Thomas Wang
The Beginning
My occupation is computer programming. The job involves significant amount of typing. About 3 years ago, I started to develop symptoms of hand tingling and numbness. These symptoms are associated with long stretchs of typing on keyboards. Gradually, these symptoms got worse, until I have to seek a doctor for treatment.
The doctor said I have tendonitis. If it becomes worse, then it would develop to full carpel tunnel syndrome. My computer career would be in big trouble.
What follows is a course of treatment and trouble shooting of the work environment. I am glad to say that today I am completely symptoms free. If the work environment is correctly set up, then there should be good chance to avoid the problems of tendonitis, or carpel tunnel syndrome.
Treatment
First on treatment. My treatment involves putting cold packs on my wrists. After the cold pack, Cortizone cream is ultra-sounded in the wrists area. This is received from Doctor ordered physical therapy. Physical therapy folks treat athletic injuries and work place injuries.
I have heard some doctors will just issue some Advil tablets and call it a day. This by itself is ineffective except for the lightest form of tendonitis.
Bandages and Splints
The usages of bandages are doubtful, because they can restrict blood flow, and make the symptom worse. Splints are somewhat controversial. Tight fitting splints suffer the same disadvantages as bandages.
A somewhat loose fitting splints may be useful in office, where it is a good visual excuse for not typing so much. However, personally I feel I did not get too much out of splints.
Hand Usage Reduction
One basic measure is to reduce the amount work using the hand. They can include typing, mousing, holding books, digging in the garden, washing dishes, video games, carrying babies, and playing tennis.
Prevention
What I learned most however is in the area of prevention. The prevention steps are very detailed. That is why I decided to write this web page, so you can see what I learned, and to apply the knowledge to your situations.
Chair
The most basic item is the work place chair. The chair should have good back support. The height of the chair should be adjustable to a comfortable height for you. The arm rest design is important. It is very bad to have your elbows to rest on hard arm rests for a long time. If you do tend to rest your elbows on the arm rests, then chairs with removable arm rests or adjustable arm rests are ideal. Move the arm rests away from your body so you are less likely to rest the elbows on them.
Recently I bought an office chair without arm rests. It worked pretty well.
Keyboard Height
The next item is the keyboard height. Usually a desk designed for writing will be too high for typing. A good typing height is a few inches lower than writing height. Just a little above the lap is usually a good keyboard height. Put the keyboard on your lap, and put your fingers on the home row. You should notice the keyboard is roughly the same height or slightly lower than your elbow.
How to reduce this keyboard height when the table is too high? There are a few options. You can put the keyboard on your lap. Although the mouse will be more of a problem if you use this simple method. Some office table will have an optional extension keyboard surface that can be adjusted in height. You can custom make a specially shaped acrylic sheet for lowering the keyboard.
I made one at a plastic hobby shop called 'Tap Plastic'. You give them the specification, and they will construct it for you.
My occupation is computer programming. The job involves significant amount of typing. About 3 years ago, I started to develop symptoms of hand tingling and numbness. These symptoms are associated with long stretchs of typing on keyboards. Gradually, these symptoms got worse, until I have to seek a doctor for treatment.
The doctor said I have tendonitis. If it becomes worse, then it would develop to full carpel tunnel syndrome. My computer career would be in big trouble.
What follows is a course of treatment and trouble shooting of the work environment. I am glad to say that today I am completely symptoms free. If the work environment is correctly set up, then there should be good chance to avoid the problems of tendonitis, or carpel tunnel syndrome.
Treatment
First on treatment. My treatment involves putting cold packs on my wrists. After the cold pack, Cortizone cream is ultra-sounded in the wrists area. This is received from Doctor ordered physical therapy. Physical therapy folks treat athletic injuries and work place injuries.
I have heard some doctors will just issue some Advil tablets and call it a day. This by itself is ineffective except for the lightest form of tendonitis.
Bandages and Splints
The usages of bandages are doubtful, because they can restrict blood flow, and make the symptom worse. Splints are somewhat controversial. Tight fitting splints suffer the same disadvantages as bandages.
A somewhat loose fitting splints may be useful in office, where it is a good visual excuse for not typing so much. However, personally I feel I did not get too much out of splints.
Hand Usage Reduction
One basic measure is to reduce the amount work using the hand. They can include typing, mousing, holding books, digging in the garden, washing dishes, video games, carrying babies, and playing tennis.
Prevention
What I learned most however is in the area of prevention. The prevention steps are very detailed. That is why I decided to write this web page, so you can see what I learned, and to apply the knowledge to your situations.
Chair
The most basic item is the work place chair. The chair should have good back support. The height of the chair should be adjustable to a comfortable height for you. The arm rest design is important. It is very bad to have your elbows to rest on hard arm rests for a long time. If you do tend to rest your elbows on the arm rests, then chairs with removable arm rests or adjustable arm rests are ideal. Move the arm rests away from your body so you are less likely to rest the elbows on them.
Recently I bought an office chair without arm rests. It worked pretty well.
Keyboard Height
The next item is the keyboard height. Usually a desk designed for writing will be too high for typing. A good typing height is a few inches lower than writing height. Just a little above the lap is usually a good keyboard height. Put the keyboard on your lap, and put your fingers on the home row. You should notice the keyboard is roughly the same height or slightly lower than your elbow.
