Re: ATM: Ergonomics Edition


I've fought this one for years, as you suggest everyone has, and there has been no permanent solution. I've gone to extremes with chairs, desks and screen placements, building and bringing in my own stuff. I've come to believe that radical moves can provide temporary relief, but that nothing is permanent. Going back to the recommended posture diagrammed everywhere is as solid as it gets, but that's not very.

Posted by: Idp | Link to this comment | 01-30-14 1:26 PM
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Based on what I've seen/heard from other people, and some minor pain of my own:

1) Stop working on computers for a week or so (might not be practical, but it's the best thing).
2) It's fine to get a comfortable setup, but any position will be painful if you're in it too long. So worry less about the one true way, and change things up as often as possible. Stand, sit on a medicine ball; use a trackpad sometimes, a mouse others; learn some keyboard shortcuts. Try the mouse/trackpad on your non-dominant side for a little while during the day, etc.
3) For acute pain: ice and NSAIDs.
4) If it really fucking hurts, stop. You can screw things up pretty badly if you try to work through RSI pain.

Posted by: ogged | Link to this comment | 01-30-14 1:28 PM
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A split keyboard may not be the entire solution, but I'm sure it would help. I've been using one for fifteen years, and I would never go back to using a regular keyboard.

Posted by: MAE | Link to this comment | 01-30-14 1:31 PM
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rms would hire high school kids to type for him while he had tantrums and sobbed and punched the wall; you could try that.

Posted by: Sifu Tweety | Link to this comment | 01-30-14 1:37 PM
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When you angle your arms in, are you angling your wrists back so that they're straight at the keyboard? (If so, don't do that, and practice typing with your hands at an angle to the keyboard and/or get one of the split ones. Basic split keyboards should be pretty cheap and an IT staff of any size probably even has a couple around).

I fully endorse all of 2.

Is there other stress at work? My worst episodes of RSI always seemed to be manifestations of other insanity in my life.

Posted by: Nathan Williams | Link to this comment | 01-30-14 1:40 PM
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I second 2 of 2. It's not about finding the one true set-up with RSI, but finding a couple of set-ups that stress your body differently, so that your body has time to recover and adapt. (This is also good advice for runners and running shoe choice.) So you could use a different mouse, or a smaller keyboard, or something like that.

Are you looking straight at your monitor? I developed horrible pain in my shoulder in college because my monitor was just slightly off to my left, meaning I was spending hours with my neck slightly turned.

Posted by: Cala | Link to this comment | 01-30-14 1:57 PM
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I endorse (2) and would add that relatively modest physical therapy was very helpful for me -- simple wrist stretching and strengthening exercises (2-3 times a day) made a big difference.

I would add that the person I work with now thinks that hunching your shoulders when you set (even unconsciously) is both common and exacerbates all sorts of problems. So dealing with neck/shoulder tension will also help your wrist.

Posted by: NickS | Link to this comment | 01-30-14 1:58 PM
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I had a comment but then deleted it by mistake.

1.) Go to a doctor. Workman's comp will cover it, and then they will fix the problem.

2.) The Microsoft Natural Keyboard worked well for me. It's around $50.

3.) A good drawer is important. Even with a crummy drawer, that keyboard helped a lot. Not reaching up/down to the keys is important. That's the biggest thing.

4.) I got an ergonomic chair which could go up and down along with a foot rest. It was called the Aspen (too lazy to link after I deleted my first comment).

5.) Finally, with a laptop, having an external monitor at eye height was very important.

Posted by: Bostoniangirl | Link to this comment | 01-30-14 2:00 PM
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I used a curved mouse with that keyboard.

Posted by: Bostoniangirl | Link to this comment | 01-30-14 2:06 PM
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The mousing is the worst part -- the most severe pain is in my right neck, shoulder, and back. and I've ordered a wireless Thinkpad keyboard with a nubbin and I'm waiting for that to come.

I read somewhere that virtually all repetetive stress injuries are the result of mouses (mice?). That's not doubt exaggerated, but sure enough, when I got my mouse situation straight, my problems went away and never returned - though my problem was entirely confined to my wrist. I got a wrist wrest and was just generally mindful about how I used the mouse.

I also endorse 2. And as with 7, stretching was helpful to me. During the worst of it, I developed the opinion that playing tennis was helpful. And as ogged says, staying in the same position is a problem. I actually screwed up a knee pretty badly at one point because of a habitual sitting position.

Posted by: politicalfootball | Link to this comment | 01-30-14 2:10 PM
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I'm with Ogged in 2:. If you find a (semi-) comfortable work-around while muscles and nerves are already screwed up you might well make things worse in the long run.

