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Input Solutions for Repetitive Stress Victims?
simiproject asks: "I provide IT consulting for a 30-person organization. Recently, I have been trying to find an acceptable keyboard/mouse solution for a staff member who experiences sharp pains in her thumb, hand and arm when using her mouse. She had been using one of those 3M joystick mice and felt it only made her situation worse since it required even more extension of her thumb. Holding a pen or stylus won't work since that requires gripping. I switched her to a trackball mouse and that helped a little but not much. However, trying to find a solution that doesn't require using the thumb is like shopping in a bizarro world where we just didn't evolve with that opposing digit. I'd be interested in what practical input solutions Slashdot has for a computer user with limited hand mobility. Voice recognition? Laptop-like touch pads (I've looked but haven't found any)?"
Same sorta thing came up with my supervisor...
Long story short....He had to relearn how he used his mouse to avoid problems.
It came to this because quite frankly no one designed something to suit his individual finger mobilty limit, mainly due to the fact that just about everyone in this situation is unique, each having their own limits, tonerances, and ability.
I had a sore thumb and a sore wrist. The following worked for me: I got a big fat trackball, the Kensington Expert Mouse, and made it a left handed mouse for my right hand. That way I click with the side of my hand rather than with my thumb or fingers. Several years without hand pain have followed.
In my experience, once pain of this type has developed, it can be very difficult to conquer without dramatically reducing computer use for a period of months. But here are some things that have helped me:
- Use programs that don't require much mouse input. I'm a programmer, and I realize that this is often not an option in non-programming jobs. However, the real RSI killer is the mouse, not the keyboard. If the hands can be kept on the keyboard almost all of the time, the reduction in stress is dramatic.
Most non-geek users ignore keyboard shortcuts even in the programs they use heavily; maybe you could explore the shortcuts available to this user and recommend a heavier reliance on them.
- Wear wrist braces. I've found that preemptively wearing wrist braces when I know I'll be spending huge amounts of time typing and mousing makes a dramatic difference. I tend to slump in my chair and use the mouse at a stressful angle. A wrist brace makes that next to impossible; I must sit up straight in order to reach the mouse at all. Since this user's pain is already entrenched, wrist braces won't necessarily improve it, but might stabilize the intensity.
- Exercise the tendons and wrists. I've found that my wrists and hands are more resistant to pain if they're well-conditioned. My solution is to split large amounts of firewood with a maul (a very grip- and forearm-intensive activity), which I realize is not realistic for most people. But any exercise designed to improve the strength of one's grip helps.
I'm sorry I couldn't suggest any miraculous solutions, but it's a tough problem. In my experience, the best way to avoid this type of pain is to reduce computer use until the pain goes away, then wear wrist braces as the computer use increases to its former levels. For me, this practice has prevented signifciant pain from re-developing after my initially bouts with it, which were very serious.
I agree. Stopping what causes the injury is the best way of fixing it.
I guess everyones experience would be a little diferent but here is mine and what i did to stop it. After long hours at the computer i started noticing sharp pains in my wriste and fingertips with it mostly concentrating in my thumb. I though Carpel tunnel but the doctors said nope. i started noticing that elevating the mouse pad and sitting differently in my chair helped to some degree. I also noticed if i combine this with stretching every hour or so wich includes standing and bending (don't know why) I don't have any pains at all.
Something else I was noticing, when I used the mouse for an extended period of time, I found I was leaning forward and resting quite a bit of my body weight on the hand using the mouse. This was puting pressure between my wriste and the gell thing on the mouse pad. Even with a regular maouse pad,i noticed it against the table. I think that elevating the mouse pad to chest high stoped that and it was one of the bigest helps I had other then stretching wich i think might have helped with the leaning.
It may be that the problem was with using the thing wrong or something (poor posture). I'm pretty much good to go with those simple changes.
You know, I rarely use my thumb for mousing on my 3 button mouse...Really should do a poll on that...
Phil
Laugh, it's good for you!
Since use of the thumb is a big issue, I'd suggest showing her a built-in usability function that comes with windows, MouseKeys. When turned on it converts the number keys into mouse function keys (movement, single click, double click, drag, drop, etc). Now normally this is used to avoid all use of the mouse, but can be a little slow moving the cursor around. In your case thought it would allow moving the mouse with the right hand and using the left hand to do the clicking/dragging. Personally I use it a lot just because using the keyboard keys is a lot less stressful than clicking the mouse keys because you don't have to grip in order to push the buttons and there's less strain, especially when you have a lot of repeated clicking in a short period. There's of course a period of adjustment before it becomes second nature to use Mousekeys but it's a no cost, effective solution. And you can toggle it on and off just using the NUM Lock key so you still have access to the number pad for number entry.
p /mousekeys.aspx
i ning/windows95/mouse.html
Here is a link to Microsofts description of how to turn them on:
http://www.microsoft.com/enable/training/windowsx
and a nice tutorial on what keys do what and tweaks:
http://www.disability.uiuc.edu/infotechaccess/tra
Likewise, I always have to remove the arms from my office chair. Whenever I get a new chair it's always the same. It might be a few months before I start to notice that I'm slumping into the arms of the chair, putting all my weight onto my elbows, and it starts to give me pains in my arms. Remove the arms of the chair and I can't do that anymore. Everyone's mileage varies, but that's one I have to do.
