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# A pain in the hand: dealing with computer-related injuries

Tuesday 6 May 2014
Tagged with

- RSI
- Emacs
- Input
- Process

You might have noticed that my latest spurt of blogging has been interrupted again. This time, it’s due to a recurrence of an old enemy of mine, repetitive strain injury (RSI). It’s coming back under control now and I thought I’d share what’s worked for me, but before we go any further, heed my warning:

If you have any sort of pain or numbness at all when using a computer, even if it’s momentary, take the time to evaluate your setup and see if there is anything you can change.

I can’t over-stress how important this is — RSI is a serious medical problem if allowed to get out of hand (potentially as career-ending as a sports injury can be for a professional athlete), and it can be prevented entirely by ensuring your workspace is appropriate to the way you do your work. If in doubt, seek expert and/or medical advice: many larger employers have occupational health advisors, and your GP will be able to advise or refer you to an appropriate specialist.

As a lot of intensive computer-users do, I’ve had numerous bouts of computer-related pain over the years, and at one point even had to switch to voice recognition software for several months. If you’ve ever tried to use voice recognition, especially to do any programming, you’ll understand how frustrating that can be.

Previously, I’ve had pain associated with using the mouse, so these days I tend to drive my computer primarily by keyboard. I use apps (like Emacs) that are very keyboard-friendly, and when on Linux I even use a keyboard friendly window manager to minimise my need to use the mouse at all. I also have a regular mouse at work and a trackball at home, so I’m varying the set of muscles I use to mouse with.

As a result, I use a lot of key combinations involving the Control, Alt and Windows/Command keys, and recently I’ve started having pain in my thumbs (particularly the left) from curling them under to hit the Alt and Win keys. Note: emacs users more commonly suffer from the problem known as “Emacs pinky”, but I headed that one off at the pass early on by remapping my caps-lock key as another Control key.

I’m very lucky: my workplace has a dedicated assistive technologies advisor, who has a collection of alternative keyboards, mice and other input devices, so I was able to have a chat with him, get some expert advice and try out several possible options before committing to buying anything.

Here’s what I’ve ended up with:

- Kinesis Freestyle II USB keyboard: This keyboard is split down the middle, and allows the halves to be positioned and tilted independently to reduce the unnatural bend in my wrist, as well as putting less strain on my shoulders. Through some experimentation with this and similar keyboards, I’ve found that having the two halves parallel but about 15–20cm apart is more comfortable for me than having them close together and angled (like the keyboards made by Goldtouch).
- Programmable USB foot pedals: These are such simple devices they can be picked up for cheap almost anywhere on the net, or even hacked together using the controller from an old USB keyboard. I have three pedals set up, with Control under my left foot, Alt under my right and Windows/Command inside Alt so I can reach it with my right foot easily. Initially, I found that I was getting some back pain after starting to use the pedals, but I’ve since realised that this was because I had them positioned awkwardly — I started over by looking at where my feet fell naturally while working and then moving the pedals into position accordingly.
- Posturite Penguin mouse: This also helps to reduce the unnatural bend in my wrist, as well as dealing with my tendency to “anchor” or rest my forearm on the desk while moving the mouse only with my fingers and wrist. It comes in three sizes to fit your hand, and has a switch to swap the scroll wheel direction so you can swap it to your other hand from time to time. Plus it’s made by a British company!

This combination straightens my wrists out completely while typing, and is slowly eliminating (as I train myself to use the pedals) my use of the left thumb for anything other than the space bar.

I hope this is of some use to a few people out there suffering needlessly from similar problems.