How I Beat Repetitive Stress Injury

Early in 2005 the muscles in my forearms started to hurt. In the beginning it was only a slight irritation, but over the course of about six months it gradually got worse, until it was so bad I actually thought I would have to switch careers  and stop programming altogether. I realized fairly quickly that I had RSI – Repetitive Stress Injury. Fortunately, through a combination of actions, I managed to get rid of the pain, and I am now completely recovered.

After about a month of pain I went to see a doctor. He thought my joints were inflamed, and gave me anti-inflammatory pills (which did not help). A little later I went to see a specialist, and after some tests he concluded that there was nothing wrong with the nerves in my arm. However, he could not answer how I could get rid of the pain.

I also went to see a number of physical therapists, and tried many different exercises (e.g. weight training), as well as acupuncture and heat treatment. Nothing helped. It was also pretty clear to me that my problem was something they had not previously encountered.

So I started doing my own research on the web, and tried different things. I read the book “It’s Not Carpal Tunnel Syndrome! RSI Theory & Therapy for Computer Professionals” by Jack Bellis and Suparna Damany, which I thought was pretty good.

I also experimented with many different kinds of mice and keyboards. I found that the Goldtouch split keyboard and a gel-filled wrist rest works well for me. The split (and angled) keyboard allows my hands to stay at a more natural angle when typing. The mouse I use is an Ullman Penclic Mouse. You hold it like a pen and move it like you move a normal mouse. Since I hold it like I hold a normal pen, I don’t have to turn my hand like I have to when gripping a regular mouse, and this helps a lot.

I also did 10 sessions of rolfing (yes, that’s rolfing, not golfing), which I feel also helped in relieving my muscle pains.

But the biggest part of the solution for me was starting to use a break program  that forced me to take regular breaks from typing – before I would program for hours without breaks. At the time I was using Linux, and it was not easy to find a program that worked for Linux. Eventually I found a really great one called WorkPace. I set it up to force me to take micro-pauses for ten seconds every five minutes, and longer breaks (with exercises) every 45 minutes.

A few years ago, when changing jobs, I switched from Linux to Windows, but I kept using WorkPace. Recently (without changing jobs) I switched to using a Mac, and unfortunately WorkPace is not available for Macs. After some testing I switched to using RSI Guard instead, which is comparable to WorkPace.

I believe that the break-program together with the ergonomic keyboard and mouse really saved me. Over a period of about six months, my problems gradually disappeared, and I can now work without problems.

In the hindsight, it feels pretty obvious that you should treat the cause and not the symptom (just like when fixing bugs). However, none of the doctors and physical therapists I saw realized this. Instead, they were all in one way or another treating the symptoms. This was six and a half years ago, so there may be more awareness today about RSI and computer-related injuries, but you never know.

So my advice is that if you feel any pain when typing, do something about it right away. Don’t ignore it and hope that it will go away by itself, because it most probably won’t. Most people have no problems, and therefore do not pay much attention to ergonomics (why should they – they have no problems). But I was programming for more than ten years without problems, and then it started to happen. It’s called Repetitive Stress Injury for good reason – it is the many repetitions of the same movement over many years that cause the problems.

In my case, the combination of a break program, an ergonomic keyboard and mouse made all the difference – without that, I would probably not be programming today.

31 responses to “How I Beat Repetitive Stress Injury

  1. Hi, for the mac there is also AntiRSI ( http://antirsi.onnlucky.com ), which is much more “apple” like … the older version is still for free, if you just want to try it out.

  2. This is certainly something most programmers don’t take seriously enough. I think they should be more proactive and come up with an RSI prevention plan before they get it.

    http://blog.vivekhaldar.com/post/8339897599/do-you-have-an-rsi-prevention-plan

  3. “RSI – Repetitive Stress Injury”

    Isn’t RSI stand for Repetitive strain injury.?

  4. Repetitive mouse clicks also causes finger joint pain and tenderness. When that pain persists (more than 3 days), then I force myself to switch hands from right-handed mouse to left-handed mouse.

    The switch is quite uncomfortable at first (4-6 hours). Then I quickly forget that I am using my left hand. After 1-2 weeks, I can return to my right-handed mouse without any discomfort.

