Ergonomics and Shoulders
July 24, 2015 3:47 PM   Subscribe

I have a new job that requires a lot of continuous, fast typing on a laptop. I'm already experiencing repetitive-strain problems with my left shoulder blade -- a chiropractor did some work on it but it's still bothering me and I don't want stuff like this to be a deterrent to my ability to do the job. It's an independent contractor gig, so I'm responsible for all ergonomics decisions and medical costs I might incur. Sort me out, MeFi. Give me some very specific actions I can take that won't cost much money.

My setup is a laptop, a (non-standing) desk, a transcription foot pedal, a standalone wired mouse, and an office chair with a lumbar cushion. I recently tried to hack a standing desk using a laptop riser, but it's too hard to stand, type, and use the foot pedal at the same time. What else can I do?
posted by mirepoix to Work & Money (20 answers total) 12 users marked this as a favorite
 
Use an ergonomic keyboard. That's probably the #1 change I made after reaching the "almost unable to work" stage of RSI, and I also used a trackball mouse for many years until my work became so mobile that it was impractical. I use wrist cushions for both keyboard and mouse to keep from dipping my wrists too low or pressing them into the edges of the desk.
posted by Lyn Never at 3:55 PM on July 24, 2015 [5 favorites]


I spent $250 on a Kinesis Advantage Keyboard (used). I'm one of 3 people on my team who uses this keyboard. It takes a bit to adjust, but is much easier to learn than Dvorak. I would definitely try this before moving onto more expensive problems.

FWIW, I used to have a lot of problems with typing long paragraphs. I still have problems with my laptop keyboard. But my Kinesis doesn't bother me at all. I'm considering getting a second one to use at home.
posted by ethidda at 4:03 PM on July 24, 2015 [3 favorites]


What else can I do?
My ex-husband began having repetitive stress when he took a break from lifting weights and continued to do a lot of typing. So working out can help counter this.

I consumed gelatin daily for like a year or two to treat ligament and tendon problems that used to be incapacitating. It was never that severe again. You can also take supplements intended to help with joints, but I am real sensitive to a lot of things so I stuck with gelatin for joint support.

When I worked at a Fortune 500 company, the desk chair and the desk both had a lot of different things that could be adjusted. Sometimes when I had to use a desk that was not my own for some reason, I learned that higher/lower/whatever really made a difference. If you can adjust your set up, play with it and see if anything helps.
posted by Michele in California at 4:04 PM on July 24, 2015


Other than the expense, is there a reason not to get an external keyboard and monitor, so you can have a more desktoppish setup? Or at least an external keyboard and a riser for the laptop to put it at a more appropriate eye level?

I've found that "type height" for me is lower than most type-height desks, fwiw. I like my desk at about 27".
posted by adamrice at 4:12 PM on July 24, 2015 [1 favorite]


Get an external keyboard and a few reams of paper. Plug the keyboard into the laptop and stick the laptop on the reams of paper, so that with your chair as close to the desk (vertically) as possible the top of the screen is at eye level and the screen's about arm's length away. You might need to put the pedal on another couple of reams of paper to get it at the right height (since you may have to raise the chair to the point where your feet don't reach the ground comfortably).

Basically you want your shoulders to be as neutral as possible.
posted by asterix at 4:21 PM on July 24, 2015 [2 favorites]


My left shoulder blade is a trouble spot for me, too (are you also left-handed?). Working out in a very specific rotation that includes trainer-suggested specific stretch exercises that target the shoulders has mostly solved this issue for me. My gym gave me one free session with a trainer, and that's how I spent it - asking for specific exercises I should do to combat sore areas. So maybe seek out a trainer or physical therapist for exercise-based strengthening solutions even if you do also attempt to modify the repetitive strain issues.
posted by vegartanipla at 4:23 PM on July 24, 2015 [3 favorites]


Proper keyboard & mouse, ergonomic is good, but anything is better than a laptop keyboard they are a nightmare for RSI. Gel wrist rests to help keep your hands at the right height. Armrests on your chair can help to, I get pain just between my shoulderblades if I type for long lengths of time with my arms unsupported.
posted by wwax at 4:34 PM on July 24, 2015 [2 favorites]


I probably will look at getting a desktop computer and/or fancy ergonomic keyboard as a long-term goal, but I'm going to try strengthening my shoulder and using an external keyboard as things I can do right now. Thanks!

(vegartanipla, I am left-handed!)
posted by mirepoix at 4:44 PM on July 24, 2015


If your mindful about your geometry in relation to your desk and how you are actually sitting and typing, you might not need the fancy ergonomic stuff. For laptops it can be hard to have proper keyboard and screen height, so an external keyboard might be a good idea. This is the handout(PDF) we use at work for ergonomic consulting. Making sure your not placing too much pressure on your wrists/elbows, but also not hunching your shoulders is critical. That can be achieved to a large degree with proper chair and desk height.

