EVERYONE who suffers from RSI should read this:

https://news.ycombinator.com/item?id=1269951

I read it about a year ago, and it was probably the single most important article I've read in my entire life.

Some background: I've been using computers since I was a little kid. Used to play videos games a whole ton. Around the age of 15, I started having severe RSI-related pain in my hands. Even after I stopped gaming, I could never get away from the keyboard and mouse, because I was a technology professional.

Fast forward 15 years. I'd been dealing with constant pain every day for as long as I could remember. My hands hurt even when I wasn't typing. It was bad enough that I was considering changing my line of work.

I'd tried every type of medical remedy under the sun. I'd seen (many) doctors, physical therapists, chiropractors, acupuncturists, etc., but I couldn't find any sort of treatment that provided anything but temporary pain relief.

Through some stroke of incredible luck, I stumbled across this article randomly while looking for something else. I read it and found Aaron's experience closely mirrored mine in a lot of ways. I immediately bought the book he recommended, started reading it on my Kindle, and began following the advice contained within.

Two weeks later, I was almost entirely pain-free. Now a year out, I can type all day without even the slightest twinge of pain. Seem too good to be true? I probably would've said the same thing if it hadn't happened to me.

I will say one thing -- I've recommended this book to a number of people at this point, but not all of them have had the same kind of result I have. I've noticed the ones who really buy into it and become convinced that their pain has a psychosomatic basis see their pain disappear. The ones who still stick to the idea their pain is caused by an previous injury or old age -- those folks don't seem to get much benefit.

Recently I've had RSI and been having physio. My physiotherapist seems to be very experienced and pretty much right about everything. Here's what she told me:

1. Fix your posture. 2. Use ergonomic devices. 3. Exercise to strengthen your core and back muscles, and counteract your sedentary lifestyle.

Details below.

1. Posture

The main cause of RSI is bad posture at the desk. Both the way you type and use the mouse, but importantly also the way you sit.

There's little point treating the symptoms if you don't treat the cause. Looking around my workplace, I see pretty much no-one in the correct posture.

- The back of your chair should be in contact with your back, i.e. actually touching it at all times.

- You should be right under the desk. If your chair has arm rests that stop you from getting under the desk, get a new chair.

- Top of screen at eye-level (most people have this spot on).

- Keyboard a little back from the edge of the desk.

- Elbows at approximately 90 degrees

- your wrists should not be at an awkward angle as they approach the keyboard.

2. Ergonomic devices

Get a good sized keyboard. Don't use awkward keyboard shortcuts, e.g. alt-tabbing on a Mac running virtual box requires your left thumb to reach underneath the other fingers. This is bad. Re-map common shortcuts or use two hands.

Get a mouse that has a natural (hand-shake/vertical) grip. e.g.

http://www.amazon.co.uk/Wireless-Vertical-Ergonomic-Optical-...

This reduces the stress on your wrist. Made a huge difference to me. Check out the reviews.

3. Exercise

My physio recommended swimming, as physios so often do! It will strengthen your back and core, to help you sit up straight.

However, she also recommended walking. Walk at lunch and in the evening, to get away from the sitting posture.

This has pretty much cured my RSI. Take it or leave it! :-)

I'm currently trying to solve my RSI problems by going farther than the normal progression of ergonomic peripherals. If that doesn't work, I'll have to give up and go to voice control.

I've designed and built my own chording keyboard, which should be 10x less stressful to type on than a normal keyboard. I also have an eye tracker that I'm going to program to use to replace most mouse tasks.

I don't like the idea of inaccurate input that makes noise (me speaking) that could disturb others in an office. I have a feeling that being too noisy for an open-concept office might limit my career options in the future. But I would still rather live with that than live with RSIs.

I do really like the idea of running Windows in a VM and proxying the commands to linux. That was previously one of my qualms with voice control: that I'd have to switch to Windows.

My other idea is to switch to a mass-motor gesture and eye-tracking based system using an Oculus Rift with an IR camera mounted in an eye socket. That might be an interesting and fun way of programming even if it wasn't to solve an RSI problem.

this is all I think of when I think about programming by voice: https://www.youtube.com/watch?v=KyLqUf4cdwc I remember laughing so hard the first time I saw this. (granted its from vista, and I know voice has come a long way since then)

However I could see myself using voice commands that activate Macros or other actions. I just bought a Nexus9 and am going to try to use it for coding, I can definitely see potentially using voice commands to augment that workflow.

