From: Dan Wallach <dwallach@nas.nasa.gov>
Subject: FAQ: Typing Injuries (1/3): General Info [monthly posting]
Followup-To: sci.med
Organization: NAS Program, NASA Ames Research Center, Moffett Field, CA
Date: Fri, 14 Aug 92 12:05:14 GMT
Supersedes: <typing-injury-faq/general_711662904@loch.nas.nasa.gov>
Summary: information about where to get more information
Expires: 22 Sep 1992 12:05:06 GMT
Reply-To: Dan Wallach <dwallach@nas.nasa.gov>

Archive-name: typing-injury-faq/general
Version: $Revision: 4.3 $ $Date: 92/08/13 10:36:11 $

The Typing Injury FAQ -- sources of information for people with typing
injuries, repetitive stress injuries, carpal tunnel syndrome, etc.

By Dan Wallach <dwallach@nas.nasa.gov> or <dwallach@soda.berkeley.edu>

The opinions in here are my own, unless otherwise mentioned, and do not
represent the opinions of any organization or vendor.  I'm not a medical
doctor, so my advice should be taken with many grains of salt.

[Current distribution: sci.med, news.answers, and e-mail to
		       c+health@iubvm.ucs.indiana.edu and
		       sorehand@vm.ucsf.edu]

Table of Contents:
    ==1== Mailing lists, newsgroups, etc.
    ==2== The soda.berkeley.edu archive
    ==3== General info on injuries
    ==4== Typing posture, ergonomics, prevention
    ==5== Requests for more info

==1== Mailing lists, newsgroups, etc.

USENET News:
-----------
comp.human-factors occasionally has discussion about alternative input devices.
comp.risks has an occasional posting relevant to injuries via computers.
sci.med and misc.handicap also tend to have relevant traffic.

There's a Brand New newsgroup, sci.med.occupational, chartered specifically
to discuss these things.  This would be the recommended place to post.

Mailing lists:
-------------
The RSI Network: Available both on paper and via e-mail, this publication
    covers issues relevant to those with repetitive stress injuries.  For
    a sample issue and subscription information, send a stamped, self-
    addressed business envelope to Caroline Rose, 970 Paradise Way, Palo
    Alto CA 94306.

    E-mail to <crose@applelink.apple.com>

    $2 donation, requested.

c+health and sorehand are both IBM Listserv things.  For those familiar
    with Listserv, here's the quick info:

    c+health -- subscribe to listserv@iubvm.ucs.indiana.edu
		post to c+health@iubvm.ucs.indiana.edu

    sorehand -- subscribe to listserv@vm.ucsf.edu
		post to sorehand@vm.ucsf.edu

Quick tutorial on subscribing to a Listserv:
    % mail listserv@vm.ucsf.edu
    Subject: Total Listserv Mania!

    SUBSCRIBE SOREHAND J. Random Hacker
    INFO ?
    .
That's all there is to it.  You'll get bunches of mail back from the Listserv,
including a list of other possible commands you can mail.  Cool, huh?  What'll
those BITNET people think of, next?

==2== The soda.berkeley.edu archive

I've started an archive site for info related to typing injuries.  Just
anonymous ftp to soda.berkeley.edu:pub/typing-injury.  (128.32.131.179)
Currently, you'll find:

Informative files:

    typing-injury-faq/
        general           -- information about typing injuries
        keyboards         -- products to replace your keyboard
        software          -- software to watch your keyboard usage

    keyboard-commentary   -- my personal opinions on the keyboard replacements
    carpal.info           -- info on Carpal Tunnel Syndrome
    carpal.surgery	  -- JAMA article on CTS 
    carpal.tidbits	  -- TidBITS article on CTS       --NEW!--
    tendonitis.info       -- info on Tendonitis

    rsi-network/*         -- archive of the RSI Network newsletter

Programs:
    hsh.shar		  -- a program for one-handed usage of normal keyboards
    typewatch.shar	  -- tells you when to take a break

Pictures (in the gifs subdirectory):
    accukey1.gif	  -- fuzzy picture
    accukey2.gif	  -- fuzzy picture with somebody using it
    bat.gif               -- the InfoGrip Bat
    comfort.gif           -- the Health Care Comfort Keyboard
    datahand1.gif	  -- fuzzy picture
    datahand2.gif	  -- key layout schematic
    datahand3.gif	  -- a much better picture of the datahand
    kinesis.gif           -- the Kinesis Ergonomic Keyboard
    maltron[1-4].gif      -- several pictures of Maltron products
    mikey1.gif            -- the MIKey
    mikey2.gif            -- Schematic Picture of the MIKey
    twiddler1.gif	  -- "front" view
    twiddler2.gif	  -- "side" view
    wave.gif		  -- the Iocomm `Wave' keyboard

If you're unable to ftp to soda, send me e-mail and we'll see what we
can arrange.

