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How to avoid carpal tunnel syndrome when typing

Programmers, writers, accountants, and many other people who work in office jobs will often spend their whole day typing. If proper care isn't taken, injuries can occur such as carpal tunnel syndrome, or repetitive strain damage.

 

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome (CTS) is a medical condition caused by the compression of the median nerve as it travels through the wrist at the carpal tunnel. The main symptoms of carpal tunnel syndrome are pain, numbness and tingling in the thumb, index finger, middle finger and the thumb side of the ring finger. 

2.Carpal Tunnel Syndrome symptoms

What's the difference between carpal tunnel syndrome (CTS) and repetitive strain injury (RSI)?

Carpal tunnel syndrome (CTS) is a type of repetitive strain injury (RSI). RSI is a term for any damage to tissues caused by repeated physical actions. There are a number of conditions that can be classed as repetitive strain injuries, including: Carpal tunnel syndrome, tenosynovitis, bursitis in the wrist, knee, elbow or shoulder or other joints.

Symptoms of Carpal Tunnel Syndrome 

  • People with CTS experience numbness, tingling, or burning sensations in their thumbs and fingers, in particular the index and middle fingers and the radial half of the ring finger.
  • Less-specific symptoms may include pain in the wrists or hands, loss of grip strength, and a loss of manual dexterity.
  • Weakness and atrophy of the thumb muscles may occur if the condition remains untreated, because the muscles are not receiving sufficient nerve stimulation. Discomfort is usually worse at night and in the morning.

 

Carpal Tunnel Syndrome symptoms

Carpal Tunnel Syndrome Risk factors

Risk rate

In particular, people who often work with a mouse and keyboard are particularly susceptible to this disease, with a very high incidence. Data shows that the incidence of carpal tunnel syndrome in the general population is 1% to 5%, while special people like programmers and writers have an incidence as high as 14.5% or more.

Risk factors

The Canadian Centre for Occupational Health and Safety (CCOHS) lists the following occupations as high risk for CTS:

  • Office workers using mouse and keyboard.
  • Farmers, and specifically those milking cows.
  • Assembly-line workers handling objects on the conveyor belt.
  • Gardeners weeding by hand.
  • Locksmiths, turning keys.
  • Mechanics, using screwdrivers and pushing down ratchets.
  • Musicians using a bow for a stringed instrument.
  • Painters who repeatedly use a spray gun.
  • Poultry or meat processing workers who are deboning and cutting.
  • Stablehands, painters, and carpenters who press tools into the palm.
CTS and RSI risk

Which typing motions can result in carpal tunnel syndrome?

 

For those of us who spend a lot of time typing in front of a computer, carpal tunnel syndrome is mainly caused by the improper wrist positioning, which is usually due to overextension.

Don't underestimate the importance of wrist positioning. When the wrist is overly bent toward the center of the hand, the pressure in the carpal tunnel is 100 times that of the neutral position. When the wrist is extended excessively toward the back of the hand, the pressure in the carpal tunnel is 300 times that of the neutral position. When a user suffers from bad mouse operating posture, the gravity of the arm will put the wrist under tight pressure on the desktop, increasing external oppression.

 

Wrong and right typing motions

 

As you can see from the diagram above, we should try to keep our hands as straight as possible without over-bending our wrists. The wrists and palms should always be level. Neither mouse nor keyboard should require excessive twisting of the wrist.

 

10 Ways to reduce your risk of Carpal tunnel syndrome in the workplace

1. TAKE BREAKS!

Be sure to take breaks from using your computer. Every hour or so, get up and walk around, get a drink of water, stretch whatever muscles are tight, and look out the window at a far off object (to rest your eyes).

2. Practice good posture.

If you can't hold good posture, it probably means it's time for you to take a break from typing. If you are perpetually struggling to maintain good posture, you probably need to adjust your workstation or chair, or develop some of the support muscles necessary for good posture.

