Notes on RSI for Developers

I’m not a medical authority, these are just my notes to self, please get professional help if you need it.

Basic Facts

What is RSI? (from Harvard RSI Action)

RSI stands for Repetitive Strain Injury. It includes a whole spectrum of conditions, from tendonitis of the hand or wrist to carpal tunnel syndrome to cubital tunnel syndrome. Basically, if your hands or wrists hurt or go numb or tingle, that may be RSI. If these symptoms are associated with repetitive tasks, such as typing at a computer, it is almost certainly RSI. (Note that such symptoms do sometimes go away within a few minutes, hours, days, or weeks.) Other symptoms include losing strength or coordination in your hands, or perhaps dropping things.

Not everyone experiences all symptoms, and sometimes your symptoms may not occur until several hours or even days after the activity which causes them. (Have you ever hiked a long way and not been really sore until the next day or even two days later?) Some people, especially at UHS, call RSIs Cumulative Trauma Disorders (CTDs); it’s the same thing.

  • RSI seems to have many causes. Everyone’s RSI is different. The cause can be equipment, but contributing factors can be broader (overall body health like sleep/head/neck/back posture factors, psychological factors). Sometimes you might have RSI symptoms, but it might actually NOT be RSI!
  • Pronating wrists (turning face down) is bad - therefore the default mouse and keyboard alignment is bad! 😱
  • Tilting wrists up is bad - the normal up-sloping keyboard is bad. It should be exactly the opposite: image
  • Arm posture/lumbar/upper back support is important.
  • Constant pressure in one position is a cause - vary it up and take frequent breaks
  • Long key travel (up/down) is bad.
  • Long key travel (sideways) is bad therefore QWERTY is bad.
  • Multiple pressure at the same time is bad, therefore Ctrl+C/S/V with one hand is bad.
  • Sometimes the cause is psychosomatic - subconscious stress.
  • Exercise helps sometimes - pushups, pullups, dips, and situps. Not too much, though. Sleep too. But it doesn’t always fix RSI.
  • It is never “cured”, just managed. Know what triggers your RSI.

Basic/Cheap Recommendations


Expensive/Extreme Recommendations


If really bad, see a physiotherapist.

More Resources and Blogposts

“I’ve been battling RSI for 20+ years. Can recommend getting standard blood tests. I was extremely low in vitamin D. Once that was fixed, one whole layer of pain fell away.” - Matthew Taylor

My Context

I’m starting to feel some Repetitive Strain Injury (RSI) in my left hand. A few weeks ago it was so intense I had to stop typing for a weekend. Fortunately I am right handed, so I could still do most other things well. I gave it some rest and then I made a full recovery. I’m feeling the beginnings of it again today. It’s a matter of time until I get hit by it again and don’t recover.

I decided to collect some information about it to make improvements now rather than later. If I intend to write as much code and words as I do for the rest of my life I better do this right. People have been forced to quit programming over stuff like this.

I’m not an expert here, just collecting notes and sharing it in public. I will update this over time as I learn more, please comment or @me and add more info and I will curate.

Tagged in: #reflections

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