Wrist supports are one of the worst things you could buy for yourself. All you're doing is further weakening the supporting muscles, and making the injury worse.
Buy yourself a set of climbing shoes, a chalk bag, and a membership to a climbing gym. Your wrists, not to mention your whole body, will get a lot stronger, and RSI will become a thing of the past.
Completely anecdotal, but I used to climb a lot, before moving to Tokyo, and since I've been here, haven't been out once... and you know what? Wrist pain.
I always thought that CTS was caused by the muscles in the wrists being over developed. But I just read the Wikipedia article[0], and it seems that there is no evidence that CTS is related to typing. I'm not sure if wrist health can be helped by braces or exercise, except that it can be caused by obesity.
This is a great piece of marketing though, whether it is intended to be one or not. I wonder how many wrist braces were sold.
When typing, the muscles on the outside of the forearm (anterior group) get a lot more use than the ones on the inside (posterior group), so they get a lot stronger. This lack of balance is (likely) a contributing factor to CTS, in the same way that a weak neck and thoracic stabilizers cause UCS (upper-cross syndrome)
Climbing is ideal here, because you spend a lot of time grabbing and holding on from odd angles, giving your entire forearm a solid workout.
Completely agree. By not allowing your wrists to take any stress, the muscles will get weaker, not stronger.
Far better to take that money spent on wrist braces and buy a decent keyboard instead (<insert Kenesis Ergo plug here>).
I would concede that there is a time for wrist braces - if you are developing RSI issues, wearing a wrist brace in bed can help you from accidentally sleeping with your wrists in an unnatural position and aggravating the situation.
You know what really works? Swap your keyboard and mouse every month. The subtle changes in geometry and force between 3 or 4 sets of keyboards/mice somehow prevents RSI from becoming chronic.
I once suffered terribly from RSI, until I got a small collection of input devices and established the habit of changing them every now and then. For the last 10 years I've been swapping between an Apple wireless keyboard, a Vivanco generica, and a Logitech keyboard every few months, different mice too. It feels great..
The main point is always worth reiterating (take care of your body), but before a bunch of people run out and buy wrist supports I just want to add that things like this are not universally endorsed by physical therapists (or fellow injury-prone hackers). They can lead to secondary issues like atrophy and poor circulation, which in turn lead to more issues, etc.
Having been through multiple versions of these (the kind he has, less restrictive ones, custom-molded ones), I found my body held up best when I kept it active and strong on its own. The term "crutch" has a double meaning in the English language for a reason: sometimes it's truly necessary, but when it's not truly necessary it's actually hurting you in the long run.
It's worse, actually. Last I remember reading the whole idea of keyboard-induced RSI is basically a myth. For RSI sufferers, keyboard use irritates the problem to the point where it can be debilitating. But there is no known correlation between keyboard use and RSI.
Some people have wrist pain, some (like me, despite living full time at a keyboard for most of the last 20 years) don't. If you do, take care of yourself. But don't do stuff like this prophylacticly, it's more likely to hurt than help.
This. It should be pointed out that we already have 'wrist support' built in. It's called tendons and ligaments. Center a workout around heavy deadlifts twice per week, and these support structures are guaranteed to strengthen, along with the rest of the body.
It's much more comfortable sitting in a nice chair, with two big monitors, an external ergonomic keyboard (Microsoft Natural Keyboard Elite), and the Razer DeathAdder mouse (Not as ergonomic as a trackball mouse, but very ergonomic for a regular mouse).
You could do this with a laptop too, but you'll be more prone to coding on the couch, which will dramatically increase your chances of getting carpal tunnel.
At the peak of my RSI I could barely hold a mouse, I switched to an adesso keyboard with touchpad in the center. It didn't cure it but it had an immediate and fairly lasting impact for the better. I'm so used to using a touchpad now I only use the mouse for PC games. See my other comment in here for the full story.
