Comment by georgieporgie | Hacker News Reader

Comment by georgieporgie | Hacker News Reader

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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.

Wrist pain can be a product of Thoracic Outlet Syndrome. http://en.wikipedia.org/wiki/Thoracic_outlet_syndrome

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.

Got a link to some diagrams showing what "isometric training on bars and doorframes" means?

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.

Great advice. I can attest to the wrist strengthen and stretching as well.

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