think there's something concrete here, like this mouse might be the magic bullet. It's pretty funky & gets a lot of comments from my coworkers, but if you're not afraid to be different and you're serious about your RSI, then this mouse should be near the top of your list.

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