Changes I've Made, Stuff I've Used . . .

This site is moving to a new host and updated information will only be found here.

RSI experts insist that good posture, technique, and work habits are the most important changes you can make to avoid RSI, more so than ergonomic gadgets or technological fixes. However, there are software, hardware, and other items or measures that may be beneficial. These are discussed at length in the F.A.Q. files and other resources to which the RSI Page links, but on this page I want to comment on the things that I've tried myself.

This page has been around for over a decade and some information is out of date. I'm currently editing it and hope to end up with product reviews in blog-style reverse-chronological order, with the most recent reviews and comments first.

[Dvorak][Mouse] [USHER][Voice] [Keyboard][Screwdriver] [Pens][Offbeat] [Drugs] [Bikes] [Microcurrent] [T'ai Chi] [LapDawg X4 Review]

My Current Mice: Review of Logitech Marble Mouse, Kensington Orbit, and Kensington Expert Mouse

1 May 2008

I've used of a lot of pointing devices over the years, and these days I'm partial to using trackballs. In particular I like how trackballs can be kept snugly against the edge of your keyboard where no reaching is needed; that you don't need space to move them around; and that they can be used with a variety of techniques, none of which require you to grab or hold them. Here's what I've been using, in the order I got them.

The Logitech Marble is inexpensive and widely available. I particularly like that the ball spins easily and that the whole device is shaped to fit under your hand effortlessly. For a while I kept it tilted at a bit of an angle but even if you don't, you can use it with your hand in the "handshake" position, that is, without having to turn your hand flat and horizontal. Constantly twisting your forearm to keep your hands flat to type or mouse is a stress and risk factor for RSI. The switches, too, fall naturally under your thumb and fingers and are very easy to actuate. I've used the Marble heavily on my Mac at work. There's no scroll wheel; I programmed one of the mini-buttons to be a "scroll-down" function, but it's not really an improvement over using your "PageDown" key. I found it gets important to pop the ball out and clean fuzz and dirt off the three tiny bearings that support the ball, and to buff the ball a bit, if you want to keep that easy-spinning action happening.

I decided I wanted something similar for home and the Kensington Orbit trackball looked like a similar widget at an attractive price. I used it with my Mac for a bit before taking it home to live on my Windows machine. I found that the Orbit's shape is an even better fit to your hand, very easy and comfortable to use, and the buttons are a shape that don't require a particular hand position to access. The Orbit has just the two buttons, which can be configured for a number of functions. More would be nice. No scroll wheel BUT you can program it so that hitting both switches toggles the ball into scrolling mode. That sort of works, but I ended up wanting a drag-lock function more than I wanted a scrolling function and I programmed the double-button mode to activate scroll lock.

At one point I cleaned my Marble with a chemical that actually damaged the plastic and I started looking for another trackball in case it decided to die entirely. I was tempted by the Kensington Expert Mouse, which has a big ball and four big buttons and a new "scroll ring". But it was expensive. Finally I caved in and bought it anyway. I discovered that the unit as a whole is bigger and flatter than either the Marble or the Orbit, and it does not fit naturally under the hand in the same way as the these other, smaller devices do. It also slopes up from the near edge to the back edge. Both factors make this somewhat counter-ergonomic in my opinion. I landed it on the left side of my keyboard on a keyboard tray that is tilted down from the near edge to the back edge, and I propped the Expert mouse's right-hand side (closest to the keyboard) up so it tilts away from me. This improved my ability to use it without having to flatten my left hand. I found the ball is heavier and larger than the Marble, requiring more effort to use. Likewise, while the four buttons are nice and large, the actuation force seems higher than for the other trackballs I use.

BUT it is terrific having four programmable buttons. Besides having the normal left and right click, having a button set for double-click and one set for drag-lock is great and definitely reduces hand stress. But the real kicker on this trackball is that scroll ring. This is a plastic ring that surrounds the ball, and in my opinion it is better than any scroll wheel I've ever used. You can whip that baby around effortlessly to zip up and down pages. Big plus.

So what's my favorite? Well, actually, because it took a bit of time to get used to the Expert, I put it on the left side of my keyboard and continued to use the Marble on the right hand side .... and discovered that while that may seem like overkill, actually it works really well to have two pointing devices like this. You can move the pointer with one hand while activating the buttons with the other, and this is much less stressful than trying to push a button and move a mouse or ball with a single hand. My ideal trackball would have the ease of ball movement and switch activation of the Logitech Marble, the shape of the Orbit, and the four switches and scroll ring of the Expert.

UPDATE My opinion of the Kensington Orbit has risen. First, because it gets used a LOT at home and I'm finding it is comfortable with extended use. Secondly, because I explored the enhanced control panel a bit more and realized that even though there's just 2 buttons, I could program it to, for example, drag-lock if I hit the keyboard SHIFT key while I click button 1, or make button 2 double-click when used with SHIFT. So my "not enough buttons" critique falls away. The "virtual scroll wheel" - programming a key or button to switch into a mode where rolling the ball scrolls the screen - is still unimpressive (kind of slow), so I don't do that, but I don't miss that much.

Review of LapDawg Laptop Table

http://www.lapdawg.com

Notebook computers used to be the privileged possession of executives and technology gurus, but dropping prices and wireless networking are rapidly making notebook computers the personal computer of choice for all users. What is not widely understood in this sea change is that the supreme convenience of notebook computers almost, but not quite, overshadows inherent ergonomic problems they present. With the display married directly to a keyboard, a typing and mousing position that doesn't stress your arms and hands is likely to stress your neck and shoulders as you hunch to view the screen. Awkward reaches or viewing angles can result in serious physical problems over time. The two most common notebook locations - a table top, or the lap - usually are far from optimal, at least without a prop to help position the computer. Increasingly powerful notebooks can generate too much heat to be comfortable or safe in an unprotected lap, and having an expensive machine slip off the lap is a common issue.

Enter the LapDawg, a hollow, extruded aluminum lap desk with multi-section legs. With the legs completely folded at the ends of the desk, it sits easily in the lap and eliminates any discomfort from a hot machine. The two slightly grooved stripes that run across the top surface of the desk provide friction for stability, and may add some degree of ventilation to the underside of a notebook computer. One of the long edges of the desk is a rounded spine that houses the joints for the legs and also is padded by a large rubber bumper.

I've used a variety of makeshift materials or objects as a lap platform for my notebook before, but none of them included the legs that make the LapDawg so flexible. Each leg is made of three strong aluminum box-beam segments, with ratcheted joints that release with spring-loaded pushbuttons to permit each joint to be positioned at ten-degree intervals through 360 degrees. Consequently a great number of configurations are possible. It is possible to create a floor-standing table, or several variations on the “bed desk” theme.

This latter application is of particular interest to me (and to my wife, who has taught online classes from her bed.) Many times I’ve chosen to use an ancient notebook system over a much faster desktop computer simply because it permitted me to crash on my couch or in my bed and work there. This requires keeping my knees up and feet back and also has kept my elbows anchored to the bed. While this seems comfortable at first, it doesn’t remain so for long.

