Typing Injury, or Repetitive Stress Injury (RSI) refers to a wide range of problems, of which Carpal Tunnel is the most well known. All of the people I know who have RSI developed it from using computers. Their symptoms involve some sort of pain in the hands and arms when typing and using the mouse, and generally end up making many daily activities painful or impossible. For instance, many people have trouble carrying groceries.
I had RSI for over 4 years. The main thing I learned is that there are lots of different kinds of RSI, and that what helps one person may not be at all helpful for another. Most people get better by changing the way they work on the computer: one friend uses a trackball, another uses a trackball but positions it backwards, so that it slopes away from his hand. I personally find trackballs to be terrible.
You might want to look at the Typing Injury FAQ Home Page.
I would recommend finding people with your particular symptoms and learning what works for them.
My main symptom was pain in my forearms. My forearms always felt tense and spasmed. If you preseds the underside of my forearm, you could feel that all of the muscles were tight and clenched. I had problems with both arms. When my symptoms got worse, Iwould feel pains in my hands, wrists and elbows. The pains would be aching, and occasionally sharp. It never got so bad that I would wake up at night.
Certain activities are particularly bad. For instance, flipping through a stack of business cards could cause my forearms to seize up. Carrying a cup of coffee or an umbrella was difficult. However, carrying with arms hanging straight down, not bent, felt ok. The problem seemed to be related to muscles and nerves in my neck and shoulders. If I twisted my head in certain ways, I could feel a shooting pain down my arm that hurt in all of the places that my arms hurt when my symptoms were bad.
|1. Putting the keyboard in my lap|
I got a lap board from TAP Plastics that is about 3/8" thick. In addition to holding the keyboard, it has a larger area to the side for the mouse. This lets me type with my arms hanging straight down from the shoulder, with elbows bent at about 90°.
An adjustable keyboard tray attached to a desk is even better than a lap board, since you have to find a place on your desktop for the lap board whenever you want to stand up. I tried one that had too many metal parts underneath, so I couldn't lower it sufficiently close to my lap. I now use a Banana board, and it's great.
|2. Getting a good chair|
I got a good chair from Soma Ergonomics, Inc. (800) 836-9130 or (408) 988-6458. It is called the Soma Bioform chair and costs $285. They have several different sizes of backs, seats, and heights, so you can get a custom chair that is the right size for you. The chair helps me sit with good posture, rather than slumping, and keep my shoulders relaxed. It's important to be able to lower the chair enough so that my feet are flat on the floor. I also find it important to have a chair without arm rests, since hunching my shoulders and resting my elbows is bad.
|3. Using the Kensington Thinking Mouse|
Kensington makes high quiality mice, both for Mac and PC.
Probably the worst thing for me is dragging the mouse with a button held down. The "Drag" feature on the Kensington mouse is truly great for me.
On a Mac, I use the front left button for Click, and the rear left button for Double-click. The front right button is Drag, and the rear right button is Application Menu.
On a PC, I use the same settings, except that the rear right button is the standard PC right button.
I clean the mouse frequently. If you move the mouse and it sticks at all, you will tense your muscles in the worst way. The instructions that come with the Kensington Mouse are excellent: wash the ball in soapy water, and dry with a lint-free cloth. Clean the inside of the mouse with isopropyl alcohol and a cotton swab. Sometimes you need to use a pin to remove lint from the rollers. If you notice that the mouse is always "catching" as you roll it, check to see if the little circular teflon pads on the bottom are nicked or folded.
I never use a mouse pad -- the desktop or lap board surface is always better. At worst, I tape a piece of cardboard (from the back of a pad of paper) to the desktop.
You can't get the Thinking Mouse any more. I have yet to find an ideal substitute. I currently use a Kensington PocketMouse Pro on a Mac and a Logitech Bluetooth Mouse on a PC, but the Logitech doesn't let me drag and drop with two clicks.
|4. Taking frequent forced breaks|
Working for long stretches of time is very hard on my forearms. I wrote a program (called Restie) that forces me to take periodic breaks. During the breaks, I hold my hands over my head and shake them out. Or, keeping my elbows at my side, with my elbows bent at 90°, I stretch my arms and chest by rotating my forearms outwards as much as possible.
A physical therapist once mentioned that if you are sitting with your hand on the mouse while you read something on the computer, your hand and arm muscles remain poised and tense. Learning to immediately place my hands in my lap when I'm not actively using them has been helpful.
|5. Keeping my arms warm|
I got a pair of leg warmers at a ballet store. I wear them on my arms, from my wrist to over my elbows. In the winter I sometimes strap a heating pad around my forearm.
In physical therapy, I tried hot-and-cold contrast baths, but I find that just hot gives me the best relief. I often soak my forearms in a sink of hot water in the morning.
|6. Relaxing and adjusting my neck and upper back|
This hasn't, in fact, really helped. But I still believe my neck is a large part of my problem, so I continue to work on it. I had bio-feedback training to teach me to relax the muscles in my arms, neck, upper back, and lower back. I don't know whether it helped. I spent a couple of years getting weekly massage therapy neuro-muscular, myofascial, and rolfing. I like all of them. They are helpful at forcing the cramps out of my forearms. I had several months of chiropractic work, and now I frequently flop my head from side to side, in an attempt to get by neck to pop and relax. I have the belief that this is slowly making improvements in my posture and neck alignment, and that it will eventually make me feel better, but I'm hard pressed to justify this belief.
After several years of caring for my arms, I now feel that I am better. I generally no longer have pain from typing. I can get some symptoms when I am programming extensively, and I then quickly become careful (i.e. take lots of breaks), but my work routine these days does not involve long stretches of continual typing.
After 3 years, I became disappointed in doctors. My doctor said I had tennis elbow. Then why the forearm pain, and only occasional elbow pain? He didn't have a good answer to that question. He also told me to stop riding my bicycle. It's not easy to give up my main form of exercise, but I did for a year. There was no improvement. But in recognition of their good intent, it is true that my doctors did insist all along that I should take active responsibility for getting better, whereas I just wanted them to do something and fix me.
I think part of the problem is that the California Worker's Compensation system limits what doctors can do. My doctor told me that he can not prescribe ongoing massage therapy to help with my pain. He can only prescribe treatment that will lead to a cure. However, he doesn't know of any cure for my condition.
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