I guess it was inevitable with my line of work, my wrists are starting to show signs of repetitive strain injury. I'm curious what others here have done to deal with it, as I ponder my options.

One thing that has helped greatly at work is switching full time to the Magic Trackpad with my left hand, instead of using the Revolution MX mouse with my right hand. However, it hasn't taken care of the issue completely, and I still have minor pain at the end of a work day.

Two of my coworkers at Vigil had the Fingerworks Touchstream keyboards, and seemed to really like them. The one problem with that route for me is finding one for sale, as the company was acquired by Apple in 2005. Retail price was $300 new, aftermarket sales sometimes hit the 4 digit range.

When I had a bout of RSI back 10+ years ago, I simply switched hands and learnt to use the mouse as a lefty.

Problem went away, and eventually I found myself back as a righty again.

Cheers

Me too around about 1995. My employers health and safety dpt. Provides Ergo Evals.

They did one for me, and while I didn't pay attention to all the recommendations, I did pay attention to the one about the wrist. Pain dose that.

A simple wrist pad in front of the mouse, elevating the wrist, straightening the tendons solved my problem.

It's dorky, they look ridiculous, most of them anyway, but the pain went away. Relief isn't instant, the recovery was slow but it did happen.

I had a Touchstream for about a year. The gesture support was amazing, but typing on it without tactile feedback was way too difficult. I eventually got to maybe 60-70% of my typing speed, but it took a lot of concentration. Sure, having the gestures available anywhere saved some switching back and forth form the keyboard to a mouse/trackpad, but overall, except for casual usage, it wasn't workable -- certainly not for someone who writes code for a living.

Some people on the forums claimed to get close to their old typing speed, but I have to think that they were folks who didn't type that fast to begin with, or who had more severe RSI / handicaps that made conventional typing too difficult. For someone with only minor RSI or who types in the 50wpm or higher range, I can't see how it would be a net positive.

It'll be interesting to see if Apple ever tries to reincarnate the idea in some form or another -- there have been rumors to that effect, but none I'd call reliable.

When I was a college undergrad, in the summer of 1991, I trashed my wrists quite thoroughly and wrote the initial Typing Injury FAQ, back when that meant running a robot that regularly reposted those documents to Usenet. I later moved it to the web (~1993) and passed it onto somebody else (~1997). The current web site, such as it is (with a split between tifaq.com and tifaq.org, with both sucking - both used to redirect to one place), is a sad leftover.

For what it's worth, my recovery from the hell of bilateral tendinitis (at its worst, I couldn't pick up a toothbrush) was a combination of:

- a Kinesis Contoured / Ergonomic Keyboard (costing a whopping $700 in 1992, and I had to pick up an aging 286 and write the software to adapt it to drive the Sun workstation I was really trying to use; now it's $200 or so and has a standard USB interface); cool bonus, I can type maybe 80wpm on a standard keyboard and over 100wpm on a Kinesis.

- having my own desk and chair suited to my needs, notably including removing the arm rests and having the keyboard as low as possible to my lap (bad posture, in every possible way, was a significant contributor to my original injury)

- learning and tweaking all the keyboard equivalents, so I don't use the mouse as much, and specifically going out of my way to avoid click-dragging (which is radically worse for you than just clicking)

When I was initially recovering from my injury, they had me in wrist braces (which sucked), had me taking 800mg of ibuprofen, multiple times daily (which felt awful), and had me doing ice baths (which were an exercise in torture). It probably took two solid years for me to even vaguely recover, and another five years for me to feel that I was truly healed. Among my discoveries:

- hot/cold contrast baths, which you can do in any sink, were every bit as effective (for me) as plunging my wrists in ice, but were far less painful

- keeping my wrists warm, while working, was and still is essential to being comfortable (I even convinced a friend, who wanted to knit me some socks, that what I really wanted were some custom arm tubes, which I used for driving and for typing years after my initial injury)

- I got a professional-grade Plantronics headset for my office desk phone; it's the only comfortable way to have a long phone call and still be able to use my computer

There is no one product or gizmo that can single-handedly help you recover from a nasty repetitive-strain injury. The best thing, of course, is not to get one in the first place and to listen to your own body. If it hurts a little and you say "oh, I just need to finish this one thing" you're asking for a world of hurt where you really, really don't want to go. To recover from my injury, I did all kinds of self-experimentation, like the arm-tubes above (which started as an experiment with socks sans feet). It took that kind of all-out effort to claw my way back.