The cause of the problems might not be work-related, I've strained things wrenching on cars and bikes, and with home repairs and paid for it at the keyboard and mouse.

Posted by: biohazard | Link to this comment | 01-30-14 2:10 PM
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I actually could do 2.1 if I used all my vacation.
5.1, I don't think so, no. My hands are angled, in line with my wrists.
5.3. I'm happy at work and my job is peaceful. Well, until now.
6.2 I think so.
8.1 I have to see the doctor about my knees anyway, so maybe I can make it a joint -- ha! -- appointment.

Posted by: Tia | Link to this comment | 01-30-14 2:16 PM
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There's a particular class on yogaglo for shoulders, neck, and back I've been doing at night. I feel almost better afterwards and then miserable again as soon as I get to work. I'm currently typing on my tablet. I could also potentially spend half days next week doing reading for work. Then I'd only use half my vacation.

Posted by: Tia | Link to this comment | 01-30-14 2:21 PM
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I'm going to assume this is yoga for Juggalos. Nobody correct me, please.

Posted by: Moby Hick | Link to this comment | 01-30-14 2:23 PM
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14: I was going to go with giggolos, but that works. Or maybe it's held in a nuclear power plant or something.

Posted by: togolosh | Link to this comment | 01-30-14 2:36 PM
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Try switching the mouse to your left side. This was ergo tip #1 when I worked at Giant Internet Company; most keyboards these days have a numberpad on the right side, so if you have the mouse on that side too you have to reach way far out to use it. Putting the mouse on the left side keeps it much closer to your body and puts much less stress on your shoulder. Also, you want to move the mouse as much as possible from the elbow/shoulder rather than the wrist.

If you can't get a full ergonomic workup at your job, you can fake it for the most part with reams of paper. Your monitor should be an arm's length away from your eyes, with the top of the monitor at eye height. (This is where the reams of paper come in.) If you need to raise your chair up to make the desk/monitor height work, use more paper as a footrest.

Posted by: Josh | Link to this comment | 01-30-14 3:13 PM
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I went through this a few years ago when I left my office job to freelance from home. It took a while but I beat it pretty thoroughly.

My symptoms were chiefly tightness in the forearms, some pain in the neck and back. Various professionals tended to agree that the problem was downstream from my neck. My yoga instructor also thought that tightness in my hamstrings was responsible.

The combination of things that paid off for me were:

1. A physical therapist gave me exercises. Throughout the day: chin tucks and wrist flexes. (I still do these when I'm writing for a long stretch -- see Software, below.) Nightly: sleeping with a neck roll. Weekly: head traction, lying on the floor with my head suspended a couple of inches off the floor in a towel, 2x/week.

2. I hired a freelance ergonomist who came to my home work setup, took pictures of me on various chairs, then took me shopping for a new desk setup. I bought a $500 Girsberger Presto chair which has been extremely helpful, and an articulated keyboard. One thing about the keyboards - the top of the keyboard should be lower than the bottom, so your hands angle downwards from your wrists. I wedge a wrist pad underneath the space bar. I didn't end up getting anywhere with the ergonomic mouses he left me, and I still use a regular Mac mouse.

3. I took a private yoga lesson with a trusted instructor. I told her what was wrong and she designed a 20 minute daily routine that was very helpful.

4. I installed TimeOut from to lock me out of my computer for 15 seconds every 10 minutes, plus 3 minutes every 48 minutes. I do wrist flexes in the short breaks, and I get up and do 30 sec chin tuck 15 sec each wrist flex on the big breaks.

As mentioned above, the important things are not staying locked in one position. Having the seating axis unlocked on your chair is very good, as is using a laptop and just moving between standing and sitting or working on a couch or at a table.

I also work standing from time to time -- but it's not a great idea on a laptop because you can't have the monitor at eye level and the keyboard lower than your elbows.

Posted by: k-sky | Link to this comment | 01-30-14 3:17 PM
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I endorse 2. Alternating between sitting and standing is the only thing that's made it possible for me to keep working at a computer. Maybe I should rethink this...

Posted by: mcmc | Link to this comment | 01-30-14 5:39 PM
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For me, Microsoft Natural keyboards definitely help. Also, although I didn't like it at first, the Apple Magic mouse. Lots of things I used to use my arm for I now do by just sliding my finger over the mouse body. I'm reaching far less.

Regular stretching, but also just getting away and walking regularly. Not just standing up for a few seconds but walking at pace.

Also, the relaxed but fast spinal rotation and shoulder movement from boxing helps. I'm sure lots of other sports or activities would do the same. Yoga maybe plus something a bit quicker.

By contrast, I've largely found physios useless for work related pain and for sports injuries.

