June 6, 2006
Software developers, like pianists, rely on their hands to practice their craft. I've used a keyboard and mouse obsessively since my early teens. Fortunately, I have never had any problems with hand or wrist pain – nor have I experienced any Repetitive Stress Injury, which includes carpal tunnel syndrome. But others aren't so fortunate.
So what can you do to keep your hands and wrists strong under the duress of extreme computing?*
Get some exercise
Real exercise. Surprisingly, this stuff is good for you, or so I'm told:
Want to be a little smarter? Have a better memory? Stay mentally sharp? Improve higher brain function? Run. Those who exercise have a mental advantage over those who don't.
"…exercisers showed significant improvements in the higher mental processes of memory and in "executive functions" that involve planning, organization, and the ability to mentally juggle different intellectual tasks at the same time. What we found so fascinating was that exercise had its beneficial effect in specific areas of cognitive function that are rooted in the frontal and prefrontal regions of the brain."
The brain-boosting (and prevention of brain decline) effects of physical exercise have been studied nearly to death. The confusing part is why so many humans do not exercise.
I once took a class in college taught by a clinical psychiatrist. He believed so strongly in the connection between physical health and mental health that he forced all of his patients to undertake an exercise regimen. And his classes, too. Part of our grade was determined by a weekly exercise journal. In the journal, we recorded what exercise we chose, and how we felt before and after. And I'll be damned if I didn't feel better after exercising – every single time!
Of course, talking about the many benefits of exercise is easy. The real difficulty is getting over the inertia and actually doing it regularly. We geeks have a certain way of approaching exercise that's … unique.
Vary your working position
It's called repetitive stress injury for a reason. Try changing things up on a regular basis:
If nothing else, just take a break to stretch every hour or so. Some of the carpal tunnel prevention stretches are pretty quick and easy to integrate into your day.
And it might be a good idea to use a different mouse and keyboard at home than you use at work, for variety's sake. It's not just fun to experiment with different mice and keyboards, it's healthier, too.
Exercise your hands
Now we get to the fun stuff.
Crazy Aaron's Thinking Putty is my all time favorite desk tchotchke. They have some new super illusion colors that are amazing.
Putty is a fascinating, endlessly malleable toy; it's also a legitimate form of hand exercise. And there are lots of cool experiments and tricks you can perform with it, too.
The Powerball is another hit at the office. It's a major gyroscopic hand workout.
Be sure to get the model with the RPM readout, because you'll have a lot of fun challenging co-workers to see how fast they can get it to spin. Once they try a few times, they'll have no doubt that this little gyroscopic toy is a serious hand, wrist, and forearm workout! The only downside of the powerball is that it's a little noisy.
The Gripmaster is another popular hand exercise device. It was originally popularized by climbers who used this tool to strengthen their holds. But it's also useful for anyone who works with their hands. It comes in several spring strengths.
Toys, particularly those with therapeutic value, are fun. But if you're experiencing pain in your hands or wrists while programming, you should take it very seriously – it's one of the few things that can put you out of commission as a programmer.
* I am not a doctor. I'm just some random guy on the internet. So take this advice with a grain, nay, a warehouse full of salt.
Posted by Jeff Atwood
Years ago I caught a snippet of the Late Show, in which Letterman had a guest who specialized in hand training for pianists and surgeons. He had a book out an was promoting it. Several times I tried to find the book, but couldn't, since I don't know the author's name or the book's title.
I know carpal tunnel all too well, I got it operating robots. It is not fun at all and mandated a creer change. Since then, I have had few problems. You made some good points, I thought I might share a few of my experiences.
Straight writst, a palm rest and keeping the keyboard as low as possible seem to help me the most. Avoid the mouse... for me it can be a rapid aggrivator.
Exercise does help. Bromalian, a pineapple extract, is a great anti-inflamtory if taken on en empty stomach and seems to give me good relief. Chi balls as an exerciser seem to help as well.
I tried it some years ago, I think that I programmed 12-14 hours straight for some days, my entire left arm suddenly started to sleep(don’t know the English word for it, but it often happen if you are in same position for too long) . I think it took 3-4 days before my arm felt normal again. That pretty much scared the sh#t out of me, so I try to vary my working positions as often as I can, I try to take as much time away from the computer as I can and I started to workout in the gym.