  5. My brother Alex does Rolfing in Los Angeles it. I found that it worked very well for me. http://function5fitness.com/nutritionmassageandrolf

  6. or try happy hacking keyboard – without wristguard, so your hands “flow” around it when typing. it was cure for me, afer all that flat wrist-planted (such as on laptops) keyboards. such a happiness after 30 years onboard.

  7. Can you feel the pulses in your fingertips?

    Exercises like this increase inner body awareness which seemed to conquer my repetitive strain problem.

  8. Freddy Terranean

    I had a bad RSI about 15 years ago with several sets of symptoms that was not any of the tunnel syndromes. I finally got rid of it by stopping working and going into poverty.

    Before that I tried over 20 doctors, physical therapy, occupational therapy, tie-chi, tens, stretching, exercise, rest, and all kinds of pills. They altered the pain, but didn’t get rid of it. I probably had several different problems, and that masked the arthritis that came on later, until it couldn’t be hidden any more.

    The state disability program is mostly good for creating stress and anxiety.

    There are a few things I still can’t do with my hands, but they’re things I rarely do anyway, like using a scissors for over 10 minutes.

  9. As a dev, I’ve been dealing with this for the past 9 years. Mine’s specifically tendonitis, but the causes are generally similar for most wrist/arm RSI.

    I wrote up a post about ways I’ve dealt with it.
    http://www.cleverkoala.com/2010/04/how-to-deal-with-tendinitis-part-1-posture-and-computer-equipment/

    tl;dr
    Upgrading my equipment and using a wrist brace when I code have been life-changing. A keyboard tray cannot be emphasized enough either.

    Also, it’s stupid expensive, but the Kinesis Advantage is the only keyboard I’ll touch anymore. On the other hand, $300 for equipment that makes your job enjoyable is chump change.

    For more extreme measures, learning Dvorak, and using a foot pedal for a shift key have really reduced wrist strain (and speed up your typing as well).

    Geeky, I know, but this is serious stuff that affects your career. Take care of your hands, we can’t “think” into computers (yet).

  10. I can one up you on this, I cured my RSI.

    My story is similar to yours (short of the rolfing and acupuncture.) Around 2005 developed extremely painful RSI. Just using a non-ergonomic keyboard hurt like hell within 10 minutes. The only thing that really helped was limiting my work and typing.

    That was, until I started doing body weight exercises back in late 2010. Back in 2005 when it hit me hard I was lifting weights regularly. That led me to believe that the weight lifting was at least half responsible. I backed off all upper body strength training completely. I felt like I was physically damaging myself when I did.

    I wanted to build up some basic strength so I got this book “You Are Your Own Gym.” I hadn’t done a pushup in years so I started out doing them against a wall. By the end of the month I was doing normal pushups no problem. Then one day I got really sick and sat in bed on my laptop. Hours in I realized I had no pain whatsoever. It was mind blowing. Just months earlier things had progressed so my hands were partially numb *all* of the time.

    Its been over a year and a half now. I had a few tiny incidents were I developed minor pain. I can do pull ups all day long. I can do clapping pushups. I can do handstand pushups. No wrist pain using a laptop 12 hours straight. I was really cautious saying this at first but I’m pretty sure now that I’m cured — assuming I get up with my workouts.

  11. Don’t stop looking (and spending) until you find a good mouse, keyboard and chair. All of these are important.

    I’ve tried dozens of keyboards and mice and am never satisfied enough to stop looking. Same with chairs. These are the three most important things—they’re worth spending a lot of money on, and are certainly getting obsessed over.

    Keep using different mice, keep searching for a good ergonomic keyboard, and keep searching for a perfect chair. $1,000 for a Herman Miller is a small price to pay over 10+ years.

  12. I rarely touch a mouse. I mouse with my feet: http://www.youtube.com/watch?v=IkusPR1ywiA
    Works great.

  13. Hakan Soderstrom

    My personal recipe is using the left hand for the mouse. I switched many years ago when I felt pain developing and never had a problem since. Being a right-handed person I felt awkward to begin with. But it’s doable. For clarity, the mouse is still configured for a right-handed person. A big advantage is you can use just about anybody’s equipment, nothing is special.

  14. Several years ago I got very scared when I was having a lot of problems with my right hand and wrist, and started having numbness. I never went to a doctor, because I immediately knew what the causes were and my only hope of preventing further damage. One was that I was gripping my mouse too hard. Another was that I would engage in marathon coding sessions too often.

