A brief introduction to lowering RSI risk and treating RSI symptoms for programmers, sysadmins, and other people who type too much.

1. Be Kind ToYour Wrists
(you'll miss them when they're gone)
Denise Paolucci
Dreamwidth Studios
denise@dreamwidth.org
Tuesday, June 4, 13

2. Slides downloadable at
end of talk
Tuesday, June 4, 13

3. DISCLAIMERS
• I am not a doctor
• Or a physical therapist
• If you're having symptoms, GO TO A
DOCTOR
• Cape does not enable wearer to fly
Tuesday, June 4, 13

4. Show of hands:
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5. A cautionary tale
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6. Age 10
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7. Age 16
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8. Age 19
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9. age 22 :(
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10. • Carpal Tunnel Syndrome
• Medial epicondylitis ("golfer's elbow")
• Lateral epicondylitis ("tennis elbow")
• Radial Tunnel Syndrome
• Ulnar nerve entrapment (Cubital Tunnel
Syndrome)
• Thoracic Outlet Syndrome
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11. Tuesday, June 4, 13

12. Carpal Tunnel Syndrome
• Compression of the median nerve
• Numbness/tingling in thumb, index, middle
fingers
• Waking up with entirely numb hands
• Poor fist grip strength
• Pain: possible, but not a key indicator
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13. Radial Tunnel Syndrome
• Compression of the radial nerve
• Pain in top side of upper forearm
• Very similar to "tennis elbow", but nerve-
based, not tendon-based
• Muscle weakness in back of wrist/forearm
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14. Cubital Tunnel
Syndrome
• Compression of the ulnar nerve
• Numbness/tingling in pinky and ring finger
• Ulnar compression starts at elbow
• Can manifest as pain in forearms
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15. Lateral Epicondylitis
• aka "Tennis elbow"
• Tendon-based, not nerve-based
• Pain in elbow and back of forearm
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16. Medial Epicondylitis
• aka "golfer's elbow"
• Tendon-based, not nerve-based
• Pain in underside of forearm, especially with
resistance
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17. This isn't an exhaustive
list of either RSIs or
symptoms
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18. Ergonomics
"scientific study of the efficiency of people in the
workplace," coined from Greek ergon, "work" + second
element of economics.
(http://www.etymonline.com)
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19. Kinesiology
from kinesi-, combined form of Greek kinesis
"movement, motion" + -ology.
(http://www.etymonline.com)
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20. Rapid Treatment
GO TO THE DOCTOR.
I MEAN IT.
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21. Ergonomics
Adapt your environment to your body, not your body
to the environment.
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22. Every body is different.
Listen to your body and to the feedback it's giving you
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26. (image credit: http://www.abates.org)
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27. • Top of monitor at height of eyes
• Keyboard height at or slightly below elbow
height
Two most important rules:
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31. Ulnar deviation
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32. Radial deviation
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33. Dorsiflexion
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34. If you take one thing
home from this talk,
make it this:
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35. THROW OUT
YOUR WRIST REST
(they encourage awful habits)
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36. Hands floating, wrists neutral,
in line with shoulders
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37. Obviously impossible with a standard
keyboard, but get as close as you can. Or:
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38. Input devices
• Same principles
• Neutral position
• Vary your motions
• Minimize elbow and forearm motions
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39. Kinesiology
Adapt your motions and condition your body
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40. Stretches
At least 2 minutes, every 15-20 minutes.Yes. I mean it.
Even if you're deep in hack mode. Especially if you're
deep in hack mode.
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41. Inner wrist stretch
• Interlace fingers
• Turn palms out
• Extend arms to push palms away from you
• Hold 10-15 seconds
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42. Overhead stretch
• From previous stretch, reach upward
• Palms "pushing" against ceiling, shoulders
pulled back
• Stretch should be in shoulders, not biceps
• Hold 10-15 seconds
• (stop if your hands go numb)
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43. Shoulderblades stretch
• Hold hands flat
• Extend hands all the way out, at your sides
• Rotate arms in small circles, keeping
shoulders back
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44. Cross-body arm stretch
• Hold out one arm
• Hook other arm around it and pull first
arm across your body
• Leave your wrists relaxed!
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45. Enforcing Stretch
Breaks
• Workrave (Linux,Windows):
www.workrave.org
• TimeOut (Mac): http://www.dejal.com/
timeout/
• Firefox: "Take a Break"; Chrome: "Break
Helper", "Gimme a Break"
• Trusted friends or significant other :)
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46. If it hurts:
STOP TYPING
You do not get prizes for being stoic!
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47. What if you're already
showing symptoms?
(You know I'm going to say it: GO TO THE DOCTOR.
But there are a few other things, too.)
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48. Sleep in wrist braces
• You do more damage to
your wrists overnight
than you think
• Metal insert removable
so you can wash them
• (You'll really want to
wash them.)
• But don't use them to
keep typing through the
pain or numbness
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49. Ice
• Eight gazillion brands of
reusable ice packs; gel
style is most adaptable
• In a pinch: ice cubes in a
ziplock bag!
• 20 minutes at a time,
three to four times a day
• Keep more than one in
freezer so you always
have one cold
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50. Regular massage
• Look for sports massage or neuromuscular
massage therapists
• Make sure your therapist is accredited and
experienced with RSI treatment
• American Massage Therapists Association:
http://www.amtamassage.org/findamassage/
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51. All together, now:
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52. GO TO THE DOCTOR
• Not your GP: see an orthopedist who
specializes in RSI treatment
• There are other options than surgery --
sometimes rest alone will work!
• Each case is different and sometimes there
is no surgical treatment
• Surgery is not the end of the world, though
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53. Q&A (or grab me later)
Slides available at:
http://www.slideshare.net/dreamwidth/be-kind-to-your-hands
or
http://tinyurl.com/k8tys82
Tuesday, June 4, 13