be kind to your wrists (you’ll miss them when they’re gone)

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Be Kind To Your Wrists (you'll miss them when they're gone) Denise Paolucci Dreamwidth Studios [email protected] Tuesday, June 4, 13

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A brief introduction to lowering RSI risk and treating RSI symptoms for programmers, sysadmins, and other people who type too much.

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Page 1: Be Kind To Your Wrists (you’ll miss them when they’re gone)

Be Kind To Your Wrists(you'll miss them when they're gone)

Denise PaolucciDreamwidth Studios

[email protected], June 4, 13

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Slides downloadable at end of talk

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DISCLAIMERS

• I am not a doctor

• Or a physical therapist

• If you're having symptoms, GO TO A DOCTOR

• Cape does not enable wearer to fly

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Show of hands:

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A cautionary tale

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Age 10

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Age 16

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Age 19

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age 22 :(

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• Carpal Tunnel Syndrome

• Medial epicondylitis ("golfer's elbow")

• Lateral epicondylitis ("tennis elbow")

• Radial Tunnel Syndrome

• Ulnar nerve entrapment (Cubital Tunnel Syndrome)

• Thoracic Outlet Syndrome

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Carpal Tunnel Syndrome

• Compression of the median nerve

• Numbness/tingling in thumb, index, middle fingers

• Waking up with entirely numb hands

• Poor fist grip strength

• Pain: possible, but not a key indicator

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Radial Tunnel Syndrome

• Compression of the radial nerve

• Pain in top side of upper forearm

• Very similar to "tennis elbow", but nerve-based, not tendon-based

• Muscle weakness in back of wrist/forearm

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Cubital Tunnel Syndrome

• Compression of the ulnar nerve

• Numbness/tingling in pinky and ring finger

• Ulnar compression starts at elbow

• Can manifest as pain in forearms

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Lateral Epicondylitis

• aka "Tennis elbow"

• Tendon-based, not nerve-based

• Pain in elbow and back of forearm

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Medial Epicondylitis

• aka "golfer's elbow"

• Tendon-based, not nerve-based

• Pain in underside of forearm, especially with resistance

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This isn't an exhaustive list of either RSIs or

symptoms

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Ergonomics"scientific study of the efficiency of people in the

workplace," coined from Greek ergon, "work" + second element of economics.

(http://www.etymonline.com)

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Kinesiologyfrom kinesi-, combined form of Greek kinesis

"movement, motion" + -ology.(http://www.etymonline.com)

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Rapid TreatmentGO TO THE DOCTOR.

I MEAN IT.

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ErgonomicsAdapt your environment to your body, not your body

to the environment.

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Every body is different.Listen to your body and to the feedback it's giving you

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(image credit: http://www.abates.org)Tuesday, June 4, 13

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• Top of monitor at height of eyes

• Keyboard height at or slightly below elbow height

Two most important rules:

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Ulnar deviation

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Radial deviation

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Dorsiflexion

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If you take one thing home from this talk,

make it this:

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THROW OUTYOUR WRIST REST

(they encourage awful habits)

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Hands floating, wrists neutral,in line with shoulders

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Obviously impossible with a standard keyboard, but get as close as you can. Or:

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Input devices

• Same principles

• Neutral position

• Vary your motions

• Minimize elbow and forearm motions

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KinesiologyAdapt your motions and condition your body

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StretchesAt least 2 minutes, every 15-20 minutes. Yes. I mean it. Even if you're deep in hack mode. Especially if you're

deep in hack mode.

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Inner wrist stretch

• Interlace fingers

• Turn palms out

• Extend arms to push palms away from you

• Hold 10-15 seconds

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Overhead stretch

• From previous stretch, reach upward

• Palms "pushing" against ceiling, shoulders pulled back

• Stretch should be in shoulders, not biceps

• Hold 10-15 seconds

• (stop if your hands go numb)

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Shoulderblades stretch

• Hold hands flat

• Extend hands all the way out, at your sides

• Rotate arms in small circles, keeping shoulders back

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Cross-body arm stretch

• Hold out one arm

• Hook other arm around it and pull first arm across your body

• Leave your wrists relaxed!

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Enforcing Stretch Breaks

• Workrave (Linux, Windows): www.workrave.org

• TimeOut (Mac): http://www.dejal.com/timeout/

• Firefox: "Take a Break"; Chrome: "Break Helper", "Gimme a Break"

• Trusted friends or significant other :)

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If it hurts: STOP TYPING

You do not get prizes for being stoic!

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What if you're already showing symptoms?

(You know I'm going to say it: GO TO THE DOCTOR.But there are a few other things, too.)

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Sleep in wrist braces

• You do more damage to your wrists overnight than you think

• Metal insert removable so you can wash them

• (You'll really want to wash them.)

• But don't use them to keep typing through the pain or numbness

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Ice• Eight gazillion brands of

reusable ice packs; gel style is most adaptable

• In a pinch: ice cubes in a ziplock bag!

• 20 minutes at a time, three to four times a day

• Keep more than one in freezer so you always have one cold

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Regular massage

• Look for sports massage or neuromuscular massage therapists

• Make sure your therapist is accredited and experienced with RSI treatment

• American Massage Therapists Association: http://www.amtamassage.org/findamassage/

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All together, now:

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GO TO THE DOCTOR

• Not your GP: see an orthopedist who specializes in RSI treatment

• There are other options than surgery -- sometimes rest alone will work!

• Each case is different and sometimes there is no surgical treatment

• Surgery is not the end of the world, though

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Q&A (or grab me later)Slides available at:

http://www.slideshare.net/dreamwidth/be-kind-to-your-handsor

http://tinyurl.com/k8tys82

Tuesday, June 4, 13