Not long after getting a LapDawg to test, I fell ill with some persistent bug that left me unable to leave my bed for very long. I got my notebook and experimented with the LapDawg until I found a configuration that allowed me to lie flat, with a comfortable viewing angle, and able to reach the keys with only the slightest effort. I spent almost an entire day reading from the notebook, where in the past I would have not found this comfortable for more than maybe an hour.

Very quickly my teenage son, making heavy use of the notebook he purchased after detasselling corn this summer, figured out that the LapDawg makes crashing on the couch or floor for a marathon “Runescape” session both more comfortable, and less likely to result in his precious machine plummeting from his lap. When I took the LapDawg up to work for a week to show it to somebody, both my son and I found ourselves missing it. It’s back home now.

Which brings up the point: while it is not heavy, this lap desk is not something you can pop in your briefcase. Being large enough to be useful means it is larger than would be trivial for somebody who is flying or traveling light. (It would be no big deal to toss in the car, though.) To my thinking, it is more likely to be a well-used tool that a notebook user keeps in their primary computer-using location. Or you could get a second one, except that ….

Price is a consideration. I have to be honest: I am an obnoxious penny-pincher when it comes to technology. The LapDawg’s list price of $125 gives me pause. Despite having the 1st review unit come with a sticking joint-release pushbutton, these appear well engineered and may be worth that price. But in my miserly view, once the price gets up above about $75 for a non-essential accessory, I hesitate. This begs the question: is it essential? Or just cool and handy?

Having had to struggle out of a life-changing repetitive strain injury a decade ago, I strongly advocate that the tools and instruments you use most relentlessly should be as carefully tuned to your body’s needs as possible. If you make intense daily use of a notebook computer, this accessory could be an excellent addition to safer computing. Remember that other common “fixes” for the shortcomings of notebooks – like using an external keyboard, monitor, or docking station – also cost money.

Paul Marxhausen
November 12, 2007

Dvorak Keyboard

In brief, the Dvorak keyboard layout was developed in the 1930's as an alternative to the standard QWERTY keyboard arrangement in an attempt to remedy the latter keyboard's deliberate obstacles to speed. In normal typing with the Dvorak system, 80% of the keystrokes are on the home row. This has long been touted as allowing faster typing speed: whether it is less stressful on the hands is a matter of controversy. With the coming of computers, using Dvorak involves only a simple software change and a not-so-simple retraining of your touch-typing skills. You can easily make this change on MS-DOS, Windows, and Macintosh computers, and can swap between Dvorak and QWERTY in an instant with a hot-key combination, so it can be used on shared computers too. In my case, the Kinesis keyboard on my main computer has been re-mapped to Dvorak in it's firmware so I don't have to use any drivers or such . . . but I haven't changed the keytops around, so nobody else can use it!

Switching to Dvorak is now easily done in Mac OS 10, Windows, or Linux, so I no longer post the various some of the ancient drivers or hacks I used to have here. If you are using MS-DOS, I do have a keymap called DVORAK.SYS that works with the DOS KEYB command. It can be obtained as the self-extracting file GA0650.EXE (32K) from Microsoft's FTP server. It includes a full explanation of installation.

People are understandably concerned that relearning their touch-typing is too daunting, and will leave them stranded if they have to use a non- Dvorak computer. My experience is that memorizing the new layout took under a half hour, followed by at least a couple weeks of extremely wearying typing because I had to think of every single individual letter as I typed instead of blasting along doing whole words and patterns. But in about two months I was acceptably proficient and comfortable at the new layout.

Here's the amazing thing . . . . after I made the mental switch to Dvorak touch-typing, using a QWERTY keyboard on a computer without Dvorak drivers meant I was back to two-finger visual typing. But something strange began to occur . . . I gradually regained my ability to touch-type QWERTY . . . WITHOUT losing my ability to touch-type Dvorak. Yes, I now am faster/fewer mistakes on Dvorak, but it's common for me to sit down at a computer, start touch-typing, look and see by the nonsense on the screen that I'm in the wrong layout mentally. . . and I'll take off typing in the other layout without a second thought. It's kind of freaky and magical, but your brain can do it. So the upshot is, don't be put off by the idea that "if I switch, I'll be stranded on a computer that doesn't have Dvorak."

MORE INFO . . . additional info and resources regarding Dvorak keyboarding can be found here , and here, and here . . . (And here.) There's even A Basic Course in Dvorak on-line. Help with using the one-handed Dvorak keyboard is here .

I've been trying out the "Perfect Keyboard" macro software for Windows, which lets you do a lot of shortcuts. I have to do a lot of Web-based ordering in my job and being able to just type ".n " and have my whole name spit out, or ".p" and have my entire phone number appear, really is cool. I wish it worked inside MS-DOS windows since I use some DOS databases where it would be especially handy, but I'll take what I can get. Download and try at: www.pitrinec.com. Also is capable of a lot of other Windows automation stuff I haven't even investigated. Actually, found Perfect keyboard *does* work inside MS-DOS applications but must execute macros using control key combinations - can't do the ".n" or other period-delimited sequences. I went ahead and paid to register this. In fact, since my old IN3 voice software is having trouble on the soundcard in my new PC, I may end up using Perfect Keyboard even more.

Linux and Keyboard control . . . As of March 2004 I've gone to using the KDE 3.1 desktop on SuSE Linux 9.0 almost 100% of the time. I have to say that it's possible to do a LOT of keyboard shortcuts on this system and with almost all the applications I have to use every day - mail, file managers, etc. It's possible to add custom shortcuts under KDE although I haven't had to do so.

Mouse Abatement

It comes as a surprise to many to find out that the humble computer mouse can be as dangerous, and possibly much more so, than keyboards in bringing on RSI. The stress of positioning the mouse or trackball and clicking or holding down the buttons while moving it is traumatic over time. There aren't any magic pointing devices that are risk free, but I found a number of ways to reduce the impact.

First: Learn all those obscure keyboard shortcuts that Windows (or the Mac, or OS/2, etc.) has. (see lists here .) Remember to use two hands for some of those [Alt][Tab] kinds of things instead of stretching and twisting one hand, and pick up your hands instead of keeping your wrists anchored.

Second: Microsoft and Apple and others now put what they call "accessibility features" into control panels or system preferences for differently-abled computer users. Some of these may be helpful for people recovering from RSI.

Additional note: since ergo researchers and my experience seem to suggest that keeping your arms in the usual palm-down position at the computer is itself a problem, I stuck a little cardboard tape roll core (1" diameter by 1.5" high) on the back of my mouse with doublestick tape in a vertical position. Since I'm doing the button clicks with my right hand, I can run the mouse around with my left hand holding the tube like a joystick, which keeps my hand in a neutral palm-sideways position. Sounds silly but does feel better when I'm having problems. Cheaper than exotic mouse alternatives, too.

8 February 1995 OK, I got an exotic mouse alternative. the $25 Appoint pen mouse has replaced all the above and is very comfortable. Can be used on your leg, a paperback book, bare desktop, whatever. Cool.