3. Use an ergonomically optimized workstation to reduce strain on your body.

4. Exercise regularly.

This includes strengthening, stretching, and aerobic exercises.

5. Only use the computer as much as you need to.

Think before you type to avoid unnecessary editing.

6. Don't overstretch your hands for the hard-to-reach keys.

e.g. BACKSPACE, ENTER, SHIFT, CONTROL... basically everything but the letters. Instead, move your entire hand so that you may press the desired key with ease. This is crucial when you are programming or typing something, where non-letter keys are used extensively.

7. Let your hands float above the keyboard when you type

and move your entire arm when moving your mouse or typing hard-to-reach keys, keeping the wrist joint straight at all times. (The correct position is shown in the diagram above)

8. Use two hands to type combination key strokes,

such as those involving the SHIFT and CONTROL keys.

9. When writing, avoid gripping the pen too tightly.

10. Realize that you are not invincible.

RSI can happen to you. Don't be afraid to ask for help.

Good position for typing

 

How to avoid carpal tunnel syndrome from your keyboard

Stop typing?!

This would be the best solution, but obviously isn't practical for most people. We can't seem to change the way we type, and we can't remember so many “remote” key combinations. Should we stop working with our keyboards? Of course not! A well design ergonomic keyboard can be a good solution. 

How do ergonomic keyboards help you to avoid CTS?

Ergonomic design

Optimal ergonomics vary by person, so it is impossible to give a universally standardized and correct answer to what keyboard design is best. Ergonomic designs are better for the overwhelming majority of users. They can reduce finger travel (reducing fatigue) and prevent users from needing to twist their wrists while typing. 

 

Choose proper typing posture

Layout Customization

Many specialty professions like programming or accounting require users to often use shortcuts and macros. The best keyboards will support customization for these features. Keep and eye out for QMK firmware, the most powerful customization software in the industry. 

X-bows configurator

A screenshot of the QMK customization software

BUT ERGONOMIC KEYBOARDS DON'T WORK FOR ME

Some people begin using an ergonomic keyboard and still feel no improvement in their wrist pain. There are two things to troubleshoot in this instance. 

1. Make sure that you don't already have serious RSI.

Ergonomic keyboards are most effective for prevention of RSI, they cannot solve the problem if it is already severe. If your wrist is already hurting badly, please see a doctor and avoid typing altogether.

2. Take the time to adjust to the ergonomic layout. 

A new keyboard layout requires some time to retrain your muscle memory. But don't be afraid of the adjustment period. Split ergonomic keyboards are notorious for a steep learning curve, but a keyboard like X-Bows requires less learning. Most X-Bows users report getting used to their new layout in 3-7 days and within a few weeks, many report that their overall typing speed has increased 10-20%. 

 

Hand exercises to prevent Carpal Tunnel Syndrome

In addition to the usual attention to typing with the correct hand posture, it is best to incorporate with some hand movement to relieve the pressure on our wrists. This exercise is from the Ortho El Paso Orthopaedic Clinic's website

Hand exercises for avoiding RSI

 

 

Below, you can find some additional resources to learn about CTS and RSI. All cases are different, so you cannot consider anything in this article to be medical advice. If you have significant pain or numbness in your wrist, seek help from a medical professional. 

 

References:

1. Burton, C; Chesterton, LS; Davenport, G (May 2014). Diagnosing and managing carpal tunnel syndrome in primary care

2. https://ada.com/conditions/repetitive-strain-injury/#what-is-rsi

3. https://web.eecs.umich.edu/~cscott/rsi.html##ten

 

More information on CTS and RSI:

1. http://www.rsi.deas.harvard.edu/preventing.html

2. https://orthoinfo.aaos.org/en/diseases--conditions/carpal-tunnel-syndrome/

3. https://ada.com/conditions/repetitive-strain-injury/

4. https://cs.brown.edu/about/system/ergo/prevention/

5. https://www.rsihelp.com