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Jerod Santo
Jerod Santo

Posted on • Originally published at jerodsanto.net

How I beat RSI before it beat me

Note: I published this on my blog back in 2015, but I don't write there much any more. Now I'm busy making podcasts for devs like myself.

I’ve been battling pain in my left hand1 and wrist for the past couple of years. There are but 3 things on my person that I need to bring to work each day:

  1. A Brain
  2. Eyes
  3. Hands

Losing any of these faculties would send me down a new career path, so I’m quite protective of these particular body parts. This hand pain worried me.

It started out in my forearm and felt like fatigue more than anything else. Over time, the pain slid down my arm and in to my wrist. Finally, it rested on the left side of my hand and in my pinky. It wasn’t debilitating, but it was annoying. And getting worse.

So I did what all Internet denizens do: I Googled the crap out of it.

The diagnosis

I had been warned of Carpal Tunnel Syndrome (CTS) before, and it scared the dog doo out of me. I suspected that might be what it was, but my symptoms didn’t quite line up.

I was playing Racquetball once or twice a week when the pain began, so I thought it might be related. The pain started in my forearm, so I considered that it might be some form of Tennis Elbow.

Ruling out Tennis Elbow was easy: I quit playing Racquetball for awhile. The pain persisted.

I won’t share all the Internet avenues and back alleys I went down in search of diagnoses and solutions. I’ll just say that by the end of it, I was pretty sure I was experiencing some kind of Repetitive Strain Injury (RSI).

What sucks about RSI is it starts out minor and slowly gets worse until you can’t handle the pain anymore. You can’t simply tough it out. You have to change your habits or give up the activity that’s causing strain altogether.

Not cool, dudes

Not cool, dudes

With visions of surgery and hand braces dancing in my head, I set out to find some solutions.

The non-solutions

It was a long and windy road of non-solutions. A lot of the advice out there says to strengthen and stretch your hands. To help in that effort, I purchased a set of Chinese Stress Balls. I took regular breaks from typing and used these stress balls instead.

Shiny!

Shiny!

Aside from being fun to play with — and an infinite source of juvenile jokes — these asian delights did bupkis to reduce my pain.

Next up on the hit list (and a more common purchase than the Stress Balls, for sure) was an ergonomic keyboard.

The mouse is heavy, but it grew on me

The mouse is heavy, but it grew on me

Ergonomics are a huge part of curing (and preventing) RSI. Switching to an ergonomic keyboard was the #1 piece of advice that I came across on the web.

And when it comes to ergonomic keyboards, Microsoft’s is one of the best2. The Sculpt had just been released when I was shopping, so I bought it instead of its bulkier predecessor, the Natural.

I quickly fell in love with the Sculpt and use it to this day. The mouse: not so much, but it grew on me3. The only problem with it: my pain didn’t go away!

At this point I was pretty upset and had almost resigned myself to a life of hand pain when I came across the one person on the Internet who had my exact symptoms!

The solution

So much of what Greg was saying had me pegged:

I would suppose that many people have had this problem without a complete diagnosis or an optimal treatment plan.

Me.

The right pinky is used for 16 keys, and the left pinky for 10 keys, while every other finger is used for at most 8 keys. This may not matter much for typing text in English. However, a lot of computer typing these days is nothing like English

Me again.

In my case, this led to extreme pinky overuse and, worse, typing with my hand twisted (ulnar deviation)

ME ME ME. This image he included in his post perfectly mirrored what my left hand looks like when I type:

It’s called “ulnar deviation” which is a fancy way of saying “OUCH”

It’s called “ulnar deviation” which is a fancy way of saying “OUCH”

By this point in his article I couldn’t read the solution fast enough:

I tried a variety of standard remedies that may or may not have helped (see below), but the most important long-term solution was a non-standard keyboard mapping.

You can read the whole thing to learn about how Greg remapped certain keys to reduce usage of his right pinky, but I didn’t need to. With this knowledge in hand, I came to grips with they key which was really stressing my left pinky out: the blasted control () key.

Anyone who is a big user of keyboard shortcuts on OS X is a big user of . I’m no exception. What’s worse is that this particular key (which I use all day every day) is in the lowest, leftest corner of the keyboard. The only key more stressful to reach is the double blasted fn key. Thankfully I rarely use fn.

