7 ms·

When you ignore (or are unaware of) ergonomic issues for years, you can get into serious trouble (like I did). I had been programming for over 10 years without

When you ignore (or are unaware of) ergonomic issues for years, you can get into serious trouble (like I did). I had been programming for over 10 years without any problems (and without paying any attention to ergonomics), and 7 years ago I got Repetitive Stress Injury (RSI) really bad. I tried many things to get rid of it, including lots of exercises like the ones in this post, but it was very hard to get rid of. The RSI got so bad that I thought I had to give up programming all together. 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/ 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 (some people think they are expensive, but they're not). 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.

peteretep 14y ago
I know these are looked down on, but this is a +1 comment. Break program saved my ass, having been told by a doctor that I'd have to give up programming as a career. I had tried all sorts of other stuff (DataHands keyboard, a vertical keyboard, wrist rest, bla bla bla), but the enforced breaks were the game changer.
- aniketpant 14y ago
  Nothing like this has happened to me so far. But I am going to be watching for signs all the time. Is going for a stand-up desk worth it? I have heard that they really improve your working.
  - henrik_w 14y ago
    I got rid of my RSI without using one. However, I do feel that a stand-up desk is good for my body as well. You can get some variation through the day by alternating between sitting and standing. It also makes it a lot easier to adjust the desk to the correct height when sitting at it (no more turning little screws at the bottom of the desk legs to adjust the height). There were also reports a while ago about how sitting all day lowers your life expectancy - another reason to try to stand up part of the day.
    - aniketpant 14y ago
      I agree man. We can't really make this world a great place if we don't live long. So, lets stand up.
  - eru 14y ago
    From my experience, standing desks are worth it. It will take a week or a few to adapt your feet and legs, though.
- ohwp 14y ago
  Sometimes a break program will make things worse. When you are under (time) pressure and the break program is blocking your PC you will get stress. And stress is one of the main reasons for getting RSI.
  - henrik_w 14y ago
    Hopefully being under such time pressure is not the normal mode of operation though ;-) All the break programs I have used have a "manual override", and you can also turn them off. Occasionally I have done that if is something really critical that has to go out at once. But for me that happens maybe once or twice a year.
  - driverdan 14y ago
    Repetitive strain injury is caused by repetitive motions (hence the name), not life stress.
    - joebo 14y ago
      I've found that it can be hard to isolate whether pain is solely from repetitive motions or if it's stress induced. Reducing both have helped me.
      - peteretep 14y ago
        I have found my RSI noticeably worse when stressed, too
ohwp 14y ago
Years ago I also got RSI. One thing that helped me a lot was to think about lactic acid. Your body doesn't have a lot of problems with repeating motion unless the milk acid can't be transported. And I think stress is the main reason why the transportation of milk acid is blocked because it make your muscles contract. I also think we are so used to stress that we don't even realize we are under pressure. That's why exercise is great. It will help your remove the milk acid but also to release stress.
- eru 14y ago
  I doubt that this is how lactic acid works..
- rquantz 14y ago
  Any sources you can cite here?
- JshWright 14y ago
  You have a flawed understanding of how your cells consume glucose. Lactic acid it not produced in any significant quantity during 'normal operation' of your body. Your cells break down glucose into a molecule called pyruvate in a process called 'glycolysis'. This yields some 'energy' (in the form of ATP). This process requires some energy, so the net gain is only two ATP. It also requires a couple NAD- ions, which pick up some spare hydrogen protons that get kicked out. Those NAD- get turned into NADH, are are used later in the process (and turned back into NAD-, so they can facilitate more 'glycolysis'). If the cell has enough oxygen, it can then oxidize the pyruvate in the Citric Acid Cyle (aka the TCA cycle, aka the Kreb's cycle), gaining many times more ATP (34, in total). If, however, the cell doesn't have enough oxygen, it can't run the TCA cycle. This isn't a big deal in the short term. Your cells can keep running through that glycolosis process to produce energy as long as they have enough glucose to break down, and enough NAD- to grab protons. The glucose isn't generally a problem. Your body keeps a fair amount of it in the blood, and the liver can release more pretty easily. The problem is the limited number of NAD- ions in your cells. Once those are used up, glycolosis stops. Fortunately, your cells can 'free them up' by using them to turn pyruvate into lactate. This produces the 'milk acid' you talk about, but it frees up the NAD- for more glycolosis. The cell hangs on to the lactate for a while in the hopes of getting more oxygen it can use to turn it back into pyruvate and run it through the TCA cycle, and if that doesn't happen, it eventually diffuses out into the blood where it ends up in the liver, which uses it to build up its glycogen stores for the next time there's a sudden demand for a lot of glucose. So, in short, unless you're exercising hard, your body will have no trouble meeting its oxygen demand, and no lactic acid will be produced. This has been an overly simplified (but mostly accurate) description of this process. I'd encourage you to do your own research to learn more (the search terms 'cellular respiration' 'glycolosis' and 'citric acid cycle' should all be useful)
aerique 14y ago
May I ask what your age is? Also, when you got the RSI did you have symptoms before that you ignored or was it a binary affair (ie. it just hit you hard one day and you had RSI). I ask since I am 38 now and have been using computers (gaming and coding mostly) multiple hours per day since I was 12 or so. However, I have always listened to my body and naturally get breaks by getting a glass of water every 30 to 60 minutes.
- henrik_w 14y ago
