|Volume 1: No. 26|
There's another debilitating cumulative trauma disorder (CTD) or RSI: tendinitis. I've been nursing a "sprained" left wrist for the last three months. Varied activities, short breaks, and exercises can prevent the problem, but once you get a swollen and irritated tendon, further exercise just makes it worse. Even minor typing is enough to keep the condition from healing.
Each tendon is attached to a muscle. Exercises elongates the muscle so that it applies less stress to the tendon. (Heat applied to the muscle may also help, but don't apply heat to the damaged tendon. Ice works better.) Typical exercises involve using one hand to bend the other wrist up or down, optionally rotating the forearm in one direction or the other. Hold for a few seconds, then shake the hands limply.
My own problem stems from a muscle on the bottom of the forearm that pulls the wrist down. I did wrist warmups when I studied aikido, and open-hand pushups for a karate class. During this last year, though, I allowed the wrist to lock up. When I began this newsletter business, the restricted and repetitive motion of typing proved too much -- especially one-hand control- key or shift-key stretches. There are also plenty of motions in "real life" that pull on the same tendon, such as pushing down on a faucet handle. Having my watchband a notch too tight may also have been a problem.
One wrist exercise that might have saved me is to turn the left palm up, grab with the right fingers on top of the left ones and the right thumb pushing into the wrist from below, and apply force to arc the left hand out from the body and then downward. You should feel the stretch near your left elbow. A variant is to place your palms together in a prayer position, then gently raise your elbows to stretch the forearm muscles for ten seconds. This should be done about once per hour of typing. (Taking a break every 15 minutes is even better.)
When you type, keep your wrists straight. (With my sore wrist, it helped to keep it angled slightly down. This is not recommended under normal circumstances.) Adjust your chair height as necessary; an inch can make a big difference. Use a wrist pad or rolled-up towel to keep your wrist from bending upward. Heavy- duty keypunchers (11,000 keystrokes per hour) risk carpal tunnel syndrome if they use wrists rests, but most people should use them -- it saves the constant muscle tension of holding the forearms horizontal. Don't use a sharp edge for a wrist rest, though.
Keep your keyboard far enough away that you don't have to bend your wrists sideways; 12" is good. I find it helps to angle my keyboard so that it's further away on the left. (This takes some getting used to. I had to move my monitor to the left to keep from turning my whole body to the right, but now I risk getting a little stiff in the neck.) Don't use backless or kneeling chairs for prolonged periods. Keep your shoulders relaxed and drop your elbows. Be sure to check your body position while typing from printed copy; I was damaging my wrist most while copying from text at the left of my keyboard.
Bodies differ, and diagnosing can be tricky. If you suspect tendinitis, see a doctor. If the condition gets worse, seek out a support group. (The RSI group in San Jose can be reached at (408) 246-1544.)
For information on preventing CTD, your company can contact Lauren A. Hebert's company, IMPACC (Bangor, ME), (800) 762-7720. They offer training, consultation, books, and posters. Some of Hebert's books are: The Neck Arm Hand Book; Worksmart: The Industrial Athlete; and Taking Care of Your Back (with Gaynor Miller). [Michael Sauda (firstname.lastname@example.org), C+HEALTH, 9/16.] I've also seen literature from FingerTip Info (Palo Alto, CA), (800) 484-1095 x4421, and Wrist Watch (San Diego, CA), (800) 722-6837.