Tips for typing with an injured arm?

October 11, 2004 12:51 AM

Last month, I injured the nerves in my left forearm. Since then, I have not been able to work - I type for a living. Worse yet, I type code for a living. (more inside)

Typing itself did not cause my injury. When I moved, I gave away my old desk and began using an old oak work table, the kind you might have seen in study hall thirty or so years ago. The upside is the table is quite roomy and fits perfectly in my rather small apartment. The downside is that when I rest my arms to type, it causes the nerve that runs under my forearm into my last two fingers to become aggrivated. Untreated, the nerves caused the muscles to become inflamed. I have maintained full use of my hands otherwise and can type some without serious pain or discomfort, just not long enough or consistant enough to produce billable hours.

I expect with continued treatment to some day be able to type again. In the mean time, I need to earn a pay check. Several people have suggested voice recognition software as the way other coders have used to overcome injuries to their typing arms or hands. What software would you suggest? From what I understand, Dragon Naturally Speaking is best suited for natural language transcription. What I need is to be able to say something like "pound bang foreward slash bin forward slash sh" and have it produce "#!/bin/sh".

I'm on Windows 2000, Windows XP Professional (SP2), Linux or Mac OS 10.3. My iBook is woefully underpowered, so any Mac software would need to be extremely special in order for me to suffer through using it as my primary machine.

Lastly, I'm looking for suggestions for wireless headsets to use with the software. I have a preference for Bluetooth headsets, but would be interested to hear your opinions of USB microphones or wired headsets. (The headset would serve a dual purpose - I'd also use it to access the phone line through my PC.)

Budget is a non-issue, but I expect to only use the software for one to four months, so I'd prefer not to spend thousands of dollars in software and equipment. Personal stories, experiences or links to others who have gone through similar ordeals would be appreciated. Thanks for your help.

posted by sequential to Health & Fitness (9 answers total)

While coding is for the most part thinking and not typing, I think for me having to speak out all my code would still be a major slow-down compared to typing it. Have you considered a one-handed keyboard layout?
posted by fvw at 1:19 AM on October 11, 2004

I know somebody (actually a coder at a mud I run (into the ground)) who went through a similar problem. She actually is using a dictation system now and I think she even has it working with emacs. She hasn't been on for a while because of time but I'll see if I can get in touch with her.
posted by substrate at 5:42 AM on October 11, 2004

I haven't tried using ViaVoice to code, but it did come with a "technical" vocabulary pack, and in theory could be trained as you suggest.

In my research on mics and voicerec, now a couple years old, wireless headsets were strongly NOT recommended. Things may have changed.

This place looks possibly helpful. So does this, and this.
posted by mwhybark at 6:36 AM on October 11, 2004

Do you have one of those padded cushy forearm rests yet? If no, go invest immediately. Google "ergonomics" or something, and do a basic assessment of your workspace. Your chair level, your desk, the position of your arms, etc. Occupational health stuff.

Sounds like you've compressed your ulnar nerve. I don't know much about the syndrome, but there may be suggestions that you could research with that knowledge. Could this be coming from your elbow? There's a syndrome for that, too.
posted by gramcracker at 7:41 AM on October 11, 2004

The FrogPad is great and you might even increase your typing speed over your old two-handed approach.
posted by 4easypayments at 7:50 AM on October 11, 2004

The downside is that when I rest my arms to type, it causes the nerve that runs under my forearm into my last two fingers to become aggrivated.

First of all, stop using that desk. Second, ergonomists say that you are not supposed to rest your arms while typing. Move your keyboard lower (you'll need a tray or very low table) let your upper arms hang down, and type without resting your forearms or wrists on anything. Good posture is crucial as well.

The following is from this site:

In a huge majority of my clients with ulnar nerve adhesions I have
discovered that the nerve seems to get stuck to the base of the
triceps, just above the elbow (tip of the bone). The triceps in that
area is a broad, flat tendon made up of dense, non-stretchy fascia.
The ulnar nerve passes right along side of this tendon. When stress is
present in the area (from muscle contraction, static positions with
the elbow bent, constant carrying of objects with the elbow bent,
etc.), the nerve seems to have more opportunity to get stuck to this
structure. This means that if your ulnar nerve is stuck in this
fashion, every time you bend your elbow the nerve gets more and more
irritated because it is being tugged but it can't slide along its
pathway. Here is one suggestion that you might find helpful:

Let's assume that your nerve is affected in your right arm. Place
your bent right arm across the front of your body. Place your left
hand over your elbow area and wrap your fingers around your arm to the
back of your arm, in the area just above the tip of your elbow. Press
your fingertips firmly into this area and while pressing, slowly
straighten and bend your arm. This places pressure on the tendonous
area that may be the site of the nerve adhesions and the motion of
your arm encourages the tissues to become less stuck.

This little technique may not solve all of your nerve symptoms, but it
often does make a considerable difference for the people I am treating
for this problem. It might be necessary for you to repeat this process
2 or 3 times a day until the symptoms diminish. Note that pressing
into the tendon may be uncomfortable if the tendon is adhered.
Remember to never do anything to your soft tissues that cause real
pain. If you find you overdo this process, stop doing it for several
days until the tissue calms down. Then try again, only more gently.
Remember, it does you absolutely no good whatsoever if you do
something to the point where it creates lingering pain.

posted by callmejay at 8:34 AM on October 11, 2004

I second this technique. Thanks to my Uncle Sam I've got trashed elbows--yay punitive pushups! Toward the end of my grad school career when I was in front of a computer ~14hrs/day things got so bad it felt like I'd bashed my funny bone 24/7. A combination of re-structuring my work environment, employing decent posture, and keeping the ulnar nerve from being trapped brought me back to mostly normal within a few months.

Other hints:

1. a big-ass trackball instead of a mouse will help force better posture
2. elastic elbow braces will also help you remember good posture
3. sleeping with arms straight keeps the tension off the nerve. I wrapped mine in towels FWIW. You feel totally silly, but a whole lot more comfortable

Finally, if you can see a physician, it's not a bad idea. If you let this go too long you'll eventually lose motor function in your hands and surgery to repair the damage is iffy at best.
posted by Fezboy! at 2:18 PM on October 11, 2004

I used Dragon Dictate for a while. It has fewer "natural language" rules and I found it tolerable. Not terrific, just tolerable. It worked OK for debugging but not writing huge amounts of code.
posted by plinth at 4:29 PM on October 11, 2004

If you let this go too long you'll eventually lose motor function in your hands and surgery to repair the damage is iffy at best.

This may be a myth. Get it from a reputable source (no offense, fezboy) before freaking out.
posted by callmejay at 8:24 AM on October 12, 2004