Something else a lot of people don't understand is that the word "ergonomic," as it's applied to office furniture, is frequently abused and is often totally meaningless. I once had an office with a desk where I would bang my knees into the top of the desk every time I would roll my chair into it. I called the company facilities people to raise the desk but they were really reluctant to do that because, they claimed, the desk was "official ergonomic height." In the end they actually took a saw and sawed off the part of the desk I was banging my legs into, rather than give me a higher desk.
Now, think about that for a second. Obviously it's totally crazy -- I'm six foot three inches tall. It would be physically impossible to have some kind of official, "ergonomically correct" desk height that would suit me the same as it would a five foot tall person.
Not to mention the fact that ANY kind of activity or posture that you take repeatedly can be the cause of repeat stress injuries (notice that R-word in there). The ONLY type of furniture that is truly "ergonomic" is furniture that allows you to adjust your position whenever you feel like it and as often as you want. Maybe up, maybe down, maybe tilted, maybe over to the left today, maybe over to the right tomorrow. If you can adapt the position of how you sit/work to what makes your muscles, bones, tendons etc. comfortable RIGHT NOW, you're probably doing OK.
But you will NEVER find that "magic position" into which you can place a desk and a chair and expect to be able to keep it that way every day, five days a week, 50 weeks a year, without any kind of discomfort. There is no such magic ergonomic formula. Free motion is the key, including stretching, moving around as much as possible, and adjusting the position of your furniture as often as you feel like it.
Breakfast served all day!
Use your feet to click your mouse.
Seriously. Get a Smart Joy adapter and a Reload Pedal, and remap the joystick input to mouse click... though you may have to unscrew the top and cut the spring in half for easier clicking, like I did. Alternatively, get a mouse with very large buttons, remove the trackball / tape over the sensor, and leave it on the floor as a secondary mouse. Both sets of clicks will register.
The key to RSI, is to not find one "optimal" solution. Switch keyboards and mice throughout the day. Change your position completely. Walk over and talk to someone about a spec they had written. Put your feet up. Take your feet down. Really, the reason we get RSI is because we do one thing repeatedly. No matter how ergonomic that one sitting position or wrist angle may be, if you stay fixed in that position eventually your ligaments and joints will break down. Change position, take coffee breaks, mouse lefty for a little, turn your body to the side... anything to keep from falling into the trap of the one perfect body position.
The ______ Agenda
Hoverstop.com might be worth a look. They sell a mouse that looks and operates normally except it vibrates gently after a period of inactivity. This is to remind the user to remove their hand from the device. The manufacturers claim that this reduces stress and helps people with RSI and similar problems. Hillos
A lady in our office uses something called a Nomus. It's developed by a Swedish company and is like a laptop track-pad, but with endstops for left and right that continue to move the cursor. It has buttons for left and right handed use and doesn't require any settings to be changed to change hands.
I hate it, but she loves it and says it relieves her neck, arm and hand pains.
Most RSIs aren't caused by the device being used. They're caused by poor workstation ergonomics in general. Start with her posture. Is she sitting with her feet flat on the floor, knees bent at about 90 degrees? Are her chair arms removed or set as low as possible? Ideally, she shouldn't rest her elbows, wrists, or the heels of her hands on anything while typing. When typing, her elbows should be close to her body and bent at about 90 degrees also. Given the posture constraints, her keyboard and mouse height will likely have to be adjusted. It's important to adjust the height of the equipment, not the height of the chair. Raising the chair will raise her legs, causing her to adjust her posture away from the optimum. For sensitive users, such as this person seems to be, you need to throw away all those wrist rests, pads, and other items that may put pressure on or near the carpal tunnel area. Even those swoopy microsoft keyboard, with the huge, non-removable wrist rest aren't very good for truly sensitive types. Correct posture of the legs, back, arms, and wrists is the real solution.