==3== General info on injuries

First, and foremost of importance: if your wrists are hurting at all, then
you absolutely need to go see a doctor.  As soon as you possibly can.  The
difference of a day or two can mean the difference between a short recovery
and a long, drawn-out ordeal.  GO SEE A DOCTOR.  Now, your garden-variety
doctor may not necessarily be familiar with this sort of injury.  Generally,
any hospital with an occupational therapy clinic will offer specialists in
these kinds of problems.  DON'T WAIT, THOUGH.  GO SEE A DOCTOR.

Ahh, you say, but I'm not that bad.  Yes you are.  Any of the following are
signs that you should go see a doctor.  More than one means you absolutely
*must* get to a doctor, immediately.

- any tension, anywhere in your elbow, forearm, wrist, hand, fingers
- pain, whether low throbbing or intense stinging
- feeling cold
- tingling
- numbness

You could have any of a number of problems, although if you catch it soon
enough, you may be lucky enough to avoid some of the worse ones.

The two main types of injuries you've probably heard of are tendonitis and
carpal tunnel syndrome.  In a nutshell, tendonitis is when some of your
tendons are inflamed.  Normally, you use your tendons and muscles all
the time, and everything works.  Sure, you just moved your T.V. set, and
now your arm hurts a little, so you sit down, have a beer, and watch T.V.
Your arm calms down, and life is good.  However, when you're typing, you
never really give your fingers a chance to heal themselves, if they get
hurt.  If you ignore the pain and keep on typing, you piss your tendons off.
Voila!  Tendonitis.

Carpal tunnel syndrome happens when you continue ignoring the pain, and
your tendons get more and more inflamed.  Eventually, they squish the
bones in your wrist, which squishes the nerve that runs up and connects
to all your fingers.  That nerve runs through, you guessed it, the carpal
tunnel.  Well, as you might imagine, squishing nerves is generally a bad
thing.  And, unlike tendons, nerves don't heal very well.  The carpal tunnel
release surgery that you've probably heard about attempts to remove some
of the pressure on your nerve by re-arranging some things in your wrist.

Obviously, the above is a gross over-simplification of a complicated problem.
The files available on the soda archive go into greater detail.

==4== Typing posture, ergonomics, prevention

Of course, for every messed up typing posture, there's a different exciting
injury you can get.  What?  Proper posture matters?  You bet.

Push back from your desk and follow these instructions.  If your chair is
height-adjustable, raise yourself so your feet are flat on the floor.  Sit
up straight.  As straight as you can manage.  Hang your arms down, limp.
Now, just from the elbows, lift your hands up to make around a 90 degree
angle.  Your elbows should still be at your side.  Okay.  See where your
hands are, now?  That's where you want your keyboard to be.  You want your
hands to be right over the keyboard, dangling your fingers down onto the
keys.  Wrist pads are bad.  Very bad.  Your wrists shouldn't be resting on
anything.  Instead, you're arranging your body so your shoulders bear
the weight of your arms.

But, you say, your keyboard is 6 inches higher, up on your table.  Well, that's
a problem you need to fix.  Most modern modular furniture can have fancy
keyboard drawers or tables to put the keyboard at a better height.  Barring
that, putting the keyboard in your lap is often better than nothing.  If you're
using your lap, it often helps to take the keys, wallets, etc. out of your front
pockets, so you don't have weird-shaped objects pressing into your arms.

But, you say, your chair's arm rests are getting in the way.  This is another
problem you need to fix.  If you're lucky, all you need to do is get a
screwdriver and remove the arms.  If you're unlucky, you need to go find
a new chair, or invest in a hack-saw.  Now, some of the really expensive
chairs have height-adjustable elbow-rests.  It's a personal call, whether
they're good for you, or not.

Now that you've arranged yourself, look at your hands on the keyboard.
You want your torso centered on the middle keys, with your forearms coming
in at the same angles.  Normally, you might bend your wrists sideways
to line your fingers up with the home row.  This is actually a bad idea.
You might want to try typing at an angle, so your wrists come in at their
natural angle, and your fingers extend a little more.  If you're injured,
this may or may not be a very good idea.  Consult your doctor.

But, you say, you just can't get comfortable on your old keyboard.  Well,
you should look into getting a new one.  A number of manufacturers make
keyboards which are anything but flat.  Consult typing-injuries-faq/keyboards
for more information.

==5== Requests for more info

Clearly, the above information is incomplete.  The typing-injury archive
is incomplete.  There's always more information out there.  If you'd like
to submit something, please send me mail, and I'll gladly throw it in.

If you'd like to maintain a list of products or vendors, that would be
wonderful!  I'd love somebody to make a list of chair/desk vendors.  I'd
love somebody to make a list of doctors.  I'd love somebody to edit the
above two sections, looking for places where I've obviously goofed.
-- 
Dan Wallach              "One of the most attractive features of a Connection
dwallach@nas.nasa.gov    Machine is the array of blinking lights on the faces
                         of its cabinet." -- CM Paris Ref. Manual, v6.0, p48.