  I was 39 when I got it. It took about 6 months to develop from no symptoms at all to really bad. Before the first symptoms I hadn't had any problems at all (and I have been programming since I was 15). In retrospect, I should have done much more as soon as I felt the first symptoms. However, I didn't really know what to do, and I was sort of just hoping that it would go away by itself. Then I went to see several doctors, but none of them could help. It was only when I started doing my own research that I found effective ways to deal with it. Also, it seems pretty clear from the research I did that not everybody will get RSI, even if they work just like I did. But the problem is that we don't know beforehand who will get it. Listening to your own body is a good precaution though. I wasn't very good at that I think.
- nazgob 14y ago
  I got one when I was 28, 2 years later I'm almost good. Breaks(I use MacBreakZ on OSX and Workrave on Windows), Colemak, Kinesis keyboard, trackball and regular stretching helped me a lot.
davidcuddeback 14y ago
Thanks for sharing your experience. I'm starting to take ergonomics seriously, and I appreciate hearing what works for others. In your write-up on your blog, you mentioned that you used a program called WorkPace on Linux and Windows. I looked into it, but I only see a Windows version on their website [1]. After a little Googling, I found a similarly named WorkRave [2], which is available for Linux and Windows. I was wondering if you might have meant WorkRave. I have also been saving up for a few months to buy an adjustable desk and ergnomic chair. Most easily-adjustable desks that I've found cost between $1k and $2k, such as the Humanscale Float desk [3]. I don't mind paying that much if that's what it takes, but it seems excessive. I'd appreciate pointers to any other resources for adjustable desks. [1] http://www.workpace.com/WP:DOWNLOAD_SYSREQ:680095134 http://www.workpace.com/WP:DOWNLOAD_SYSREQ:680095134 [2] http://www.workrave.org/ http://www.workrave.org/ [3] http://shop.humanscale.com/products/product_detail.cfm?group=float http://shop.humanscale.com/products/product_detail.cfm?group...
- henrik_w 14y ago
  No, it was WorkPace. I've notied that they've stopped supporting Linux since when I got the license. Maybe bug them to see if they'll start supporting Linux again. As for desks, the two that I have used have both been from the companies I've been working for, so I never had to buy one myslef. However, where I worked before (www.tilgin.com), everybody got an adjustable height desk (electric motor). They only bought the legs (cost a bit over 100 Euro per desk I think), and had some guys go around switching the legs on all the desks. The brand of my current desk is www.holmbergsbordet.se but it looks quite expensive.
  - davidcuddeback 14y ago
    Thanks for the update. I did put in a request for Linux support with WorkPace. I installed WorkRave this morning and have been trying it out while I work today. I like it. It seems like it would work really well with Gnome. I'm using XMonad. It's fully functional in XMonad, but the "tray" just floats on whichever desktop I start it on, which isn't ideal for XMonad. I get the impression all the adjustable-height desks are expensive. I'm not a big fan of motorized ones. I tried them out at the Relax-the-Back store. They're way too slow at raising and lowering the desk for my taste, which is why I'm leaning toward something manual like the Float table.
edj 14y ago
I, too, have battled with RSI in my right hand and wrist. Things that helped: Posture. Back straight; elbows bent 90 degrees (no less); monitor at eye level so neck is straight. Physical therapy. Deep-tissue massage; fascia massage with tennis or golf ball; theraputty [1]; hand exercise balls [2]; and stretching. Standing desk. Went with the DIY model, though I hear the motorized ones are choice. I switched to standing because of general health concerns with sitting, not because of RSI. However it has had tangential benefits there in that it seems easier to get the right height so my elbows are bent 90 degrees. Chair. I still sit some of the time I'm working. The greatest chair I've ever sat on is the Swopper [3]. Keyboard. I use the DAS Keyboard [4]. It's clicky, but not ergonomic. I find the clickyness helps me use a lighter touch and still type fast. Mouse. I use the Logitech Trackman Wheel [5]. It's long since discontinued. I bought a new-in-box specimen on ebay to replace my old one when it became unreliable. [1]: http://www.amazon.com/s/ref=nb_sb_ss_i_0_6?url=search-alias%3Daps&field-keywords=theraputty&sprefix=Therap%2Caps%2C263 http://www.amazon.com/s/ref=nb_sb_ss_i_0_6?url=search-alias%... [2]: http://www.amazon.com/Isokinetics-Inc-Hand-Exercise-Squeeze/dp/B001CS9XDO/ref=sr_1_1?ie=UTF8&qid=1356970880&sr=8-1&keywords=Physical+therapy+eggs http://www.amazon.com/Isokinetics-Inc-Hand-Exercise-Squeeze/... [3]: http://www.swopper.com/www.swopper.com/index.html http://www.swopper.com/www.swopper.com/index.html [4]: http://www.daskeyboard.com/ http://www.daskeyboard.com/ [5]: http://reviews.logitech.com/7061/166/logitech-trackman-wheel-reviews/reviews.htm http://reviews.logitech.com/7061/166/logitech-trackman-wheel...
bosie 14y ago
Have you tried the penclic over a regular vertical mouse like an evoluent? care to tell us how you like it?
- henrik_w 14y ago
  Yes, I tried the Evoluent vertical mouse. I found it too big and thick - I couldn't hold it in a relaxed way (but it could be because my hands are smallish). The Penclic let's me keep my fingers and thumb closer together, which feels better for me.
martinced 14y ago
You didn't switch to an ergonomic keyboard. I do love good keyboard and your Goldtouch is a very good split keyboard. But it is not ergonomic. You simply cannot have a (non-symmetric) staggered layout that is "ergonomic". Real ergonomic keyboards are mostly symmetric: a Maltron or a Kinesys for example. Or a good split + matrix (symmetric) layout. But a regular keyboard, no matter how good the keyswitch, like your keyboard or a Cherry MX-5000 or a IBM Model M15 (split) aren't ergonomic. They're "less worse" than the typical keyboard in that they're split and they're easier to adapt to. But you have to realize that your brain (just as mine) has been destroyed by years and years spent on typing on non-symmetric keyboard. This makes zero sense from an ergonomist' point of view. Basically one half of your keyboard's rows are shifted "the wrong way". There's no logic to that and it's really bad. For what it's worth: I'm on a HHKB Pro 2 + Aeron chair. It's not perfect and it's not the most ergonomic, but it's not too bad either.