Posted by: nattarGcM ttaM | Link to this comment | 01-30-14 5:48 PM
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Lots of good advice here.

Google alternatives to computer mouse. Here too changing things up is best.

Posted by: David the Unfogged Commenter | Link to this comment | 01-30-14 6:15 PM
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Here's something I wish someone had told me when I had pains and aches a couple of years ago: I think everything will be alright. Take this very seriously, figure out what you should do, but know that you'll most probably be fine.

Posted by: David the Unfogged Commenter | Link to this comment | 01-30-14 6:28 PM
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I had no idea this type of thing was so common.

Posted by: heebie-geebie | Link to this comment | 01-30-14 6:42 PM
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I had exactly the same thing as the OP. The first time it happened it came on strong enough that I honestly worried it might never go away and I'd be unable to continue working. I followed basically the advice in this thread--rest when possible, mix things up when possible. The paid downgraded and became intermittent and now I mostly manage it okay.

Posted by: urple | Link to this comment | 01-30-14 6:50 PM
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Have you tried leaning in?

Posted by: fake accent | Link to this comment | 01-30-14 8:44 PM
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Some of the first things that Well-Known Computer Company does when an employee complains of RSI are :
- set desk height in cubicle to match your seated height. Adjust monitor height ditto.
- install user-adjustable kb/mouse tray(s)
- provide a fully split keyboard, the Kinesis Freestyle, and set it up "tented" to varying degrees.

Posted by: joel hanes | Link to this comment | 01-30-14 9:10 PM
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I had this horribly ten years ago. The single simplest thing was switching to a left-handed mouse. I was clumsy for a couple of weeks, but after that it was fine and made a *huge* difference to the state of my right shoulder and forearm, which have nver been so bad again. Right at the moment, for silly reasons, the left-hand mouse is in another room and I can feel my arm beginning to be silly again. I will have to retrieve it.

Second most important: a good physio because she gave me numerous exercises to clean up my posture. It was what i did to my back on a regular basis that really helped, rather than what she did. But she told and showed me what to do.

A proper chair - not hugely fancy, but capable of adjustment in all the right ways - and a desk that puts the keyboard where it should be.

Hoisting the monitor up to eye level so that I sit up straight to look at it.

A microsoft or Logitech split keyboard. No doubt there are others just as good, but those are the ones I could afford. The Well Known Computer Company probably uses a better brand.

I tend naturally to take breaks every hour or so. But when things were bad I did use one of those nagging software packages to knock me off the keyboard. Cannot too strongly endorse ttaM's recommendation for taking real, rather vigorous exercise breaks.

A book on posture called (from memory) "It's not Carpal Tunnel syndrome" was extremely helpful. Certainly in my case, the problem was in my spine, and once I had that straightened out (in a manner of speaking) everything else followed, over time.

Posted by: Nworb Werdna | Link to this comment | 01-31-14 12:47 AM
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A book on posture called (from memory) "It's not Carpal Tunnel syndrome"

I used to read a blog called "Managed Care Matters" which focuses a lot on workman's comp. There are a ton of workman's comp claims for carpal tunnel syndrome, but true carpal tunnel syndrome is now not thought to be a repetitive strain injury, so it shouldn't be covered by workman's compensation. The people probably do have workplace-related injuries, but not carpal tunnel.

Posted by: Bostoniangirl | Link to this comment | 01-31-14 6:32 AM
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Re: 26

I have workmates who are maybe 300m away in the same building and I always walk to see them rather than phone or email and I make a point of doing it fast there and back. Ditto the people a few floors away. Little things but it's little bursts of proper walking interspersed regularly all day, on top of a lunchtime stretch/walk. Admittedly I rarely take a proper lunch but it's easy to take a short brisk walk.

Posted by: nattarGcM ttaM | Link to this comment | 01-31-14 6:38 AM
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"It's not Carpal Tunnel syndrome"

Worse episode of House ever.

Posted by: Moby Hick | Link to this comment | 01-31-14 7:06 AM
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You know, I started on Adderall for the first time ever a couple of months ago. I'm undisciplined enough about taking it that I don't *think* this is causative, but one of the things I've liked about it is that it makes me less fidgety and less likely to constantly pop up from my desk. I guess I should keep an eye on that.

Another thing different about this year is that I've gotten less exercise than in any other since 2005 or 6. I was just starting to maybe be on track to addressing that.

Very grateful for my tablet and stylus right now! I can sit on my futon with a neck pillow and peck out letters at arms length.

I have a meeting with my boss today. I'm going to tell him I don't think I can do anything but read and watch videos for a week. He might not even make me take vacation. He's pretty compassionate, he's a doctor, and he's very invested in my long term happiness and job satisfaction. And ill make a doctor's appointment.

