from Hacker News

RSI as a Developer

by mulholio on 8/31/19, 6:01 PM with 74 comments

• by orpheansodality on 9/1/19, 12:09 AM

  Disclaimer: RSI can have many different causes and what works for any one person may not work for someone (or anyone) else. But here is what worked for me:

  I had completely debilitating RSI in both arms for years, eventually getting to the point where I was using Dragon Naturally speech recognition for any computer interaction, and a hamfisted stylus for using my phone since actually using fingers with any dexterity hurt too much.

  On my better days typing for short periods was ok, but any interaction with a mouse was immediately painful. Once I discovered I could use a trackball mouse on the floor with my feet I was able to get back to a point where I could work professionally again. But if I ever went too far I would be out for at least the next few days without being able to do much.

  A year or two after I realized that the pain was generally worse when my arms were cold. After some experimentation I found that almost all of the active-use pain went away when I kept my arms warm.

  Since then I've been able to get back into the full swing of things. I'm consigned to always be wearing sweaters, jackets, and hoodies while working, but that has been a small price to pay for being productive again.

  Any time I forget and use a computer bare-armed it comes right back again, but so far keeping them warm has been the silver bullet for me. If you're at the end of your rope give it a try!

• by codingdave on 8/31/19, 9:54 PM

  I had RSI that was so bad I did stop coding for a year, went through physical therapists, doctors, and finally surgery, and I have one piece of advice to everyone:

  Ask a doctor. There are far more variations of RSI than most people know. Taking someone else's advice may work, but you may be trying something that fixed a problem you do not have.

  My problem ended up being a genetic variation in the structure of the tendon sheaths in my wrist. Many people have it, but if you fall in the middle of the Venn diagram of people with this problem and people who type a lot, it is a problem. Surgery was the only answer to fix it, in my case.

  Again, my case will surely be different than yours. For many other people, ergonomics are all that is needed. But ask someone who specializes in these things. They can save you a lot of time and trouble.

• by rgbrenner on 9/1/19, 1:52 AM

  I once had RSI so bad I could barely type for over a year.

  I swear by these mice: https://www.logitech.com/en-us/product/wireless-trackball-m5... You don't move your hand.. just rest your hand on it and lightly move your thumb by less than an inch in any direction (half inch typically.. if you're moving it much more than that, increase your pointer speed). There are ball mice that use your middle fingers, but I find those put stress on the tendons on the top of your hand.

  Add a keyboard that requires very little force to press the keys. I use this one (without the number pad).. it's decent: https://www.microsoft.com/accessories/en-us/products/keyboar... I don't know that the split in the keyboard matters all that much.. I think the pressure required to press the keys is the most important. Buy whatever kb you like with soft keys.

  I also have an articulating keyboard tray: https://www.amazon.com/Bush-Business-Furniture-Articulating-... That lets you move the tray in every direction (back&forth, up&down, side to side, and tilt angle) so you can position the keyboard where it's suppose to be. Add a computer chair.. and you can position everything... even if your posture, etc isn't the best it could be every day.

• by tempguy9999 on 8/31/19, 11:08 PM

  I was off work with it for literally years so I guess I'm an expert. WRT my own body anyway. Here's my advice.

  All the fancy keyboard make no difference if you type too much. Pre RSI I'd type out some code, consider it carefully, rewrite it, reconsider and rewrite. Only then would it be run. It multiplied up the amount of typing I'd do. Now I'll think it through before putting hand on keyboard. No experience with dvorak but logically less typing must beat a 'better' layout.

  Emails are shorter now. Just practice getting to the point. Writing docs, I used the dragon voice recognition. It works acceptably when trained, though that is not a quick and painless process.

  I have a kinesis keyboard and its splitting/tilting don't help. But, because it lacks a number pad to the right it means I can place my trackball closer, so less risk of shoulder stress from reaching further out sideways. That's very worth it.

  I found a mouse to be bad, something to do with pressing the button on top. I now use a trackball. I suspect that's specific to me though.

  Above all, when it starts hurting, stop, and for a decent period of time - "But I can't afford to stop!" will be your response. Well, you will stop, nolens volens, it'll just be whether you choose to or your body packing up.

  Hand RSI is really bad, I have it now and it'll never go away. It gets better but it's taken over a decade and I'll have it forever. So please note my the para about it hurts so stop.

  Also be really cautious about any device that claims to help RSI such as those gyroscopic hand exercisers. They can help when it's improved (IME anyway), but when it's bad it will aggravate it.

  All the above my own experience, with a grain of salt as everyone's different - except for the bit about "when it starts hurting, stop" cos I think that's probably universal.

• by Marsymars on 8/31/19, 9:35 PM

  I've haven't had RSI problems yet, but I'm pretty proactive in methods of avoidance. I use Kinesis Advantage keyboards with Dvorak layout and CST trackballs, I'm 50/50 between standing/sitting, and 50/50 between left and right hands for trackball use. I also exercise daily to keep muscles/tendons/ligaments in shape.