9 August 1995 I'm back to a "normal" mouse on right hand, with a small Dixie cup trimmed down and placed upside down on top of the mouse for the "fat joystick" effect mentioned above. Of course, this makes it hard to use the buttons, so the voice-operated "clicks" I have are critical.

3 May 1996 These are my brief impressions of the Contour Mouse which I received recently and have been using daily. Detailed info about it's features, software, and theory are on-line at their web site so I won't attempt to explain all that here, just how it works for me. SOREHAND readers probably remember a while back, Mike Mossey's explanation of how he tries to "drive" his mouse with his whole body/arm/hips instead of just hand motion. The Contour Mouse seems designed with that concept in mind. It comes in 3 sizes, is form-fitting to your hand, tilted to the outside edge, and is meant to have you whole hand rest on it without any effort required to "grab" it at all. (Has a thumb rest too.) There are three large buttons that are supremely easy to operate. I am using IN3 voice command software for mouse button actions like clicking, dropping and dragging, so I'm not fully evaluating the buttons but they seem to be excellent and operate with minimum effort. The software included lets you do a host of fancy Windows shortcuts, including setting up various Windows actions or macros to activate according to whatever combination of the 3 buttons you wish. Also some cursor tweaking, accelleration customizing, etc. etc. See the website for more on this. Again, I'd likely have much more use for these if I didn't already have the voice command software able to do all the same functions. Driving a mouse with the whole arm takes some practice. It's not hard but goes against many engrained habits of motion. I'm still learning just how much I have to lift my arm to be able to move the mouse: very little, if any. Letting that arm relax takes a conscious decision for now, but I'm getting there. The upshot: the Contour IS _very_ comfortable. I don't believe I could effectively relax and rest my hand for whole-arm mousing with standard mice like I can with this one. Forearm/wrist/finger pain that used to surface when I couldn't avoid a lot of mouse work is conspicuously absent now. (I've previously used both a pen mouse and standard mice.) However, I've had some unfamiliar aches in the upper arm, elbow and shoulder that surface when I mouse a lot: I suspect they are connected with my re-learning to drive the mouse. I expect this to pass as I learn, but I'll keep y'all posted on the long haul. In any case, I'm sticking with it. An additional note: the maker strongly advises finding a proper location and elevation for the mouse so your arm meets it at the proper level angle. This does seem to be important to being able to drive it well. Since I have a keyboard tray with a negative tilt, I had to cobble up a surface to mouse on with a bit of metal, tape, and a mouse pad.

10-15-1998
I did stay with the Contour, and any initial problems quickly faded. It comes in more sizes and left-handed versions now also, and I never hesitate to recommend it to people.

10-19-1999

The Cruise Cat is different. It is *very* sensitive and can be tweaked to just the right amount of speed. It requires a human finger/toe/whatever to work it (no pens, stylus, etc.) and the lightest touch works fine. Clicking and dragging are easily done with either taps on the pad or with the well-placed mechanical switches.

A fundamental difference between it and the Contour Mouse I've used for years (and still recommend as one of the best pointing devices I've used) is that the touchpad *can* prompt you to stiffen your finger - I found myself more or less "writing" on the pad as with a pen. But this is not necessary and probably not desirable. You can rest a relaxed finger or thumb on the surface and move your whole arm. I find using the SIDE of the end of fingers lets me keep the plane of my hand more vertical instead of having to turn it to be flat. Sometimes I'll hang my whole hand off the edge of my keyboard tray and run the cursor around with my thumb.

Lots of special features and of course an elaborate control panel to tweak it all. Among these are three "buttons" set in the touchpad surface to launch your Web browser, e-mail, or media player - I think you can change these to run anything. An additional button pops up a "gesture" box in which you can scribble a gesture, using the touchpad - an "M" to maximize a window, horizontal line to minimize, etc. . This is interesting and innovative but I never use it because keyboard shortcuts to do the same things are faster. I don't often use the launch buttons either.

The top edge of the touch area works like a "slider" to browse forward and back through Web pages; the left hand margin area can zoom in certain applications (none of which I have); the bottom margin lets you scroll horizontally in windows that have horizontal scroll bars; and the right hand margin lets you scroll vertically through any window or pull-down list.

This latter scroll feature is REALLY useful, the only one of the special features I really use all the time. You don't have to move the cursor anywhere near the scroll bar on screen: if the cursor is anywhere out in the middle of the thing you want to scroll, using the scroll region will operate the scroll bar, and when you "let go" of the scroll, your cursor will pop back to wherever it was on the screen. This really is handy and cuts down on hunting for screen controls.

The other "peripheral controls" like the zoom, browser forward/back, etc., I don't use much, and since they are contiguous with the main touch pad I ocassionally activate one of them unintentionally.

I have a Kinesis 120 keyboard, and many Kinesis users have mentioned putting a touchpad in that big blank space between the keyboard halves. I tried this, but found I was reaching too far to use it out there in the middle. It just didn't feel comfortable to me. With about a 1.5" margin at the lower edge of the touchpad, it's a bit too far forward and certainly reaching for the middle of the keyboard defeats the point of moving the typing keys outward in the first place. So I landed the touchpad at the right edge of the keyboard. (The Kinesis doesn't have a number pad/control key area on the right side to push the pointing device far to the right.)

I guess I'm also impressed that the double tap/drag method of doing drags/text selection works so well. I still tend to use Windows keyboard shortcuts to do text selection, but using the pointer works better on the Cruise Cat than any touchpad I've ever had to use.

The upshot is that I'm not planning on going back to my mouse any time soon. I still think the Contour Mouse is a very desirable pointing device. But if you want to try touchpad technology, I'd pony up the dollars for a Cirque model instead of a generic touchpad. It really is better.

16 January 2004 I should have updated this . . . my hassles with Windows 98 finally pushed me over the edge and I installed SuSE Linux 8.1 with the KDE 3 desktop. One of the things that held me back from this change was "what about my cool touchpad?" I knew it "looks" like a Microsoft mouse but what about it's other features, would they work under Linux? Yes and no. No, my 'scroll regions' at the edges and the program-launching buttons (which I never used) don't work with KDE. But YES, the superior double-tapping/dragging/selection response apparently is built right into the hardware and works fine - which is good, because I was afraid I would have to use the hardware buttons on it instead of tapping. I did have to play with the mouse speed settings in the KDE controls a bit. So yeah, it's certainly a better pointing device used with Windows, but I use it every day in Linux.

Voice control

I used to have a lengthy review of voice software I was using. All of the packages I discussed are now long gone and I don't use voice software anymore anyway. I'll just say that for quite a while I did use a voice-command package: not for dictation, but to launch programs, switch between them, save and print files, minimize and maximize windows, things like that. Well, now both Windows Vista and Mac OS 10 have some of that functionality built in. This CAN be helpful to give your hands a break, but you've GOT to be patient: it's slower than doing all the same things with a pointing device or keyboard.

