Computer & Phone Ergonomics – Until It hits you

Background:

RSI also is known as wrist tendonitis, carpal tunnel syndrome, down syndrome cubital tunnel syndrome golfer’s elbow tennis elbow and also many of the names. There is no single correct name it can be several factors of many like it was in my case. I suffered from many of them listed above. I was reading something regarding RSI and then I realise that this is correct work that ergonomics can be nothing until it hits you.
I have been using computers for almost my whole life. I don’t even remember when I was not using it for very long durations. I was 7-years old I started using computers so it’s been a journey of more than 22 years. I’m proper a computer nerd, computers and technology is pretty much everything for me. A few weeks ago that I was working on a project for a client, and I was spending more than 12 hours a day. In the start, I thought it was nothing and with the time the pain started bothering me. Until I couldn’t even hold a mouse for a minute. And then I thought ok I can just use the left hand, it went well for a week and now my second hand is also banned. This is the time that I am not in good condition. I did go to a doctor he diagnosed me and another doctor diagnosed me and another doctor diagnosed me I went through several tests like MRI and similar tests. And the result was nothing, just take it off for some time and you will be healthy. After about 8 weeks I realised now that agnostic from the doctors and the physiotherapy is not working.

I have designed this post for myself and also for my colleagues in the technology world who are or might suffer from this condition. Following help me and might help you. I’ll keep updating this post and keep adding content to that

RSI stands for Repetitive Strain Injury. It includes a whole spectrum of conditions, from tendonitis of the hand or wrist to carpal tunnel syndrome to cubital tunnel syndrome. Basically, if your hands or wrists hurt or go numb or tingle, that may be RSI. If these symptoms are associated with repetitive tasks, such as typing at a computer, it is almost certainly RSI. (Note that such symptoms do sometimes go away within a few minutes, hours, days, or weeks.) Other symptoms include losing strength or coordination in your hands, or perhaps dropping things.

http://www.rsi.deas.harvard.edu/what_is.html

How bad is RSI
RSI is potentially disabling. It can make typing, writing, eating, and even holding hands painful. It can last for many years, and you can get it in just a week, or even less.

How do you get RSI
The most common way to get RSI is too much typing with bad ergonomics. Writing or other repetitive activities can also cause RSI. For some people, RSI comes on suddenly. For others, it comes on gradually.

How do I prevent RSI
Take frequent rest breaks from typing, perhaps 1 or 2 minutes every 10 or 15 minutes. Do this even if you have something important due: when you are working long hours, it’s more important than ever to rest periodically.

Type properly: don’t rest your wrists while typing, but keep them floating above the keyboard. Don’t rest your hand on a wrist rest: use it as a reminder to keep your hands up. Don’t contort your hands to type key combinations like control, shift, or alt: instead, use the index finger of the opposite hand to type combinations. Don’t rest your arms on arm rests while typing.

Credits: Hooper’s Beta

Someuseful insights from the internet:

