9 years of pain
I’ve been typing with pain for 9 years.
In that time, I’ve been a world-class developer, published thousands of words, done more than my share of tweeting, and taught my daughter to program.
To be able to use computers myself, I’ve tried everything.
Everything from eye-tracking to voice commands to buying experimental keyboards via estate auction. Everything from physical therapy to psychotherapy to aromatherapy to prolotherapy (don’t ask).
Dozens of times, friends have asked what products and solutions I have found that work best. Here is that list.
Your mileage may vary, but I promise at least that these are not just the first things I stumbled across. I’ve owned 10 different trackballs, 15 different traditional mice, and 20 keyboards of all shapes and philosophies. I’ve seen more than 60 medical and physical practitioners, and tried more than 20 prescription and over-the-counter drugs.
I’m not listing 95% of what I’ve tried.
Kinesis Advantage keyboard
The Advantage is a conversation starter because of its bizarre shape, which looks like a keyboard that’s been melted and reassembled by a mad scientist.
The concave shape makes sense only after you’ve spent a good two weeks adjusting — yes, you need that long for it to start to feel normal. Then you realize how brilliant it is.
Other ergonomic keyboards, due to arm position, finger strike angle, and switch design, seem to take twice the finger pressure and wrist contortions that the Advantage does.
Mind you, the Advantages are notoriously buggy. I often have to reset them, or unplug them and plug them in again to get a key unstuck. I’d say 50% of them are unusably glitchy after 3 years. But I’ve owned 4, and I’ll keep buying them with no complaints as long as they feel this good!
Logitech Wireless Performance Mouse MX
I alternate equally between three mice for variation and flexibility, and often use two at once. The MX is the most traditional of the three.
It has ergonomic tilt, but not too much: your hand sits maybe 30 degrees tilted from where it would on a standard mouse. That’s enough for me; I find the totally sideways mice, like the Evoluent, require uncomfortable shoulder and finger tension.
Finally, the MX’s low-friction scroll wheel (which you can toggle between flywheel-style and stepped) saves me miles of finger travel.
Logitech Trackman Marble Mouse
Many trackball mice are very wide, making me lift my thumb and pinkie finger up towards my knuckles, and press downwards towards the desk with my thumb to click. It would feel more natural to press inwards towards my palm, as you can with the Logitech Trackman.
Of all the trackballs I’ve used, only the Trackman is truly easy on the thumb and lets my hand rest in a natural position — a surprisingly rare description for what should be a wonderful category of mouse.
Contour RollerMouse Pro2
Here’s where things get weird. I use this mouse… with my toes! In fact, I’m using it right now with my toes, to write this post.
The RollerMouse isn’t meant to be used that way, of course. But I’ve tried several mice that are meant to be used by your feet, and they seem not to have been made with humans in mind. (Although the promo video for the FooTime No Hands Mouse makes unintentionally hilarious viewing.)
The RollerMouse, on the other hand, is perfect for below-the-belt mousing. It provides a perfect resting place for your big toes right next to the motion bar and main button, from which place they can spring into action with a slight flick.
Plus, it’s hard to explain how pleasant it is to have your hands free to type, take notes, or relax while you mouse around.
Ace TekZone Wrist Brace
(available on Amazon, but make sure to get Right and Left, sold separately)
I sleep with two of these on, but don’t wear them during the day for fear of atrophy, restriction of motion, and plain old vanity. I didn’t find that wearing them during the day helps on net. But I’m a side sleeper, and my wrists are sometimes under my head; so I find sleeping with these on seems to distribute pressure away from my wrists.
It’s one of the few traditional physical therapy devices I’ve tried that makes a reliably noticeable difference.
Dragon for Mac/PC
(formerly and alternatively known as “Dragon Dictate” and “Dragon NaturallySpeaking”)
This software is both crucial and heartbreakingly disappointing.
When you speak whole sentences with an excellent microphone, it does a very good job understanding what you’re saying. But when you do many of the other things you wish to do, it breaks your heart.
You’ll be disappointed when you try to:
- speak one word or one letter at a time
- create brief custom commands
- try editing what you’ve written when Dragon makes a mistake
- use Dragon to write more than a sentence at a time in your browser
- enter and train custom vocabulary
- speak series of numbers
- tweak its annoying tendencies to, say, insert extra spaces before everything
- interpret the spoken term “exclamation point” as the symbol “!”
It’s surprisingly hard to find honest discussion of these problems, amidst the glowing reviews from lazy tech writers everywhere. (I’m looking at you, David Pogue.) Try this post and this video for a good sense of the type of issue you’ll run into.
Still, Dragon saves me a huge amount of typing, and it has gotten better over the years. I recommend a fast computer with a solid-state hard drive, and a top-notch desk-mounted microphone like the one I recommend for podcasting, rather than a headset.
iPhone, Android, Google Docs voice recognition
Both iPhone and Android have quite good voice recognition, even with background noise. I find Android drops content more often and is slower to start up (and you can’t expect much from Android voice commands). I’ve run side-by-side comparisons, and iPhone recognition is consistently better.
If you only use these on occasion, try relying on them more heavily for a few days. They can free up quite a bit of typing.
Google Docs also has excellent voice recognition that works only while editing a text document, though few users notice this feature in the Tools menu.
