Software Development Is Bad For Your Health
alexmedearis.com
alexmedearis.com
Fortunately I managed to find a combination that worked for me. The most important component was using a break program that made sure I took breaks to rest my arms and hands, and to do some exercises. I also switched to an ergonomic keyboard and mouse. I am now completely recovered, but it really made me realize that we need to pay attention to ergonomics.
I've written up my story in more detail here: http://henrikwarne.com/2012/02/18/how-i-beat-rsi/
In addition to what I mention in my post, I am now also using a height-adjustable desk (like the OP). It's really good to be able to switch between sitting and standing. If you are like me for the first 10 years of my career (i.e. ignoring ergonomics), consider paying a little bit of attention now, otherwise it may become a problem later on.
Pointing this out seems akin to hanging out with a friend in multiple social settings and when he tells a story you have heard before but the group hasn't, you stop him and tell him he's told that before.
I still experienced severe wrist pain, finally peaking out in 2010 where the pain and numbness was continuous. I assumed incorrectly that I had irreversible nerve damage.
Unrelated to this I started doing upper body strength training. Besides going from not having done a pushup in years to doing hand stand pushups I can now sit at my computer for 12 hour stretches with zero pain. By the way, this was about 3 weeks of training before the pain vanished. Over the past few years I've had brief pain a handful of times, that went away quickly.
Now whenever I start developing any sort of problem I revert whatever piece of my lifestyle that is out of balance back to its normal state. I wish I had figured this out a decade ago.
http://news.bbc.co.uk/2/hi/6187080.stm
http://www2.rsna.org/timssnet/media/pressreleases/pr_target....
It seems like writing about ergonomics is bad for web servers ;-)
google cache to the rescue
http://webcache.googleusercontent.com/search?q=cache:http://...
- Don't use your laptop without a 'docking station' for long. Strain to your neck, back and hand/wrist. A mouse/keyboard and support to keep the screen at eye level does wonders
- Don't use a 'moving mouse'. Apple magic trackpad is great. Trackballs are great as well.
- Even better, limit the use of a pointing device (if your job allows it, e.g. for anything graphic this is difficult). Today I do most of my work with keyboard alone, even web browsing (the exception is clicking links and buttons)
Frequently working with two different folders? open a new window(Ctrl+N) and dock one window on each side of the screen with win+left/right. Then simply alt+tab between them, or use the win+nr if you have it docked on your taskbar.
The only thing i'm missing for keyboard navigation is a hotkey to toggle navigation bar on/off and a more sleek autocomplete, such as visual studios or quicksilver.
I have used Apple Magic trackpad for almost an year and I started having severe discomfort when I my middle and ring finger are stretched. I was not resting my palm properly and that probably contributed to the issue. I switched to an evoluent mouse (http://www.amazon.com/Evoluent-VerticalMouse-Regular-Right-V...) and it got better very fast (in couple of weeks).
For those who want to get started, but don't know how checkout Nerd Fitness: http://www.nerdfitness.com/blog/ I have no ties, only that it's a great place to start learning about how to take care of yourself.
Maybe the smartest and most talented person I ever met.
Born in 1895 is eastern Europe and as a child never went to school, missed many meals, feared for his safety, and emigrated to the U.S. alone at age 11. Married my grandmother 6 years later and raised 6 children in a 2 room flat during the depression. His entire adulthood: painted buildings with lead-based paint, installed asbestos, smoked cigarettes, and lived in Pittsburgh back when the skies were black with soot all day long. Worked his ass off and suffered and died from emphysema at age 80.
Me:
I write software in an air-conditioned office, eat delicious healthy food every meal, work out at a fancy gym, and have more money than I know what to do with.
I'd say we have it pretty easy.
The right comparison is between you and someone who has achieved the same education/social level in the same period of time.
My own grandfather did hard manual labor his entire life and drank whisky like a fish until he was in his late 60's. Chewed tobacco his entire life. When he was 88 I saw him working in the back yard and he had muscles that I didn't have at my prime (in my 20's). He died at 95.