jacobolus on Nov 19, 2016 [–]
“RSI” from typing too much in an uncomfortable way or using bad equipment is too serious to brush off.For anyone reading here, if you’re regularly feeling any level of pain while typing, take an immediate break to figure out what’s wrong. If you let it persist it can do you serious damage.There are a number of ways you can relieve your symptoms. Scale back your typing and keep trying ideas until the pain goes away. If pain persists or if it is acute/severe, go see a doctor right away. A doctor can much better diagnose you than internet commentary.(1) Make sure your wrists are in a straight and neutral position while typing. This is in my opinion (having talked to many people with RSI and watched their typing style) the #1 contributor. Other arm/hand/finger position problems can also contribute, but keeping the wrists relatively straight and relaxed is the first most important step to take. Try to pull your keyboard in close to your body and tilt it so that its top is parallel to your forearms (the right tilt to use will depend on the height of your desk and chair and the shape of your body) and stop resting palms, wrists, or arms on a palmrest whenever actively typing (leave your hands “floating” above the keyboard, with just fingertips resting lightly on the home row). If the keyboard’s flip-out feet won’t let you get to the appropriate angle, try propping books or something under the near or far side, as needed.(1a) More generally, pay attention to your body, and try to notice any muscles/tendons which are statically loaded while you type. Ideally you should be able to be in a position where your muscles are mostly relaxed, and only being used to actually press the keys.(2) Try to avoid typing for too many hours a day, or for too long at a stretch. (Take a break to stand up and walk around a bit once at least every 45m or so. Go to the bathroom, make yourself a coffee, walk around the block, whatever.)(3) Examine your seat and desk. Try to make sure your back is as straight as possible and your arms are in a relaxed position. Consider switching seat positions at least a few times throughout the day. Most office workers have their desks set too high compared to their torsos (this is because standard office furniture was designed for medium-tall European males to write with a pen on paper, not for people of arbitrary size/shape to type on a keyboard). You can either lower your desk or raise your chair to compensate. Consider alternative types of chairs (e.g. saddle seats) or an adjustable-height (e.g. sit–stand) desk.(4) Try to eat a balanced diet, get enough sleep, exercise a few times per week, and avoid too much stress in your life. Obviously you should try to do these things anyway, but they can absolutely contribute to typing pain.(5) If those changes don’t help, consider changing your physical keyboard/mouse hardware. A split keyboard with sufficiently “tented” sides eliminates the need to pronate your wrists, as is required for one-piece keyboards. This allows the elbows to be brought closer to the body, the shoulders to be relaxed, and generally reduces static load on several tendons/muscles. Consider an “ergonomic” mouse, a trackball, a roller mouse, or similar, or try to eliminate extraneous mousing. Consider changing the keyboard layout to avoid awkward stretched chords (“emacs pinky”), or even get a Maltron or similar row-oriented keyboard. Get a keyboard with switches that actuate halfway through the stroke (not a standard rubber dome keyboard), and try not to smash the keys hard into the bottom of the stroke while typing – aim for a light, fluid “dancing” style of typing.
overcast on Nov 18, 2016 [–]
This article is totally missing the basics. Exercise. I promise it will make ALL the difference. Get yourself a pull-up bar, and if you’re feeling extra fancy, a dip bar.Push-ups, pull-ups, dips, and sit-ups. Every day. You’ll be a coding machine. At the VERY least, push-ups. Every hour or two, take a break, knock off ten push-ups, walk around a bit, get some water, get back to work. I’ll do this right at the office, often in the server room.A good chair helps, but all of this other nonsense is unnecessary. Exercise, and nutrition is the key to basically everything in life.As mentioned below. SLEEP.

mrexroadon Nov 19, 2016[–]
> Push-ups, pull-ups, dips, and sit-ups. Every day. You’ll be a coding machine. At the VERY least, push-ups.

ehhhh… years of daily pushups contributed to the slow shredding of cartilage in my wrist and two operations before i could type again.

but

> walk around a bit, get some water, […] SLEEP.

this. can’t stress enough.

Same for me. I am very thin, slim hands. My first smartphone nearly destryoed my hands. 1. Stopped using phone in subway. I used to look down – strain my neck. 2. 30 Pushups everyday 3. Once a week walk/run 5 km Fixed it.

Excersises & Streches

Start with hands:

Move Towards Wrists:

Streches Chart:

Trigger Finger

Many times the culprint is one of the finger which trigers it. In my case it was middle and index finger on both hands. Follwing activities greatly helped it:

Tennis Elbow / Mouse elbow

Golden: Yes, I also have along with other symptoms.

TMS Side

Tension Myositis Syndrom Angel: Many do have certain extent of pain mainly due to TMS. It is worth a try.