Voice recognition for full dictation has gotten astronomically better, now requiring little or no training and accuracy rates that may exceed typing. Dragon Naturally Speaking rules this roost, and there's new stuff out for the Mac as well. The quality and pricing have now become favorable enough for people to use this just because it's easier even if they are not injured. However, just like using software voice command, writing by speaking requires you to think first, then write, and to organize your thinking/writing differently.

Keyboard

I've had a Kinesis Model 120 ergonomic keyboard purchased for me at the recommendation of satisfied users. It's very comfortable and well engineered, but I still can't type much just yet. (Maybe 15 minutes a day.) In the long run I'm hoping it helps. The footswitches and programmability are very helpful. I also have a very nice keyboard tray that lets me position this thing in the back-edge-down position that ergonomists recommend.

AS someone who also has to run around tending other PCs that don't have my fancy Kinesis keyboard or other accomodations, a tip: if I'm going to be installing a bunch of software or similar somewhere, I type up the procdure (as much as I can) as a batch file that I can save on floppy or a file server. Keeps me typing on my "easy" computer. This becomes especially crucial if I'm doing the install/etc. on, say, all 29 PCs in our user rooms - if I can just run to each and type "x"[ret] and let a batch file do everything (like completely reinstalling Windows from a server), it's a big help.

11 June 1998 - I should add here that I've had the Kinesis for a long time now, and it really is part of what's kept me working. I can tell when I have to do very much typing on anything else. Quality and design-wise, I recommend it whole-heartedly. Besides, the Men in Black use it, and so does Robin Williams in the movie "Flubber"; it does have a design that turns heads and invites questions. In relation to the discussion of Dvorak above, the Kinesis 120 keys can all be remapped arbitrarily, so I set it up to be Dvorak and no longer need any different drivers or software to use Dvorak on my PC as a result. However, the key tops cannot be freely interchanged: for some fee Kinesis will provide a Dvorak upgrade kit that includes key tops. I just depend on my memory instead.

Review of Pace VG-101 keyboard.
These are some disorganized comments about the Pace VG-101 adjustable keyboard, which I have been evaluating in recent weeks. I was provided with the keyboard and an adapter to permit this PC-compatible keyboard to function with my Macintosh IIci at home. You can see and read about the Pace on the Web at: http://www.ids2.com/pace/.

(At the outset, let me comment briefly about the Mac adapter. The Keystone Macintosh adapter from Silicon Valley Buss Co. appears to install and work very painlessly - with the simple installation of a control panel, everything is fine and operates OK with my mouse. The only thing that doesn't seem to work, Mac-wise, is a couple of obscure Keyquencer macros that use 4 simultaneous keys (Command-Control-Option-C to open the control panels), but I've not seen any ordinary Mac usage conflicts. On at least two occasions, I've had the keyboard go unresponsive on me without freezing the computer, requiring a cold restart. There's no way to know if this was the fault of the Pace or the Mac adapter, I think it's most reasonable to assume the latter.)

On to the keyboard itself. Very roughly, the Pace is what you would have if you cut a standard PC keyboard in half, then mounted each half on the swivel bases found on computer monitors, about ten inches apart. So besides starting out with the halves separated, each half can be rotated and tilted in a great variety of ways to optimize comfort, or to permit changing for variety's sake. The two halves sit on a common base, so it's a moderately bulky assembly.

I really like the adjustability, and it has a very light touch. I note two things it has in common with my Kinesis: one is that the construction makes it significantly thicker, so getting it low enough so I'm not reaching up *demands* that I have it in my lap or nearly so.

THe other similarity to the Kinesis is that if I set the halves to slope down in a negative tilt, the way some researchers suggest, the broad space in front of the space bar makes a palm/wrist rest. That's very comfy, but tempting to leave the palms on there while typing. But as I observe my own typing, I can see that I've established an engrained habit of not parking palms while typing. Being able to just drop palms that 1/2" every time I stop, even momentarily, is nice and unloads the arms.

My hands are a little confused, though . . . just like I daily switch from touch-typing Dvorak to semi-touch-typing- QWERTY, I think I switch gears kinesthetically when I type on a normal keyboard and back when I'm on the Kinesis. On the Pace, with the seperated halves and negative tilt set, it feels to my body like I'm using the Kinesis, but that kinesthetic expectation is somewhat thwarted by the fact that the Pace uses the "normal" staggered rows of keys, whereas the Kinesis keeps them all in straight vertical rows. I'm not saying one is better than the other, far from it - just that it is spoofing my hands. I suspect users of standard keyboards will find the Pace's maintenance of staggered rows to be an asset to adapting to it rather than a hurdle.

On the Pace model I received, which may not be new and unused, the Enter key sticks once in a while. The issue of the numeric keypad on the right making the keyboard wider and forcing the mouse to sit farther away applies here as it does with conventional keyboards. However, the Pace *has* been designed to shorten that distance some: the cursor keys have been scooted down under the Enter and right shift keys, and the Home-End- PageUp-Pagedown and other keys moved to the upper right hand corner of the right keyboard half, to permit the actual numeric pad to sit immediately adjacent to the Enter key, so it's better in that regard than the standard keyboard. Among other key changes, there's an added backspace key on the left side between the left space bar and left Alt key.

A significant difference from the Kinesis is that keys like Enter are still off to the right, whereas the Kinesis puts these and the Alt-Control-backspace-delete-pageup-pagedown cluster in the middle to be operated by thumbs. In particular, I notice having to reach for the far top right corner for PageUp/PageDown, but because it is such a reach I tend to reach with my whole hand instead of trying to catch it with my pinky. It seems to me the space bars have been shortened a bit so the Alt and Ctl keys on the right side are easier to hit with fingers other than the pinky.

My 10 year old daughter, who is being taught touch-typing in school this year, tried the Pace and liked it immediately. I asked her why, and she explained and demonstrated that like me, she liked the ability to rest her palms on the front of the keyboard when she was stopped or looking for a key, whereas on standard keyboard she said it was common to just let one's wrists drop down (cocking the hands back) every time they paused.

Of course, anyone who prefers the Microsoft Natural type of layout, where the keys slope up from space bar to number keys, can set the Pace up in a similar fashion, but I really find the negative tilt configuration feels much more comfortable.

Not too long ago I bought one of those surplus Flex-Pro keyboards, which "tents up" in the middle. I never really found the angles were helpful or useful. The Pace, however, reminded me of the Kinesis in that it immediately felt comfortable and I was able to put it to work with very little awkwardness or adjustment time.

I was talking to Dr. Susan Hallbeck, an ergonomic researcher here, who is informally examining a number of "ergo" keyboards. She showed me the Comfort keyboard, which in general principal is similar to the Pace: the Comfort has three keyboard "chunks", the left half, right half, and numeric keypad, all independently adjustable for angle, tilt, spacing, etc. While the Comfort looked potentially more adjustable with the numeric keypad separated out like that, it's also kind of a clumsy, awkward looking construction. I know some people like them and they may be just fine, but I think the Pace is less klutzy, quicker and easier to adjust. Not that appearance matters worth beans, but the Pace looks a lot less like a science fair experiment, too.

