EPTSince January, I have been dealing with several forms of RSI, that is, Repetitive Stress Injury which is a type of injury most serious gamers will probably encounter in some form, even if it's only a light discomfort. During the course of my recovery, I have done a great deal of research and study on what can be done to heal these types of injuries.
I had to personally develop a plan for myself to try to get on track to recover fully for the release of Starcraft 2, and so far things are going well enough for me to try to write this up, so I would greatly like to share the information with anyone.
I hope to help users with light to mild pain deal with it cheaply and effectively.
I will cover the topics of workstation layout, posture, exercises and stretches for the following conditions:
- Tendonitis of the wrist, forearm, hand, and elbow(also known as tennis elbow or mouse elbow)
- Carpal Tunnel Syndrome
- Cubital Tunnel Syndrome
+ Show Spoiler [What is RSI?] +
From Wikipedia:
Repetitive strain injury (RSI) (also known as repetitive stress injury, repetitive motion injuries, repetitive motion disorder (RMD), cumulative trauma disorder (CT), occupational overuse syndrome, overuse syndrome, regional musculoskeletal disorder) is an injury of the musculoskeletal and nervous systems that may be caused by repetitive tasks, forceful exertions, vibrations, mechanical compression (pressing against hard surfaces), or sustained or awkward positions.
Ergonomic Workstation Guide:
When I first found myself having pain in my arms and hands, the first thing I asked myself was "what has changed?" The only thing that had changed since before the pain started happening was my desk height. The height of my desk was too high and causing me to have terrible posture, resulting in me putting pressure on the carpal tunnel and cubital tunnel of my right hand, and the cubital tunnel of my left hand. The thing that really agitated this was the mashing the f keys while resting my arm on the left armrest of my chair. The major extension of my pinky really did a number on me, and even as I type this now I can still feel it.
I knew something had to be wrong with my workstation, and oh boy it really was. It was extremely hard for me to access a guide with extensive knowledge how I should be positioned in all ways for a workstation. Thankfully Cornell University has an ergonomics department, and after going through their information, I found a very comprehensive guide to how to setup a workstation.
There are a number of obvious choices such as split keyboards and ergonomic mice for maximum health and comfort. According to Cornell University, wrist alignment is much more important than hand position.
+ Show Spoiler [Ergonomic Workstation] +
- Wrist rests - these were very popular a few years ago, but research studies haven't demonstrated any substantial benefits for wrist rests. In fact, a wrist rest can actually increase pressure inside the carpal tunnel by compressing the undersurface of the wrist (take a look at your wrist and you'll probably see blood vessels that shouldn't be compressed!). Studies by Dr. David Rempel at the University of Berkeley, California, show that pressure applied to the underside of the carpal tunnel is transferred into the tunnel itself via the transverse carpal ligament and that intracarpal pressure doubles with a wrist rest compared with floating the hands over a keyboard. If you choose to use a wrist rest, using one with a broad, flat, firm surface design works best, and rest the heel of your palm on this NOT your wrist. Try not to rest while you're actually typing, but rest in between bursts of typing movements. Avoid soft and squishy wrist rests because these will contour to your wrist, restrict the freedom of movement of your hands, and encourage more lateral deviation during typing. Look at the surface of a typical wrist rest that's been used and you'll see that it gets eroded away, which means that the user has been sliding their wrists over the surface which also compresses the blood vessels often visible at the wrist. Remember, your hands should be able to glide above the surface of a wrist rest during typing, don't lock them in place on the rest while you type.
- Chair armrests - Having armrests on a chair can be helpful to aid getting into and getting out of the chair. Also, the armrests can be useful for the occasional resting of the arms (e.g. when on the phone, sitting back relaxing). However, it is not a good idea to permanently wrest the forearms on armrests while you are typing or mousing because this can compress the flexor muscles and some armrest can also compress the ulnar never at the elbow. Ideally, it should be easy to get the armrests out of the way when you need to have free access to the keyboard and mouse. These days most office chairs have armrests and many of them have adjustable height armrests, so look for a chair that is a comfortable fit to you and that has broader, flatter, padded armrests that you can easily move out of the way if needed is the best approach. If you are able to occasionally rest your hands on the keyboard on a palm rest and if you have a comfortable chair that does not have any armrests then this is also quite acceptable.
- Put the monitor at a comfortable height that doesn't make the user tilt their head up to see it or bend their neck down to see it. When you are seated comfortably, a user's eyes should be in line with a point on the screen about 2-3" below the top of the monitor casing (not the screen). Sit back in your chair at an angle of around 100-110 degrees (i.e. slight recline) and hold your right arm out horizontally, your middle finger should almost touch the center of the screen. From that starting position you can then make minor changes to screen height and angle to suit. Research shows the center of the monitor should be about 17-18 degrees below horizontal for optimal viewing, and this is where it will be if you follow the simple arm extension/finger pointing tip. You actually see more visual field below the horizon than above this (look down a corridor and you'll see more of the floor than the ceiling), so at this position the user should comfortably be able to see more of the screen. If the monitor is too low, you will crane their neck forwards, if it's too high you'll tilt their head backwards and end up with neck/shoulder pain.
- viewing distance - the monitor should be at a comfortable horizontal distance for viewing, which usually is around an arms length (sit back in your chair and raise your arm and your fingers should touch the screen). At this distance you should be able to see the viewing area of the monitor without making head movements. If text looks too small then either use a larger font or magnify the screen image in the software rather than sitting closer to the monitor.
- Make sure that the user can reach the keyboard keys with their wrists as flat as possible (not bent up or down) and straight (not bent left or right).
