Sammy Sosa wouldn’t dream of going into a baseball season–or his next record-breaking game–without enough batting practice. When thousands of runners toe the starting line at next month’s LaSalle Banks Chicago Marathon, hundreds of thousands of miles will have been logged in preparation for the big event. Even bowlers don’t roll a league series without some trial balls.
So why doesn’t everyone who works or plays on a computer think about getting ready for a day’s use or consider any regular routine to keep in keyboard shape or uplink personal computing with personal health?
That is, until it’s too late: Until carpal tunnel syndrome or another repetitive strain injury dramatically alters the digital playing field. That’s when most people realize that sitting before a monitor (usually too closely) for numerous hours each day (without enough breaks) in unhealthful postures (shoulders hunched forward) can be harder on muscles, joints, nerves and (oh so tender) tendons than any three sets of tennis or a session on the stair climber.
Here’s your chance to reverse the trend. This is your game plan for staying out of trouble–and not having to wear those wrist braces becoming all too common at the office. Just pretend you are a quarterback reading the defense before the linebackers and free safety can begin blitzing.
Doctors themselves use sports comparisons in describing RSI.
“In contrast to athletes, computer users are too frequently in a static position,” said Dr. Margit Bleecker at the Center for Occupational and Environmental Neurology in Baltimore. “There is distinct lack of movement. All you really do is repeat the same motion over and over with a precious few selected muscles.”
Repetitive strain injury is the blanket term for a number of medical conditions caused by overuse or misuse of body parts. Perhaps best known is carpal tunnel syndrome, a median nerve injury that can lead to debilitating wrist, thumb and finger pain. It makes up more than 40 percent of computer-related RSIs. Tendinitis is another common condition, an inflammation of the elbow, wrist, hand or shoulder socket not altogether different from injuries that shorten the careers of baseball pitchers.
Back injuries are considered part of the RSI count for worker’s compensation purposes, representing more than two-thirds of annual claims. But roughly 350,000 to 500,000 RSI claims–depending on whose estimates you accept–are made for upper-body pain and disability, mostly associated with computer use. Statistics vary depending on whether workers, employers, insurance companies, private interest groups or government agencies do the reporting.
In any case, the medical terms are technically challenging for even the most computer-savvy operator. Carpal tunnel syndrome, radial tunnel syndrome (arm and forearm) and cubital tunnel syndrome (elbow) are some of the nerve disorders. Muscle and tendon injuries have proper names like myofascial pain, tenosynovitis, extensor tendinitis and de Quervain’s disease. Other conditions are cervical radiculopathy, focal dystonia and thoracic outlet syndrome.
The usual response is a shrug and mouse drag-and-click. Next topic, and it better not be another Web site about typing technique (don’t twist your hands) or wrist position (keep them above the rest pads if you have them).
Neal Taslitz doesn’t want to be in the I-told-you-so business. He sells ergonomic furniture and work station designs as owner of BackCare Corp. in the west Loop. He seeks out leading researchers to evaluate some of the new products he markets, especially accessories like movable arm rests that can promote correct posture at reasonable cost. He has helped petition the federal government to create more formalized strategies to prevent RSIs. He answers dozens of phone calls each week from prospective customers who have too many employees missing days of work–or their own RSI problems.
He is in the I-told-you-so business, like it or not.
“Most problems are preventable,” said Taslitz, executive director of the Chicago-based National RSI Association. “Typically, no one is trained in proper physical technique for using a computer. The computer is unpacked from its boxes and set up, then you just start keyboarding.”
To be sure, many companies have appointed in-house ergonomics experts. But any advice is usually applied once a problem arises. The best-informed individuals tend to be workers with painful conditions that have crossed the line between bothersome and permanent nerve damage. There is a lesson for you in listening to their troubles–before you have any problems or at least when any related sensations are mild.