How to reduce this keyboard height when the table is too high? There are a few options. You can put the keyboard on your lap. Although the mouse will be more of a problem if you use this simple method. Some office table will have an optional extension keyboard surface that can be adjusted in height. You can custom make a specially shaped acrylic sheet for lowering the keyboard.
I made one at a plastic hobby shop called 'Tap Plastic'. You give them the specification, and they will construct it for you.
Posture
The correct posture for typing is for your arms to hang down naturally from your shoulders, with fore-arm and hand held in horizontal position. Move the chair forward until the fingers reach the home row.
If the keyboard is too high, it can lead to a typing style that I call 'frog swimming'. The frog swimming typing style is very bad for blood circulation. Imagine the keyboard is so high that it is almost up to your shoulders. Your arm is not dropping down, but stretched out horizontally. Your fore-arm is bent inward, so if your hands are straight they will touch each other. In order to type however, you have to bend the hands outward to span the keyboard. This resembles the frog swimming style, right? If you are typing like this, you are sure to develop tendonitis.
While typing, it is important not to lean forward. Typing while leaning forward is much more straining than typing while sitting straight. If the screen font size is set too small, you may lean forward unconciously.
Wrist Rests
How about wrist rests? A SOFT wrist rest can be useful when the keyboard is at the right height. You palm can touch lightly with the soft wrist rest while you are not typing. Resting your wrists on the wrist rest WHILE you are typing is very bad. This will cut off blood circulation to the hand, with negative effects even if the wrist rest is soft. Pressing the wrists against a hard table surface while typing is absolutely the killer- guaranteed tendonitis.
Reaching for Mouse
After these ergonomic changes, I still have right shoulder pain. I was puzzled, until I found out this is due to my reaching out for the mouse pointer device.
Today's keyboards are usually rather wide. Therefore the mouse will have to be positioned to the far right side of the keyboard. Constantly reaching out for the mouse caused my right shoulder to hurt.
My solution was to use a mini-keyboard without the numeric key-pad. Now the mouse can be moved in at least 4 inches. My shoulder pain disappeared within a month. I think an alternate solution is to use a keyboard with built-in touch pad at the center. This would be compatible with the keyboard on the lap approach, as a bonus. The design of touch pad varies, so you will have to see if a particular model is suitable for you.
One more way I dealt with the mouse is to put the mouse on the left hand side of the keyboard, and use my left hand for mousing. It only took a few days before I am used to it.
Monitor Height
I have received some comments that computer monitor located below eye level can reduce neck and shoulder strain. I think this is a sound advice. Certainly a monitor set above eye level can increase neck straining.
I have seen my co-workers construct 'glare shields' out of cardboard boxes. It is glued to the top or side of the monitor to reduce light glare. From what I have seen, it worked well when glare is an issue.
Conclusion
I was able to become tendonitis free with the ergonomic changes outlined in this article. I wish you too, are able to stay pain free. Of course, a few rest breaks per day never hurt!
The correct posture for typing is for your arms to hang down naturally from your shoulders, with fore-arm and hand held in horizontal position. Move the chair forward until the fingers reach the home row.
If the keyboard is too high, it can lead to a typing style that I call 'frog swimming'. The frog swimming typing style is very bad for blood circulation. Imagine the keyboard is so high that it is almost up to your shoulders. Your arm is not dropping down, but stretched out horizontally. Your fore-arm is bent inward, so if your hands are straight they will touch each other. In order to type however, you have to bend the hands outward to span the keyboard. This resembles the frog swimming style, right? If you are typing like this, you are sure to develop tendonitis.
While typing, it is important not to lean forward. Typing while leaning forward is much more straining than typing while sitting straight. If the screen font size is set too small, you may lean forward unconciously.
Wrist Rests
How about wrist rests? A SOFT wrist rest can be useful when the keyboard is at the right height. You palm can touch lightly with the soft wrist rest while you are not typing. Resting your wrists on the wrist rest WHILE you are typing is very bad. This will cut off blood circulation to the hand, with negative effects even if the wrist rest is soft. Pressing the wrists against a hard table surface while typing is absolutely the killer- guaranteed tendonitis.
Reaching for Mouse
After these ergonomic changes, I still have right shoulder pain. I was puzzled, until I found out this is due to my reaching out for the mouse pointer device.
Today's keyboards are usually rather wide. Therefore the mouse will have to be positioned to the far right side of the keyboard. Constantly reaching out for the mouse caused my right shoulder to hurt.
My solution was to use a mini-keyboard without the numeric key-pad. Now the mouse can be moved in at least 4 inches. My shoulder pain disappeared within a month. I think an alternate solution is to use a keyboard with built-in touch pad at the center. This would be compatible with the keyboard on the lap approach, as a bonus. The design of touch pad varies, so you will have to see if a particular model is suitable for you.
One more way I dealt with the mouse is to put the mouse on the left hand side of the keyboard, and use my left hand for mousing. It only took a few days before I am used to it.
Monitor Height
I have received some comments that computer monitor located below eye level can reduce neck and shoulder strain. I think this is a sound advice. Certainly a monitor set above eye level can increase neck straining.
I have seen my co-workers construct 'glare shields' out of cardboard boxes. It is glued to the top or side of the monitor to reduce light glare. From what I have seen, it worked well when glare is an issue.
Conclusion
I was able to become tendonitis free with the ergonomic changes outlined in this article. I wish you too, are able to stay pain free. Of course, a few rest breaks per day never hurt!
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