It is not secret that a human will become better doing the things he/she continues to do, over and over. Some things like smoking is of cause more dangerous doing then running. But professional athletes have to watch out as well. But of cause that is understandable when their main function is their body. But yes running is good, but too much can be dangerous if you don’t watch out and listen to your body. We software developers will say that our main function is our brain, and often tend to forget to watch out for our body as well. Some geeks care more for their operating system then them self.
Anyway, I think it is good with variation in everything you do. Bring in more chaos ..
Don’t sit the same position and do the same stuff every day.
Don’t life the same place all your life, remember to take travel somewhere every year to see something new.
Don’t eat the same food all the time, try something new.
Don’t do the same thing every day, get new hobby’s, meet new people, try new clothe, new movies, new .. whatever .. open your mind..
Don’t use the same programming environment all the time, try other operating systems, other languages, other search engines, other crazy technologies. ..
Anyway, just take care of yourself, the computer business is still new, and I hope to continue see other great releases from you geniuses reading Jeff's execelent Blog many years from now. :-)
I sometimes switch my mouse over to my left hand (I'm right-handed). It takes a short while to get used to it, but I can use it easily these days for most tasks. And it takes some stress of my right hand and arm, which can be a relief after days of long work. The only things I can't do with my left hand are graphics and gaming.
(And I never bother switching mouse buttons. That's just plain unnecessary.)
Actually, I'd like to see a warehouse full of salt.
I got RSI for a couple of years and switched to voice recognition to get by. After a weeks holiday where I did some walking - that's all - it started to get better. Since then I've done semi-regular exercise - exercise bike and rowing machine, and kept free of it. For me I think the key was exercise of arms and shoulders.
Thinking Putty is awesome. I just ordered one of the new heat-sensitive colors for my office. Great exercise for the hands (and great for annoying your coworkers with popping-bubble noises if you so choose).
I'll also add a plug for the Kinesis ergonomic keyboards. I have one of the contoured "bucket" style models, and while keyboards like the Microsoft Natural did almost nothing to help my hand and wrist pain the Kinesis has relieved just about all of it. The split layout looks intimidating, but I adapted in a couple of days and fluent touch typists shouldn't have a problem. They are expensive though.
When I got my back checked by a chiropractor a couple of years back, she observed that my right shoulder was overdeveloped so the muscle was deadening the nerve. This results in greater mousing finesse because it reduces hand shake, but all the other muscles in your back have to compensate and it can have some very detrimental effects over time- nothing immediate, but stuff that becomes noticeable when you get older. At 26 she said I had the shoulder of a 60-year-old man.
She recommended changing mouse hand from time to time so no one shoulder gets too much control and shrugging your shoulders occasionally during the working day. Very small measures, but apparently enough to alleviate the worst of it.
PLEASE don't use the dynaballs in an shared office - the noise is INSANELY annoying to coworkers...plus the hand movements required to keep it going cause utter hysteria in any man in sight - which is also extremely annoying!!!!
I use a mouse on the left while at work (8 hours a day), and then on the right at home (another 3-4 hours a day, plus weekends).
Easy to switch back and forth. I don't even conciously think about it. And it breaks up how much mouse time each hand gets.
I also have Dragon 8, but only use it on occasion.
The same goes for your eyes as well. Be sure to take a break every hour or two to let your eyes focus on something further away than just your monitor. If you have a window to look out of, that's ideal, but a mirror is supposed to work well too.
...she observed that my right shoulder was overdeveloped...
I was stretching my arm a couple weeks ago when I noticed that my right forearm (between the wrist and elbow) bulged slightly like Popeye’s arms. Sure enough, the left arm (non-mouse hand) didn't have the bulge. A quick survey of co-workers found the "condition" in 2/5 of workers, always on the right (mouse) hand and in both righties and lefties.
I knew someone who had pretty bad RSI and alleviated it by switching to a trackball, so I guess they do work to some degree.