I walk 4 or more miles a day, 7 days a week, some up steep hills. That's my commute, on the days that I go to work, my exercise when I don't. I really don't expect that I'm simulating my grandfather's level of exercise, but I hope it does something to get me to 95, in as perfect health as my grandfather was when he died.
For a man born in 1895, life expectancy was 48 years. For a man born in 1985, life expectancy is 71 years.
For example, claims of necessary action based on real statistical data are unwarranted. The existence of populations that thrive in the so-called 'unhealthy environment' do show there are more variables at work. Who's trumpeting "we should all work like 1800's laborers for good health!"? Nobody, but not because its not true. Because we're lazy-ass modern narcissists who want a quick fix.
I can not connect my problems to bad ergonomics, because the way I was sitting in front of my computer all the way up until university years, those were far from ergonomic positions. But if you are relaxed and have fun, you automatically vary your posture and position.
Ergonomic chairs and keyboards are only one way to make you be able to endure your stressful work condition a bit longer when you sit there stressed trying to meet deadlines and whatever problems you fight with. The pains will show up, only later.
Myself, I often try to wake up from the work, feel my body and if I'm actually stressed. Take a deep breath, see if I can let my arms hang loose and relaxed. If I feel that I'm actually sweaty and have a high pulse, then I need to go for a walk. A good manager that I can bring this up with helps.
Also a bit of a fuck-off attitude also helps: My health is so much more valuable than the job and its compensation.
I suggest reading "The Mindbody Prescription" by Dr John E Sarno. Here is one of the better summary of the ideas (in Word doc format): http://www.rsi.deas.harvard.edu/handout.doc
Personally, I have been pain free for over 10 years thanks to this.
Here is the story of someone else who cured his RSI pain using this method, it is very similar to what I experienced: http://aaroniba.net/articles/tmp/how-i-cured-my-rsi-pain.htm...
Anyways, the symptoms disappeared quite suddenly during an LSD trip, weirdly enough. It was one of the most blissful days of my life, just relaxing in nature with some good friends.
Still unemployed and depressed, but at least I don't have horrible pain to deal with every day...
If your boss won't allow you to do this then seriously consider quitting. Your personal health is way more important than some job where you're taking orders from someone who won't even give you 10min to walk around.
Edit: I've gotten some great responses below. In case it helps anyone here is what I do to help myself:
* lower the brightness of displays as low as possible
* make sure I am looking down at any screens
* fish oil supplements
* I wear these ridiculous yellow tinted motorcycle sunglasses (motorcycle sunglasses are padded, trapping moisture)
* avoid overhead fluorescent lighting
Of course, this is just one of the possible causes.
Other things that can help:
- Have good ambient light. Don't look at monitors in the dark.
- Adjust the monitor backlight/bright to as low as possible, while it still looks good.
- Take short rests often. Every ~40 minutes, get away of the computer. Look at a distant point in the horizon for a couple of minutes.
Also, as monitors have gone up in resolution over the years, pixel density has increased, shrinking the default font size from what is appropriate for the eyes.
Lowering the brightness is not always beneficial. In fact, the opposite can be true. Brightness is usually controlled electronically by rapidly switching the backlight on and off. Therefore, lowering the brightness can increase the amount of flicker, which is imperceptible but still implicated in strain. Try turning the brightness all the way up, which will minimize flicker. If it's too bright, wear sunglasses and see if that helps.
This one has been the big one for me. My vision is not excellent, and the coke-bottle glasses are a testament to that, but I'm just about 20/20 with them on and I still end up feeling weird after staring at a screen for too long. I tend to use fonts about three steps up from normal size and I never have problems anymore.
Big fonts and 1920x1200 (Retina) on a 15" screen makes for a lot of workspace and it looks good. :)
It'd be great if many apps actually let you do that. Finder on OSX - how do increase the font size there? IntelliJ - how do you increase the font size there? I can increase the font size of my editing area, but not of the tree area with files in it.
Have been using macs for the past few years, and this is my one of my biggest bugbears - font sizes are often very locked down, and I end up having to shift my position or squint.
While browsing a folder, do a secondary click (right button on Magic Mouse or two-finger click on a trackpad), open "Show view options". A popup window will appear; select your desired font size (I think 16px is the maximum). Then click on "Use as defaults" and all folder and file labels will use the same font size.