/ergonomic workstation evaluator
posted by kendrak at 4:51 PM on July 24, 2015 [3 favorites]


Try the exercises in the book Pain Free at Your PC by Pete Egoscue. (I've written about the Egoscue Method of physical therapy before because it changed my life and ended my chronic back pain.)
posted by Lexica at 5:09 PM on July 24, 2015 [2 favorites]


if you're left handed, do you mouse on the left? which is where the pain is, right? you could try switching the mouse side, or getting a keyboard with a "nub", or using the trackpad.

i became mouse ambidextrous, after some rsi issues. it was surprisingly easy - i think i was fluent within a day of changing. that's a quick, easy change you can try tomorrow.
posted by andrewcooke at 5:20 PM on July 24, 2015 [1 favorite]


Using the mouse with the right hand lately. The problem is on my left shoulder, though.

I've ordered the Egoscue book; thanks.
posted by mirepoix at 6:38 PM on July 24, 2015


An adjustable keyboard tray is the third most important thing for ergonomics, after seat adjustment and monitor height.
posted by rhizome at 6:45 PM on July 24, 2015


For sure you need an external monitor (with a stand), keyboard, and mouse. There's no way around it. I bet you can find a cheap used monitor. Cost of the keyboard, mouse, and stand are trivial.
posted by radioamy at 7:36 PM on July 24, 2015 [1 favorite]


At the very least, I would suggest getting a separate keyboard. Whether "ergonomic" or not, they are bigger than a laptop keyboard, which seems to help. I just finished a 4 month gig using only a laptop keyboard (with a LOT of copy/pasting ... like 4000 times a day), and my left shoulder is currently killing me. Before that I'd been using a "proper" full-sized keyboard for ... well, all my life since I first touched a computer 30-odd years ago, and never had a problem.
posted by Diag at 9:40 PM on July 24, 2015 [1 favorite]


A lot of that shoulder pain will be coming from your head being tilted forward because your screen is too low. Unless you're using an external keyboard and mouse (and you can get these in supermarkets now for about $15 each, it's ridiculous) then a laptop forces you to choose a screen that's too low or a keyboard that's too high, either of which will hurt you.

Taking a two minute break to walk around and stretch your arms every half hour will save you more productivity than it costs.

If your current pain is one-sided, make sure your desk is set up in such a way that you don't need to spend most of your time with your head turned to one side. If you're transcribing printed text, you might be better off arranging that above or below your screen than to one side.
posted by flabdablet at 9:55 PM on July 24, 2015 [1 favorite]


Get an external keyboard, probably wireless, one that you love. Some people like mechanical keyboards for the feel. Others want the ergonomic keyboard (split halves) and so on. Yes, it's more crap to buy.

Get a riser, i.e.a 'stand' to hold up the laptop to eye level. As you have external keyboard it doesn't matter if it's on a stand or not.
posted by kschang at 11:10 PM on July 24, 2015


I keep a high bounce rubber ball with me (tennis ball sized but the high bounce ones aren't fuzzy and move better on the wall). Do self massage with the ball between your shoulders and the wall. Regularly, like for 5 minutes every few hours. I've found it to be AMAZING at helping out with muscle tightness. There's lots of info online, videos on youtube etc.
posted by kitten magic at 12:29 AM on July 25, 2015


Strain on the right arm can cause problems in the left shoulder. It is all interconnected. If you can mouse with either hand, try switching it up.

I am right-handed. When my tendon and ligament problems were real bad, I learned to mouse left-handed. I was slower when working left-handed than right-handed, but it was faster than ending up in so much pain that I could not work at all. Using the other hand for an hour in the middle of the day meant I could get to the end of the day without winding up in agony and then it was possible to recover overnight and not start the next work day already hurting. That made a really huge difference in keeping the issue manageable.
posted by Michele in California at 10:05 AM on July 25, 2015


+1 to external keyboard (I use a kinesis too) and external monitor placed at eye height, not chest height. Laptops are basically the worst. I hurt for all those people pecking in coffee shops! And +1 to being mousebidextrous. That's like rotating your tires.

I am not your PT but I will tell you what works for me when I'm sore and need to recover.

I put a foam half-roll flat on the floor and lay so that it's directly underneath my spine, running from my butt to the base of my skull. I put a number of pillows underneath my legs so they're supported in essentially a sitting position, with my feet parallel to the wall. Then I tuck my chin so that my neck is as flat as possible against the foam roll and I relax my whole body, letting gravity give me a gentle stretch through my neck and shoulders around the axis of my spine. I'll hold this position for several minutes, it can take me awhile to get my muscles completely slack. Conscious release of tension with breathing outward really helps here.

From this position, I'll roll my head from side to side, letting gravity do all the work, and I'll also press the back of my neck down on the foam roll. This stretches out pretty much my entire neck & shoulder assembly.
posted by Sauce Trough at 4:16 PM on July 27, 2015 [1 favorite]


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