Software developers, like pianists, rely on their hands to practice their craft. I've used a keyboard and mouse obsessively since my early teens. Fortunately, I have never had any problems with hand or wrist pain – nor have I experienced any Repetitive Stress Injury, which includes carpal tunnel syndrome. But others aren't so fortunate.
Years ago I caught a snippet of the Late Show, in which Letterman had a guest who specialized in hand training for pianists and surgeons. He had a book out an was promoting it. Several times I tried to find the book, but couldn’t, since I don’t know the author’s name or the book’s title.
I know carpal tunnel all too well, I got it operating robots. It is not fun at all and mandated a creer change. Since then, I have had few problems. You made some good points, I thought I might share a few of my experiences.
Straight writst, a palm rest and keeping the keyboard as low as possible seem to help me the most. Avoid the mouse… for me it can be a rapid aggrivator.
Exercise does help. Bromalian, a pineapple extract, is a great anti-inflamtory if taken on en empty stomach and seems to give me good relief. Chi balls as an exerciser seem to help as well.
I tried it some years ago, I think that I programmed 12-14 hours straight for some days, my entire left arm suddenly started to sleep(don’t know the English word for it, but it often happen if you are in same position for too long) . I think it took 3-4 days before my arm felt normal again. That pretty much scared the sh#t out of me, so I try to vary my working positions as often as I can, I try to take as much time away from the computer as I can and I started to workout in the gym.
It is not secret that a human will become better doing the things he/she continues to do, over and over. Some things like smoking is of cause more dangerous doing then running. But professional athletes have to watch out as well. But of cause that is understandable when their main function is their body. But yes running is good, but too much can be dangerous if you don’t watch out and listen to your body. We software developers will say that our main function is our brain, and often tend to forget to watch out for our body as well. Some geeks care more for their operating system then them self.
Anyway, I think it is good with variation in everything you do. Bring in more chaos …
Don’t sit the same position and do the same stuff every day.
Don’t life the same place all your life, remember to take travel somewhere every year to see something new.
Don’t eat the same food all the time, try something new.
Don’t do the same thing every day, get new hobby’s, meet new people, try new clothe, new movies, new … whatever … open your mind…
Don’t use the same programming environment all the time, try other operating systems, other languages, other search engines, other crazy technologies. …
Anyway, just take care of yourself, the computer business is still new, and I hope to continue see other great releases from you geniuses reading Jeff’s execelent Blog many years from now. 
I sometimes switch my mouse over to my left hand (I’m right-handed). It takes a short while to get used to it, but I can use it easily these days for most tasks. And it takes some stress of my right hand and arm, which can be a relief after days of long work. The only things I can’t do with my left hand are graphics and gaming.
(And I never bother switching mouse buttons. That’s just plain unnecessary.)
Actually, I’d like to see a warehouse full of salt.
I got RSI for a couple of years and switched to voice recognition to get by. After a weeks holiday where I did some walking - that’s all - it started to get better. Since then I’ve done semi-regular exercise - exercise bike and rowing machine, and kept free of it. For me I think the key was exercise of arms and shoulders.
Thinking Putty is awesome. I just ordered one of the new heat-sensitive colors for my office. Great exercise for the hands (and great for annoying your coworkers with popping-bubble noises if you so choose).
I’ll also add a plug for the Kinesis ergonomic keyboards. I have one of the contoured “bucket” style models, and while keyboards like the Microsoft Natural did almost nothing to help my hand and wrist pain the Kinesis has relieved just about all of it. The split layout looks intimidating, but I adapted in a couple of days and fluent touch typists shouldn’t have a problem. They are expensive though.
When I got my back checked by a chiropractor a couple of years back, she observed that my right shoulder was overdeveloped so the muscle was deadening the nerve. This results in greater mousing finesse because it reduces hand shake, but all the other muscles in your back have to compensate and it can have some very detrimental effects over time- nothing immediate, but stuff that becomes noticeable when you get older. At 26 she said I had the shoulder of a 60-year-old man.
