Need a crash course in ergonomics.

January 16, 2012 12:47 PM

Advice and a crash course regarding ergonomics (and, to a lesser degree, posture) needed for a young web worker with a Macbook Pro and some signs of RSI.

So, I've had symptoms of some sort of RSI for a while now - some aches in my wrists, weakness in my grip, etc. - but two recent occurrences have caused me to rethink how seriously i need to take this:

1. A bout of lower back pain for the last week that has at times been severe, especially when sitting down at work. (I saw my doctor about this on Saturday, and she personally believes it to be a narrowing of the spinal column that comes with age, and gave me a prescription for x-rays before moving forward. However, in her words, it can't hurt for me to take a look at how I'm sitting at work, and she seemed receptive when I mentioned a standing desk as a possibility.)

2. I realized that it's very difficult for me to write, with a pen, for any extended period of time, even for just a minute or so, if it's continuous writing (i.e. writing an essay) and not, say, making a list, where there's lots of stops-and-starts. I've been thinking lately that I want to write more, and it really depresses me to think that using a notepad/notebook to write won't be an option.

So, I want to start tackling this head-on. The only problem is, I know just about nothing about ergonomics, and I'm not sure where to start on making this better. There are some threads on best ergonomic equipment on AskMe, but the ones specifically talking about RSI seem to be at least a few years old, and I don't know what's been developed since in terms of mice, keyboards, stands, particularly since the "standing desk" phenomenon really got going online.

As for me, 27-year-old male (if it matters), employed to work on the new media side for a non-profit group - so, my day is basically spent on a computer. Currently, I use a Macbook Pro for work, at a simple table-like desk. There are so many questions I have here, but to give a sense of how little I know about this: should I use an external keyboard/mouse? Are there any mac-specific, particularly so I can still do stuff like switch pages by swiping on the trackpad? Is Dragon Dictation worthwhile? (I saw a good review on Engadget of the new 2.5 version.)

What about special gloves while working? Worth getting a weekly massage for my hands at a nearby physical therapy space? (A local spa, Graceful Services, offers something called a Tech Thumb massage.) Is there any ready-made standing desk-like set-ups that can be put on a desk? Is it *worse* for my hands if I'm standing up and still using the built-in laptop keyboard?

Is yoga worthwhile? Alexander Technique? Any new RSI programs for the mac that are particularly? I have a vacation coming up - would it help to take a 2-week break from using computer keyboards, or maybe limiting it to a half-hour per day?

Sorry for all the questions - I'm just a little freaked out by this issue, and appreciate any help I can get.

posted by Ash3000 to computers & internet (13 answers total)

I highly recommend you try this: http://www.armaid.com/

My problem is/was with my elbows but it will massage from
wrist to pit.

Also recommend stretching periodically and wearing wrist braces at night to keep your wrists straight.

Kind of confused as to why you mentioned what kind of computer you have.
posted by just sayin at 1:05 PM on January 16

I'm a 28-year-old male (if it matters) who uses a MBP all day. Here is what I have done:

-I learned Dvorak. My fingers have felt much better since. It's been a couple years.
-I use an external mouse for a lot of mousework, but I try to do almost everything with keyboard shortcuts because that's less movement. My mouse (Logitech G500) can be made to do anything you need shortcut-wise with the help of external software.
-I use a wristrest and I am careful to adjust my height relative to my Mac so there's no strain.
-I have the ability to stand while working. It makes my back feel better which helps me sit straighter which helps my fingers and wrists.

I don't feel the need for dictation software because of these steps but I have enjoyed Dragon in the past.
posted by michaelh at 1:09 PM on January 16

Thanks for the advice. As for the computer I'm using, mentioned it for 1. the compatibility issues (e.g. don't know if there's a external keyboard/mouse that will allow me to use the trackpad swipes, or is more intuitive for people used to the built-in keyboard) and 2. in case there's some specifics of the laptop that matter that I'm not aware of in finding an ergonomic solution, standing desk, etc.
posted by Ash3000 at 1:09 PM on January 16

Ah, I see. You might want to try a contour roller mouse pro too (USB).
posted by just sayin at 1:17 PM on January 16

I only recently got it so can't really give useful evaluative feedback yet, but I got one of these keyboards for my MBP, with the VIP addon kit
posted by Bwithh at 1:22 PM on January 16

Basic Laptop Ergonomics Tips (Vodafone)

You can use an Apple wireless keyboard and a magic track pad with your bluetooth MBP.
posted by plokent at 1:39 PM on January 16

Find a physical therapist who you like & is convient to you. Make an appointment to meet them to have them evaluate your wrists. In some states (NJ & NY happen to be among of them, not sure of the others) you have "direct access" to physical therapists for most insurance. That means that you can go to a qualified physical therapist, have them evaluate you, and then get approval from your health insurance to pay for at least part of it.

A good PT will give you specific stretches and strengthening exercises to do, meet with you at least weekly to evaluate whether you're getting better or worse, and help you do the exercises properly.

I've had off and on RSI problems for years, and seriously - don't play around with it. It's very easy to try to follow a video of exercises online, pick the wrong ones for your injury or do them improperly, and hurt yourself. Even if you only go to a PT once or twice, it's worth it to get them to check out your injury and make sure you have the right exercises for your condition.


