RSI: Acknowledgement

So, I'm pretty sure I have a developing case of RSI on my hands (I actually wrote that without intending a pun, believe it or not). RSI (repetitive strain injury) is an overuse injury caused by a repetitive activity over a long period of time. More specifically, it's the hand, wrist and arm problems that some computer users get. This admission is simple enough but it actually took me a long time to accept the possibility that I might have it. I first started noticing some aching in my forearms in August, shortly after we moved, and immediately tried to write it off as something minor: a tennis injury, or strained muscles from moving furniture, or the adjustment to a new desk. When it didn't let up, I sought a doctor, who prescribed some anti-inflammatories and didn't seem too worried about it. When the drugs didn't help, I got a new chair and monitor stand and tried to pay more attention to my wrist position, but that was no quick fix either. The achiness subsided during a few weeks of light computer usage over the holidays but returned by mid-January.

This is when I started to get worried. How could this be happening to me? I've only been typing at a full-time job for two years. I get plenty of exercise. And I'm young! Everyone spends all day at a computer these days and many devote their evenings to blogging from fashionable PowerBooks, how come they're not having the same problems? Was my condition accelerated because of my years of piano playing? Or aggravated by the fact that I carry a twenty-odd pound weight around a lot of the time? This may sound overly dramatic, but it's kind of scary to see something developing that could potentially affect the way you make a living. After all, I can't exactly stop typing to let these problems clear up, but on the other hand if I can't stop them from worsening I might end up in a position where I can't work.

I started getting tired of the worrying and speculating so I decided to get informed. I just finished reading It's Not Carpal Tunnel Syndrome! RSI Theory & Therapy for Computer Professionals, a book touted as the best second-generation RSI book (the RSI bible Repetitive Strain Injury : A Computer User's Guide being the first) and I would heartily recommend it to anyone that is interested in knowing more about RSI, whether you think you might have it or you want to make sure you do everything to avoid it. It's written by a therapist so the approach is more therapeutic than surgical, which suits me just fine. The book focuses on two things: understanding computer-related RSI as it relates to the whole body (and mind, for that matter), and outlining a comprehensive program for healing and recovery. Furthermore, I learned two things from this book: how to understand and evaluate my symptoms, and how to formulate and manage a plan for recovery. My condition seems to be something between 1st and 2nd degree RSI, as they define it--I have occasional to frequent symptoms, somewhat predictable, comprised of minor pain (mostly aching and burning) but with no apparent nerve involvement (no tingling, numbness, etc.). Could be better, could be worse.

Here is my plan of attack, which I'm putting down as much for my own good as anything else:

• See a doctor: Not that I haven't already seen a doctor, but I'm hoping to get a referral to a specialist (ideally a physical therapist) that can diagnose the severity of my problem and work with me on this recovery plan.
• Improve posture: My seated posture is absolute rubbish. It is the worst of anyone I know and others have corroborated this. I have a new chair and I've adjusted it to the best of my knowledge: armrests removed, back upright, at a height so the bend in my knee is a right angle, and tipped slightly forward to encourage good posture. I will probably need to work on strengthening my back in order to make this stick.
• Take breaks: Everyone agrees that breaks are essential for avoiding overuse. I found a great open source program called Workrave to help enforce work breaks. It allows you to schedule micro-breaks (mine are thirty seconds every five minutes), rest breaks (mine are five minutes every half-hour), and tracks your total activity time for the day. When it's time for a break, a pop-up window appears as a reminder and all input is blocked unless you click to skip or postpone it. In fact, I've been interrupted several times in the writing of this post to take a break. It's very good at taking active and idle time into account and even suggests exercises and stretching for the longer rest breaks.
• Get enough sleep and exercise: Obviously these are always important but especially when your body is constantly recovering from daily overuse injuries.
• Try an ergonomic keyboard: Anyone have any experience with these? Microsoft's is the cheapest but seems a little bulky. The Typing Injury FAQ alternative keyboard page has a lot of other, generally more expensive, alternatives.
• Try to use larger muscle movements: Lowering mouse sensitivity, using two hands for keyboard shortcuts, hitting the spacebar with fingers instead of thumbs, etc. These are all things I'm going to try.
• Increase strength and flexibility: The book provides several stretches and exercises to help improve posture and take some of the strain off of the small muscles and tendons of the arm and hand.
• Keep a pain/activity log: Hopefully this will help the doctor determine the best course of action.

So that's the plan, subject to change at the doctor's recommendation. I'm hoping that by seeking help early and staying persistent I will be able to let my body heal so I can continue my current activity level without doing more damage. I find it hard to believe that there's already so much damage that this won't be possible but a quick Google search of my symptoms provides enough scary stories to keep me worried.

I'm not posting this here because I'm looking for advice (although I won't ignore it), but I am looking for support in the form of "I've been through that and this is how I got past it." At the very least, hopefully I can provide that for the next person that comes along looking for hope from fellow RSI sufferers.