RSI-Relief.com, as well as the RSI-Relief Blog, has been up and running for a little over a month now, and I’ve had numerous queries about my RSI experiences, so I’ve decided to share my own RSI story.
The symptoms began about seven years ago for me, with wrist pain and tingling in my pinkie and ring fingers. At the time, I was deep into a long and intense programming project, and had been working long days and long weeks, trying to write the software for a new product release. At the time I knew nothing of ergonomics, exercises, or taking breaks. I’d work basically non-stop, in whatever position I happened to find myself, and it finally caught up to me.
I scheduled an appointment with the family doctor, but by the time I actually reached his office, a few days later, the symptoms had subsided. At that point, I basically had to describe the pain from memory, and I’m afraid I wasn’t able to be too precise. The doctor diagnosed tendonitis, and prescribed some anti-inflamatory prescription drugs, but advised me that the next time, I should visit him while the pain was still present.
I took the drugs, and the pain remained at bay. It was at about this same time that I started to educate myself a bit, and started to improve my ergonomics. I bought a new mouse (a Logitech Marble Mouse), and started to wear a wrist brace. This allowed me to keep working and get thru the project.
I continued working in basically the same way for the next few years. I still knew that there was a problem, but it was manageable, and except for occasional flare-ups, it didn’t interfere with my work. in fact, even at that time, the relationship between work and pain was pretty obvious: if I worked to long, or too intensely, it would result in pain.
My next major problem occurred after a long period (several months) of very intense programming, followed by a few weeks of intense CAD work. Programming, for me, is primarily keyboard-driven – the mouse is not used all that often. CAD work is just the opposite – the mouse if used almost exclusively, requiring lots of scrolling, lots of clicking, and very precise movements. I was (again) working on a very important project, and when the inevitable pain from the CAD work began to grow, I decided to work through it. It didn’t hurt that bad, and this work had to get done, and I was the only one that could do it.
I got the work done, and that part of my project was a success, but I paid the price. My right arm hurt for about three weeks solid – elbow, wrist, and especially for the forearm. The company was going thru some insurance issues at this time, so I didn’t go to the doctor. I self-medicated with ibuprofen and rest. Luckily, this period corresponded with the Christmas holiday, so work requirements eased off. But the severity of this episode scared me. I was seriously thinking “What if the pain doesn’t go away? What if I’ve seriously injured myself? What if I can’t work again?” We’re talking disability here. Yeah, scary stuff.
But the pain did eventually go away. My workload was reasonable. Low-level pain was still there at the end of workdays, but it was not a big deal. Crisis averted, I could relax again.
I had purchased several RSI-related books during this period, and worked my way thru them. The books, along with the pain, had convinced me that I had to make some changes. Here are a few of the changes I came up with:
- I got an ergonomic keyboard. I tried a number of them, and finally settled on the SK-6000 from PC Concepts. This is a split keyboard with an integrated touchpad. I used the touchpad for awhile, but eventually abandoned it. But I still use the keyboard.
- I got an better mouse. In addition to the Marble Mouse mentioned earlier, and the touchpad integrated into my keyboard, I tried a number of other pointing devices. I’ll write about this in greater detail at some point, but I ended up using the Microsoft “Wireless Optical Mouse Blue”. This mouse is probably the most “regular” mouse I tried, less agressively egronomic that most. But it has a simple shape that can be used with either the left or right hands, and it’s wireless, which allows greater flexibility in placement. It works for me.
- I started using program called “WorkPace”, which tracks how long, and how intensely you’re using the keyboard and mouse, and prompts you to take breaks every so often, based on effort expended. The program provide both micro-pauses (a 30-second-or-so break approximately every 15 minutes) and exercise breaks (longer breaks every hour or so, accompanied by suggested exercises). The exercises include animations that show how they’re performed, and include all sorts of stretches, as well as simple suggestions such as “drink plenty of water”, and “focus your eyes on something other than your work”.