One evening I spotted my wife writing away on the Pace at her usual zippy pace, and her only concern was to know what to use for the Mac command key (Alt substitutes.) Later I asked her how she liked it and she looked up and said, "oh. It's OK." Actually, I consider it says something about the Pace that anybody can sit down and take off using it comfortably and with no difficulty right off the bat, without requiring a period of adaptation. On a later occasion, she said she did not care for it on the basis that keys were not where she expected them to be. Her computer use has historically been almost 100% Macintosh, whereas I make heavy use of PCs at work.

Is it the perfect ergo keyboard? I don't know, but it is comfortable and nicely executed and easy to adjust and use, and certainly makes a very good drop-in replacement for standard keyboards. Now that I'm back to using the tight compact little TrackBoard by Datadesk, I'm even more struck by how much space the Pace seems to take up visually and on the desk, BUT there is no question that it is also more comfortable to have keys spread out in this fashion, and I find myself missing it.

For more information, contact:
PACE DEVELOPMENT CORPORATION
111 23rd Avenue North
Nashville, TN 37203
Phone: (615) 327-9169
(800) 541-6769
Fax: (615)327-9205
E-mail: cfort@mindspring.com

Screwdriver

This is completely out of the realm of computers, but it is a very important item. As an electronics technician the single most commonly used tool I have is the screwdriver. When RSI hit me, I discovered that the act of turning screws is really hard on your wrists and provoked nasty flare - ups. I had an electric screwdriver, but it was one of those inexpensive straight-line ones, and still required a less-than-ideal hand position and plenty of wrist tension to use. After searching all over, I found what I really needed at Sears with their Craftsman Model 315.111240. It's not a drill, just a light, cordless, pistol-grip reversible single-speed rechargeable electric screwdriver with adjustable slip clutch and a LOT of torque. About $40, and worth every dime. (They sell a less expensive model as well, without the fancy clutch.) While I can't use it in some tight places, it's permitted me to continue working without jeapardizing my recovery. When you get RSI you start to look for things like this to eliminate aggravating factors.

Pens

There are pricey ergonomic pens, but the Pilot EXPLORER is a fat, ergo-shaped, easy-writing rollerball that costs only $2.00. Didn't realize how much it helped till I ran out of them and started using stick pens again. Also very nice is the Pentel Gizmo mechanical pencil; very comfy and inexpensive. I have also used the interesting and comfortable Ring-Pen ,

but I prefer rollerballs over the Ring-Pen's ballpoint tip.

Jan 2004 - these days my fave pen is the Pilot DR. GRIP Gel . Anymore there are a LOT of nice fat pens and pencils at the office supply stores.

Offbeat Stuff . . .

In reading all the stuff I could about repetitive strain injuries to the hands and arms, I see that there's a lot of value placed on promoting blood circulation in the affected areas. Medications, massage, water baths and various high-tech gadgets are touted to bring this about. There is a no-cost, low-tech way to get more blood down in your hands/wrists/arms, though. Please note I make NO CLAIMS AT ALL as to this being useful, I don't know if it's helping as I recover, etc. etc. etc. But it does without question get the blood going, at least temporarily. I recall reading about this in a couple of magazines years ago, as a means of staving off frostbite in the extremities. The idea is to relax the arms as much as you can, let them hang limp and loose, and imagine your hands getting heavy and hot. Think of waves of heat and blood flowing, pulsing down your arms to your hands. There's nothing mystical here, you're just persuading your body to relax and increase blood flow and this kind of thinking helps it happen. It's not like trying to visualize yourself cured from cancer or that kind of thing. And it does work, your hands do get warm and flushed and may even sweat or tingle. The down side of this as a remedy against frostbite, where it has been documented to work, is that you are fighting your body's natural tendency to conserve your core temperature by reducing blood flow to the extremities. Since we aren't worried about trying to survive here, this isn't a consideration.

A detailed description of this method is explained here.

Soaking your arms/hands in a washbasin of ice-cold water does fun things for your circulation too; if nothing else, this technique seems to give good pain relief when pills aren't cutting it. The action and warm water of hand washing dishes also seems to be good therapy.

Icing down muscles when you're really sore is often recommended; somebody told me this recipe for homemade slush packs. Haven't tried making one but sounds like a good idea.

I took a pair of the cheapest brown cotton work gloves I had and snipped the ends off of the fingers and thumbs to make what my daughter calls "burglar's gloves." I wear these at work most of the time to keep my hands warm on the theory that it will increase circulation. This does seem to reduce discomfort, although it looks strange. Recently a friend showed me wrist-warmers, and I made my own from soft men's tube socks cut off just below the heel. It's remarkable how much keeping the forearm & wrist warm with these helps with pain. Pictures here and here.

In a more commercial vein, you can get lycra gloves like the Handeze or HANDWEL Support Gloves, which I wear when my thumbs get sore.

10-15-1998
Here's some info on other "glove" products.
Just recently I was sent samples of two similar products.

1) MouseMitt keyboarders (http://www.mousemitt.com/). Unlike the Handeze or Handwel, these things just cover the wrist and wrap up around the web of the thumb, but in addition they have a thick pad on the underside of the wrist. So you basically have a wrist rest that travels with you.

I've found I like these things and have been using them, not because my wrists hurt, but because I find I do like having that pad there when I set my hands down. But in addition, I find having these on tends to gently encourage the wrists to stay straight without rigorously restraining motion like a splint. I also like that they come in some cool colors including red and zebra stripes! When I wear these I look like a Power Ranger or Spiderman or something.

2) IMAK's Smart Glove (http://www.imakproducts.com/) is similar but like the Handeze and others covers the palm of the hand as well. It also includes a soft pad coming up into the palm of the hand, to serve as a rest. But it also has a plastic spar that runs up the back of the hand to resist cocking the hand back. (This is removable.) Someone with longstanding habits of typing with the hands tipped back might find these helpful in breaking that habit.

IMAK also makes the Pil-O-Splint. The Pil-O-Splint is meant to give you something more comfortable to sleep in if you are supposed to be sleeping with a splint on. Since I'm not in an acute injury stage anymore, I found a friend who is - a choir director/music teacher/pianist with epicondylitis (sp) and other pain problems with playing, because I knew she had been told to sleep with splints. I caught her at church yesterday and debriefed her. She loves the Pil-O-Splint and says it is far more comfortable to sleep in than standard splints. In addition, she's taken it to her physical therapy sessions, and her P.T. was very favorably impressed, in fact the device evidently got passed around the practice from PT to PT - "look at this!" - while she was doing her exercises or whatnot.

Cheap Drugs . . .

OK, you should NOT TAKE ANY MEDICATIONS NOT APPROVED BY YOUR DOCTOR, right? I just wanted to add the tip that if, like a lot of RSI patients, you have been told to take ibuprofen (Advil, Motrin, etc.) as an anti-inflammatory for your condition, you can run down to Walgreens or Target and look for their generic brands in a monster 500-tab bottle which makes it way cheaper than any other way you can buy it. It is my subjective - experience - your - mileage - may - vary feeling that regular ibuprofen gave me better pain control than the prescription Naproxen they gave me. (I was told that I could do the ibuprofen instead when the stuff ran out.) SEE YOUR DOCTOR before you go off self-treating with any medicine: and read these comments on NSAID drugs.