peteretep 14y ago

I know these are looked down on, but this is a +1 comment. Break program saved my ass, having been told by a doctor that I'd have to give up programming as a career. I had tried all sorts of other stuff (DataHands keyboard, a vertical keyboard, wrist rest, bla bla bla), but the enforced breaks were the game changer.

aniketpant 14y ago
Nothing like this has happened to me so far. But I am going to be watching for signs all the time. Is going for a stand-up desk worth it? I have heard that they really improve your working.
- henrik_w 14y ago
  I got rid of my RSI without using one. However, I do feel that a stand-up desk is good for my body as well. You can get some variation through the day by alternating between sitting and standing. It also makes it a lot easier to adjust the desk to the correct height when sitting at it (no more turning little screws at the bottom of the desk legs to adjust the height). There were also reports a while ago about how sitting all day lowers your life expectancy - another reason to try to stand up part of the day.
  - aniketpant 14y ago
    I agree man. We can't really make this world a great place if we don't live long. So, lets stand up.
- eru 14y ago
  From my experience, standing desks are worth it. It will take a week or a few to adapt your feet and legs, though.
ohwp 14y ago
Sometimes a break program will make things worse. When you are under (time) pressure and the break program is blocking your PC you will get stress. And stress is one of the main reasons for getting RSI.
- henrik_w 14y ago
  Hopefully being under such time pressure is not the normal mode of operation though ;-) All the break programs I have used have a "manual override", and you can also turn them off. Occasionally I have done that if is something really critical that has to go out at once. But for me that happens maybe once or twice a year.
- driverdan 14y ago
  Repetitive strain injury is caused by repetitive motions (hence the name), not life stress.
  - joebo 14y ago
    I've found that it can be hard to isolate whether pain is solely from repetitive motions or if it's stress induced. Reducing both have helped me.
    - peteretep 14y ago
      I have found my RSI noticeably worse when stressed, too

ohwp 14y ago

Years ago I also got RSI. One thing that helped me a lot was to think about lactic acid. Your body doesn't have a lot of problems with repeating motion unless the milk acid can't be transported. And I think stress is the main reason why the transportation of milk acid is blocked because it make your muscles contract. I also think we are so used to stress that we don't even realize we are under pressure. That's why exercise is great. It will help your remove the milk acid but also to release stress.