Also, there is a fair bit of evidence (though it has not been proven) that CTS cases can be treated in part with vitamin B6 (50-200 mg/day), preferably as part of a vitamin B complex supplement (or just eat lots of bananas). This would be in addition to antiinflammatory medication, physical therapy, and ergonomic changes. There also seems to be some indication that reducing the consumption of saturated fats and fried foods helps as does eating larger quantities of curcumin (a main ingredient of curry)
I've been dealing with RSI/CTS in both my wrists/hands for the last four months. One thing that has helped me tremendously has been yoga. (Just be sure not to push your body, especially any injured areas - that means no "down dog" or other postures that put weight or strain on your wrists.)
I have seen many people who had to change careers completely due to RSI. When I started getting the typical RSI symptoms I naturally became seriously worried as I suck at anything other than computers.
Then I switched my mouse from my right to my left hand and although it took a couple of days to get used to, it fixed my symptoms.
This is also excellent. Very nice guy who writes the software and it works well (I think it's only win (not Mac). http://www.cheqsoft.com/break.html
PS: I am not affiliated at all (really), I just exchanged a few emails.
I got some thinking putty on the strength of this article, and I'm pretty impressed so far.
My only question is: Which type is shown in your picture above?
I searched online, but couldn't find out which one it was. I bought the scarab variety, but it doesn't seem to be that one.
Taking breaks is definitely the best way -- take a moment for your eyes, hands and back.
Oh, there's a new chair out (I've used an aeron for years) that resembles a stool. It has a nice cushy seat, and the seat feels like it's floating, really amazing. A client's ceo had one and I tried it out; was really amazed, but I only sat on it for about a half-hour or so.
The biggest problem is that we're still shackled by the physical interface of a keyboard and mouse.
I've wanted to go dvorak for a while now to see how I feel... but like most haven't taken the time to attempt the switch. But maybe it'll be worth it just to see a guest user's expression when they first sit before my keyboard.
Ya know, I tried a bunch of mice and input devices, even that fancy sideways mouse, and I settled on the one-button (!) apple mouse. It's straight-edge design I found better than all those sculped monsters from logitech et al. And the sides curve underneath the mouse so your fingers get some leverage beneath the mouse to grip it easily. Fancy that.
But never fear, I'm building the next great end-to-end UI.
I bought the scarab variety, but it doesn't seem to be that one.
The one in the picture is Oil Slick. It's an "iridescent".
We go through a lot of putty at work; each new hire gets their own tin of Thinking Putty in a unique color. The iridescents are my favorites, followed by the metallics..
Wrist braces, check. lefthand ergonomic mouse, check. standing workstation, check. icepack, check, physical theraphy, check. excercise, diet and sleep, check. b vitamins check.
This RSI in my right hand is a royal pain, between playing violin and doing financial analysis.
I had RSI in early 2002 and was able to deal with it simply by switching hands. Nowadays, I keep switching the hand that i use for the mouse every few days. My RSI has not recurred since 2002.
Hmm... there are some that suggest that CTS is more of a syndrome that is caused by the mind (ie. when you think too much about it can inflict injury to you). Can't remember where I found it on the internet.
My experience though, I have been feeling the pain (although not much, and not serious) some time long ago, even before I know what is carpal tunnel syndrome. And then some how it just disappeared. And then another year, I feel the pain again.
Then I read some stuff on the internet and stop *pounding* the keyboard, and the pain slowly goes away. It turned out that the years I dont feel the pain was when I was doing project management most of the time, with little or no programming. Diving to the code introduces it back to me.
I have never had any problems or injuries. Except that using a laptop cursor control plate gets my wrist starting to almost immediately to wear out of strength and aching. Wrist support pad does not help.
I have found out that keyboards are quite lousy. Some keyboards are stretched in half for better hands positioning, though. But almost all are more or less noisy and some have small mechanical or layout bugs.
I like keeping some roleplaying polyhedral dice on my desk, to roll around in my hands when I want a tactile distraction.
They're also useful for deciding how to answer user help requests. 1-4 "Have you tried rebooting", 5-8 "Log out and then back in" etc.