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rsi

this is about my experience with rsi

i have daily, constant pain in my arms and pinkies. i hate it. this is the second time i've had RSI (the first time went away after i implemented a stretching regime before daily starcraft practice). it is depressing and stressful, it makes me worried i won't be able to do my job. it really sucks in the middle of a pandemic with everything completely online and through a computer.

i also love computers. i spend a lot of time on them for fun, and rsi is taking away much of a hobby i really enjoy during a time when the hobby would be relief from everything else.

this post isn't really about any one thing; its just me having RSI and talking about it.

what and when it happened

in 2020, in may, i started noticing rsi symptoms. i was halfway through a difficult professional training called the OSCP, and felt i needed to push through. this was a mistake.

i continued to work hard, staying at my computer for 10-14 hours every day. i did see a doctor and looked into options for managing what i was experiencing for the duration of my (several month long) training. the doctor was confident this was a blip, that it was something I could manage, nothing to worry about. i followed his advice, doing stretches, wearing a brace, etc. eventually the pain got so bad i was forced to stop my training, and then take a step back from work.

a digression about rsi and medical understanding of RSI

there isn't a lot of agreed upon science for rsi. every medical professional has agreed with my official diagnosis of "golfer's elbow". i also have all the symptoms of "tennis elbow" (the same thing as golfer's elbow but on the other side of the elbow, basically). My doctor recommended a brace, my PT recommended never wearing a brace, saying it would make things worse.

this was pretty confusing. turns out, there is not a medical consensus on what, exactly, RSI is. there are some specifics where that's not true as far as I can tell, carpal tunnel syndrome for instance appears to be more understood than "golfer's elbow", but the water still seems to be pretty cloudy. this, i imagine, is what leads to there being no medical consensus about proper treatment. in turn, this seems to lead people to look at alternative medicine. some people swear by acupuncture, some by massage therapy, some by the alexander technique.

what i've done

just to list out everything, here's a non comprehensive list of what i've done in pursuit of not having daily rsi pain:

  • gone to the doctor, worn a brace, did the stretchings prescribed. my primary doctor was very sure we could do something about this with just: rest, ice, compression, elevation. he also referred me to a physical therapist when his original plan didn't halt my symptoms.
  • gone to pt once-twice weekly (as dicated by my therapist), did the stretchings prescribed daily. i was engaged in the process and asked him questions every time i saw him, raised doubts about my progress, did everything i knew to do in a medical context. this process was very expensive, even with insurance. i don't think he did anything for me beyond give me hard requirements for stretching and being fit. several thousand dollars later i stopped going. i have not noticed a difference in how i feel.
  • adopted a morning regimen including meditation, yoga, and weights. see below in the "what i'm doing now" section. this has helped some, though that could be mostly a mental thing; a fake idea of me having control. i'm not sure.
  • keep warm; my home office is naturally warm because its full of ancient computers, but i am also sure to wear warm clothing to make sure cooler temperatures aren't hurting me.
  • quit my professional development training, cut back on working, change how i work. a lot of what i do involves convincing other people to do something that they don't want to do. i used to do all my thinking while typing - i'd type up email responses or POC code for something and edit as I type. that is really hard on me now. i do some storyboarding on paper prior to typing anything.
  • read alternative theories on rsi causes and treatments (notably dr sarno, so many people say that guy cured them, but man that just seems fake).

what i'm doing now

in my head i've broken down my current self-directed plan into two parts: equipment and process.

equipment list

The desk specific items are are all about preventing further damage to my hands and arms while still allowing me to work.

  • I have a motorized standing desk. This is important because it allows me to stand, and also to adjust the overall height of my desk to best match me when I am sitting. standing has been nice, but the standing itself helps me way more with back pain than with anything else. adjusting desk height relative to my sitting height has helped a good amount with rsi.
  • I have monitor arms with custom monitor risers to allow me to adjust my monitor height independent of my desk height. This is important because my posture while sitting necessitates a different monitor height (relative to my desktop) than my posture while standing. Adding this piece to my setup seemed to help a decent amount.
  • I have an ergodox that I've programmed with a custom key layout to be more forgiving to my hands. The split nature is important because proper typing posture requires 90 degree elbow bends while arms are shoulder width apart. this is probably my best tool for helping prevent further damage. specifically, i remapped control, alt, shift, hyper, and delete to be under my thumbs instead of my pinkies. i've had this keyboard for years but did not remap many keys from the standard layout until rsi forced me to. fucking whoops lol
  • I have several mice that I rotate through during the day once a particular repetitive motion starts to bother me: a mouse that aligns to my rough hand shape, a bigger version of that mouse, and then a large trackball and chassis. The rotation through the different mousing styles helps keep my mouse arm from seizing up too bad.
  • I have a yoga mat, a few different variable weight sets, a massage gun, lacrosse balls, a pull up bar, and some resistance bands. These are all mostly related to the other category,

process

this is mostly about pain management and upkeep. I have a daily routine and then some flex activities to help on specifically bad days. some ✌️😒✌️ experts ✌️😒✌️ opine that rsi is purely psychosomatic, and can be treated by talk therapy and meditation. i personally am willing to believe that there is at least a kernel of wisdom there, though i think that the most famous guy in particular is a fucking liar, so I'm hedging my bets.

  • Daily routine:
    • ~30 minutes meditation and journal to keep my stress manageable.
    • ~45 minutes yoga
    • ~20 minutes arm specific stretches
    • ~30 minutes weights and resistance bands
    • ~20 minutes arm, back, and shoulder specific training (variations on pushups, bridges, double and single arm hangs)
    • ~40 minutes of biking, or ~20 minutes of walking
  • Bad day relief:
    • massage gun helps for ~15 minutes at a time; very temporary pain relief
    • lacrosse ball works the same way, but for different muscle groups.
    • pull up bar allows me to lift weight off of some parts of my back that don't get a lot of relief. this helps some.
    • pull up bar also allows me to work grip muscles; hanging by my fingers several times for ~30 seconds at a time seems to relieve pain in the short term.

what i'm going to do

i am not totally sure. i'm continuing to add to and refine my daily routine. i am about to add in several more body weight exercises, especially upper arm and back focused ones. I've only just added in grip training, hoping to simulate rock climbing. i haven't had RSI when I was climbing, or doing trapeze, or pole dancing. anecdotally, a lot of people on hacker news / the rsi subreddit report that rock climbing helped them tremendously.

i think there's probably room to add talk therapy to my list of Tried Treatments. i'm not looking forward to it, it'll cost my a lot of money, time and emotional bandwidth. if it helps i'll write about it.

prior art, acknowledgements, and references

my brother has written about RSI and how it affected him. he also wrote a website to show his custom keyboard layout and how that's help him. you can look at that here.

my brother also is currently letting me use his massage gun to help when i have particularly bad days. he's really great.

this thing was written by someone who also experienced very painful RSI and worked in a similar field. he also reminded me that temperature could be imporant.

this is a book referenced heavily by people looking for non traditional options for rsi treatment. i think this guy is probably a quack. i'm hedging my bets though, and following a lot of his advice. if nothing else, I suspect it is Generally Good for me to be less stressed and to spend time working specifically on meditation and thinking through any mental issues i have.

this subreddit was useful in seeing what other people are doing and if i'm way off base on something. it also showed me that so many people really like dr sarno's book. christ.

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