For example, symptoms of RSIs include weakness of the hands and forearms, fatigue, tingling, numbness, heaviness in the arms, increasing clumsiness, difficulty opening and closing hands, stiffness in the hands and cold hands. Early warning signs often come during sleep. Patients wake up for months with numb hands or heavy arms without ever making the RSI connection.
Shooting wrist pain is one result, though twinges in the shoulder or neck might be the first hint of trouble–that blindside blitz–and a chance to prevent the worst-case scenario.
Despite the complexity of technology, the game plan for beating RSI is simple.
“The single best thing a computer user can do is work on posture,” Bleecker said. “People tend to tilt their shoulders forward and chin toward the screen. They lean on armrests of their chairs. All of this isolates the wrists rather than allowing you to type with your entire arms.”
Bleecker is a specialist in preventing RSIs. She is comfortable discussing the scientific particulars of carpal nerve damage and state-of-the-art treatments for RSIs (surgery is an option for advanced cases; ultrasound is a cutting-edge option with promising results reported in the British Medical Journal earlier this year). Her knowledge of ergonomics is better than most top-flight worksite consultants to corporations.
But what Bleecker most prefers to do is talk to computer users experiencing minor symptoms of discomfort before they turn into long-term patients with long-term pain.
For starters, Bleecker said most of the business and technology community has it wrong.
“The primary intervention in offices is developing a totally adjustable work station,” Bleecker said. “But you can have all of the latest high-tech equipment and accessories in the world and still end up with major problems.”
Close your eyes and the last sentence could be straight from a golf magazine.
“You can still lean too far forward or incorrectly rest your elbows on the armrests while using the keyboard in a thousand-dollar ergonomic chair,” said Alan Hedge, a leading researcher and professor of ergonomics at Cornell University in Ithaca, N.Y. “It might be less high-tech, yet improving your posture is highly effective. In our studies, I have observed too many people find complete relief in symptoms by the proper body adjustments to ignore the obvious.”
“Paying attention to your body is the key intervention,” Bleecker said.
While improved positioning at the computer is literally and virtually overlooked, Hedge said hardware-makers also have contributed greatly to the problem. Seems our keyboards are sloped in the wrong direction, back to front, making it even harder on the wrists. He has conducted several impressive studies showing a “reverse-slant” keyboard position can alleviate all sorts of RSI symptoms.
The idea was originally developed in the Tasmania region of Australia during the mid-1980s. Government officials commissioned researchers to explore whether “changing the geometry of the work station” would benefit the disturbing number of workers with carpal tunnel symptoms.
“Six or seven years ago, most everybody thought I was crazy” for pursuing field experiments about reverse-slant keyboards, Hedge said. “Now it is a de facto standard at ergonomic conferences.”
Yet at a price tag of about $150, such keyboards are not very common. Hedge said manufacturers don’t figure such a product can compete with standard keyboards that can cost less than $50.
If you are skeptical, try this at-home experiment, Hedge said: Place your keyboard in your lap and simulate typing. There is less pressure on the wrists, the motion seems more natural. Then put your keyboard back in its typical spot. Tension in the wrists, thumbs and fingers are likely to be noticeably different.
“Reverse-slant keyboards are just a start for addressing (RSI) problems,” Hedge said. “Our lab tested a vertical keyboard this summer. The palms of your hands actually turn to face each when typing. People found it remarkably comfortable and touch-typists were surprised how easily they learned the technique.
“The keyboards of tomorrow could look radically different–and that could be very good for the health of computer users.”
TURN TO THE WEB FOR PREVENTION TIPS
Here are some Internet sites that provide useful information about preventing repetitive strain injuries:
– www.tifaq.com: Solid review of most frequently asked questions about ergonomics and typing injuries.
– kidshealth.org: Provides valuable advice about an overlooked group of potential RSI sufferers. Search for the keyword “ergonomics.”
– www.eecs.harvard.edu/rsi: Practical tips from the Ivy League; great resource for college students created by college students.
– ergo.human.cornell.edu: Learn more about reverse-slant keyboards and other cutting-edge accessories.