Really, you cannot possibly be too vigilant in taking care of your hands.

Perhaps the products from this company would help? The keyboard is motorized and changes position every few minutes. I believe the mouse is mostly on some sort of pivot. You can see an interview with the inventor at CES starting around minute 21 here.

I used a combination of a wrist rest for my mouse, a wrist guard (which I still wear some days if I am doing far too much computer work - it helps the wrist rest to keep my wrist elevated) and an ergonomic keyboard.

When it is really bad, large quantities of ibuprofen followed by ice baths help immediately to kill the pain so you can then get on with doing something else.

Longer term - playing the guitar really gets the wrist moving properly again, and ensures the blood flow is back up (as that is one of the issues I had - the swelling reduced blood flow to my hand)

The general progression of evil goes something like swelling --> reduced blood flow --> increased friction in your tendons --> increased swelling. Ice or contrast baths are fantastic at reducing swelling, but you have to take care to let yourself warm back up before using your hands again. Trying to get work out of cold hands/wrists is a recipe for more of the aforementioned cycle of doom.

Wrist rests/wrist guards have dubious benefits. The do encourage proper posture, but you really don't want any pressure on your palms or wrists, since that gets back to the cycle of evil again. With even a cheap keyboard tray (I have a cheapo plastic Kensington drawer model that I screwed into the bottom of my desk), a better keyboard like the Kinesis, and so forth, you end up with your elbows hanging straight below your shoulders, so there's less weight that you would otherwise need to support on a wrist rest.

Wrist rests are evil. I'm convinced that they're what cause typing and mouse-related RSI 90% of the time. Just learn to type with your wrists loose but at a neutral angle. Yes, your arms will get tired after a while, but that just means that it's time to get up and do something else for a while anyway.

My mother was a professional typist for many years — at least 15 — and I never knew her to have any wrist pain or espouse any physical recommendations beside just holding your wrists properly. And by "professional typist", I don't mean "secretary". She transcribed court cases and 90% of her job was typing. And on a real typewriter; not these low-pressure mush-boards we have now. In fact, I use a mechanical keyboard, mostly because I like how they feel, but it has been suggested that the way one types on a mechanical keyboard is better for you than on a membrane keyboard because you don't end up bottoming out on the key; you actually press less hard, despite the fact that the pressure required to activate the key is actually more.

Many people swear by those old IBM ka-chink ka-chink keyboards. A buddy of mine keeps several in his closet, "just in case." Kinesis was also modestly clever in their design, where the key switch activates very close to the top, but has a long travel after that. You can teach yourself to type with less effort and you never bottom out.

Yeah - for a couple of machines I still use original IBM keyboards - I just like the noise - but for my main one I use a Logitech G15, which is pretty nice.

I love those, and use them for my home PCs.

Actually, they are still being produced by Unicomp:

http://en.wikipedia.org/wiki/Unicomp
http://pckeyboards.stores.yahoo.net/keyboards.html

One of my coworkers is already pissy about the noise from the buckling dome keyboard I have now. There would be a total melt down If...

Dan, thank you very much for that post. I am fortunate in that I have had only minor brushes with RSI, but you have opened my eyes to the real danger. I had always assumed that if my wrists started hurting, I'd just back off from the computer for a day or so and everything would be all right.

I had no idea that the recovery was so long and so difficult.

I am going to be more careful and much more aware of what is going on with my arms, wrists, and keyboard from now on.

tanstaafl.

I've had a Kinesis since around 1998 or so. I still love them (although I did upgrade to a USB version). It helped my wrist pain so much that I bought an extra one just to take to work (was faster than waiting for work to purchase it). It took less than a day to learn to type on it and feels so much more natural than flat keyboards.