The human body wasn’t evolved to work in front of a computer for 12 hours a day, and so it’s no surprise that a lot of people have physical problems as a result of such work. I’ve been dealing with tendinitis in my wrists, forearms and elbows since I was 17. It’s always been a frustrating thing, struggling with a device that plays such an important role in my life.
To be honest, computers and I really have a love-hate relationship, but my repetitive stress injury (RSI) is something that I’ve learned how to deal with, and have been able to enjoy a productive career as a software engineer. By consciously taking care of it, I can still do all the things I enjoy, as long as I stay conscious of my limitations. Over the last several years I’ve learned a lot about what works best for me and figured that it really couldn’t hurt to share it with the world. Obviously your mileage may vary, but hopefully you can find a few nuggets in here that may help out.
Disclaimer: I’m not a doctor. Tendinitis is not the same as carpal tunnel, although they can have similar symptoms. Some of these techniques may help with carpal tunnel, but I’m simply explaining what works for me, and my particular situation. Your mileage may vary. Please don’t sue me. If you have a real problem, talk to a doctor. I did, and it was a great starting point for me.
Part 1: Posture and Computer Interaction
The most significant thing you can do to improve your tendinitis is to improve your posture. There are many aspects of this, but the most important principle of it is to relax your body while you work, to reduce the strain and tension. A key point to note is that everything involving your posture affects everything else in your body. Minuscule, barely noticeable muscle movements and tension will compound, and your tendons will make sure that you notice it. Slouching or staying in unsupported positions for extended periods tends to wreak subtle havoc on your body. The most interesting thing about your body is when it comes to structural problems, what hurts is usually not the root cause of the pain. In your case, if your desk job strains your wrists, there may be other contributing factors which if improved could help your wrist problems.
Chair and Keyboard Tray
Getting your chair well adjusted and comfortable is incredibly important for keeping your arms/wrists healthy in the long run. A keyboard tray is also a worthwhile purchase to help achieve a neutral position. From the ground up… When sitting, feet should be evenly planted on the ground, ankles should be roughly perpendicular to the ground, and knees should be at about 90 degrees. This may require adjusting your chair. Your back should be straight, but relaxed. Think “sitting up straight” but make sure not to overdo it, as you want your body relaxed, not rigidly trying to hold a position. Adjust your arm rests so that they are just supporting your elbows. Make sure NOT to use them to support your body. Resting your body weight on your elbow rests can lead to muscle fatigue in your shoulders, chest and neck. Move your keyboard tray so that it is roughly even height with your arm rests. The goal is to be able to keep your hands and wrists in a relaxed, neutral position. You should be able to use your keyboard and mouse without cocking your wrists in any direction. This may require you to change the angle of your keyboard tray. When you have your workstation reasonably well set up, take a moment to close your eyes, relax, and pay attention to your muscles/body. If you sense that your muscles are tensed or flexing anywhere, that’s a good place to start. No matter how minor, any muscle tension compounds and can lead to aches through prolonged use. Tweak your setup to reduce your muscle usage, especially when typing or moving your mouse. Note: If you normally keep a wallet in your back pocket, try taking it out when you are at your desk. You’d be amazed at how much the asymmetry messes with your body.
Bigger is better. The more screen space you have, the less you will be moving windows around, scrolling, resizing, minimizing, etc. I consider dual 22” monitors the bare minimum at this point. On top of ergonomics issues, studies have shown that having a second monitor improves productivity by up to 40%, depending upon the type of work you do. If you do go this route, take the time to position them in a way that is comfortable for you. Stack them on top of books and magazines to get them at the right height if need be.
The crappy keyboard that came for free with your computer was never meant to be ergonomically friendly. It was made to simple and cheap. Try something that was designed to be more wrist friendly. Split “natural” keyboards are relatively inexpensive and easy to find, and may be able to keep your wrists in a more neutral position. Everyone is different, so being able to try a few different keyboards might help with your decision. If you are willing to explore a more exotic route, check out products by Kinesis (http://www.kinesis-ergo.com/). Since trying it, the only keyboard that I will touch is their Advantage model (http://www.kinesis-ergo.com/advantage.htm). The downside is that although this keyboard is amazing, it is also a $300 investment (double Ouch for work and home). Worth the money for me, but it will depend upon your situation. If you are interested, I know they have a 60-day money back on their stuff if you want to give it a try. I own 2 and don’t think that I could stay in technology industry without them.
I personally use the Kensington Expert Mouse (which is actually a trackball). Once again, that cheap mouse that came for free with your computer is exactly that. Cheap. Check out a bunch of different mouses at an electronics store. If your wrists are as fussy as mine, you may even have to go to a few stores before you find something that feels “right”. Make sure that you check out mice and trackballs, as everyone is different. Even the angle at which my trackball sits on my keyboard tray affects my wrist fatigue. For me, mice are the devil, and thumb trackballs are even worse. Index finger trackballs, however, work and the Kensington Expert Mouse in actually quite comfortable for me. Once again, ergonomics is expensive and that one runs around $100. If you have a laptop, using the trackpad can put a lot of strain on your wrist and forearm. For prolonged work, I’d reccomend a more serious mouse. Also, due to their weight, wireless mice can be quite aggravating to your wrist, so try to avoid them unless you need them. If trackballs aren’t your thing, there are a lot of somewhat exotic mice out there for ergonomics. Google “ergonomic mouse” and you’ll find a ton of interesting solutions.
Get your laughs out. I’ll wait… All better? Although it will probably inspire super-nerd jokes from co-workers, a foot pedal has become an essential part of my computer setup. Kinesis sells a 3-pedal switch that attaches to their Advantage keyboard. Each pedal can be mapped to a different button. Personally, I mostly use just one of the pedals, but it is mapped to the Shift key, and I find it absolutely invaluable to reduce the amount of finger acrobatics and awkward movements required to type capital letters.
I usually work with a wrist brace on my right hand, as mousing takes the greatest toll on my wrist. This is especially helpful on “tired” days (where your muscles may get lazy) to keep your hands in a healthy position. If you go this route, be prepared with an answer to “What happened to your hand!?!?” because you will get it a lot from everyone that sees you looking like a cripple.
The level of nerdery going on here puts most Star Trek conventions to shame, and I haven’t even started evangelizing Dvorak yet. On the other hand, if your day-to-day job involves heavy computer use, and it’s been taking it’s toll, there is a lot that you can do to stay healthy. Improve your desktop setup, and stop slouching. Now. Maybe even leave yourself a post-it note reminding yourself to fix that crappy posture. Hopefully this was helpful, and if not, then I don’t know why you are still reading. I’ll be writing a follow-up post next week outlining stretches, massages, and physical techniques that can do wonders to revitalize your wrists. If you have any questions, feel free to leave a comment, and I’ll follow up on it.