In the Lisp Keyboard we can see that CTRL key can be press with the thumb.
The bottom corner position in modern keyboards is painful for the pinky finger.
For years I switch CTRL key and TAB key, whereas this is better, you still overuse pinky finger.
Nowadays I use palm to press CTRL (I found this trick here: http://ergoemacs.org/emacs/emacs_pinky.html). I stick a pad on CTRL buttons to improve the trick.
Fundamentally, IMO, Emacs just has poor ergonomics. Single chorded key sequences are one thing... other editors and IDEs, including Vim, frequently rely on single chorded commands or a single chorded command followed by a sequence of single characters.
But having to enter multiple chorded keys in a sequence to complete a command greatly exacerbates RSI issues when using Emacs heavily, as the meta key has to be held for a much longer period of time.
Fortunately, there are options like evil and viper that give you the best of both worlds (though I've never made that transition).