• by adimitrov on 8/31/19, 9:32 PM

  I developed RSI from typing up long equations and calculations in TeX on a German keyboard layout with Emacs. It was a nightmare.

  I switched to Vim, and a Dvorak layout. I really like the feel of Dvorak - every time I have to type Qwerty for an extended amount of time, my hands get uncomfortable.

  I also like modal editing. You cut down on the amount of key chords you need. I've since switched back to Emacs with Evil.

  Another trick is to implement some break routine. A typing break of 30 seconds every five minutes may already be enough. There are many tools ta enforce these. I used the venerable Workrave, but it's ancient and has bad UX.

• by mnm1 on 8/31/19, 10:13 PM

  What works will depend on the person. For me it's the kinesis advantage 2, roller mouse red (not really a mouse but way better), an adjustable or standing desk (you can make this with a couple of monitor and laptop stands for travel and saving money purposes), and adopting touch typing in combination with sticky keys to avoid having to hold down keys. In addition, I do massage and chiro and have done PT, acupuncture, etc. I use a lacrosse ball on the back muscles to massage them and that brings the most relief as well as massaging the arms. I get rsi from holding my phone or even just sitting and watching tv (especially if it's not eye height). For me it seems to be mostly a muscular issue. I've also been working a bit with weights though I don't know if that helps. Everyone is different. If you have rsi, the most important thing is not to work through pain and try different things to fix it.

• by caseyf7 on 8/31/19, 9:48 PM

  Companies and desk makers need to bring back keyboard trays. I see so many people typing with their keyboards too high.

• by eutropia on 9/1/19, 4:16 PM

  Pick up heavy things with your hands so that your arms and wrists don't atrophy. I started developing random elbow pain as a young developer ( with years of sedentary lifestyle already ) and it persisted for some time until I started lifting weights a few times a week, and it disappeared within a month or so.

• by nemo1618 on 8/31/19, 9:43 PM

  I encourage anyone with chronic wrist pain to look into TMS. This blog post by Y Combinator's Aaron Iba helped me completely cure my RSI: https://aaroniba.net/how-i-cured-my-rsi-pain

• by pfarnsworth on 8/31/19, 11:25 PM

  For my, it was 100% my mouse. I had my mouse off to the side, and I realized after debilitating wrist, elbow and shoulder pain that it was because my wrist was at an awkward angle all the time because of my mouse.

  The reason for it is obvious when you look at it. When you write in a notebook as a student, your arms are almost crossed and your hand is bent at an angle relative to the table. You can maintain this position for hours a day, years on end when you're writing notes. When you're using a mouse, your arm is bent outward and your hand is parallel to the table surface, which twists your wrist. That ends up pinching a nerve in your wrist, which causes all these other problems.

  I switched to a pen mouse (back in 1997) which immediately fixed the problem. However, the pen mouse broke after a few months, so I went back to my regular mouse, but I first put it in front of my chest, in front of the keyboard, and I cup the mouse so that my hand is at an angle to the table. My arm from the shoulder to the elbow is resting against my chest, just like when I write on paper, and I don't let it get off my body. When I type I move my mouse out of the way, and when I use the mouse I move the keyboard out of the way.

  It's been 22 years now without any repeat of the problems, so I know at least for me this fixed the problem.

• by benologist on 8/31/19, 6:26 PM

  One thing that recently became very important to me was something to rest my wrists on as I type or use my mouse. Using Apple's keyboard and mouse my hands were always comfortable enough but switching to a big plastic PC keyboard and mouse there is actually over an inch difference in height to consider and my forearms started hurting.

• by chewxy on 9/1/19, 11:45 AM

  I recently had suffered RSI that I had to take a few days off work - my elbow felt like it was on fire and my grip weakened to the point where I was unable to open doors with my dominant hand. My physio prescribed me ridiculous amounts of diclofenec - so much I was afraid I was going to burn a hole in my stomach.

  Bought an ergodox, within a week the symptoms started going away, which prompted me to buy a second one for home. It's about one month now, and my elbow only has the occasional twinge.

  Yesterday I discovered you could map mousekeys on an ergodox. Haven't needed the mouse today, which was the cause of pain.

  I still haven't found the optimum ergodox layout though. My current one allows for plenty of mispresses of Ctrl and space. Also some kind of software feedback where if I am in emacs the keyboard switches to an emacs layer would be fantastic.

• by bearhall on 9/1/19, 6:44 PM

  I had a battle with tendinitis for about a year and it was terrible. I was icing my hands multiple times a day at work just to get by and it really destroyed my productivity.

  One thing I noticed that’s not in this article (and from my perception is commonly missing from resources about RSI) is cortisone shots. In my case I tried for a long time to get by with better ergonomics, stretching, NSAIDs, and ice but getting cortisone shots in both my hands made the pain stop for long enough that I could actually rehab my hands properly and function at work.

  After the shots I started lifting weights and focused on my ergonomics and it never came back. I’d highly recommend asking about them if you have an inflammation issue. In my case it bought me the time and space to really fix the underlying problems.

