Date: Thu, 1 Oct 1998 11:06:08 -0700
From: Andrew Laurence
Subject: Adventures with Tendonitis (Long)
Hi all,
>From the presentation and discussion at Wednesay's CLC meeting, it seems
that ergonomics and repetitive stress injury are very hot topics these
days. I've suffered from tendonitis in my hands for several years, and
have experimented with different furniture, accessories, braces and whatnot
in attempts to alleviate the injury. I'm writing this in the hopes that
others may find my experiences beneficial - whether for themselves, staff
or anyone with RSI.
Disclaimer: In this article I mention specific products which I have
tried, which may or may not have helped me. This is not intended as a
specific endorsement of these products, only a note of Andrew's personal
experiences. While a solution may work for a given person, that same
solution may have no effect for another person, or may in fact make that
person's condition worse. As they say, "your mileage may vary."
Original Symptoms:
It started in my right hand - a feeling of fatigue or tiredness
which was alleviated by relaxing and shaking the hand, much like "walking
it off" after being hit by a baseball. In the weeks and months to follow,
this feeling of tiredness progressed to both hands, until it felt as though
the muscles in the back of my hands were cramping up. Again, relaxing and
"shake it out" alleviated the soreness, albiet only briefly.
Eventually this progressed to sharp, stinging pains along the backs
of my hands, along the wrists to approximately my wristwatch.
Wrist braces:
A doctor at Kaiser daignosed my condition as tendonitis, not carpal
tunnel syndrome. He prescribed the steel-braced wrist braces which have
since become commonplace for RSI patients. I wore the braces, on both
hands, for several months. I was quite adamant about it - nearly always if
I was awake, and *always* when using a computer. Over several months, I
eventually recovered to the point of not needing the braces, and proceeded
to use computing equipment as normal. (After a while I found the basic
braces from Kaiser to be uncomfortable, and tried a thick padded one which
I found at Sport Chalet, under the Tru-Fit brand. While the padding made
it more comfortable, it was also considerably more bulky, without any
additional healing benefit.)
Shortly after, however, my usage patterns of computers changed
considerably. Up to this point I had been using typical keyboards, on
desks with wrist rests, and standard mice. (While wearing the braces I
switched to a Kensington trackball, positioned on the left. This was in
order to offset the injury on the right hand, as it was far worse than the
left.) Soon after recovering from the original injury, I began using
laptop computers almost exclusively. The laptops were often placed on high
desks; compounded with the lesser key travel of a laptop's keyboard, it
wasn't long before the tendonitis returned, as bad as before.
I tried several things: attaching a standard keyboard to the
laptop (helped a little), moving the keyboard to the lower surface of a
typewriter return (helped a little more), different keyboards, mice and
whatnot. Each of these changes in equipment and peripherals made
incremental inprovements in the severity of my condition, but only a little
bit.
Wonderful Product #1: Hand-Eze gloves
I learned of these gloves in the TidBITS newsletter. They sell for
around $20, and are made of a material similar to lycra. The gloves are
fingerless, with a long cuff which extends from the back of the hand to the
wrist. The clinging material of the gloves seems to provide additional
support to the hand, as well as provide warmth. While I don't have the
knowledge of physiology to explain why this helps, the gloves definitely
helped me. I quickly took to wearing them on a regular basis while using
computers; I keep a set at work, and at home. (Many at UCI have seen me
wearing these so-called "super hero gloves.")
TidBITS articles:
http://db.tidbits.com/getbits.acgi?tbart=02372
http://db.tidbits.com/getbits.acgi?tbart=02359
http://db.tidbits.com/getbits.acgi?tbart=01796
Hand-Eze Reseller in Montana:
(Good pictures)
http://www.handeze.com/
APS Technologies' Keyboard page:
(I usually buy my gloves from them)
http://www.apstech.com/store/keyboard.html
Of the things I had tried so far, lowering the keyboard and the
HandEze gloves made the most difference for me. In placing the equipment
at my workstation, I found that I was most comfortable with my arms hanging
in a relaxed position, and the keyboard at a height whereupon my forearms
are parallel to the floor. The position is very similar to playing a
piano: feet flat on the floor, shins forming a 90* angle with the thighs,
wrists parallel to the floor.
Between carefully placed equipment and wearing the gloves (and the
braces, on bad days), I found myself able to function normally and perform
the necessary tasks of a computing professional. (i.e., spend *way* too
much time in front of the computer.) Over time, I've learned that my
condition worsens during cold weather, and is almost unnoticeable during
the warm months.
I've tried many keyboards, to varying degrees of success and
failure. The bent "natural" keyboards never worked for me, for a variety
of reasons, as well as the ones which break the keyboard into tilted
halves, similar to an A-frame. I found that traditional, solidly-built
QWERTY keyboards were the most tolerable, although I flirted briefly with
the chording keyboards. (The chording keyboards, as well as the DVORAK
layout, seemed too far afield for a profession which requires using many
other computers on a dialy basis.)
Wonderful Product #2: Kenesis Ergonomic Keyboard
Then I sumbled onto a formed keyboard made by Kinesis. Their
Ergonomic Contoured Keyboard has a design which seemed to make a lot of
sense: the keyboard is broken into halves, following the touch-typing
lessons of the QWERTY layout: left-handed and right-handed keys. The
keyboard is about as long as a standard 101 keyboard, albiet with the
halved placed at the outer edges of the keyboard. This placement puts the
hands closer to shoulder width; the hands aren't forced into the severely
off-wrist-angle of standard keyboards. In addition, the left and right key
sets are placed in concave bowls, such that with the fingers at rest, they
automatically land on the home keys.
The modifier keys (space, shift, control, alt, command, option,
page up/down, home, end, backspace, delete) are place in two 'pods' toward
the middle of the keyboard; the buttons on these pads are pressed by the
thumbs.
This keyboard is very different. When I first used it, I felt as
though I was learning to type again. It took about a month to return to
full speed. However, it's the only keyboard I've every used on which my
hands *don't* hurt. At all.
(It's important to note how subjective and unique to the person
these solutions are. One staff member here tried the keyboard, and while
it improved his hands, his elbows got worse. Another staff member was
forced back to wrist braces after using the Kinesis. For me, however, it's
been a godsend.)
The keyboard is available in several options, comprising:
PC or Mac/PC-switchable
Varying degrees of memory for remapping keys or programming macros.
QWERTY or DVORAK layouts.
Kinesis Ergonomic Countered Keyboard:
http://www.kinesis-ergo.com/contspec.html
Now, with the Kinesis keyboard, I never wear the wrist braces, and
I almost never wear the gloves. It's taken five years to get to this
point, such that I don't feel crippled on a daily bases. However, admist
all of this, I cannot stress enought the importance of taking breaks,
changing the working position from time to time, and getting up and walking
around.
For those not afflicted, it's difficult to imagine what RSI feels
like. (Just as a person with perfect vision cannot understand what the
world looks like to a person who needs corrective lenses.) However, it is
indeed real, and can be very debilitating. One summer during college, I
temped as a typist for a woman with a severe case of carpal tunnel
syndrome: she had just returned from six weeks' medical leave; it was
either that or surgery. When I worked with her, she was wearing braces on
both hands, and doctor-forbidden from using a computer, at any time,
whatsoever.
There it is. I hope you find this helpful.
Best,
Andrew
--
Andrew Laurence atlauren@uci.edu
Office of Academic Computing http://www.oac.uci.edu/~atlauren/
UC Irvine
"Perceive the need." |