I just skimmed through carpal tunnel papers on pubmed, and found a surprising large amount of papers stating, that there is no correlation between keyboard use and the syndrome.
I find myself wondering if the studies you reference actually studied the effects of poor posture, or only the use of keyboards themselves.
I have found I'm much more prone to discomfort in my wrists when I am typing on my 10" netbook half-lying down on the couch with my shoulders 30-45 degrees out-of-line with the monitor.
I'm wondering this because I might be using the keyboard and touchpad in a different way than others, but naturally for me, as in: the path of least resistance.
For scrolling, my right forearm points at the touchpad in a 45 degree angle, my middle finger touches the pad and I move my whole hand at the wrist to scroll. So all the middle finger does is touch the pad and raise again.
I use my right index finger for pointing. To move the cursor up & down I do the same as for scrolling, only with my index finger. For left & right I do what would look like pushing a marble to move the cursor left and the reverse to move it to the right. So my index finger really points (mostly) to the left side (depending on forearm position) and expands in it's natural path.
Regarding heavy keyboard use you often hear about the emacs pinky when somebody over years strenuously used their pinky to hold the control key down.
Well, I've noticed that I press control with the finger nail of my pinky and alt with the nail of my thumb. I'm sure it's unusual and it looks a bit funny, but it's completely natural to me and not strenuous at all.
Wouldn't wearing wrist supports all the time atrophy your wrist muscles and make the problem worse later? I always hear that doing free weights solves this issue. He says he's strapped for time, but there's also the old "spend time being sick later" adage.
Yes, aside from the occasional aching in the forearms and wrists the day or so after some tough pulls, working ones grip this way seems to be only for the better. Author got it right that prevention is the best approach to this kind of injury, but may have chosen the wrong method to do so.
I've been typing away on computers for fifteen years now and, knock on wood, never had any wrist problems. Split keyboards help a lot.
However, in the last few years, I've had increasing difficulty with my neck and shoulders, one one side mostly. I am also an avid whitewater kayaker, and the first time my shoulder cried out in protest, I put it down to making some wrong moves while playboating. Physical therapy and a break from the water took care of it eventually. So naturally I stopped the exercises, and the shoulder pain came back with a vengeance the first time I was back on the water.
Now paying attention to my posture, and doing neck and shoulder stretches several times a day, is slowly improving my condition. So don't forget to not only support your wrists, but also to support your whole lower arm, either by sitting very close to the table or by having a decent ergonomic chair with adjustable arm rests. It prevents your shoulders from hunching up and developing all sorts of knots in your shoulder and back muscles. Your neck will thank you.
I've been anti arm rest for awhile since I started guitar (another activity not great on your hands), and I've wondered if it takes its toll on you. I figured it doesn't do it any favors since your forearms are constantly engaged as you type without an arm rest.
I recently had a new suit tailored and was surpised/amused to learn that my right arm is 1/4" longer than my left (this hasn't been the case when I've been measured in the past). My guess is that I was out of alignment from my habit of sitting slightly diagonal to my desk and reaching for my mouse with my right hand for much of the day.
I'm already much more of a keyboard guy than a "mouser" (as I'm sure most HNer's are) -- but I'm switching to a standing desk next week and correcting my bad habits. I'm to young for this!...
Besides the physical impact, you should definitely look into the mental impact of the craft as well. I've learned (unfortunately through the hard way) that regular exercise (be it yoga, running, etc) helps to relieve stress that our body encounters throughout the day.
I've never liked wrist braces. Much better, in my opinion, to exercise and not bash your wrists up with too much programming.
If my mousing wrist does ever get sore, I have a Logitech Marble trackball that I use until any pain goes away. Motrin can also be your friend to reduce inflammation.
I've also recently switched from a somewhat mushy Apple clear keyboard to one of the aluminum and chiclet metal ones. Seems ok so far, and pretty close to a laptop feel.