And please realize that painkillers can

mask your pain so that you don't stop the offending activity as you should.

I now take pills only when I'm really miserable, and I don't type or work with my hands when I've done so.

Microcurrent Electrical Therapy

Here's a few comments on microcurrent therapy for rsi. I've been grilling a friend about her MET unit, reading Web stuff about it and doing some experiments on myself, thought I'd report back. For details on MET (much of it promotional), see the following Web sites. Please note that under U.S. federal law microcurrent devices require a prescription and are regulated by the FDA.

www.cellstim.com/research.htm
http://www.earthen.com/index.html
BMPS
NEW TREATMENT FOR MUSCLE STRAIN INJURY

My thoughts:

1) Microcurrent seems to relieve some of my chronic pains. A notable exception was the tight/sore spot under my left scapula, up through my neck, where the current did nothing or maybe even provoked things to be a bit more sore. Also seemed to have limited effect on really acute pain. But worked surprisingly well to temporarily stop nagging, deep chronic aches in base of my thumbs, and elsewhere. Leaving the stimulus on for long periods of time seemed to produce an odd lingering ache of it's own: short treatment seemed best.
2) So far as I can determine, as an electronics tech designing research equipment, microcurrent is a very simple technology: upon reading the specifications in the above web sites I could walk over to my electronics bench and set up my signal generator to reproduce it. In fact some of the research I read was done with direct current, thus could be done with a battery and resistor alone! General purpose signal generators are NOT medically safe from the standpoint of leakage, grounding, and the fact the outputs is not current limited, so I built two simple boxes operating on 9 volt batteries to test on myself, including a bi-phasic, semi-randomized output design with true current limiting.
3) Despite #2, many commercial units are amazingly expensive. Some are in the $120-$300 range but a number of others are from $700-$900, and I saw some well over $1000. Part of the price can be pegged on the extra timers, LCD displays, computer interfaces, etc. that are in- corporated in some units, and doubtless the requirement that any such units MUST BE APPROVED as Class II devices by the FDA adds significant overhead. Also, companies tout mysterious exotic waveforms that distinguish their units. As mentioned in a bit, the higher voltages and rechargeable batteries in commercial boxes also raise their cost. STILL . . . my experiments didn't cost me more than $20 and used common parts available in any Radio Shack in the country.
4) The theories and rationales for why MET works range from the plausible to the dubious to the ridiculous . . . and there are strange opinions on why it DOESN'T work in some people. In regards to the latter, there is a very mundane reason my testing revealed: people's skin resistance varies considerably. _Under_ the skin we're all about 100 ohms: but between skin electrodes is something like 5000 to 20000 ohms for me when using saline to moisten the skin, and even higher on my co-workers. If the skin resistance is high, getting current to flow simply takes a voltage higher than I want to fool with. (Commercial units DO use higher voltages and this is part of why they cost more.) This is also why one NEVER NEVER NEVER wants to introduce currents under the skin, onto breaks in the skin, or into any body orifice: get into that 100 ohm interior resistance directly and even a 9 volt battery could supply enough current to KILL you if it got across your heart. In addition, some points on your skin - say the pulse point on your wrist - are much lower resistance than others, such as the palms of your hands. There seems to be some thinking linking microcurrent with acupuncture and in fact, using MET on acupuncture points is suggested by some.

So the upshot is that it may be worth getting a prescription for MET from your health care provider,

but disregard the one manufacturer's warning against "cheap Taiwanese units"; I'd say buy the cheapest one you can find with fewest bells and whistles.

It's not that there aren't reasons for the high prices; it's just that my experiments convince me that no-frills, effective units ought to be available.

Bikes

Bicycling can put a lot of stress on your wrists and back, so I took my street bike to a bike technician and asked him to remove the standard straight handlebars, and to instead install the curvy "dropped" racing handlebars, *BUT* to rotate them back up about 160 degrees or so. The result is that the ends of the bars, instead of being way down there someplace, are up in the air and also back towards the rider somewhat, plus the resulting grips do not require you to turn your wrists in. This required some relocation of my shift levers, of course, but he did a nice job. The additional help was that in making the changes, the bike ended up a lot more balanced to where it's much easier for me to ride no-hands, sitting straight up.

A final change is an unsafe alternative to those "tri-bars" for long-distance riders. I got some of that foam tube insulation for water pipes and put a couple short chunks around the part of the handlebar right next to the stem. For a change of pace while riding, I can lean forward and park my forearms on those pads to steer, with my hands completely relaxed. This is an invitation to a catastrophic accident so don't do it in traffic or on rough terrain, but I haven't myself crashed as a direct result of it (yet).

T'ai Chi

Someone asked:

>     Does anyone have any experience in trying tai chi to heal movement
>     injuries?

I took a couple T'ai Chi classes at the YMCA, then additional training for a while at a local dojo.

It's certainly a good way to get aware of your body, learn to move gently, improve your balance, and it conditions your legs a lot more than you might imagine. Yet it is still something that injured or frail persons can practice - you just don't extend as far in the movements. In my case, I think it cleared up a nagging old knee injury by gently conditioning my knee. (Yeah, my doctors had prescribed exercises to do the same thing, and I bet they would have worked, HAD I DONE THEM. Compliance is a big deal in rehab; and a big plus of T'ai Chi is that it is fun to do, so you're more likely to do it.)

I discovered that a classmate of mine also had tendinitis in her arms, and she averred that by the end of the courses she had seen significant improvement. It was harder for me to tell, because I had already done a lot of healing. I DO know that one common T'ai Chi practice, the two-person "push hands", was a problem. You move with another person, with wrists gently in contact, and slowly move around sensing the other person's motion, both yielding and trying to find an opening. (It *is* a martial art.) It's not grunting and straining, but even so, I had one particularly bad session where my two partners for push hands were a couple of elderly folks who were extremely strong, and I ended up in a world of hurt. So I opted out of "push hands" whenever I could.

I still do T'ai Chi, every day when I can. Not only is it good physical conditioning, but it is a very meditative and beautiful ritual that I find useful for mental and spiritual focus, even though I am not an adherent of the metaphysical philosophy often connected with it. (I don't imagine many Lutherans are.) Despite claims to the contrary I think it's possible to keep these things separated.

So if you have access to a class, it's worth checking it out. I think it's good for stress control, and I find that the overall philosophy of not trying to meet force with force but instead redirecting force and yielding when necessary has spilled over into how I handle stuff life throws at me.

Here's a first person story of somebody who endorses Tai Chi as helpful in RSI recovery.

Recently I saw a posting from somebody else who credits Tai Chi with helping him, and he recommends a video he thinks is particularly good: "I have tried many videos, and this one is by far the best. Tai Chi Chi Kung for Fitness by Lee Holden It is hard to find, so I will include a link. http://www.lightworksav.com/browseproducts/Tai-Chi-Chi-Kung--Lee-Holden....