- Make sure that the user's elbow angle (the angle between the inner surface of the upper arm and the forearm) is at or greater than 90 degrees to avoid nerve compression at the elbow.
- Make sure that the upper arm and elbow are as close to the body and as relaxed as possible for mouse use - avoid overreaching. Also make sure that the wrist is as straight as possible when the mouse is being used.
- Make sure the user sits back in the chair and has good back support. Also check that the feet can be placed flat on the floor or on a footrest.
- Make sure the head and neck are as straight as possible .
- Make sure the posture feels relaxed for the user.
![[image loading]](http://img19.imageshack.us/img19/5845/workstation12tips.png)
simply put
You can't set a flat work surface at an appropriate height for the 5 main tasks of office work - keyboarding, mousing, writing, viewing documents and viewing the screen- these all require different heights for an optimal arrangement. A negative-slope keyboard tray system serves as the height and angle adjustment mechanism for the keyboard, and the mouse platform serves as the height and angle adjustment for the mouse when attached to a work surface that is set for writing height. Monitor height is best adjusted by a separate monitor pedestal rather than trying to move a whole work surface. There are a number of new split work surface designs that may work quite well to achieve optimal monitor positioning.
With all that being said, my "workstation" could hardly even be called such. I rest my monitor on a folding card table, with my mouse and keyboard on a separate, height adjustable laptop table. The laptop table can be purchased for about 30-40 bucks, and the folding table well... it's a folding table. I recently made the switch from a keyboard with scissor switches(laptop style keys) to a keyboard with mechanical switches and noticed a great deal of comfort, along with owning the best keyboard I have ever used.
The point I'm making here is that you don't really have to go all out to be comfortable in your work station. It's nice to have a cool looking one but a cardtable and adjustable smaller table for my keyboard worked perfectly fine for me and probably cost about 50 USD in total.
Stretches:
If you think you are suffering from RSI, and you have narrowed it down to a certain condition, certain stretches may be more beneficial for relieving the stress on your tendons and muscles than others, but I would personally recommend doing all of them as a preventative measure. If you any really bad pain during any of these stretches, you should probably go see a doctor.
I'd recommend holding these for about 10-15 seconds each, doing them 3 times a day minimum, up to 10 times a day.
+ Show Spoiler [Hand Stretch] +
Make a fist, then spread your fingers as far as possible. I typically hold my fingers stretched for about 10-15 seconds.
![[image loading]](http://img84.imageshack.us/img84/4329/handb.gif)
+ Show Spoiler [Wrist Stretches] +
This probably helped me out the most personally. Stick your arm out, palm facing down. Keep your arm straight and tilt your wrist up so your hand is vertical until you feel a pulling in the back of your hand.
![[image loading]](http://img96.imageshack.us/img96/3789/stretch1.gif)
+ Show Spoiler [Forearm Stretches] +
Arm stretched out, palm facing up, pull your palm back with your opposite hand while keeping your arm stretched and elbow locked.
![[image loading]](http://img210.imageshack.us/img210/6690/forearmstretch.png)
One other stretch that doesn't do much for me but people might find helpful is basically doing this only instead of using your other hand, push your palm against a wall, and then to pull your thumb up. I've read it's useful for pain in the thumb and that area of the hand.
Of course, all stretching is good, so if you can think of any more, do them! It helps believe me.
Exercises:
The goal in these exercises is to strengthen the core muscle groups that we use when on the computer.
What you'll need:
- 1lb / .5kg dumbbell
- 2lb / 1kg dumbbell
- Grip Strengthening Tool / Stress Ball
- Rubber Band
For grip strength even a tennis ball works here for or even a wet rag. Stress balls are pretty cheap at any sporting goods store. I got mine for around 5 dollars. Here's something similar http://www.officeplayground.com/Stress-Balls-C9.aspx
Before you try these you should make make sure you have the range of motion required to perform these exercises, meaning you should be able to do all of the stretches comfortably. If you have any sort of pain while doing this you should go back to stretching and resting. Most would recommend 3 sets of 15 repetitions. I would say go until you feel a burn and then a little further and then stop and rest. Doing these every other day should be fine.
Starting with the lightest weight you have, here is a simple exercise routine that should cover everything. Finish it off with the ball squeeze or gripping exercise tool you have.
+ Show Spoiler [exercises] +
![[image loading]](http://img149.imageshack.us/img149/5530/exercises.png)
Just a random note / trick that I picked up about the rubber band. If you twist the rubber band between each finger you can have a much easier time keeping it from rolling up your hand. I had a much easier time doing the rubber band exercise after learning how to do this.
With this routine, I have been able to ease my way back into personal computer use, and I plan on following it for my lifetime so that I hopefully don't slip into injury again.
Stay healthy!
Update: Another thing I would recommend doing is going to a nice massage place. If you are gaming and having complications in your forearms from playing so much there's no better way to relieve the stress / lactic buildup in your forearms. I now go once a month to get a regular massage and I believe that this has helped me out quite a bit, almost as much as the stretching.
Thanks to flamewheel for this post about flux. I really love this program.
On December 20 2010 11:36 flamewheel wrote:
Oh yeah I found a program this year that's pretty good on your computer screen. It auto-adjusts the tint of color based on the amount of natural light available so it's better for your eyes at night.
http://www.stereopsis.com/flux/
Oh yeah I found a program this year that's pretty good on your computer screen. It auto-adjusts the tint of color based on the amount of natural light available so it's better for your eyes at night.
http://www.stereopsis.com/flux/
