Cady has coined the phrase,
''Silicon Valley Syndrome" as it relates to computer engineers sitting
at computers for extensive periods. This puts
a lot of strain on the neck from looking at the monitor,
the wrist and shoulder from using a mouse and keyboard,
and the lower back which is in the most stressful
position of sitting. This is also called a Repetitive
Strain Injury (RSI).
more and more work, education and recreation involves
computers, everyone needs to be aware of the hazard
of Repetitive Strain Injury to the hands and
arms resulting from the use of computer keyboards
and mice. This can be a serious and very painful condition
that is far easier to prevent than to cure once contracted,
and can occur even in young physically fit individuals.
It is not uncommon for people to have to leave computer-dependent
careers as a result, or even to be disabled and unable
to perform tasks such as driving or dressing themselves.
Repetitive Strain Injuries occur from repeated physical
movements damaging tendons, nerves, muscles, and other
soft body tissues. Occupations ranging from meatpackers
to musicians have characteristic RSI's that can result
from the typical tasks they perform. The rise of computer
use and flat, light-touch keyboards that permit high
speed typing have resulted in an epidemic of injuries
of the hands, arms, and shoulders. Use of pointing
devices like mice and trackballs are as much a cause,
if not more so. The thousands of repeated keystrokes
and long periods of clutching and dragging with mice
slowly causes damage to the body. Another name for
the condition is Cumulative Trauma Disorder. This
can happen even more quickly as a result of typing
technique and body positions that place unnecessary
stress on the tendons and nerves in the hand, wrist,
arms, and even the shoulders and neck. Lack of adequate
rest and breaks and using excessive force almost guarantee
may have heard the term Carpal
Tunnel Syndrome in connection with these injuries,
but in fact CTS is only a small and dangerous percentage
of typing injuries. Tendonitis, Bursitis
, Tenosynovitis , Tendinosis , DeQuervain's Syndrome
, Thoracic Outlet Syndrome, Trigger Finger/Thumb ,
Myofascial Pain Syndrome, Cubital Tunnel Syndrome,
and several other related conditions may also be involved.
All of these are serious and in advanced cases can
cause great pain and permanent disability. In addition,
patients injured by repetitive strain sometimes develop
Reflex Sympathetic Dystrophy.
are the Symptoms?
Tightness, discomfort, stiffness, soreness or burning
in the hands, wrists, fingers, forearms, or elbows
Tingling, coldness, or numbness in the hands
Clumsiness or loss of strength and coordination
in the hands
Pain that wakes you up at night
Feeling a need to massage your hands, wrists, and
in the upper back,
shoulders, or neck
associated with using the computer
How Do I Prevent It?
Correct typing technique and posture, the right equipment
setup, and good work habits are much more important
for prevention than ergonomic gadgets like split keyboards
or palm rests. The picture to the right shows proper
posture at the computer. Research suggests that a
monitor position lower and farther away may be better.
Note that the chair and keyboard are set so that the
thighs and forearms are level (or sloping slightly
down away from the body), and that the wrists are
straight and level - not bent far down or way back.
Also note that the typist is sitting straight, not
slouching, and does not have to stretch forward to
reach the keys or read the screen. Anything that creates
awkward reaches or angles in the body will create
problems. Please note that even a "perfect"
posture may result in problems if it is held rigidly
for long periods of time: relax, move and shift positions
frequently. This isn't just about your hands and arms
either: the use or misuse of your shoulders, back
and neck may be even more important than what's happening
down at your wrists.
While you are actually typing your wrists should
not rest on anything, and should not be bent up,
down, or to the side. (Figure
2) Your arms should move your hands around instead
of resting your wrists and stretching to hit keys
with the fingers. (wrist rests give you a place
to rest your hands only when pausing from typing,
NOT while you are typing.) When you stop
typing for a while, rest your hands in your lap
and/or on their sides instead of leaving them on
Wrists also should not be bent to the side
. . . but instead your fingers should be in a straight line
with your forearm as viewed from above.
is easier to do if you tilt the back edge of your
keyboard down, away from you. Put a prop an inch
or two thick under the edge of the keyboard closest
to you, but make sure the whole thing is still low
enough so you aren't reaching up. This is a good
argument for getting an adjustable keyboard tray
that permits optimal positioning.
INCREASE YOUR FONT SIZES. Even with ever-larger
monitors, many people favor tiny little fonts in
their desktops and applications. This encourages
one to hunch forward into the monitor to read things,
putting pressure on nerves and blood vessels in
the neck and shoulders. Microsoft Windows and Macintosh
desktops and applications can easily be configured
to use larger, easier-to-read fonts. Also consider
using color schemes that are easier on the eyes,
particularly shades of gray for text documents.