I was on the brink of RSI (numbness in the fingers) until I changed to a Kinesis Advantage keyboard, and a trackball mouse (thumb movement). Some lingering issues were cleared up with exercise -- mostly wrist rollers and grip training. I still use a flat keyboard & normal mouse occasionally without issue.
Back pain is a little battle, but a good chair (Steelcase Think) is night & day if you're sitting for more than a few hours at a time. Generally I do the best here when I'm not being lazy about my exercise. Squats, deadlifts, weighted sit-ups, etc. all help a ton.
Also agree that most people here would benefit from a strength training routine.
The only OS that I've had issues on is Windows. There's a USB3 driver issue there. But I don't program in Windows, so doesn't affect me.
There is one thing that I missed though: play, pause, ff, volume and brightness controls on the keyboard. I haven't worked out a solution for volume and brightness, but play, pause, and ff I do with keyboard shortcuts through Quicksilver.
The solution that worked for me came from books by Pete Egoscue. "Health Through Motion", especially: http://www.amazon.com/Egoscue-Method-Health-Through-Motion/d...
He describes how to analyze posture (once you learn, you see signs of bad posture -- aka muscle imbalances -- in nearly everyone: people at work, at the store, even professional athletes), and then he lists dozens of simple exercises that work to restore your muscle balance. And at some point you'll do an exercise that engages a muscle you haven't used in years, and when that happens, your body feels FANTASTIC!!
The books are just the tip of the iceberg, too. There are Egoscue clinics around the country that can take you to advanced levels.
Trigger point therapy was the big one. I had a few spots in my right forearm that were messed up. The therapist jabbed them. It hurt terribly, but then my arm was much better.
I'm strong enough that I can now do the same thing to my own arm if I feel it getting tense. Armaid is also a great tool for this.
On my left arm, I had something worse. Found a physiotherapist who did MAT (muscle activation technique) and he managed to work out some adhesions in the upper part of my left hand.
If you have pain, go see a relevant therapist. There's a decent chance you have some kind of muscle trouble.
Note: I saw several non-useful therapists. For muscle adhesion problems, results should be pretty quick. I only needed 1-2 sessions with each of these guys.
Standing is so much better for you: http://www.bbc.co.uk/news/education-20947605
and http://www.washingtonpost.com/wp-dyn/content/article/2010/10...
and http://www.nytimes.com/2012/12/02/business/stand-up-desks-ga...
Use of this keyboard totally reduced very severe hand pain.
Also, after an adjustment period, I now type faster.
I'm so excited for it to come in the mail it makes me sick.
The idea with the saddle is that it is so unbalanced that you have to correct your position with small movements all the time.
The mouse should move very easily. (try lightly touching it with you little finger)
Green Tea keeps me moving.
What about milk, sugarfree soda, or sugarfree juice?
Sugarfree soda = the devil.
Sugarfree juice -- the real stuff -- is probably ok in moderation. However, a good chunk of the health value in fruits comes with the pulps and skins and pithes and the like. Fruit juice is really just a portion of the healthy nutrients one can get from fruit. Moderation is the key, as the glycemic load of fruit juice, even just the squeezed stuff, can really be high.
Never mind what all this stuff does to one's dental health, which is harsh (even milk is a culprit.) I simply can't encourage those of us who sit at desks in this job to drink enough water. 64 oz is the recommended minimum a day, but I think it should be higher.
Caveat: this works for me, so your mileage may vary.
Working at the DMV is bad for your health
Being a lawyer is bad for your health
Working in management is bad for your health
Driving for a living is (really) bad for your health
etc
Am planning to invest in a good ergonomic chair myself, have decided on Herman Miller Mirra chair. Any suggestion on other not so costly chairs?
The Aeron is a bit cheaper and you can find quite some at a bargain price if you're in the U.S.
I forked that and $300 or so on a Topre-switch based keyboard (an HHKB Pro 2 but YMMV, some people prefer bigger keyboards -- I'd rather move my hands / fingers as few as possible). Probably that a real split / symmetric keyboard like the Kinesis Advantage or the Maltron are even better (they're using Cherry Mx switches, no Topre).