eru 14y ago
I doubt that this is how lactic acid works..
rquantz 14y ago
Any sources you can cite here?
JshWright 14y ago
You have a flawed understanding of how your cells consume glucose. Lactic acid it not produced in any significant quantity during 'normal operation' of your body. Your cells break down glucose into a molecule called pyruvate in a process called 'glycolysis'. This yields some 'energy' (in the form of ATP). This process requires some energy, so the net gain is only two ATP. It also requires a couple NAD- ions, which pick up some spare hydrogen protons that get kicked out. Those NAD- get turned into NADH, are are used later in the process (and turned back into NAD-, so they can facilitate more 'glycolysis'). If the cell has enough oxygen, it can then oxidize the pyruvate in the Citric Acid Cyle (aka the TCA cycle, aka the Kreb's cycle), gaining many times more ATP (34, in total). If, however, the cell doesn't have enough oxygen, it can't run the TCA cycle. This isn't a big deal in the short term. Your cells can keep running through that glycolosis process to produce energy as long as they have enough glucose to break down, and enough NAD- to grab protons. The glucose isn't generally a problem. Your body keeps a fair amount of it in the blood, and the liver can release more pretty easily. The problem is the limited number of NAD- ions in your cells. Once those are used up, glycolosis stops. Fortunately, your cells can 'free them up' by using them to turn pyruvate into lactate. This produces the 'milk acid' you talk about, but it frees up the NAD- for more glycolosis. The cell hangs on to the lactate for a while in the hopes of getting more oxygen it can use to turn it back into pyruvate and run it through the TCA cycle, and if that doesn't happen, it eventually diffuses out into the blood where it ends up in the liver, which uses it to build up its glycogen stores for the next time there's a sudden demand for a lot of glucose. So, in short, unless you're exercising hard, your body will have no trouble meeting its oxygen demand, and no lactic acid will be produced. This has been an overly simplified (but mostly accurate) description of this process. I'd encourage you to do your own research to learn more (the search terms 'cellular respiration' 'glycolosis' and 'citric acid cycle' should all be useful)

aerique 14y ago

May I ask what your age is? Also, when you got the RSI did you have symptoms before that you ignored or was it a binary affair (ie. it just hit you hard one day and you had RSI). I ask since I am 38 now and have been using computers (gaming and coding mostly) multiple hours per day since I was 12 or so. However, I have always listened to my body and naturally get breaks by getting a glass of water every 30 to 60 minutes.

henrik_w 14y ago
I was 39 when I got it. It took about 6 months to develop from no symptoms at all to really bad. Before the first symptoms I hadn't had any problems at all (and I have been programming since I was 15). In retrospect, I should have done much more as soon as I felt the first symptoms. However, I didn't really know what to do, and I was sort of just hoping that it would go away by itself. Then I went to see several doctors, but none of them could help. It was only when I started doing my own research that I found effective ways to deal with it. Also, it seems pretty clear from the research I did that not everybody will get RSI, even if they work just like I did. But the problem is that we don't know beforehand who will get it. Listening to your own body is a good precaution though. I wasn't very good at that I think.
nazgob 14y ago
I got one when I was 28, 2 years later I'm almost good. Breaks(I use MacBreakZ on OSX and Workrave on Windows), Colemak, Kinesis keyboard, trackball and regular stretching helped me a lot.

davidcuddeback 14y ago

Thanks for sharing your experience. I'm starting to take ergonomics seriously, and I appreciate hearing what works for others. In your write-up on your blog, you mentioned that you used a program called WorkPace on Linux and Windows. I looked into it, but I only see a Windows version on their website [1]. After a little Googling, I found a similarly named WorkRave [2], which is available for Linux and Windows. I was wondering if you might have meant WorkRave. I have also been saving up for a few months to buy an adjustable desk and ergnomic chair. Most easily-adjustable desks that I've found cost between $1k and $2k, such as the Humanscale Float desk [3]. I don't mind paying that much if that's what it takes, but it seems excessive. I'd appreciate pointers to any other resources for adjustable desks. [1] http://www.workpace.com/WP:DOWNLOAD_SYSREQ:680095134 http://www.workpace.com/WP:DOWNLOAD_SYSREQ:680095134 [2] http://www.workrave.org/ http://www.workrave.org/ [3] http://shop.humanscale.com/products/product_detail.cfm?group=float http://shop.humanscale.com/products/product_detail.cfm?group...