Swype keyboard and its imitators
This includes SwiftKey and the stock Android keyboard (my favorite mobile phone keyboard of all). These are terrific on Android, though still a bit clunky to use on the iPhone. Do you use your thumbs to type on the phone? Try switching to a swipe-style keyboard, which just uses your index finger, and you’ll spare your overworked thumbs many repetitive motions.
Dictating to a human
I’m blessed with enough income as a programmer to pay a human typist to sit with me and perform the majority of my keyboard and mouse use. This way of working is out of reach for most people, so I hesitate to mention it, but I’d be lying if I said I could get by with only the tools on this list. [Update: I no longer need to use a human typist to work! I credit CBD oil/Cannabidiol; see below.]
Watch me dictate to Adrian, who worked for me for hundreds of hours over the last few years. You’ll get a sense of the intense focus this work requires of a typist, and how inadequate dictation software is to the pace of real computer work. “Take a memo” it ain’t!
Hot and cold
I can get relief from my arm pain even just by running my arms under hot water for ten second. A 20 minute hot bath will seem to affect me for hours or even a whole day. I got the idea from my wife Kate, a violinist, who says it’s a common remedy among musicians.
I have no idea why this seems to work. Is it relaxing the blood vessels or skin or muscles? Is it just sending novel signals up my nerves which, as with scratching an itch, displace the unpleasant pain signals? Is it just a psychological response?
I do think I have evidence that one aspect of heat makes a big difference, and that is the general temperature of my forearms. When I work in an air conditioned space — particularly an aggressively frigid one — the pain is reliably greater. It took me a long time to realize that it improves my pain by a small but very consistent amount to simply wear a sweatshirt indoors, even when it’s hot outside.
I’ve tried a good 15 or so prescription drugs for my pain, none of which seemed to make a difference. But recently I’ve been surprised and thrilled to find that a marijuana extract oil called cannabidiol, which is not psychoactive, gives me significant relief.
I’ve written up my experience with it here.
You might not have heard of all of these. I’ve had some incredible experiences with all three, but have also had lackluster experiences, perhaps at the wrong time, with the wrong teacher, or from too little focus on my part.
My (poorly informed) understanding is that Alexander Technique is a practice of performing various everyday movements — walking, sitting, standing — under the guidance of an experienced practitioner, who points out the muscles you are tensing unnecessarily. By learning how to do these movements with shifts of balance and posture, you can release those muscles, and the resulting improvement in your body’s relaxation can have cascading effects that improve health in unexpected ways. It’s popular among actors and dancers.
Feldencrais is more difficult to put my finger on. It also deals with unlearning and relearning aspects of balance, posture and tension, but it also includes massage and movement therapies that are supposed to remind your body of its range of motion and natural mechanics. It’s a bit more New Age-y than Alexander Technique. (Even further in the New Age-y direction than Feldencrais is “craniosacral” therapy, which I’ve tried but never found helpful.)
It’s hard to say what exactly it is that has made yoga, Feldencrais and Alexander Technique work for me. Is it simply that I’m cultivating a physical practice, no different than a morning jog or calisthenics? Is it the fuller sense of the relative motions and tensions of the parts of my body? Is it some subconscious release of unnecessary tension?
It’s hard to pinpoint, but I can’t deny there’s something there that lessens my pain when I use these techniques regularly.
You don’t need to spend a lot of money to get something out of Alexander Technique. Find someone who knows about it to explain it to you, pay attention and try to notice the tensions it describes.
As for Feldencrais, I highly recommend attending the workshops taught by Harriet Goslins and her students. Goslins has her own brand of Feldencrais, and I found her trainings to be a small revelation. I think you’d get a lot from them, no matter what your physical situation.
I don’t blame you if this stuff seems like mystical pseudo-science! All I can say is that in my experience, it’s really just a form of exercise where the point isn’t muscle fatigue but reminding yourself of the body’s wider range of motion when multiple muscles coordinate at once.
I’d be remiss if I didn’t mention two wildcards that might have helped me, though I can’t be sure: 1) the Colemak keyboard layout; and 2) acupuncture.
Colemak is an alternative keyboard layout intended to let a typist move her fingers less than the traditional Qwerty layout. I taught myself Colemak by practicing for a few hours, and then forcing myself to touch type with it exclusively, no matter how slow I was.
Progress was slow: it took me six months of using Colemak to get back up to a fast typing speed. I was a 90 wpm Qwerty typist, and I’m still only at 60 wpm with Colemak.
It does seem to reduce the distance that my fingers travel. Though I still use it for nearly all of my typing, I can’t really recommend such a drastic transition without clearer evidence that it made a difference to my pain. (Interesting side note: I seem to be unable to touch type on a keyboard in Qwerty anymore, but I can totally type on my phone screen in Qwerty with no problem!)
As for accupuncture, while 10 sessions of acupuncture did seem to give me some relief, it was also incredibly painful—I have been told by practitioners that the reputation for painlessness is a common misconception — and I doubt I’ll ever do it again.
As I wrote earlier, your mileage may vary. In fact, it will vary — and your greatest and most attentive investigator is yourself. No doctor will ever keep track of your patterns and responses and history with one quarter of the attention you can. Keep trying new things and record your results.
Ben Wheeler is an independent developer and teacher in Brooklyn.
Most of my tips originally came from my rich network of fellow users who help each other discover new things to try. You can help expand that network by pointing people you know to this, if you think they might find it relevant!