Place your palm on the silicone pads. Be sure to select the correct size (please refer to question #1). The use of Carpio may feel a bit weird in the beginning, but this is totally expected. As you're placing your hand differently than before, your wrist needs some some to adjust to the new position. The strap will help you keep the Carpio in the perfect spot at all times. The Carpio can also be used with your keyboard. Just slide the hand with your Carpio from the mouse to your keyboard and vice-versa.