POUND on the keys: use a light touch.
two hands to perform double-key operations like
instead of twisting one hand to do it. Move your
whole hand to hit function keys with your strong
fingers instead of stretching to reach them.
LOTS OF BREAKS TO
STRETCH and RELAX.
This means both momentary breaks every few minutes
and longer breaks every hour or so. Pace and plan
your computer work. Fidget a lot! Here are some
animations of some stretches you can do, courtesy
of David Brown & the New Zealand Occupational
Safety and Health Service. -> (Don't do
these at the speed displayed. Easy does it.) Notice
that several stretches involve the neck & shoulders,
which have more involvement with typing injuries
than you might imagine. From the same source, here
are some still
pictures of exercises/stretches to do. Another
good source of stretches is the innovative
E-Stretch Web site.
the mouse lightly, don't grip it hard or
squeeze it. Place the pointing device where you
don't have to reach up or over very far to use it;
close to the keyboard is best. Better yet: learn
and use keyboard
equivalent commands whenever possible, as no
pointing device is risk-free. Even trackballs have
your arms & hands warm. Cold muscles & tendons
are at much greater risk for overuse injuries, and
many offices are over-air-conditioned.
unnecessary computer usage. No
amount of ergonomic changes, fancy keyboards, or
exercises are going to help if you are simply typing
more than your body can handle. Don't try to be
the fastest, most powerful hacker around - the cost
is too high. Also: is there recreational computer
use you can reduce? Can some of your electronic
mail messages be replaced by telephone calls or
conversations in person? And lose the computer/video
games . . . which often involve long, unbroken sessions
of very tense keyboard or controller use.
If nothing else, PAUSE the game every 3 - 4 minutes.
Don't sacrifice your hands to a game!
voice recognition. Software that allows computer
control or full voice dictation is becoming more
powerful and less expensive.
other activities. Problems may be caused or aggravated
by other things you do frequently. Sports, carrying
children, hobbies requiring intense small work (like
knitting), and excess effort/tension in other daily
things may have enormous impact too.
TUCK THE TELEPHONE BETWEEN YOUR SHOULDER AND EAR
so that you can type and talk on the phone at the
same time. This common procedure is very aggravating
for your neck, shoulders, and arms.
CARE OF YOUR EYES. Eyestrain is also a related,
widespread problem that should be addressed at the
same time you are setting up your computer for healthier
use. See this article from Doctor
ATTENTION TO YOUR BODY. Pain is your body yelling
that it's in big trouble, but learning what is comfortable
or awkward for your body before you're in
pain may prevent injury.
ARE AT RISK TOO .. . with increasing hours in front
of the computer at home and school, using equipment
that rarely is set up correctly for people their
news article also examines the problem. Also,
read this Workstation
Ergonomics Guidelines for Computer Use by Children
published by Cornell University. The program
Break for Kids can be downloaded for free.
What If I Have Symptoms of RSI?
all have occasional aches and pains that go away in
a day or two, especially when we overdo anything.
But if you have the symptoms listed above regularly
when you are using the computer, run, do not walk,
to your chiropractor or other health care provider
right away. Dealing with this early is critical
to limiting the damage, and to spare you a world of
hurt, trouble, and frustration. You are not overreacting:
by the time you have symptoms there has already been
some damage done, and if you try to ignore the pain
you may sustain a serious injury. If your doctor doesn't
seem to know much about RSI, find one who does. When
you find one, listen to them and check with them about
any changes you intend to make or therapy you want
to try. In order to be an educated patient,
read the other resources on this page.
THERE ARE NO QUICK FIXES.
No wrist splint, arm rest, split keyboard, spinal
adjustment, etc. is going to let you go right back
to work at full speed if you've been injured, and
even carpal tunnel sufferers
who undergo the release surgery on their wrists can
be back in pain and trouble if they don't make the
long term changes in technique and work habits that
hurt them in the first place. Healing can happen
but it may take months, even years. That's why
it's important that you . . .
DON'T GIVE UP!!!
Many RSI patients do regain the ability to work and
substantial freedom from pain, although they may find
that they remain vulnerable to re-injury and flare-ups.
DON'T GIVE UP. Recovery may take much longer than
you think you can bear. DON'T GIVE UP. Almost everything
in your life may turn upside down in the course of
dealing with long-term recovery. DON'T GIVE UP.
us today for an appointment at 408-739-2273