How do you organize all the keyboard shortcuts you've acquired over your career?

‪I'd like to hear how people have coped with the situation of running out of space on your keyboard due to the copious amounts of keyboard shortcuts you have programmed. Plus, the issue of a shortcut conflict when an app is open in the background with the same shortcut keys that you're trying to use but instead are only wreaking havoc on your other app.

It's also the concept that I've truly exhausted all the easy ways to use/remember the shortcuts I need everyday only to have another piece of software come into my life and I gotta figure out where I can harbor this New Key on the Block. So my question truly is: after you've used up all the standard Modifier + letters shortcuts and your pinky has grown an extra half inch for reaching all the way to the numbers row while still holding CMD + Opt with the same hand for the last month what do people do to accommodate this issue?