Repetitive strain injury logbook

Repetitive strain injury leads to $6.5 billion/yr in workplace compensation claims in the US alone (van Tulder, 2007) and causes something like $1 trillion/yr in lost productivity globally (something like 1/100th of the entire world’s GDP!)

And yet, there seems to be almost

It’s interesting that a situation can occur where a common workplace disorder , and yet there is a great paucity of basic research and total lack of understanding of the mechanisms and etiology

Evidence also suggests that the pres-
ence of two or more risk factors can have a
highly synergistic effect; e.g., workers who per-
form repetitive and forceful activities have
higher rates of hand-wrist disorders than those
who perform either repetitive or forceful activi-
ties alone (34 – 36).

In acute injuries, the process of tendon heal-
ing is an indivisible process that can be categorized into three overlapping phases for descriptive purposes. Tendon healing can
occur intrinsically, via proliferation of epitenon and endotenon tenocytes, or extrinsically, by invasion of cells from the sur-
rounding sheath and synovium. Despite remodeling, the biochemical and mechanical properties of healed tendon tissue never
match those of intact tendon. Tendon injuries account for considerable morbidity, and often prove disabling for several months,
despite what is considered appropriate management

Biology of tendon injury: healing, modeling and remodeling
P. Sharma1 and N. Maffulli2

Really good paper

When throwing away q tip strong pulling feeling pinkie knuckle pad, palm side, on right hand

While I found the advice from the physiotherapist helpful, I wanted to know a bit more about what was wrong with my hands - I wanted to talk to an expert in hand RSI.

I found an occupational therapist in town that seemed to have good expertise - actually, I found two, but the first did not reply. While I had pain on the days bracketing, I did not type much before the appointment, and presented symptom-free.

Contrary to the appointment I had some 8 months ago, the test involving tapping on the (I believe this is called Tinel’s sign) did not cause numbness and tingling to propagate up my hand - to the contrary, there was no response at all. None of his tests were positive, starkly contrasting as well with the previous physio appointments ~6 months ago, where most tests clearly induced dull pain.

The “Q-tip” nerve glide pain was nonexistent at this time -

I mentioned forearm pain and pain in the palm - he seemed confused by the palm pain.

I had a small amount of pain when gripping the grip-strength tester.

The therapist’s suggestion was that I previously had both tendinitis (tendinopathy) and carpal tunnel, but the carpal tunnel had now resolved.

He recommended the following regimen (“since you aren’t currently in pain”). I don’t think it’s a good idea for other people to follow this blindly - he was careful to point out

  • 5 lb weight Table edge front curls back curls 8 - 12 reps - pain free arc

My arms both currently have a lot of weakness pulling the weight up

foam Ball squeesing, hard, same reps, once per day, both hands, don’t over do it

Ball I can close strneth

Pulling exersizes

He also stressed that there should be no pressure on wrists while typing.

Accuracy of Provocative Tests for Carpal Tunnel Syndrome


Great paper.

Here’s an observation: Before writing the above comment, did the “Q-tip” nerve glide. I did not have the symptom I reported before - a dull “stretching” feeling in the pads of the last two fingers - in my right hand.

Now, after writing it, my right forearms are feeling poor, I have tried it again - and I have the symptom. Clear, unmistakable.

This is not really very meaningful, but it’s interesting.

Tried a cheap pen tablet. Haven’t got the settings and palm rest set up in a comfortable manner yet, but some people say it works for them.

Scrolling a mouse is one repetitive action. Push-to-scroll features (autoscroll)

I also bought an MX Ergo trackball mouse for work, though I’m a bit concerned that my thumb will get worn this way.

spacemouse-like methods

Up arrow - enter for scripts, replaced with ‘gravekey’, seems to work well.

I often take my hands off the keyboard to move the arrow keys. I don’t really have a modifier key

Backspace is another issue

I (along with other people online) am surprised that logitech designed the k860 with such a prominent wrist rest - the conventional wisdom I am aware of is that your wrist shouldn’t be in contact with anything.

The only concern I have when using it is that the numberpad makes the board a little wide, which many of the microsoft sculpt boards don’t have. I haven’t actually had any issues with this in practice though.

The keyboard is also significantly higher than a standard board, so you might need to be careful with your desk height.

home row (hjkl) arrow-keys is something I might want to get used to.

There are lists of assitive or accessible- mouse options.


Found a video where I’m struggling with RSI in the right hand in june 2020

June 29 - left arm, right arm is fine, after abiut 3 days of doing EPU python. Pain is in the forearm, about a quarter of the way down, and the inside palm is tingling aa bit.

Pain at the right joint,

carried heavy groceries and heavy laptop bag on shoulder and hand
Aug 8 - had to stop at 8 pm, didn’t type hard, right wrist and forearm cold pain;

Aug 9; left palm, pad of pinkie and the finger beside it

Aug 10: fairly bad but mad it through the day. Both hands but mouse hand far worse. sscrolling mousewheel but also page

Shooting numbnews if I hunch shoulders and touch nerve under arm

Could I hire a typist? Might keep me focused too…

Aug 13: very bad. Worst in 6 months. Didn’t type much today but I overdid it last week. No heavy lifting recently. shoulder numb, muscles, etc
severe pain when closing finger at inside wrist-forearm, also behind the arm

aug 15: so, so bad. bought ergo keyboard. just made it through the day.

Really just want to learn if there are excersizes
Nerve glides

He says it’s tendonopathy + carpal tunnel before but that test was negative now

Aug 24: worked till 1 the night before. Programmed from 9:30 to 5 pm, right wrist got progressively worse over the day.

“but came up with scheduled breaks and also changed my posture”
Split and ortholinear did nothing for my RSI

Split and ortholinear did nothing for my RSI

“Perform two-key commands with two hands; rather than stretching to reach shift and another key with the same hand, use both hands”
Brown CS: Preventing RSI

I wonder if something like the razer orbweaver, for the left hand, wouldn’t be a good idea, particularly because of the thumb that could be used for scrolling.

foot pedals, can cause rsi themselves though

learning Vim might be a good idea to minimize keystrokes for general editing tasks

or some other advanced multi-cursor

tried out eviacam. definitely will see my neck getting sore.

Because I really want multi-monitor, glasses-based solutions look like the best options. There are a few projects out there that use IR

Eye tracking seems like the ‘right option’. eyes don’t have much mechanically going on, they move a lot and repetitively anyway

really interesting work at york. essentially parity with mouse is found when “The Eye+SPACE Key (ESK) technique allowed participants to “point” with the eye and “select” by pressing the SPACE key upon fixation.”.

However, eye fatigue was a concern (3.5). Participants complained that staring at so many targets made their eyes dry and uncomfortable. Eye fatigue scored lowest among all the questions. Participants gave eye tracking a modest favorable response overall of 4.5, just slightly higher than the mid-point. Discussions following the experiment revealed that participants liked to use eye tracking and believed it could perform similar to the mouse. Of the three eye tracking techniques, participants expressed a preference for the Eye+SPACE Key technique. Concerns were voiced, however, on the likely expense of eye tracking system, the troublesome calibration procedure, and the uncomfortable requirement of maintaining a fixed head position.