Seems like a better way to take care of yourself would be to get some exercise in this case. I bought one of those spinning gyro thingies for my wrist. I got them spinning pretty good but then I got elbow pain. Got more exercise and re-started supplements like chondroitin and glucosamine (these do wonders after a couple months) and now no pain. Should be able to do wrist exercises again soon.
I'm not a fan of wrist supports for everyday use. My strategy:
1) Kinesis keyboard
2) trackball on left and right side of keyboard, to balance mousing
3) lift weights 3 times/week
4) fish oil supplements once a day (mild anti-inflammatory)
5) standing desk
Having trackballs on both sides of the keyboard while standing lets you CODE LIKE A BOSS.
I've found setting my mouse sensitivity (pointer speed) to maximum helps reduce wrist movement. It takes just a little getting use to, but once you adjust to the increased speed your wrist moves very little. This is especially good for large displays (I have a triple monitor setup).
Switch to a touchpad keyboard. Try an adesso tru-form. It will feel really weird and uncomfortable for the first week, and then you won't look back. The only thing I can't do effectively on it now is PC games, especially FPSs.
Why not Colemak instead? Colemac is both more similar to QWERTY than Dvorak (so a lot of keyboard shortcuts like Ctrl+Z/X/C/V still works and also easier to learn) and more efficient.
Any idea if it is possible to re-arrange the backlit keys on a MacBook Air? I used to use Dvorak before I switched to Macs with their pretty keyboards.
No mention of WorkRave or AntiRSI on an RSI-related article? We're getting slow! As soon as your wrists start hurting, install the appropriate one for your platform. It will irritate the hell out of you, but save your wrists...
Upon graduating college and entering the workforce, I was debilitated by awful wrist pain. It was so bad, I could barely shift my car on the way home.
Over a decade later, my wrists hardly ever bother me. Physical therapy taught me to regularly stretch my wrists, and how to strengthen them. I began pursuing other activities which further strengthened my wrists (rock climbing is particularly great, so long as you avoid overdoing it and injuring yourself worse).
My basic advice to people now is:
1) Follow the Pomodoro technique, or whatever it takes to force yourself to get up, stretch, and move around for at least five minutes per hour. We all sort of hear that and nod, but think about how many times you've gotten really deep into a problem and sat there, twisted like a pretzel as you try to solve it, for hours on end. You have to condition yourself to take real, meaningful breaks.
2) Sit up straight, dammit. In every photo we ever see of new startups, how many people are sitting with good posture? None of them.
3) Get a keyboard with light-touch Cherry key switches. I'm partial to the Kinesis ergo line, but there are others.
4) Get active. Straighten your spine and go for a walk around the block a few times per day. Take up yoga, climbing, martial arts, or weight lifting. Focus on improving posture, flexibility, and balanced strength. Find some hobby that will get you away from the computer.
I'm really pleased you mentioned stretching your wrists. I used to work for a university in New Zealand, which had a number of people off work because of RSI injuries. As New Zealand is a welfare state, the university was paying near-full wages to these ineffective workers, and some of them didn't come back for months or years.
They hired a nurse just for RSI injuries. The first and most important rule was "Muscles don't rebuild if you don't use them, so if they are hurting, you have to use them, not protect them." Everyone had been putting their wrists into wrist supports (which is what you would do if it was a broken bone or broken skin), and the pain wouldn't go away because the wrists weren't active, and thus weren't healing.
Whenever I see someone wearing a wrist support, I bite my tongue and try not to tell them to get it off, as its making it worse. I think I just sound like a self-important jerk, so I try not to.
Going to the gym, exercising my shoulders and wrists, is the best RSI medicine I've ever found.
> 2) Sit up straight, dammit. In every photo we ever see of new startups, how many people are sitting with good posture? None of them.
