Sunday, August 16, 2020

How I've dealt with RSI and programming full-time

Around May I started developing symptoms of RSI: repetitive strain injury.

Since then, I've made adjustments to my life to help alleviate the pain and I wanted to share what worked for me if you find yourself in a similar position today or in the future.

Notes and resources

⚠️ Obligatory note that I'm not a doctor. Please don't take this as medical advice. This is simply a number of things that have helped me and might potentially help you.

I owe a lot of gratitude to both Marco Arment and John Siracusa and their openness about their RSI struggles. Their advice and optimism helped me to find changes that worked for me and my pain.

Resources and other helpful links

Finding what works for you

It's important to know that fighting RSI is about finding what works for you. The types of solutions that work for me might not be helpful for your experiences.

I'd highly recommend to keep a log of your pain as you make adjustments in your habits. Since RSI pain is about mechanical repetition, this will help you have a macro view about which changes help and which ones do not over a period of time.

Resting and healing

The first thing I needed to do with my RSI was to rest and heal. I eased back on some habits to help with the pain.

  • I avoided typing and being in a "typing position" when I wasn't working.
  • I iced my wrists and hands and used a brace to keep my wrist straight.
  • I cut back significantly on mechanically taxing actions to get relief for my pain.

Resting went a long way so that I could be prepared for changes in my habits.

Performing your own mechanical audit

When you're experiencing RSI it's worth considering all the ways you might be creating mechanical issues aside from just typing.

For instance, I frequently held my phone during a run and realized grasping my phone in my hand for a long period would excerabate my pain. Because of that I stopped running with my phone just used my watch for playing music and podcasts.

While it might not be bothersome for others wearing a watch while I typed added pressure and pain during computer usage. Removing my watch while on the computer was an easy, helpful change.

Additionally, I noticed I tend to "curl" my wrists at night. Doing this for a prolonged amount of time could certainly contribute to my mechanical problems and pain.

Aside from my watch usage these other circumstances had nothing to do with typing. Taking an audit of your mechanics can help you find other habits that are worth changing.

Wearing a brace

An immediate change that helped alleviate pain as I healed was to temporarily wear a brace that compressed my wrists and forced them to be straight.

While this made typing more difficult simply wearing it subsided the pain by quite a bit. I also wore my braces for a couple nights to prevent me from curling my wrists as I slept.

Reducing phone usage

Unsurprisingly, one of the most mechanically taxing things I do on a regular basis is use my phone. The act of stretching my thumb across the screen for hours a day seemed like something to cut back on.

Fortunately, keeping an eye on how much I'm doing on my phone was relatively easy using Screen Time, a baked-in iOS feature to reveal and limit usage.

Monitoring how much time I'm on my phone and keeping a log of the pain helped me see how much of a reduction can reduce my pain.

Changing my keyboard and keyboard habits

In 2015 I purchased the CODE Keyboard—a thick, chunky, mechanical keyboard that I used continuously for 40+ hours a week for nearly five years.

When I began developing pain I started researching proper keyboard ergonomics and I realized I was violating almost every recommendation for good keyboard ergonomics. Specifically keeping my wrists straight and not angling them upwards.

I purchased two ergonomically-friendly keyboards for testing:

Keyboard test video—including wrist example of the CODE Keyboard

As you can see in the final test my wrists are not straight and need to reach upwards for use. I believe this is one of the most significant contributions to my pain.

I kept the Microsoft Sculpt Ergonomic in case I'd like to use it in the future, but I landed on the Apple Magic Keyboard. I prefered it because it was a low-profile keyboard that was well-suited to my familiarity with macOS keyboard shortcuts.

Taking frequent breaks and stretching

It might seem obvious, but I very rarily made conscious decisions to stand up from my desk and take a break to stretch and rest.

Intentionally interrupting my day to do some light stretches and rest my hands and wrists was a very beneficial thing to start doing.

Other options

Maybe you're curious about making a far more drastic change to your computer usage and you'd like to simply type less or not type at all. Many people are doing this successfully for regular computer usage and even programming.

Final thoughts

These are the changes that worked for me in my battle with RSI and not likely to be the last. It's only a matter of time before I need to make new changes in my habits to stave off the inevitable.

However, I hope this helps you—or someone you know—feel hopeful and empowered to make everyday mechanical adjustments. It's frustrating to be in pain and struggling to do things that once came easy.

But with some rest, conscious changes (and guidance from a qualified medical professional) you have a great chance of experiencing relief.