". . . That Work For Me ? ? ?"

1995

Now that I know all this stuff and have all this great software and technology, everything is fixed, right? No. Even after the problem first came up, I kept doing a lot of typing I didn't need to do. I'm a hacker, I love to program and fiddle with computer stuff - these Web pages are proof of that. Once I get rolling on a project I don't want to stop and my little 15 minute chimes from the Barclock software go unheeded. (To download as a reminder chime, here's me saying "Take a break.") As of today (30 January 1995) I cannot do any typing at all without serious trouble, have had to put away my guitars for the first time in 26 years, and am told by the therapist that i have many difficult months of recovery ahead. So once again, don't look for the technical fixes to put you back on line like nothing ever happened. But they can help prevent the problem. I'll say more on additional stuff soon.

26 May 1995 Things are improving slowly, but you really have to cut way back on your typing/manual activities for overuse syndrome/tendinitis to heal. Slow down.2

3 July 1995
Here's what's been helping me:

1) Stopping the aggravating actions as completely as possible. I radically reduced typing and gave up my beloved daily guitar playing completely for several months. Cutting back a little bit is NOT ENOUGH if you're injured.
2) Lots of gentle stretches of arms, neck, hands.
3) Deep, cross-fiber massage of my arms, plus trigger point release. A helpful massage therapist and books taught me how to do this on myself.
4) Soaking arms in ice-cold water for 3 minutes, then NO vigorous activity for at least a half hour until arms rewarm. Done when things start to ache a lot.

8 April 1996 Progress is slow but the above is helping. The negative is that I still have "glass arms" , ie it doesn't seem to take a lot to irritate them. . . but they seem to recover more quickly and the above measures remedy any pain. Been reading/listening to Feldenkrais training to learn to use my body differently, & that makes a big difference too.

11 September 1996
A major discovery in the last two months is that my neck and shoulders have a VERY LARGE effect on what I assumed was only tendinitis. Yes, there are conditions where I can tell that it's the actual tendons in my forearms that are complaining, but many times there's been an overall achiness in my arms . . . and I've discovered that paying attention to my shoulders and neck, not slumping them forward, and doing stretches for them, makes the arm/wrist/hand pain go away. There are muscles in the shoulders and neck that can refer pain down into the arm, and indeed I found, with the help of my massage therapist, that I had some very tight and sore upper back, shoulder and neck muscles on my left side. Also, the nerves for the lower arm pass through the shoulder and neck, so any impingement on those nerves is perceived as pain in the forearms and hands. I'm now working on stretching my neck, shoulders and back, and am trying to find how I stress them or hold tension in them. Some of the introductory exercises in T'ai Chi have been helpful in slowing down and relaxing my body usage. I actually feel like I'm making progress now.

22 November 1996
Couple of musical notes :^) I've begun to concentrate on playing mostly my electric guitar now, which generally has a lower action and lighter touch to start with, but especially so when 1) you tune it down two whole steps and 2) you turn the volume way up so you can play very gently and still be heard. This is enabling me to do more playing.

22 Jan 1997
After enjoying a relatively pain-free status for some time, demands of work pushed me into a relapse as severe as anything I've experienced. This stuff doesn't go away and if you aren't careful it comes back to bite you.

30 June 1997
I think I'm on the trail of a very important item in recovery from RSI. As the comments above testify (and other RSI injurees have told me), all the good changes and treatment and rest and time not infrequently end up with one still vulnerable to flareups and ongoing pain. I read the account of an RSI victim who'd been diagnosed and treated by Dr. Pascarelli himself, and had been through multiple therapies/therapists without getting free from relapses. This individual read Dr. John Sarno's "Healing Back Pain", which theorizes that much back pain is caused by tension-induced oxygen starvation in the muscles, and that this pain (which is NOT "imaginary") may be caused by emotional stress: fear, anger, other stressors with which we do not wish to deal. Sarno's prescription (FOR THESE BACK PATIENTS IN WHICH A DOCTOR'S EXAM HAS NOT SHOWN OBVIOUS INJURY) is to realize there's nothing serious wrong, resume normal activities, and examine oneself to uncover the sources of stress.

This advice cannot be applied in it's entirety to cumulative trauma injuries, in fact it could be disasterous if one does not take measures to abate behavior and conditions that are injuring oneself. BUT it does point up the significance of mental/emotional contributions to ongoing pain in people who have already MADE changes, undergone therapy, taken time to heal, and still hurt. It's all too obvious in my experience that there is enormous fear, guilt, and stress that arises from even minor re-awakenings of pain, and this stress can feed back into pain-causing tension in the body.

The upshot is that the reader mentioned above found themselves free of pain and functional again upon taking this information to heart. After reading the book I have also been acting on it for the last couple of months, with striking results. I have NOT abandoned all the other changes I've made . . . these things remain a part of the way I use my body now. But it makes more sense to me to accept the tension-induced-oxygen-debt idea to explain recurrent flareups than to believe that after all this time and all I've done, I have permanent inflammation or scarring in my arms. I was particularly skeptical that I have "crippled" muscles or tendons after working all day helping frame the roof on my father-in-law's house addition: every part of my body hurt the next day except my arms. This was also true during a couple other construction projects this past year.

These days, when I do get pain in hands or arms (and yes, I do sometimes), I don't panic. I accept it as real, but I then take a deep, deep breath and relax. If I've a moment, I'll do the "mental-hand-warming" relaxation routine mentioned earlier on this page. I DON'T attempt to blast on ahead with work or typing, I still respect pain as a warning, but I don't go into a tense "protection mode" where I think "oh, I better baby my poor fragile arms". Two things have happened: first, my level of pain and discomfort has decreased considerably. Secondly, I began to experience a new symptom of a wierd weakness and trembling in my hands at times, esp. after doing a lot of typing. This was very troubling as I'd never had this problem before. But the last couple weeks, this has also largely gone away. When it comes I relax, and gently exercise my hands.

RSI is an obvious source of enormous stress: pain, anger, fear, despair, grief, all are common. My opinion is that it's important to realize how these very natural reactions actually may feed back into a physical perpetuation of chronic pain, through an identifiable physical mechanism. I hope to write more about this in a couple of months but wanted to post this now since I think it's important.

(This is a really controversial approach to RSI, but when it works, it's remarkable, and with that in mind here's a link to the web page of somebody who it worked really well for. Rachel's RSI homage to Dr. John Sarno

Here's another page from somebody who found it effective, with good suggestions and resources: http://www.conquerrsi.com/handout.html Still another, detailed "my story" site: "Curing Repetitive Strain Injury"

24 July 1998 - I know, I really need to post an update.

Better, I'm doing better. Pain-free is the norm now, discomfort is occassional. And the things I can do without worrying about my arms makes my daily routine essentially the same as an uninjured person, although *everything* I do, physically, is now informed by attentive habits of movement, balance and reduced force that have taken a long time to become second nature.