My solution? I remapped the key to take Caps Lock spot4 and disabled the key altogether to force myself not to use it. How to do?

On OS X, Go to "System Preferences" -> "Keyboard" -> "Modifier Keys". You'll be presented with this dialog where you can set them as you please:

 

Why was this minor adjustment such a big deal for me? Because this motion, which causes the hand-twisting-pinky-stress:

Before

Became this motion, which is not stressful at all:

After

After this one change the pain slowly subsided. It took many months for it to disappear completely, but eventually it was just gone.

Nowadays it's barely an afterthought. I can still feel a little bit of exhaustion if I type furiously all day, but it's an order of magnitude less severe than before.

Next to switching to a standing desk, remapping my key to Caps Lock is the best thing I've done to take care of my body while I work.

YMMV

I’m putting this out there in hopes that somebody with similar symptoms will find some relief. I’m thankful that Greg documented his situation and a fix, and I hope to point others to it if possible.

That being said, each person is different and RSI comes in many shapes and forms. Your mileage may vary!


  1. Why am I smiling? Because I know something you don’t know. I’m not right handed. 

  2. Can you imagine? 

  3. You can now buy the Sculpt sans-mouse, but couldn’t back when I was on the market 

  4. Who uses Caps Lock, honestly? 

Discussion (4)

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silentwarrior profile image
João Carlos • Edited on

Matias Mini Quiet Pro (the small one with awesome clicky keys, the FN button makes sense!!!!!) + Contour RollerMouse Red.

The smaller form factor of the keyboard will force your hands into a better position. The light touch will cause less stress but its also clicky so feels great. The rollermouse stops you reaching across to the mouse and use wierd positions repeatedly.

The padding on the mouse also forces your hands to be straight instead of the back of your palms sitting on the table.

Mousing becomes a two hand job, might sound wierd but after 5 minutes you will think: Why didnt I never knew this before?!

For quick actions:
Copy/paste/Single/Right/Double click are single clicks now and are done with the left thumb while your normal fingers sit on top of the keyboards keys as normal. The thumb is a big finger with strong muscles and in the right position for such actions unlike the Control/Shift/Alt buttons which cause your hand to twist.

Rolling around is done with your right thumb and its a bit slower but also more precise: selecting text and drag and dropping things for example is awesome.

For normal browsing you dont use your thumbs but instead rest your hands comfortably on top of the buttons and use the tip of your fingers with your hands in a comfortable closed position - as when you are doodling around in a meeting room touching the table.

The leather resting padding is soft enough to let your tendons have a softer surface but still move around freely - tried soft gel ones but they are too sticky and end up causing extra effort to move around and I'd often lift my hands and that causes extra stress.

For working its awesome but obviously wont work for gaming.

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engineercoding profile image
Wesley Ameling • Edited on

I am glad to read you resolved your situation. But I do want to say, even if you are in countries where medical care is expensive, please consult your general practitioner. If you read X on the internet about your symptoms along with cures (or the awesome reference Jerod uses: fixes), the same fix might not work for you.

Sure sometimes for minor things it works, but please do consult professionals. You only have one body.

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cubiclebuddha profile image
Cubicle Buddha

These are great tips Jerod. I agree with Wesley though about seeking help from an expert. If I hadn't done that, then I'd still be sad and depressed from all the pain. There wasn't a keyboard or mouse that could solve the issues I had. But I'm finally back to health: "What Physical Therapy taught me about enjoying life"

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twobridges profile image
Dean Grande • Edited on

Keymouse.com could be worth considering (not cheap though!). It's basically two mice with half a keyboard built in to each. The benefit I see is that it eliminates arm movement between mouse and keyboard.

I currently have a Logitech g502 mouse which has 9 programmable buttons. I've set this up with cursor control, page up/down, home/end, enter, delete, backspace and zero. You can assign 2 functions to each button (normal and g-shift)

The 502 has made programming much faster and perhaps halves arm movement which feels great compared to a normal setup.

Keymouse looks like an improvement on my setup so I'll hopefully try one soon.