Pain and Programming

In May of 2013, my hand pain was so intense I took nearly a month off work. When I started back at work and almost immediately felt pain again, I knew the issue was not rest, but habits.

I spent the next eight months reading a ton about posture, muscles, keyboards, mice, exercise, tension, anger and more. While I am far from pain free, I am much improved and continue to improve, by replacing my old bad habits with new good habits.

Get better, then get efficient

The gist of my approach was do everything, whether I felt it helped or not, whether I believed it or not, until I started to feel better. It was a huge time commitment, but not bigger than finding a new career. Appointments, exercise and stretches add up.

Once I started to feel better I started to remove things one by one to see if I got worse again. If I did not get worse, I stopped them for good. If I did get worse, I made sure that I started doing whatever it was again.

A Note of Encouragement

While it is possible that you are a unique snow flake and nothing will ever help you, I doubt that is true. I believe that over time you fell into bad habits, habits that have left you feeling as though you may need to switch careers and give up on the thing you love.

You don’t have to. You need to be aware of when you are doing those bad habits. You need to correct those bad habits. You need to take breaks (start with 5 minutes an hour, raise your hands above your head and get jazzy with them). You should be working “normal” hours, with regards to duration (4-6 hours at the keyboard, fill other time with reading related to work on your kindle/iPad). You should be exercising (even just 15-20 minute walk 3-4X a week).

It may take a while to start seeing results, but you will. Remember that getting to this point took years, so getting back could as well (thankfully it most likely will take more like months than years). Don’t count the days where you feel no pain, but rather focus on minutes, and then hours, that you can work pain free or with an acceptable level of pain.

Books

Pain free at your pc - muscles, alignment, stretches, etc; I dig this book and his non-pc pain free book, really practical exercises for strengthening but also really time consuming
Alexander Technique for Computer - awareness of bad habits, correct and replace with good habits, least effort; really solid stuff, reminded me to relax at the computer and just let my hands type rather than push them to be faster and faster
Mind body prescription I actually listened to audiobook, pain is tension built up from repressed anger, kind of weird to me but made me aware of tension in my muscles and to focus on always being aware of tension, anger and excitement at computer

Therapy

massage - focus on arms, shoulders and upper back, really find massages helpful, maybe start with once a week and move to once a month; some may file massages under “treat yo self”, but they really help relax me and break up tense spots in my shoulder blades and forearms
accupuncture - i mostly liked talking to the accupuncurist the most, not sure if it helped me much, but she had a lod of great stretches and things to do; when my pain was the worst I tried multiple times a week, now I do once a month mostly because I find my accupuncturist really insightful; not sure if the actual accupuncture does anything for me or not
physical therapy - they focused solely on the pain and symptoms more than the cause; others swear by occupational or physical therapy, but, while they were super nice and did help with acute pain, I did not find any long term solutions other than what I had already read in books

Exercise

I started by walking on treadmill at gym for 20-30 minutes 3X a week; when it was nice outside, I would take a walk at lunch for 20-30 minutes and listen to a podcast or music.
After walking regularly, I started playing basketball again - definitely helped, increased blood flow, loosened up arms by dribbling and shooting
When was the last time you ran? Jumped? Dodged? Rolled on the ground? Just start moving. Move throughout the day and in ways you did as a kid.
Start tracking your movement, get a fitbit, nike fuel, or whatever. Make it a game.

Exercise makes you happier too, which helps when you are dealing with pain.

Things

Imak Smart Glove - braces are a bad idea long term, but short term they can help remind you of what is correct and aleviate pain; as you start to feel better, remember to remove them for longer and longer periods of time
RPI Trigger wheel - nice to roll on forearms sometimes
Ice baths in small rubbermaid trash can - fill with 20 ice cubes and water, alternate time in water and out of water for 10 minutes each water (10 seconds in, 10 out, 1 minute in, 1 out, whatever); key is maybe doing it 3 or 4 times in a night; make sure it is large enough that you can submerge your forearms
Desks and Chairs I have bookmarked - honestly though, how I sit on the chair or at the desk makes more of a difference that the specific chair thus far for me. Granted, a better chair may be more comfortable and make sitting properly easier.

Closing Thoughts

I am sure there were other things I researched, but these were the specific things that stuck out. The tl;dr is: exercise, form good habits, take breaks, and relax.

Updates

2014-07-07

I am now using the Microsoft Sculpt Ergonomic desktop. The negative tilt on the keyboard is great. I also dig the chiclet style keys. The mouse is a great angle for my wrist as well.

In addition to the sculpt, I started using MacBreakZ a few weeks ago. I am pretty sure it has made a bigger difference than any other single thing I have tried. I used other break apps, but they never really helped much. I think the reason is that they just said stop, whereas MacBreakZ gives me stretches to do during the time off. It makes the breaks go quick and I have noticed an improvement in range of motion.

I use it with microbreaks turned on and I have it set to 30 minutes on with 5 minute breaks. At first the microbreaks were brutal, but after a few days I began to enjoy them. Be sure to Toggle the Activity Window on. As you type and click more, it moves a meter towards yellow and finally red to warn you.

While the sculpt helped, I still had some pain on the outside of my hands. Since I’ve been using MacBreakZ, I have had little to no pain, as long as I obey the breaks and do the stretches. I highly recommend giving MacBreakZ a real go.