• by salex89 on 9/1/19, 12:46 PM

  Just wanted to chime in with my experiences with the mouse. I never had any RSI since last winter. Basically my whole life I used some sort of ergo-like, lightweight large gaming mice. Sometimes very cheap ones. But on my new workspace I got a quality, yet slightly uncomfortable wireless mouse, medium sized so it can be carried around. Few months later I developed a strange pain which was going away during the weekend. Long story short, i reluctantly borrowed, later buyes, a Logitech MX Master mouse, and it all went away. I use it still. I say reluctantly because of all my gaming mice I perceived this one as heavy and sluggish. But I've got to hand it to it, after hours of using it, there is no fatigue in the wrist or arm.

• by microtherion on 9/1/19, 12:00 PM

  I've had sporadic RSI issues off and on for 30 years, but less and less over the years.

  To me, the key insight was not to focus too much on the immediate source of the pain, and instead think about overall posture. Fix the posture, and the pain will go away. Adopt unnatural remedies for e.g. the wrists, and the pain will, at best, wander somewhere else.

  The section "Desk & Keyboard Positioning" in the article, with the emphasis on right angles, seems the most important to me. In my experience, monitors are often set up too low, so that's the first thing I check when RSI issues crop up.

  Personally, I also swear by getting regular massages, so back and neck issues never build up too much.

• by DoreenMichele on 9/1/19, 1:23 AM

  Some things that may help:

  1. Clean your keyboard and mouse.

  2. Feed your tendons.

  3. Resistance training, such as weightlifting.

  I suspect one of the hidden benefits of recommendations to buy a different (ergonomic) keyboard is that simply having a new keyboard means it's probably cleaner than the one you've been using. Makes me wish someone would do a study involving three options:

  1. New, clean keyboard same as the old keyboard in terms of layout.

  2. New, clean ergonomic keyboard.

  3. Just religiously and thoroughly cleaning your keyboard.

  It would be interesting if we could quantify how much the recommendation for a new keyboard was beneficial simply because it's clean. (Though I guess you would also need to rate the filth level of old keyboards to get more meaningful data.)

• by sz4kerto on 9/1/19, 8:21 AM

  My recommendation: rocking kneeling chair. RSI can be addressed with different keyboards sometimes, but as with many other injuries sometimes the root cause is somewhere else, not where you feel the pain.

  So if your wrists hurt, don't just look at how you hold your hands. Change your sitting posture, try a standing desk, etc. - there's a chance that just sitting differently will help your RSI.

  (This has happened with me. I used all kinds of fancy ergo keyboards, plus expensive regular chairs. Now I use a Varier Balans plus a simple 68% mechanical keyboard, and all my wrist and back problems went away.)

• by cwyers on 8/31/19, 9:24 PM

  Getting an ergonomic keyboard near about saved my life. I went from discussing surgery to not even having to be on meds after buying a Microsoft Natural Keyboard.

• by tluyben2 on 9/1/19, 8:40 AM

  Is there anything known about the underlying cause of RSI? I should have it but I don't, friends of my shouldn't have it but they do... When I first heard about (and was scared of it) was mid 90s, but then it was still seen (at least here) as kind of nonsense and trying to get on disability easily without proof (that worked though after a few cases). But now, so many years later, they should know more?

• by willtim on 8/31/19, 10:12 PM

  The Kinesis Advantage completely cured my RSI. It's also much more pleasant to type on than any other keyboard I've tried. Worth every penny. I also use a Kensington Slimblade trackball for when I can't avoid moving a pointer.

• by dbb8193 on 8/31/19, 11:54 PM

  so this is a bit out there but what worked for me and really changed things was taking feldenkrais classes. I had a pile of weird ergonomic keyboards, did crazy stretches, exercised, and tried every keyboard layout but going to a feldenkrais class once a week changed my relationship to my body and stopped me from creating crazy tension any time something felt off.

  this is where i found out about it: https://www.nytimes.com/2017/10/30/well/trying-the-feldenkra...

• by jklepatch on 9/1/19, 1:22 AM

  I had some rsi-like symptoms couple of years ago. They all stopped when:

  - I stopped using an external mouse (replaced partially by mouth) - I switched to vim - In chrome I use the vimperator extension - I learned as many shortcuts as I could.

• by arnoooooo on 9/1/19, 12:31 PM

  I can't recommend reading "The mindbody precription" by Dr. Sarno enough to anybody with RSI.

• by lasagnaphil on 9/1/19, 7:45 AM

  I just freaking love the fact that he's using the titular CLRS "Introduction to Algorithms" book as a monitor stand... (I actually have to study it for a test next week)

• by Pimpus on 8/31/19, 11:01 PM

  No, buying expensive and totally impractical keyboards is not a solution, and I say that as an Ergodox owner. Really, if the root cause of your RSI is not addressed, you are going to have pain forever, whether they be back or knee problems or whatever, and you will just be perpetually playing catchup with more and more overpriced chairs and desks and weird devices.