My setup is a standup desk with an attached keyboard tray and raised monitors. And weekly yoga and pilates, lots of walking, and some exercises from a PT. Massage can definitely help but don't rely on it to fix all your problems.
posted by lyra4 at 1:48 PM on January 16

I'd either get something to elevate the macbook pro or get an external monitor. Hunching over a laptop display is no way to spend your day. I have a purpose made stand that work bought, but there's no reason a pile of books would be much worse.

If you wanted an external keyboard and pointer and liked the touchpad, get the Apple Magic Touchpad. It's the same thing, only disconnected. I use the Magic Mouse and like it a lot, but could make a good case for the Magic Trackpad.
posted by advicepig at 2:36 PM on January 16

Ergonomic mouse, split keyboard. Get a laptop riser or external monitor with adjustable height.
posted by wongcorgi at 2:48 PM on January 16

I can't say I have the problem licked, but here are some things that helped me a lot:

* A desk and chair that are comfortable and adjustable

* An external keyboard that is curved outward, so my wrists don't bend too sharply. IE: not the Apple external keyboard, that's basically just a laptop keyboard without the laptop. I'm right-handed, so it really helped to find a keyboard without a number pad, so I don't have to reach very far for my mouse, this made a big difference.

* Taking consistent breaks, by far the most important thing for me. I'm using a Mac program called AntiRSI to remind me and/or force me, there are others but I like this one best. Right now my breaks are 10 seconds every 5 minutes, and 5 minutes every 30 minutes–but I adjust that depending on how my hands are feeling.


Things that did not help me much:

* Physical therapy. Despite doing the exercises and using their massage-machine-doodads, it didn't seem to make a difference. But maybe my physiotherapist was just not the best, YMMV.

* Speech recognition. It's ok for prose, much better than it was years ago, but still a bit frustrating. It's also acceptable for browsing the web. In either of these scenarios, the Windows solutions work much, much better than the Mac ones–in fact, the speech recognition system that comes with Windows 7 is the one I like best. Regardless, my web work involves mostly coding, and speech recognition is still terrible at that.
posted by vasi at 4:15 PM on January 16

Curved keyboard (e.g. standard Microsoft one) made the biggest difference for me, but watch also for mouse position.
posted by idb at 8:59 AM on January 17

Check out Pain Free at Your PC by Pete Egoscue.
posted by eelgrassman at 8:06 PM on January 18

I regularly give lectures about RSI. I just gave one on Monday, as a matter of fact.

You can read the content on my lecture on my website. It's a long-form article about everything RSI I know.

http://gmarceau.qc.ca/articles/your-wrists-hurt-you-must-be-a-programmer.html

To answer your specific question:

> (I saw my doctor about this on Saturday, and she personally believes it to be a narrowing of the spinal column

Most generalist doctors know very little about RSI. She will be able to pursue alternative possible explanation, but if you are developing a standard-issue RSI, she will be of little help.

> I realized that it's very difficult for me to write, with a pen, for any extended period of time, even for just a minute or so, if it's continuous writing

This is definitely a sign that you should take this condition seriously. At this advanced stage, it's not going to go away on its own.

> of mice, keyboards, stands, particularly since the "standing desk" phenomenon really got going online.

There isn't much new to announce. The mainstay remains: mouse on the left or touch pad, curved keyboard with soft keys, low desk with lots of depth space, dictation.

Standing desks are good for some people. Try it. As well an sitting on an exercise ball instead of a chair.


> should I use an external keyboard/mouse?

Laptop tend to invite bad posture, since you can't decouple the position of the screen from that of the keyboard. It's not impossible to have good posture on a laptop, but it necessitate more awareness and care.


> Are there any mac-specific, particularly so I can still do stuff like switch pages by swiping on the trackpad?

The Mac Magic Touchpad is pretty great, though perhaps its clicking action needs too much force for some people.


> Is Dragon Dictation worthwhile?

Definitely. For a lot of people, switching to dictating emails is the #1 most effective action they can take.


> What about special gloves while working?

Gloves can help, but it's a minor contribution. You want a soft glove which gently help your wrist stay straight without pressing into the flesh. Their warmth also helps.

> Worth getting a weekly massage for my hands at a nearby physical therapy space? Is yoga worthwhile?

Yes and no. One one hand, a proper RSI treatment will involve lots of stretches and massages. On the other hand, these massages must be practiced by a RSI specialist. RSI looks like a sport injury, which entice medical practitioners who have no RSI-specific training to approach it as a sport injury. If they do so, their massage will more likely injure you than help. The same goes for yoga.

Absent of a RSI specialist, you can learn the stretches and the massages from RSI books. There are recommendations on my page above.


> Alexander Technique?

Yes, Alexander Technique can contribute to a recovery. The name of the game in RSI is to add lots of contribution from many different interventions, and AT can be one.


> Is it *worse* for my hands if I'm standing up and still using the built-in laptop keyboard?

There is no danger here. The point of the standing desk is that you are helping the blood to flow around your body. A large part of RSI occurs because of stagnant blood flow.

> would it help to take a 2-week break from using computer keyboards, or maybe limiting it to a half-hour per day?

First, if you don't change the ergonomics of your desk, your RSI will return immediately after the break. No doubt about that.

Second, two weeks isn't much time. I know of no injuries that can heal this quickly -- and join and tendons are notorious slow healers. Your treatment will operate on a scale of months or years, rather than weeks. But two weeks isn't nothing. Make the best of it. Learn and practice the stretches and massages, and take a break from computers, and it will lunch your recovery from a good footing.

Feel free to contact me if you have any more questions.
posted by gmarceau at 11:13 AM on February 2