She recommended changing mouse hand from time to time so no one shoulder gets too much control and shrugging your shoulders occasionally during the working day. Very small measures, but apparently enough to alleviate the worst of it.
PLEASE don’t use the dynaballs in an shared office - the noise is INSANELY annoying to coworkers…plus the hand movements required to keep it going cause utter hysteria in any man in sight - which is also extremely annoying!!!
I use a mouse on the left while at work (8 hours a day), and then on the right at home (another 3-4 hours a day, plus weekends).
Easy to switch back and forth. I don’t even conciously think about it. And it breaks up how much mouse time each hand gets.
I also have Dragon 8, but only use it on occasion.
The same goes for your eyes as well. Be sure to take a break every hour or two to let your eyes focus on something further away than just your monitor. If you have a window to look out of, that’s ideal, but a mirror is supposed to work well too.
…she observed that my right shoulder was overdeveloped…
I was stretching my arm a couple weeks ago when I noticed that my right forearm (between the wrist and elbow) bulged slightly like Popeye’s arms. Sure enough, the left arm (non-mouse hand) didn’t have the bulge. A quick survey of co-workers found the “condition” in 2/5 of workers, always on the right (mouse) hand and in both righties and lefties.
I knew someone who had pretty bad RSI and alleviated it by switching to a trackball, so I guess they do work to some degree.
Also, there is a fair bit of evidence (though it has not been proven) that CTS cases can be treated in part with vitamin B6 (50-200 mg/day), preferably as part of a vitamin B complex supplement (or just eat lots of bananas). This would be in addition to antiinflammatory medication, physical therapy, and ergonomic changes. There also seems to be some indication that reducing the consumption of saturated fats and fried foods helps as does eating larger quantities of curcumin (a main ingredient of curry)
I’ve been dealing with RSI/CTS in both my wrists/hands for the last four months. One thing that has helped me tremendously has been yoga. (Just be sure not to push your body, especially any injured areas - that means no “down dog” or other postures that put weight or strain on your wrists.)
I have seen many people who had to change careers completely due to RSI. When I started getting the typical RSI symptoms I naturally became seriously worried as I suck at anything other than computers.
Then I switched my mouse from my right to my left hand and although it took a couple of days to get used to, it fixed my symptoms.
This is also excellent. Very nice guy who writes the software and it works well (I think it’s only win (not Mac). http://www.cheqsoft.com/break.html
I got some thinking putty on the strength of this article, and I’m pretty impressed so far.
My only question is: Which type is shown in your picture above?
I searched online, but couldn’t find out which one it was. I bought the scarab variety, but it doesn’t seem to be that one.
Taking breaks is definitely the best way – take a moment for your eyes, hands and back.
Oh, there’s a new chair out (I’ve used an aeron for years) that resembles a stool. It has a nice cushy seat, and the seat feels like it’s floating, really amazing. A client’s ceo had one and I tried it out; was really amazed, but I only sat on it for about a half-hour or so.
The biggest problem is that we’re still shackled by the physical interface of a keyboard and mouse.
I’ve wanted to go dvorak for a while now to see how I feel… but like most haven’t taken the time to attempt the switch. But maybe it’ll be worth it just to see a guest user’s expression when they first sit before my keyboard.
Ya know, I tried a bunch of mice and input devices, even that fancy sideways mouse, and I settled on the one-button (!) apple mouse. It’s straight-edge design I found better than all those sculped monsters from logitech et al. And the sides curve underneath the mouse so your fingers get some leverage beneath the mouse to grip it easily. Fancy that.
But never fear, I’m building the next great end-to-end UI.
I bought the scarab variety, but it doesn’t seem to be that one.
The one in the picture is Oil Slick. It’s an “iridescent”.
We go through a lot of putty at work; each new hire gets their own tin of Thinking Putty in a unique color. The iridescents are my favorites, followed by the metallics…