    I switched immediately to using my left hand for mousing, just to give my right hand a rest. I also permanently instituted typing breaks. Not only breaks every hour or so (during which I do things like get up and take a walk to refill water or something), but just micro-breaks of pausing.

    I also switched keyboards. I am totally sold on the softer touch keyboards (as opposed to the old clickety ones) that require far less force.

    As for the switching of hands for mousing, I ended up switching
    periodically, not favoring either left or right. This has been
    beneficial in also correcting some imbalances in my left and right
    sides of my body in general (such as shoulders, sitting).

  15. In college, my hands were getting a bit tired from all the typing, so I ended up switching to Dvorak. My hands feel much better and not so tired now after long sessions at the keyboard. I also use a Wave keyboard both at home and at work which helps a little.

    The mouse is still a problem. All my remaining pain is in my right wrist. I don’t see how a pen held mouse would help though because my pain is worst when I’m writing with a pen or pencil. Maybe one of those wedge shaped mice that you hold sideways. They remind me of my old Trackman Marble FX trackball in that I could keep my hand in a mostly natural position while using it.

    • I tried a wedge shaped mouse from Evoluent for a while, but although you hold it in a better position than a normal mouse, it was too big and clunky for me. The pen mouse is a lot smaller, and my hand is more relaxed when I am holding it.

      If you haven’t tried a break program yet, I can really recommend that. For me it made a bigger difference than either the keyboard or mouse.

      • Henrik I am have been looking for a break program. I am going to try WorkPace now that you have experience with it. I have Contour mouse and a Goldtouch keyboard.
        . Will report back in a month :)

  16. Pingback: How I Beat Repetitive Stress Injury (RSI) with a Few Minor Adjustments – from ‘Henrik Warne’s blog’ « Wayne's SharePoint Tips and Arbitrary Article Collection

  17. Pingback: How I Beat Repetitive Stress Injury (RSI) With A Few Minor Adjustments | Lifehacker Australia

  18. Wow thanks you all for sharing your experience. My story is very similar to yours. My problems are with my left shouler/shoulder blade and neck area. It started with back muscle spamsm for 6 months then it became shoulder pain and headaches. I had 7 doctors, more than 8 massage therapist, 3 chiro, and not fewer than 4 accupunturist. I’ve had cortisone shots, numerous phyiscal therapy sessions. You name it, I try it all. My left shoulder still hurts and inflames when I work. I have to go walking, running, stretching after and during my work day. I use alot of high dosage IBprofin when it gets bad. My employer bought me all of the ergonomic accessories and I bought myself a sit-stand desk. After nearly a year off from work, I am back at work and managing.
    Like you I thought I had to switch career as well. I find that standing and running helps me, it seems to put the body back into its natural position.
    If all fails I just lay down, this generally helps. Cold pack also helps to numb the inflamed nerves…
    I am glad my husband sent this to me, I am not feeling so alone in this battle now. I thought about my own story many times, now i am just getting on your webiste to post instead. :-)
    Please keep the sharing coming, what works for you can really help me and others.
    Thao

    • Thanks for your comment Thao. I managed to find a combination of remedies that worked for me, and I really hope you can do the same! Hopefully my story and those in the comments will give you some more ideas to try.

  19. I am wondering if you (or any of the other RSI sufferers reading this) have considered a “mind-body” approach (for example, the approaches popularized by Dr. John Sarno) to treating RSI?

  20. Another post I found on Hacker News a while ago is called Dealing with Wrist Pain. It was discussed here.

  21. Yet another personal account of overcoming RSI, A programmer’s guide to healing RSI, and the discussion on Hacker News.

  22. Just started to feel the aches in my forearms and realised it’s prob something like this. Only problem is I now get it when I hold things and use my mobile :( Going to start calming down I think and take ur ideas into consideration… Thanks for sharing x

  23. Hey there! I know this is somewhat off-topic however
    I needed to ask. Does managing a well-established website such as
    yours take a large amount of work? I’m completely new to running a blog
    however I do write in my journal everyday. I’d like to start a blog so I
    can easily share my personal experience and views online.
    Please let me know if you have any recommendations or tips for new aspiring blog owners.
    Thankyou!

    • No, it isn’t a lot of work, since I’m using WordPress (which works really well, and is free).
      My only advice is to write about things you are interested in. You’ll learn as you go along (at least that’s what I did).

  24. I just couldn’t go away your web site before suggesting that
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