Here is a rather conventional setup with which I completely got rid of my RSI:

1) Kinesis Freestyle2 keyboard

2) mouse that fits my hands (razr doesn't)

3) listening to the body (!)

4) stretching (especially in the morning)

5) Lots of physical exercise / gym / swimming

6) speech recognition for all text (emails+code comments)

I find it hard to believe that it can be cured simply by changing your mind, but knowing that there are cures certainly helps.

Almost forgot the most important part: a good chair. No slouching! Ever! This is more against upper back pain, but I guess neck tension is related to arm pain.

This is one of the best reasons for me to have a startup: to be able to work when and only when my body tells me that it's okay.

I had a brief period of RSI while playing video games in my teens and forced myself to switch to Colemak as a Microsoft-style "natural" keyboard wasn't enough. The Colemak did the trick, until 2 years ago when I suddenly had terrible pain in my fingers and wrists for about two weeks. It eventually disappeared as I began to learn how to use an Kinesis keyboard and experimented with an RF-based Evoluent VerticalMouse 4 or a Kensington SlimBlade Trackball. Adjusting my chair and posture helped enormously also. I eventually discovered the source of the mysterious pain when I tried to solve a Rubik's Cube and it flared up again. Turns out, I'd spent the weekend before my 2 weeks of misery at a hackathon that featured Rubik's Cubes also and I'd spent time learning how to solve one. I do really want to experiment with voice, but these darn open concept offices ... As for gestures, Kinect might come in handy, it also does voice and can focus on one person of many for voice recognition. But I'd almost rather learn a custom, chorded ten-key keyboard than speak every semicolon ... Oh and the trick with the Cherry MX blue "clicky" keyboards is that you don't actually have to press as hard as people normally push the keys. Pressing harder strains your hands further, so the audible and tactile "click" feedback helps train your fingers to not push as hard -- at least, that's my two cents on them. I like it, but not enough to switch from a nicer, concave layout like the Kinesis. Makes a good backup keyboard though, as I can't afford two concave keyboards.

Watching the PyCon talk the author mentions as inspiration, the thing that seems like it would really kill this for me (even given a good macro set for the editors and applications I need) is the input lag. The whole time, it seems like he's either pausing between commands and able to react to incorrectly interpreted input, or he's speaking a long string of commands and something goes wrong in the middle that invalidates the remainder of his sentence (he ends up in the wrong mode, or in the wrong pane, or something along those lines).

The huge advantage that the keyboard has as an input device is that there's zero delay-- if I make a mistake, I can go back and fix it as soon as I'm able to see and react to it. Speech recognition has this inherent delay to it-- it has to delay execution of a command until it's concluded that there's no other possible interpretation of what you just tried to say. Speech is a lot slower than I can react-- the inherent lag there just seems intolerable.

I suppose one could get used to it if it came down to "use speech recognition or find another job", though.

Great article! I have wondered if this was possible before. The only problem is eventually you might lose your voice!

I had hand/arm problems not long after starting my first programming job, but I have solved them now.

My main advice would be to get a good chair and desk. I have a RH logic 400 chair and height adjustable desk, with an Imprint Cumulus Pro floor mat. I also use a Kinesis Freestyle 2 keyboard. All together this cost about £1700, but it was absolutely worth it. I spend approx 50% of my time standing which I find much more comfortable than sitting.

My other piece of advice would be to take regular breaks. I recently became self employed which allows me to intermingle work with exercise, socialising and eating as I want. This really helps with fatigue. At least try to take a short break once an hour. I found jawbone up good for this as you can set it to vibrate after you have been sat idly for too long.

Finally, if using the mouse is a problem, learn to use your non-dominant hand. This has pretty much solved my problems with my mouse hand.

FWIW switching to the Dvorak layout was the best thing I ever did. Not only did my fingers stop hurting, I could actually type faster than I had before. And it only took a weekend to make the transition.

Also, choose a keyboard that works for you. Different people have different opinions; the one I use was a $3 no-name one, but it felt right.