Instead of buying expensive things go buy experts book on the area of posture, or better, go talk with expert people in the field. Books like this helped me in the past(I had pain in my back years ago) : http://www.amazon.com/Steps-Pain-Free-Back-Solutions-Shoulde...
But I assert you that in the area you live there is already lots of good people that could help you. In my area I found a martial arts expert(that won Olympic gold medals when young) that could identify wrong postures from an eye shot.
PS: I code mostly standing up and with a high stool.
For my own part, I'm not someone who crunches at the keyboard for sustained periods of time, and I regularly switch up between mouse and trackpad and trackball. But I wonder if for non-hackers, the reliance on the mouse and, in my opinion, extremely inefficient computer operating methods, is a factor in how a standard office worker can get CTS even though they spend less time at a computer than your average professional developer.
In most cases there seems to be no long-term damage, and the injuries in question are probably not terribly serious. It's just harder to rest one wrists or fingers than it is (say) one's knee, ankle or shoulder.
The pain is gone now, but I take ergonomics quite a bit more seriously. I'm considering getting a split keyboard, although it breaks my heart to have to get rid of my clicky das.
http://www.kinesis-ergo.com/advantage.htm
I have one and love it. You have to be willing to invest time in it though: it took me 2 weeks to get up to full speed, plus I spent a bunch of time remapping the thumb keys to my liking.
Something else I tried was putting my mouse on a slant away from the keyboard so that the radius and ulna were not as pronated. This helped, but my mouse kept sliding off the incline. Ideally I'd like something at an angle in between a standard horizontal mouse and the vertical ones like the Evoluent. It seems there are a few new models on Amazon since I looked last--may have to try one. My pain is more in the arm than the wrist, so fine wrist motion is more important than being completely vertical. At some point it may just make sense to 3D print a mouse of the appropriate shape...
http://www.humanscale.com/products/product_detail.cfm?group=...
I use one daily and really like it, although its made of cheap plastic. The $99 list price is pushing it, you can probably find one on ebay for ~$30. I got mine for free at the Humanscale showroom when I went to look at their chairs.
Now, I primarily use the left-handed Evoluent mouse. During periods of intense mousing, if I start to feel pain, I'll switch to the right-handed Evoluent mouse for a week or two.
You mentioned wanting a mouse which put your hand at an angle in between a standard mouse (horizontal) and the Evoluent mouse (vertical). Is there a particular reason for this?
I ask because I've found the Evoluent to be incredibly comfortable. Besides which, a vertical orientation most closely emulates the position your hands would be in when you are anatomically at rest (standing, with your hands hanging down at your sides).
As much as I love the Evoluent mouse, I still feel that eliminating mousing from my computer use is the Right Way to address mouse related pain. Treat the root cause, not the symptoms, as they say.
I basically use keyboard shortcuts for everything. The two parts of using a computer which I found most difficult to control with a keyboard were web browsing and window resizing / management.
For web browsing I stumbled upon Chrome + the Vimium extension. It has non-chording key bindings for switching tabs, moving around on the page, following links, copying (yanking) text, etc. Basically, Vimium adds Vim-like keybindings to many common browser tasks. Find it here: http://vimium.github.com/
For window resizing and management, I use Moom (it's a Mac application). It is fantastic. You can setup key bindings to resize a window to a preset dimension, among other things; but that's what I use it for primarily. I have 3 key bindings that I use all the time: 1) full screen, 2) two thirds on the left side of the screen, and 3) one third on the right hand side of the screen. Moom is here: http://manytricks.com/moom/
I've also become aware of Slate for window management on the Mac, which looks amazing, but is a tool of the large investment / large payoff sort, and I just haven't had much free time lately. Slate is here: https://github.com/jigish/slate
So I even bought this heavy Logitech Natural Keyboard, I think things improved a lot. Anyway, from time to time I still had minor issues.
Being 28 now, working since some years fulltime as developer with normal keyboards, I hardly have such issues anymore. Although I have to admit that I pay attention that I get up from time to time. But I am definitely no ergonomics ideal. Half of the time I sit like depicted on the picture on the OP's link and in the evenings even worse when I hack at home on my laptop.