I had huge problems with my wrists, for years. I finally went to work for a company big enough to have an ergonomics specialist. When I mentioned it to my boss, he immediately called her, and she came to my office to assess the situation. After a *long* lecture about posture, she took away all my so-called ergonomic gear. She then had the facilities guys come install a height-adjustable keyboard tray and bring me a new chair (Aeron, w00t!). Once everything was adjusted, the problem pretty quickly went away on its own. The only thing that I do now that's exceptional is that I use a trackpoint keyboard at home (from http://pckeyboards.com/).
NaturalPoint's SmartNAV system enables mousing with your head/neck. There is a IR emitter and camera that you mount/place on your monitor, and it tracks a reflective dot that you either wear, stick to glasses, or put on a hat (the kit comes with a hat with integrated reflective dot). Clicking is accomplished by the software mapping convenient keys on your keyboard, or by voice activation.
The system is suprisingly sensitive and intuitive, with a little practice it becomes second nature to point with your head. For the record I'm not an employee of NP, but I am right in the middle of a product review on the SmartNAV3 AT package (and will be posting it at FresHDV in the very near future). I have to admit that I did not anticipate that it would be a very intuitive system. And I've been pleasantly suprised. The system is not cheap, but the relief for those plagued by RSI is well worth the cost. What's great is NaturalPoint offers a evaluation period, you can return the product within like 30 days if you aren't happy with it. It would be well worth looking into for your co-worker.
How about teaching her how to use keyboard shortcuts? Most apps work just fine without a mouse (even Windows - just learn "CTRL-Esc", etc).
No sig today...
I own laptop with a Synaptics touchpad, and while i like it for mobile use, I always plug in an optical mouse when I can. You don't have to use your thumb, but I find it stressful to use more than 30 minutes or so. They are just not designed for prolonged and ergonomic use, though perhaps that is different on stand alone touch pads.
Firehed - Unfortunately, thanks to medical breakthroughs, common sense is not as common as it once was.
who experiences sharp pains in her thumb, hand and arm when using her mouse.
Stop squeezing so goddam hard and it will stop biting her!
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Maybe this individual is experiencing pain because of lack of exercise in certain areas of the body? I can speak from personal experience here that not getting adequate exercise can lead to RSI-related issues.
A couple things that have helped me:
0. Eliminate the source of aggravation. For me it was using a computer at the wrong height, keyboard wrong height, reaching too far for the mouse, etc.
1. Workrave, or Anti-RSI for the Mac. Software like this reminds me you to take breaks on a regular schedule in case you get so involved in your work you forget about the world around you. Workrave even shows exercises on screen so you can follow along. Brings us to next point.
2. Exercise. Do some regular stretches for the areas that are bothering you. Not sure what to do? Look online for exercises for RSI.
At one point in my IT career I had RSI so bad I missed about a week of work. At that point I tried doing physiotherapy but I didn't really find the exercises or treatments I was offered did much for me.
Then I went to a yoga class and had almost immediate relief. I started going once a week to classes and overall my back pain and wrist pains were reduced signficantly.
Another thing that has helped alot specifically in the area of the wrists is indoor rock climbing. It really strengthens upper body, shoulders, forearms, fingers, etc.
- Avoiding RSI
- Some tips
- Preventing and healing* Carpal Tunnel Syndrome & Repetitive Stress Injuries
- Posture for a Healthy Back
My 2 cents, W.A related option is a keyboard with a built-in touchpad. Lots of folks here use the ergonomic layout with these here where I work. You get a full size, ergonomic keyboard (unlike with a laptop) but still have the touchpad. They're quite handy. Alternatively, check out the Logitech Marble Mouse. Your thumb becomes the left-clicker (like with a touchpad), and that's the only thing it does. You work the trackball with your index finger and right-click with middle finger. A guy in our office with pretty painful carpal tunnel swears it was a godsend for him.
Unpleasantries.
Patient : Dr it hurts when I do this ...
Doctor : Well don't do that.
It's a joke, but in all honestly it isn't a joke. If you have RSI, how about stop looking for less painful ways to continue to aggravate it and take some time off. Completely off - I'm not talking about staying home and playing on the computer for 10 hours a day (EverCrack monkeys - yea I am looking at you.) I mean off the keyboard. The company I work for gives us four weeks off per year and they damn well expect us to use it - it isn't so we can go to Disneyland or whatever (well in a way it is) - it is so we can do exactly that : take some time off and let our bodies decompress, destress, and give all the RSI some time to heal. You will never get better if you continue to wear at it - but take a month off and stay off the keyboard for four weeks, see if you don't feel like a whole new person when you come back.
You would think it was obvious, but evidently not. Take some time away from the machine. Get some sunshine in your face. Rest. Relax. Get better.
Glonoinha the MebiByte Slayer