Voice recognition can work well for English text. For writing code, it's certainly better than nothing, but on the awkward side; I found a zero force keyboard works better: http://specialneedscomputers.ca/index.php?l=product_detail&p...

A USB touchpad is a zero force mouse substitute, though a little annoying for positioning; I ended up using one for clicking in combination with an optical mouse for positioning. Has anyone yet released a mouse with zero force clicks? Microsoft released one with zero force for half a dozen useless functions, annoyingly, everything except left and right clicks.

Very interesting. Not sure if I could live with the input lag myself, however.

I've been a full time developer since 1998 or thereabouts, but have been coding since I was a child. Early on when I started working full time I found myself quickly getting RSI fatigue and tingling symptoms. I switched to a Microsoft ergonomic keyboard and various trackballs; this greatly ameliorated the growing pain.

In the past few years, however, I've made the switch to gaming grade laser mice (e.g. the Logitech G9X) and have almost no issues. The high sensitivity and precision these allow for at high DPI settings are great vs RSI. Furthermore, since a shoulder fracture earlier this year (now healed) when I was forced to use only mainly left arm for some time, I've kept up the use of left hand mouse. At clients I'll have it on left hand side, at home office on the right hand side. I believe ambidextrous use of the mouse has a lot of benefits, spreading the effort level being the biggest of them.

For keyboards, I touch type and made the switch to mechanical keyboards (Logitech G710+ with O ring dampened MX Browns) around 1.5 years ago - I'm not getting any additional pain as a result. I am however kind of interested in getting a more ergonomic mechanical keyboard for use at client spaces, to preemptively combat the RSI risk. Was held off by the cost, however I guess this means I'll be reading reviews of the TEK vs the Kinesis Advantage again shortly. ;)

As a related issue, I believe back pain is just as critical as RSI. The only way for myself to combat this is through consistently exercising. I ride 100-150km per week, mainly commuting but also MTB XC single trails whenever time permits, and try to get my deep squats, deadlifts, shoulder presses and bench presses done 1-2 times per week at gym. Only riding isn't enough; I find the gym work essential for fighting back pain, no matter what kind of chair I use - which happens to be a Herman Miller Aeron at home, and some random chair at work.

Long post, sorry. My final comment / tip will be to set up JustGetFlux for those late night coding sessions. I'll leave it at that. :)

My wrist pain is so bad I've had to change profession. Nevertheless, computers are used in every job. At first, ergonomic keyboards and mice were enough. Then any kind of mice was too painful. Then I became fully ambidextrous, writing and using mice with left hand. After I maxed out the pain in that hand, I've moved onto tablets. I find almost no pain typing on a Swype keyboard on my tablet.

I got Samsung Note 12.2 2014 pro because it has a huge screen. If I need to do a small amount of programming, I use Splashtop to accept Swype input into my Windows laptop just across the room.

If anyone has better ideas for an extreme case of RSI, please let me know. Thanks.

This is exactly what 'english script' is created for: https://github.com/pannous/english-script

Despite my extreme (32 year long) computer use, I only had RSI symptoms when using a mouse and under stress. Since I use my macbook trackpad and have no stress, I can sit in any position for any time and do anything and have 0 symptoms. I am very interested in coding without keyboards etc because these days I happen to think a lot more about my code before trying it and that means I walk around a lot; sitting down or walking to my standing desk both seem cumbersome.

Thanks for posting this. I've had a long standing tendency to get eyestrain headaches from the computer screen, and when I was writing my dissertation, my wrists hurt so bad that I couldn't finish my figures. Fortunately, an old draftsman helped me out using pen and ink.

Today, as a musician, I'm quite conscious of the health of my hands and wrists. When I hear musicians complain about wrist pain, I always tell them to evaluate their computer use.

I started setting up Aenea back in April and got distracted with porting the OS X server to the newest version of the client. Now that there's a working server, I'll have to give it another shot.

In the interval, I switched to a standing desk and it did _amazing_ things for my hands. I tend to slouch when sitting, and just standing while I worked for several periods a day reduced the pain a lot.

This was a pretty interesting read. One thing I can recommend for those with RSI are Cherry MX Blue switch keyboards.