Posted by: Tia | Link to this comment | 01-31-14 7:16 AM
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Can you get set up with voice recognition software? You probably couldn't do your job without typing at all for an extended period, but it might let you do enough to give yourself a complete break from the keyboard for a week or so and still get some things done.

Posted by: LizardBreath | Link to this comment | 01-31-14 7:18 AM
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I don't think voice recognition software will do much for me. I have very little composition to do right now; lots of file manipulation. And I can't move the mouse with my voice (can I?), and that's the most painful thing. Although! I have a wacom tablet. I need to reinstall the pen driver. But right now I'm in enough pain that I can't sit in my crap chair either. Might be better on Monday. And maybe I can steal some temporary chair.

Posted by: Tia | Link to this comment | 01-31-14 7:30 AM
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I switched mousing and cellphone-holding hands and that helped

Posted by: Annelid Gustator | Link to this comment | 01-31-14 7:42 AM
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At one of my work sites, it became the fashion to sit on giant inflatable balls. Then human resources or somebody made a rule against them, because they suck.

Posted by: Moby Hick | Link to this comment | 01-31-14 7:42 AM
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"They" referring to human resources.

Posted by: Moby Hick | Link to this comment | 01-31-14 7:42 AM
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They also outlawed those bubbling desktop fountains. That was a good call. The stated reason (water + electricity = fire) was obviously a cover for the real reason (constant sound of flowing water = way too many trips to piss).

Posted by: Moby Hick | Link to this comment | 01-31-14 7:47 AM
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35: That was a helpful clarification. I thought the giant inflatable balls were sucking people into them where they were trapped forever.

Posted by: peep | Link to this comment | 01-31-14 7:51 AM
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It's possible I'm underestimating the degree to which vr is helpful. If you say os.listdir does it know what you mean? I guess the Internet can answer this question. The real reason I can't use it is that I don't have a private office.

Posted by: Tia | Link to this comment | 01-31-14 7:54 AM
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"Siri, can voice recognition software handle non-word strings of characters with reasonable ease?"

Posted by: Moby Hick | Link to this comment | 01-31-14 7:57 AM
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Moby's workplace

Posted by: Cryptic ned | Link to this comment | 01-31-14 8:00 AM
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Modern voice software can let you interact with on-screen stuff, though it can be awkward. If applications/web pages are well-built, you can say "Click the "New File" button" or similar; at worst, you can use one of several schemes to actually move the mouse pointer. The one I've seen divides the screen into a 3x3 grid, and you speak the number of one of the grid boxes and the mouse moves to the center of that box, and a smaller 3x3 grid is drawn there; repeat until the mouse is where you want it.

But getting used to such software is kind of a steep learning curve. I don't think it's recommended for just a week or two away from keyboards.

Posted by: Nathan Williams | Link to this comment | 01-31-14 8:10 AM
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32 et seq.: Oh, that does sound pretty useless. I was thinking that part of what you were doing was generating text, and that voice recognition software could get you through that bit.

Posted by: LizardBreath | Link to this comment | 01-31-14 8:41 AM
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I should get a vpn account so I can do my work more places is what I should do.

Posted by: Tia | Link to this comment | 01-31-14 8:43 AM
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They also outlawed those bubbling desktop fountains. That was a good call. The stated reason (water + electricity = fire) was obviously a cover for the real reason (constant sound of flowing water = way too many trips to piss).

Just require people to piss in the little fountains. Problem solved!

Posted by: MAE | Link to this comment | 01-31-14 8:44 AM
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You wouldn't believe how strict they are when it comes to the rule about where you can unzip your pants.

Posted by: Moby Hick | Link to this comment | 01-31-14 8:50 AM
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So you need a length plastic tubing, some medical tape, and maybe a funnel. Jeez, do I have solve all your problems?

Posted by: MAE | Link to this comment | 01-31-14 9:30 AM
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Insert "of". And maybe the tubing, if you're up to that.

Posted by: MAE | Link to this comment | 01-31-14 9:31 AM
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I endorse 26, especially with lots of no-backpack, empty-hands walking and pseudo-bellydancing, to let the upper body relax itself back where it ought to go. It only took.... six, eight years of that to recover from my initial response, which was to take a lot of ibuprofen and cram ice-packs up my sleeves so I could keep typing. (Don't do that. That was dumb.)

AFAICT all the best voice recognition is now cloud-based, so useless for people with any security concerns.

Posted by: | Link to this comment | 01-31-14 3:13 PM
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Buy Jill Miller's Yoga Tune-up balls and DVD.

Posted by: | Link to this comment | 02- 4-14 5:51 AM
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