2016-04-30

Some things I learned about dealing with RSI

The first time had a painful RSI attack was in 2003. It was as if my world collapsed: I’d dealt with hand weirdness since the late 90s (twitches, tingles) but I didn’t recognize that as symptoms of RSI. When both my hands started hurting and even everyday chores like folding laundry turned painful, I started doubting whether I could continue my career in technology.

As it turns out, it is possible to deal with RSI, not be in pain and have a career that involves a lot of typing.

Things I (thought I) had gotten right before this started

I have always been kind of an ergonomics nerd, even before I knew that what I felt was RSI; so it was twice as hurtful that I was in pain when it struck, and everything seemed even more hopeless than it would already have been.

Before all this started, I’d invested in an expensive “ergonomic” keyboard (Kinesis Ergo Elan – I even took this to work with me), a trackball and a good swiveling chair that could be adjusted to fit my body; my desk was the best height I could get it, and the monitor was positioned such that my neck could be straight when I sat down.

I’m sure these things kept me going for a bit longer than if I hadn’t bought them (and hey, spending money on expensive stuff feels better if you can tell yourself it’s for your long-term health), however:

Mistakes I’d made (so please don’t repeat them yourself)

I sat in front of this setup day and night, working and writing. I did this for so long that I couldn’t sit up straight and had to pull my knees up to my chin so my body would not slump forward - my neck and shoulders were very unhappy with this, but this let me stay online for two hours longer. In the end, the only parts of my body not practically immobilized were my fingers and hands.

I had set up custom key combinations in apps and editors that resulted in my fingers stretching and reaching across keys a lot, and I used these very often. At times, my thumb and pinkie finger would be at opposite ends of their keyboard halves, which is pretty far apart on the keyboard I used most often.

Since I was so overworked (doing sysadmin work at a part-time job 3+ days a week, working on university courses the other 4 days, working on side projects, plus chatting on IRC and on forums), I didn’t think I could afford to take breaks or play any sports or work out, and so I just stayed at the keyboard.

What happened then

After one particularly stressful week of 3 homework assignments plus work plus an exam, I woke up with pain in my fingers, palms and arms. That pain didn’t go away for a week, which is when I saw a doctor. They told me what I’d suspected & feared: these were symptoms of RSI, and I would have to step back and stop working for a while. Argh!

They gave me some cortisone cream and a wrist brace, and told me to go to a therapy center to apply heat and electric pulses for the pain. None of these things helped.

I was out of commission for a month; while I wasn’t able to work on anything, I read through a 800-page volume on the atrocities of capitalism, so you can probably imagine the cheery mood that this set me in.

After that month, it was time to go back to work, but my fingers still hurt. So I put on the wrist brace while working and just typed less. Turns out you aren’t meant to do that, and doing it both breaks the brace and increases your pain.

What did help in the end

The real turning point in this ordeal was when I started actually reading about what people suffering from RSI can do about it themselves. These two books really helped me understand what I’d been doing wrong and how I could stop doing it & start doing something better instead:

Both have a great mix of background and exercises that help un-cramp the tiny muscle that you shouldn’t strain, and mobilize the ones that should actually do the moving. I highly recommend reading them both.

Here are the things I learned and did that helped me the most:

  • The small muscles in your hands really are meant for small high-precision movements. Instead of using them for everything, use the larger muscles in your shoulders, your back, and in your arms to move your hands in place on the keyboard. It’ll feel better and look more elegant - if you feel like you’re playing a piano, you’re doing it right.

  • Make sure you have good posture. At rest, you should have right angles in your hips and elbows. Shoulders back and back&neck straight. Look straight ahead and slightly down at your monitor. Laptops make this hard, so you may have to invest in a stand or a monitor, and in an external keyboard.

  • Take regular typing breaks. Get the computer to remind you about these breaks. On the Mac, Timeout 2 is good. On Windows and Linux, I recommend Workrave.

  • Set your break reminder to interrupt you briefly every 7-10 minutes and take the break to sit back, relax for a few seconds.

  • Set a longer break every 45 minutes to 1.5 hours, and take the time to stand up, walk and stretch. Get up and drink some water, your eyes will thank you, too.

  • Stretch in your spare time. Anything that opens up your chest or stretches your neck muscles is great. These Aikido wrist stretches feel amazing. As with anything else, do not overdo the stretches. You should feel a gentle stretch, never any pain or cramping elsewhere.

  • All this will mean you type a little less, so you’ll be very deliberate about what you type (this happens automatically!), and you’ll make fewer mistakes.

  • Once your pain is receding, build upper body and arm strength. It doesn’t matter what you do - hit the gym, do the 100 pushup challenge, do yoga, go rowing - anything goes. As long as you exercise your back, shoulders and arms, they will get stronger and you will be better able to keep a good posture, and make those large motions that help you type the right way. The key here is to not overdo exercise, especially in the beginning. You will feel like you have something to catch up to, but the way to improvement is by steadily putting in a little work so you get stronger. If anything starts hurting or going numb, stop and take a few days’ break and start doing something more gentle.

  • Get more sleep. Chances are you haven’t been sleeping well since the pain started, so you will need to sleep more to help your body heal. Exercise helps tire you out, so do some of that! (But again, don’t overdo it; or focus on muscle groups unaffected by RSI – e.g., go on bike rides.)

  • It’ll take a few weeks to months, and it’s very frustrating at first, but you will feel better.

You’ll notice that I don’t mention much specific equipment here. This is because you can achieve good posture and typing habits no matter what you type on. That said, if anything you use regularly gives you trouble, replace it! If your desk is too high, get a footrest and a chair that goes up enough so your arms are at a right angle. Find the setup that works well for you, and then build habits around that setup.

What happened to me since then

For the past (gosh) 13 years I’ve worked in IT, there were long periods where I was in no pain, but there were also stressful periods when RSI returned. These are the worst - not only am I in pain when this happens, but the whole set of old thoughts and habits comes flooding back: is this all worth it, will I be able to keep working on this thing that I love, let me just finish this one large project, etc.

When this happens, it’s good to take a step back and figure out what happened, then adjust any habits that I have formed. So far, there was always something that I could adjust that would help me feel better after a little while - most often, that’s a combination sleep, exercise and stretches.

Conclusion

If you suffer from it, RSI may seem like an unavoidable thing that can end your career. It is not. You can beat this, and you will feel a lot better by helping your body move the way it wants to move.

Please take care of yourself. <3

Categories:   Health