Do you have data that indicates that contributes to RSI? My personal experience is that trying to "sit up straight" and maintain "good" posture is the fastest, most direct route to wrist pain. Like, less than a half hour. By contrast, if I slouch my body, my wrists can maintain a graceful positive curve (not straight or bent back) and I can comfortably code or game for hours (though I try not to sit in one place that long, in general). As a side benefit, this also puts my eyes at a better angle when I'm using the laptop screen.
The thoracic region of the spine is supposedly very sturdy and resilient to injury. But sitting hunched over with head forward over many years can catch up to you.
It's possible that other parts of your workstation are out of place (this is something I need to figure out how to fix myself): chair height, monitor distance, chair angle, desk height, etc.
Do you have data that indicates that contributes to RSI?
Well, I have horrendous neck and shoulder problems from years of sitting improperly. I had no issues whatsoever for decades of uber-nerdy computing, then blammo, I went from, "my neck seems tense" to "my left index finger is numb and I can't sit at a computer for more than an hour" in a couple of months. An ex, who had previously been a massage therapist, even specifically warned me that I had problems in the upper back area, but since I felt no discomfort I ignored her.
Here's the really bothersome part: while this awful neck/back injury was developing, things that were terrible for me actually felt good. For example, having one leg crossed over the other, left arm on my knee, slouching forward with my chin resting on my hand. It felt like a great neck stretch but, wow, was it ever demolishing my neck!
As for RSI with regards to the wrist and hands, I don't see how proper posture could exacerbate wrist pain. If it does, I would suspect that you need to examine other factors, like keyboard height and hand placement width (e.g. my Kinesis puts my hands much further apart than a standard keyboard, which makes a huge difference in wrist pain).
By the way, did you know that modern shirts are actually cut differently than decades past, because the average person's shoulders have rotated significantly forward? If you try to maintain posture in a typical, modern shirt, you'll have bunching in weird places because it's not cut for that!
I dropped out of college and within 6 months had debilitating wrist pain. I couldn't even hold a mouse for more than about 20 minutes. I "fixed" it through wrist braces, like the author suggested, ergonomic keyboards (paid $1000 for a datahand keyboard while it was out of production), etc. Yet I still couldn't do simple thing like use a laptop keyboard pain free for 15 minutes. However, it was not until last year that I eliminated the pain completely.
The solution was simple strength training. Not weight lifting (I think that was a major contributor early on.) Within a few weeks of starting the beginner program in the book "You Are Your Own Gym" the pain was gone. I fully expected to have severe wrist pain and nerve damage for the rest of my life.
I hope this helps someone. The solutions to this problem are overblown (granted I suspect a combination of wrist braces and pain killers could push some people far past a recoverable edge.)
I second yoga. I have dreadful problems with my neck and back, and my arms - I am one of those who sits like a pretzel for 8 hours working on a problem.
Yoga works out all of the auxiliary, odd little muscles, and the stretches are great for my posture. And the girls in the class are beyond hot.
The fastest and easiest route to overall strength I've found(and regularly recommend in these types of threads) is isometric training on bars and doorframes. Daily 5-second holds at max power, done a few times from a few different angles, are sufficient to build strength from the toes through the fingertips, including the joints as well as the muscles. Each time I do it the body naturally buckles in a slightly different area, reflecting the current "bottleneck" of overall strength.
About 13 months in, the only kind of pain I get now is from sitting for _too long_ in a static position, which is already established as problematic in other ways.
Thanks for the advice. My left wrist has had a dull ache in it for years until I realized it was caused by my hand positioning on my laptop. I got some wrist supports similar to those mentioned in the article, but they don't seem to help very much. I'll definitely take your advice and do some physical therapy.
Buy yourself a set of climbing shoes, a chalk bag, and a membership to a climbing gym. Your wrists, not to mention your whole body, will get a lot stronger, and RSI will become a thing of the past.
Completely anecdotal, but I used to climb a lot, before moving to Tokyo, and since I've been here, haven't been out once... and you know what? Wrist pain.
Exercise. Your body needs it.