My goal now is to work on slowly building strength, because I find that *endurance* is a problem. For example, I practice my guitar almost daily with minimal discomfort. However, if I do something like I did the other day, which was give some new guitars at the music store a workout for about 45 minutes, my fingers just kind of stop working - fumbling, unresponsive. Very frightening. No pain involved with that. It's got me paying very, very close attention to how gently I can play my guitar because I have to play a one-hour concert in a couple weeks.

One helpful insight was reading a book on pain which told me that where tissues have been injured, nerves may continue to be irritable and over-sensitive even after the injury is resolved. So, I know I'm doing all the right things and not re-injuring myself, and when I do get achy I don't get as bummed about it. In addition, I now recognize that I'm at the point where I have to work on rebuilding endurance, and will have to be willing to put up with some aches as a result. However, I find the day-after aches from the very mild exercises I'm doing are a "different" kind of discomfort, not like a flare-up.

5 August 1998

I made it through a hurdle I was concerned about: playing a public concert on acoustic guitar, which involved hauling a big amp and playing vigorously for almost an hour. Experiences with my hands "giving out" when used too hard made me worry I couldn't pull this off but I did and the only aftereffects were some mild discomfort. Here again, great care in re-learning guitar (and in how to move large heavy objects without body strain) have been important. I don't feel like I'm "as good as new" and the bottle of aspirin stays handy, but I no longer feel like I'm a prisoner for life in a cell of pain and fragility.

19 October 1999

I'm playing guitar and violin in weekly church services and a weekly rehearsal for the same, and my hands, arms, and thumbs are handling it fine. Developed a whole different batch of trouble over the last year, and its relationship to my original injuries is not clear to me. I've had chronic pain on the left side of my upper back, neck, and shoulders, and in certain positions and situations this also results in buzzing/numbness down the median nerve in my left arm (can feel it in left thumb, index, middle fingers). Finally followed my own advice and saw my doctor, who pointed out my strange anatomy (very flat back) and said I needed to condition & strengthen those upper back, shoulder and neck muscles. I'm in physical therapy for this, and as a result a LOT of muscles are griping and complaining about the 3-a-day exercises. But the chronic pain is going away.

I figured that since the doc and PT told me that I'd have to work through a bunch of discomfort to get conditioned, I'm also doing modest work with wrist curls (10 reps once a day) to get my arm tendons conditioned against flare-ups. I have had some arm pain from that (and the other exercises which while aimed at the shoulders also require my hands and arms to work pretty hard), but in different places than before, so I'm not sweating it.

Because the nerves for the hand and arm emerge from the spine in the neck and travel through the shoulder where they are vulnerable, I figured out that just maybe my increased guitar time with a shoulder strap was not helping that whole situation. I looked at some alternative straps, but ended up buying a Gracie stand (www.graciestands.com) that supports my guitar "in space" without any strap, and a Hamre Neck-up (www.neckup.com) for playing in a sitting position without a strap or a footrest.

January 2002 : more updating - the problems of the last update did resolve but I experienced some similar shoulder/upper back issues during the last six months or so that I am dealing with through exercise. I'm still playing weekly church gigs and working on a CD with One Accord and working at my computer-heavy job so I am doing and feeling well. I suspect the extra rehearsal and performance time connected with our Christmas concert might have caused me some trouble except that for this concert I played only my electric guitar with its easy action and low profile. I now find myself also monitoring my teenage daughter's "ergo" health because she plays multiple instruments and like all other students has to lug around huge bags of books to/from/during school. It ain't just us creaky middle-aged people who have to pay attention to these things.

September 2005 : I regularly am asked how I'm doing and, when I explain that I'm functionally recovered, they ask what I did that made that possible. The short answer is "probably a lot of things, over a long period of time, but I'm not completely sure." This repeats what you see on this and my other pages, but here's a summary. The main RSI page has details on each of these.

careful stretching, a la Sharon Butler (see main RSI page)
deep massage of muscles, especially "trigger points"
learning how to use my body better through Tai Chi, Feldenkrais, and similar methods/techniques
stopped hurting myself by learning ergonomic ways of doing everything
using ergonomic equipment/instruments whenever possible
time, time, time, time. Lots of it.
taking Dr. John Sarno's theory about muscle pain under consideration

I first got hurt over ten years ago. I have spoken to people who have suffered many years without recovering. Many have worked through a list pretty similar to the one above over long periods of time but still experience daily pain. Why? I only wish I knew.

November 2006 Just a comment that susceptibility to some musculoskeletal problems seem directly tied to how your particular body is put together, and that gets inherited. I'm reminded of that because my daughter is now a college sophomore in music education, and between the demands on her violin playing and the neverending computer use, she's experienced problems basically identical to my own, both in terms of sore hands/arms and nasty neck/shoulder/back issues. I've gotten past the worst of these: she's in the middle of them now.

Since she was growing up while I was dealing with this stuff the first time 'round, we have been careful to monitor how she uses the computer and to encourage good violin technique, but that's not really something you can enforce rigorously ... and as I said, I think some of us just have a physique more vulnerable to these issues. (My PTs/docs always commented that the way my shoulders worked was unusual. Now Anne hears the same thing from her PT.)

The good news, I guess, is that UNL has staff at the Health Center that are very knowlegable about performing arts injuries, and Anne is working with an excellent therapist. It makes me glad to hear what she's being told by the staff, in that I know they are the things that will work, because they worked for me ... but also sad because it is all *exactly* the same batch of symptoms and therapy I went through. (And I went through it in creaky middle age while she's still young.) (Also getting a real bargain with this and other medical care for Anne since the student health center is covered by student fees and by our insurance.)

I'm also glad that there are faculty at the UNL School of Music who are really aware about musicians' medical challenges. They've hosted a speaker on the issue, one of the keyboard faculty has teamed with UNL engineering researchers to document the usefulness of 7/8-sized piano keyboards that are easier for pianists with smaller hands, and last night Anne told me her strings group was assigned reading out of Paull/Harrison's "The Athletic Musician", a good ergo-musician text that I happened to have lent Anne about a month ago. So watch your kids, I guess, if you have RSI problems - it's not just about what we do, it's how we're built too.

Review of LapDawg Lap Desk

http://www.lapdawg.com

Paul Marxhausen
November 12, 2007

Other Changes . . .

Experiencing long-term chronic pain and impairment produces changes in your mind, body and soul that I can't begin to adequately detail here. I don't pretend my own problems are remotely as severe as those of, say, a quadreplegic or a cancer patient. But they have been a challenge unlike any other I've experienced. Besides the RSI reference books listed elsewhere, I recommend:

Living With It Daily:Meditations for People with Chronic Pain.
Patricia D. Nielsen
Dell Publishing 1994 ISBN 0-440-50555-0

10/30/1997
Also: An offline discussion today reminded me that I wanted to toss out a book recommendation that I wouldn't ordinarily post here, because it's completely religious, but the author does such a good, honest job with the subject and it does apply to all of us who wonder just where the heck God is twiddling His thumbs when our world is crashing down in pain and impairment. No glib or pat answers here, but full of insight.
Disappointment with God: Three Questions No One Asks Aloud
by Philip Yancey ISBN: 0061040223 available from Amazon.com

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