Intersting Case Study:


The doctor told me to rest and take ibuprofen, from day 1 to 6 months in. Using NSAID during early stages of the tendon injury according to some convincing research inhibits tendon collagen remodeling/healing. I don’t need to tell you how much worse it got by just resting, and the weakening that occured… I started doing extensive research, reading 100s of research articles and building up a “knowledge database”. I saw how few sufferers got better and how common the recurrance of symptoms were. I also saw how much of the research conflicted with what the doctor and PT had been telling me. It scared me enough that I got the same mindset as you; “I got nothing to lose, lets experiment!”. When I came across a youtube channel called ” Precision Movement by Eric Wong”, and his article and video about golfers/tennis elbow- thats when it all turned around for me. Without going too much into detail, he still confirmed many of the same principles I had suspected to be true after reading up on research, and from living with this condition for a while. Resting does not heal a tendon degeneration injury- tendinosis. The brain likes to “shut off” or give up on painful areas that are not being used ; scar tissue is laid down and the brain stops attempting to repair further. By loading and challenging the area you bring in nutrients through blood flow, stimulate remodeling and repair. Basically telling the brain not to give up on the area of injury. I started doing eccentric wrist curls again, this time with the knowledge that its supposed to produce some pain and that high frequency is key, contra to what doctors and PT’s had been telling me. I pushed through it and after only 2 weeks, I no longer had much pain during exercise, or abnormal pain post exercise. So 2 years of resting/careful exercise didn’t end my suffering, but 2 weeks of agressive eccentric work did. My exercise routine and daily activities were no longer limited by this condition. What I also realized after reading up and speaking to a manual therapist with experience treating overuse injuries, is that many can develop elbow or wrist “overuse” injuries because of poor neck or shoulder mechanics, poor posture. Even if the actual injury can be seen on the flexor tendon of the lower arm, the root cause isn’t necessarily “overuse” or loading the wrist flexors too much. It could be a predisposition due to compromised nerve or blood flow, or poor neck/shoulder mechanics/stability that creates compensation patterns with ripple effects down your arm. Many researachers seem to believe that forward head, unstable or internally rotated shoulders, or shoulders with decreased ROM can lead to golfer’s elbow. The brain also has a tendency to “limit” the power to the arm if the shoulder and neck isn’t stable or if nerve and blood supply is compromised, as a means to defend against injury. The brain doesn’t want you doing heavy work with your arms if the shoulder’s can’t support it, because it compromises the neck and spine- and the central nervous systems first priority is guarding the spine. The most common correlation I’ve seen is weak or dysfunctional integration of the lower traps and serratus anterior in patients with arm overuse injuries. This seems to be true not only for the deconditioned, but for veteran athletes aswell. This seems to be backed up by what you are suggesting- that conditioning and making sure your body further up the chain is balanced can often have a positive impact on recovering from golfers elbow. ~Joe from Norway.

Summary from an Amazing video by Dave MacLeod
1) Take ownership of the injury (8:10) 2) Be strong. Strengthen (condition) body, esp upstream arm/shoulder. (10:36) 3) Develop awareness. Note & listen to how your body feels. Adjust volume/intensity or session type accordingly. (13:27) 4) Don’t stop moving. Maintain steady level of fitness/activity without typical ‘Western’ prolonged sedentary tenancies (17:25) 4.5) Difficulty of identifying causal factor. Sometimes change of routine/scenery can help. Trial and error methodology. (21:32) 5) Rest professionally. Top quality sleep, nutrition, reduce life stresses (22:56) 6)Respect your circadian rhythm. Increase quality and duration of sleep. (23:16) 7) Keep training. Possibly do more! (25:36) 8) Do heavy resistance training all the time! Incl typical eccentric wrist curls with heavy load (some pain might be required) and high frequency (daily!) and possibly more modern evidence of isometrics. (28:21) 9) If its not working, keep searching and try again however its tricky to decide timescale for each protocol. Lots of the data is weak/uncertain, such a nuanced issue. (34:24) 10) Tendons are made from what goes into your mouth. Nutrition. Collagen synthesis from Glycine, Proline and Vit C (comments on the recent hype train for this) but he relies on mostly eats whole foods (39:05)Show less

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