Go Web Young Man

08/21/08 – In August of 1998, I began pursuing my dream career when I entered Full Sail University as a Digital Media major. After getting my degree, I would have the knowledge I needed to pursue a number of paths such as an animator, a special effects artist, or a web developer. There was only one problem: I was suffering from numbness and tingling in my palm, forearm and shoulder of my mouse arm. In other words, I had what many might call Carpal Tunnel Syndrome; however, I would later learn that Repetitive Strain Injury or RSI was the better term for my condition.

Now, ten years later, I am happy to report that I was able to finish school and next month marks the eight year anniversary of my freelance web design business. What follows is my story of how I beat RSI.

Working on a Computer + Too Many Video Games + Weight Lifting = A Recipe for RSI

Repetitive Strain Injury results from the overuse of a tool (e.g. keyboard, mouse, joystick, etc.) or activity that requires repeated movements (source: Wikipedia - Repetitive Strain Injury). In my case, three things had contributed to my symptoms:

1. Working on a Computer - While I was a student at the University of Tennessee, I was the “computer guy” in the Men’s Athletic Department Training Room.
2. Video Games - In the late 1990’s, I was a Command & Conquer: Red Alert fiend.
3. Weight Lifting - Four days a week, I was lifting weights.

While any one of these activities can cause RSI, all three of them together were a Molotov cocktail of tingling, soreness and tightness from my finger tips to the middle of my back. Nothing I was doing would help. I tried switching my mouse — I used a thumb roller, a track ball and a joystick mouse. I dabbled with wearing a brace. I even switched which hand I moused with only to find the same symptoms creeping in.

Getting a New Perspective

During the 90’s, many persons (physicians and laity) misdiagnosed overuse symptoms related to computer use as Carpal Tunnel Syndrome. Carpal Tunnel Syndrome or CTS is a form of RSI that most commonly appears in guitarists and assembly line workers. However, in my experience and in talking with other computer users, our symptoms typically don’t line up with those of CTS. CTS sufferers typically experience pain and discomfort with a locus in the fingers, hand and wrist. Whereas, my discomfort ranged throughout my arm and upper back.

Regardless of my uneducated diagnosis, my hunch helped me to go after a proper treatment strategy, and that hunch was confirmed by what I read in the book Repetive Strain Injury: A Computer User’s Guide. In the book, Dr. Emil Pascarelli and Ms. Deborah Quilter say that repetitive motions can cause a number of different injuries to all of the delicate nerves, tendons and muscles in one’s arms. Given this scenario, they recommend a suite of measures designed to change your habits, reduce the strain on your arms and allow your damaged tissues to heal.

My Strategy Against RSI

Based on Dr. Pascarelli’s and Ms. Quilter’s advice, I began changing my habits and treating my symptoms. Initially it was slow going; however, after two or three years, I was symptom free, and I’ve since used the same strategy to remain that way. Here are my tips for beating RSI:

1. Change your habits.
This first one may be the toughest one for many of you. In my case, I realized that something had to go from this equation:

working on a computer + excessive gaming + weight lifting

I chose to quit video games altogether and that made a world of difference. Out of the three, I sensed that gaming was causing the most damage because of the focus a game required combined with the repetitive tasks of typical gameplay. I might spend long stretches building bases, guiding planes or marching solders, all the while my arm was taking a beating.

In addition, to quitting video games, initially I also had to quit lifting weights as I noticed I felt a lot of tingling in my hands and forearms after a session in the gym.

2. Adjust your workspace.
Keyboard and mouse placement are crucial when dealing with RSI. Before I started treating my symptoms, I typically worked with my mouse and keyboard sitting next to each other and I didn’t pay attention to their height. Now, I work at a desk with a mouse tray mounted underneath so that my mouse sits right above my lap. That way I can use my mouse without hardly moving my arm. This helps me keep my arm relaxed. Additionally, this configuration also lets me keep my keyboard close so that I don’t have to reach.

3. Monitor your posture.
Along with adjusting your workspace, become aware of your posture. Maintaining the same position for a long time is a trigger for RSI. Take breaks. Shift around in your seat. If possible, get an adjustable desk. I have a desk that I can raise and lower at the touch of a button. It allows me to work sitting down or standing up as I desire.

4. Learn to mouse with both hands.
Learning to mouse with both hands lets me switch hands whenever I notice one is getting tired.

Currently, I use a two button mouse with a scroll wheel. I have both of the buttons configured as right/select click buttons. While I have the scroll wheel as the left click button. This means I can switch hands without making any changes to my operating system settings.

5. Stretch your wrists and back.
Use slow stretches for your wrists and back. I’ve found that stretching these areas releaves a lot of the muscle pain and tension associated with RSI.

6. Introduce your shoulders to Dr. Jobe Exercises.
Dr. Frank Jobe along with Dr. Robert Kerlan developed the famous technique known as Tommy John surgery. Prior to the technique they developed in 1974, a torn ulnar collateral ligament meant the end of a pitcher’s career (Source: ESPN). Along with developing the surgery, Dr. Jobe is also credited with some shoulder exercises which bear his name.

When athletes were rehabilitating after rotator cuff (i.e. the group of small muscles which work to stabalize your shoulders) surgeries, Dr. Jobe found that lifting small weights of approxiamately five pounds worked best to strengthen these muscles. Anything more and you were strengthening your larger shoulder muscles like your deltoids.

I’ve found that consistently doing Dr. Jobe exercises is a great help to RSI symptoms. What happens as I’ve strenghtened my rotator cuff is that it feels as though these muscles work to balance out the musculature in my back. Initially, I noticed that Dr. Jobe exercises helped reduce tightness in my back and soreness in my arms. Through the years, I’ve continued to do Dr. Jobe exercises four days a week, and they’ve help me stay injury free when I’m lifting other weights and working on the computer.

Dr. Jobe exercises work as follows:

1. Grip with your hands or attach to your wrist some small weights (i.e. 1 to 5 lbs). (Note: When I first started, my RSI was so bad that gripping exacerbated my symptoms. So I bought wrist/ankle weights that I could strap to my forearms.)
2. Start with your hands and arms straight down beside your waist.
3. Slowly lift your arms out until your hands are horizontally parallel with your shoulders. (Note: The key here is that you go very slow.)
4. Repeat these lifts 19 times slowly, and do 2 more sets of 20 with a one to two minute break in between.

Additionally, alternate your routine by lifting your arms forward with your hands down (this is known as the “empty cans” lift because you hold your hands like you’re emptying a soda can).

7. Don’t wear a wrist brace!
This one may surprise you, but in my case, I found that wearing a wrist brace was detrimental to my condition.

In their book, Dr. Pascarelli and Ms. Quilter comment on how RSI often results from the tension you put on your body by holding your arm, wrist and hand in a fixed position for a long time. They relate how wearing a wrist brace often only contributes to this. They recommend allowing your body to move freely since not moving properly was what caused your injury in the first place.

Ten Years Later and No RSI

I’m happy to report that ten years after I had RSI, I’ve been symptom free for a great majority of that time. I am still able to keep my 9 to 5 job as a web designer and lift weights four days a week. I’ll even play a video game occasionally (i.e. every other month or so). Implementing the above strategy has taken me from the brink of having to choose another career to fulfilling my career dreams. Considering the benefits that I experienced after implementing the above strategy, it wasn’t long before it became a habit, and RSI is no longer a daily concern for me.

Finally, keep in mind that I am not a doctor. You should consult with your physician before starting this or any other treatment regime. However, when you take my advice with that in mind, it is my hope that my story will help others out there who suffer from Repetitive Strain Injury.