- I improve my workstation setup. Previously, I was using an old wooden desk with a right-angle side-table intended for a typewriter. The side-table put the keyboard and mouse at the correct height, but it was so small that I had to put my monitor on the main desk, and the mouse to the right of the keyboard. Thus, if I was facing the keyboard, I had to turn my head to the left to see the screen, and stretch my arm to the right to grasp the mouse. This led to neck and shoulder problems, as well as arm/hand problems. Ultimately, I ended up getting a new desk, a new monitor (an LCD to replace the old bulky CRT), and a keyboard/mouse tray. This put the keyboard and monitor in-line, and decreased the distance to the mouse.
- I got a better chair. Previously, I was using an old secretary’s chair, which wasn’t all bad. But I changed to a better chair with armrests and lumbar support. It still wasn’t a great chair, since it had limited adjustability, but it was OK.
Another two years passed, and my RSI was still present, with occasional minor flare-ups, but it was pretty much under control. I was maintaining.
Then, a few months ago, my work situation changed. Now, I’m working from home. Doing the same sort of work, but with greater flexibility. This is a blade that cuts both ways. I can work whenever I want, take off whenever I want. I can go for a run or a bike ride in the middle of the day. I can take a nap in the afternoon. There’s no commute, and I’m not stuck with fast-food lunches. The downside is that it’s very easy to work too much, especially on rainy days. I’ll work all day and on into the evening. WorkPace continues to be a help here, reminding me to take breaks, and even keeping track of the length of the workday, and letting me know if I’ve done too much.
I’m covered by my wife’s health insurance now, and about two months ago I decided to finally get my RSI checked medically. My condition hadn’t particularly goten worse, and I wasn’t in any sort of crisis at the moment, but I decided that now was a good time to deal with this problem for real. The only problems I was experiencing at that time were very slight tingling in the pinkie & ring fingers, a bit of thumb pain, and a bit of elbow pain.
My doctor again diagnosed tendonitis, but this time sent me to a physical therapist. The therapist and I discussed how the arm, hand, wrist, tendons, bones, muscles and nerves work together. He asked me about my workstation setup and my work routine, and I told him about what I’d been doing to manage the problem for the last few years. He agreed that I seemed to be doing all the right things.
The two things that he brought to the table, over and above what I already knew and was doing for myself, were testing and specific exercises:
- Testing – The therapist showed my how the responses, strength, and range-of-motion differed between my right (pain) and left (no pain) arms. For instance, I’m right-handed, so my right hand should be stronger than my left. But it wasn’t. My left hand was about 10% stronger than my right.
- Exercises – The therapist gave me a series of exercises to do to increase the strength of my right wrist and hand. These consisted of wrist curls with light hand weights, exercises utilizing rubber bands, and exercises to gently stretch the tendons in my wrist and arm.
I did the prescribed exercises, and ended up going back to the therapist twice more over the course of about four weeks. On the third session, we did the same tests we’d done during my initial examination. My right hand was now slightly stronger than my left, and I had a greater range of motion than before. My therapist advised me to keep doing the exercises, slowly increasing the amount of weights I was using, and the number of repetitions. Unless I was having a problem, I didn’t need to come back.
So that’s the plan now, and that’s what I’m doing. I’m currently very close to pain-free, though still have a small amount of pain if I overdo it.
My main challenges are:
- Do the exercises properly – I have a tendency to rush through the exercises, doing jerky movements rather than smooth, slow movements. I also sometimes skip the less-interesting exercises, or do fewer reps than I should.
- Don’t override the WorkPace exercise break – When you’re in the middle of something, and not in pain, it’s tempting to skip the breaks. I know I’m only risking later pain, but sometimes I do skip the breaks.
- Don’t work too long – Again, if I’m feeling good and making progress in whatever I’m working on, it’s tempting to just keep going and going.
- Watch the posture – If I’m not paying attention, I tend to roll my shoulders forward and slump. Maintaining good posture is important for proper technique.
I’ll keep on keeping on, and do the best that I can to do what I know needs to be done. The web site is part of that process for me. Researching RSI on the web, and keeping track of new research and new products, helps keep me focussed and observant of my own actions. An hopefully, RSI-Relief.com can help others deal with their own issues, providing information, resources, and inspiration.