As someone with fairly severe RSI, making the change from my normal rubber-dome keyboard over to the Blue Cherry MX switches about 2 years ago has made things significantly better. The pain and discomfort is largely gone-- its still there, of course, but its hardly noticeable.

I can't recommend a browser extension like Vimium highly enough. It allows you to browse the web efficiently without a mouse. Also: shortcat for navigating OSX dialog boxes, and Divvy for resizing windows with the keyboard. I hardly touch the gesture pad anymore (external one), and my shoulder thanks me for it.

Has anyone tried to add gestures, with a Leap Motion for example, to their development process? A handful of subtle motions could be used to automate some repetitive tasks.

Personally, I'd opt for Dasher: http://www.inference.phy.cam.ac.uk/dasher/

OT: I've been thinking about getting Microsoft Sculpt Ergonomic Desktop keyboard. Is it good?

I also had RSI which progressed to the point where I was starting to worry if I'd be able to keep using a keyboard at all. A standing desk had helped for some time, but it was reaching the point where I'd stand for 3/4ths of the day, come home, and simply lie down.

I went to physical therapy, which identified problems with my neck and shoulders, and then we began working on those muscle groups and some of my core. I should note that these exercises were very gradual, such as using no weights or 1-2lb weights -- I didn't go straight to lifting!

After a few months of this, most of my symptoms have disappeared (I only went to phys therapy for about 1.5 months; afterwards I was able to keep doing the exercises at home). Also, my wife has noticed that my posture has naturally improved as a result of the exercises, such as my shoulders no longer rolling inwards.

I still have some remaining long term problems that I've had for a decade, but now I can sit and use a computer the whole day with very few problems. Of course, everybody's situation is different: physical therapy, surgery, and "The Mindbody Prescription" mentioned elsewhere have not helped a friend of mine. But at least in my case, it was a bit humbling to realize that all I really needed to do was exercise (and I'm not overweight, either).

Something else that helped me was getting a quality mechanical keyboard with low actuation and learning how to use it without bottoming out. The model that I like (CM Storm Quickfire Rapid) is unfortunately no longer made, but it uses Cherry MX Brown switches (not loud, but still has an actuation point) and has no numeric keypad, so I can keep the mouse close by without having to stretch my shoulder. I use blue switches at home, which have a more clear actuation point and thus are probably better for a mechanical keyboard novice, but they are probably too loud to use in an open office environment. This guide is very helpful for understanding the how & why of mechanical keyboards: http://www.overclock.net/t/491752/official-mechanical-keyboa...

Yeah, it's pretty common for someone to explain why the keyboard is a better input method. And you're right it probably is at this time for healthy developers. However, you should probably stop to consider that the solution isn't for you. It's for people who can't type. Many people have disabilities, for example. This opens up a new world to them. And as for the author, he suffers from RSI, as do many other developers.

http://ergoemacs.org/emacs/emacs_hand_pain_celebrity.html

Like the author of the article, I've been making the switch to programming by voice. At first, the delay was really jarring, but you get used to it.

You're also completely correct about how when you speak a chain of commands, one of the commands in the middle getting messed up can invalidate the rest. That happens a lot. You learn to speak in shorter chains, and also to make the commands phonetically distinct.

That said, both the delay and the inaccuracy problems can be greatly ameliorated by a fast CPU and a good sound card. I don't have any benchmarks, but I have noticed the difference since upgrading.

Yes, there is a little lag but I have not found it to be a big deal. If you are getting excessive lag just make sure that the environment is mostly quiet and you have given the Windows VM enough CPU and RAM. Turns out voice recognition is hard.

Corrections on a keyboard can actually be ahead of when you see them - particularly during laggy SSH sessions - when you realize you've struck a key incorrectly a tiny moment after doing so, and hit backspace quickly.

I'm beginning to have some carpal tunnel pain brought on by heavy keyboard/phone use and my weight lifting regimen. What is it about the Cherry MX blue switch keyboards (http://www.newegg.com/Product/Product.aspx?Item=N82E16823201...) that helps with RSI? Just looking at it, it appears like it would be even harder on my wrists.

I find rotating between different types of input devices helps the most. Some weeks, I work on a laptop. Some, at a PC with a common mouse and keyboard. Some, with my Unicom and a trackball. I also change up how I sit, and the location of monitors. Any one system eventually leads to the same pain.