henrik_w 14y ago
No, it was WorkPace. I've notied that they've stopped supporting Linux since when I got the license. Maybe bug them to see if they'll start supporting Linux again. As for desks, the two that I have used have both been from the companies I've been working for, so I never had to buy one myslef. However, where I worked before (www.tilgin.com), everybody got an adjustable height desk (electric motor). They only bought the legs (cost a bit over 100 Euro per desk I think), and had some guys go around switching the legs on all the desks. The brand of my current desk is www.holmbergsbordet.se but it looks quite expensive.
- davidcuddeback 14y ago
  Thanks for the update. I did put in a request for Linux support with WorkPace. I installed WorkRave this morning and have been trying it out while I work today. I like it. It seems like it would work really well with Gnome. I'm using XMonad. It's fully functional in XMonad, but the "tray" just floats on whichever desktop I start it on, which isn't ideal for XMonad. I get the impression all the adjustable-height desks are expensive. I'm not a big fan of motorized ones. I tried them out at the Relax-the-Back store. They're way too slow at raising and lowering the desk for my taste, which is why I'm leaning toward something manual like the Float table.

edj 14y ago

I, too, have battled with RSI in my right hand and wrist. Things that helped: Posture. Back straight; elbows bent 90 degrees (no less); monitor at eye level so neck is straight. Physical therapy. Deep-tissue massage; fascia massage with tennis or golf ball; theraputty [1]; hand exercise balls [2]; and stretching. Standing desk. Went with the DIY model, though I hear the motorized ones are choice. I switched to standing because of general health concerns with sitting, not because of RSI. However it has had tangential benefits there in that it seems easier to get the right height so my elbows are bent 90 degrees. Chair. I still sit some of the time I'm working. The greatest chair I've ever sat on is the Swopper [3]. Keyboard. I use the DAS Keyboard [4]. It's clicky, but not ergonomic. I find the clickyness helps me use a lighter touch and still type fast. Mouse. I use the Logitech Trackman Wheel [5]. It's long since discontinued. I bought a new-in-box specimen on ebay to replace my old one when it became unreliable. [1]: http://www.amazon.com/s/ref=nb_sb_ss_i_0_6?url=search-alias%3Daps&field-keywords=theraputty&sprefix=Therap%2Caps%2C263 http://www.amazon.com/s/ref=nb_sb_ss_i_0_6?url=search-alias%... [2]: http://www.amazon.com/Isokinetics-Inc-Hand-Exercise-Squeeze/dp/B001CS9XDO/ref=sr_1_1?ie=UTF8&qid=1356970880&sr=8-1&keywords=Physical+therapy+eggs http://www.amazon.com/Isokinetics-Inc-Hand-Exercise-Squeeze/... [3]: http://www.swopper.com/www.swopper.com/index.html http://www.swopper.com/www.swopper.com/index.html [4]: http://www.daskeyboard.com/ http://www.daskeyboard.com/ [5]: http://reviews.logitech.com/7061/166/logitech-trackman-wheel-reviews/reviews.htm http://reviews.logitech.com/7061/166/logitech-trackman-wheel...

bosie 14y ago

Have you tried the penclic over a regular vertical mouse like an evoluent? care to tell us how you like it?

henrik_w 14y ago
Yes, I tried the Evoluent vertical mouse. I found it too big and thick - I couldn't hold it in a relaxed way (but it could be because my hands are smallish). The Penclic let's me keep my fingers and thumb closer together, which feels better for me.

martinced 14y ago

You didn't switch to an ergonomic keyboard. I do love good keyboard and your Goldtouch is a very good split keyboard. But it is not ergonomic. You simply cannot have a (non-symmetric) staggered layout that is "ergonomic". Real ergonomic keyboards are mostly symmetric: a Maltron or a Kinesys for example. Or a good split + matrix (symmetric) layout. But a regular keyboard, no matter how good the keyswitch, like your keyboard or a Cherry MX-5000 or a IBM Model M15 (split) aren't ergonomic. They're "less worse" than the typical keyboard in that they're split and they're easier to adapt to. But you have to realize that your brain (just as mine) has been destroyed by years and years spent on typing on non-symmetric keyboard. This makes zero sense from an ergonomist' point of view. Basically one half of your keyboard's rows are shifted "the wrong way". There's no logic to that and it's really bad. For what it's worth: I'm on a HHKB Pro 2 + Aeron chair. It's not perfect and it's not the most ergonomic, but it's not too bad either.