How to fix your RSI

Or, “It’s not Carpal Tunnel Syndrome”.

TL;DR

Remove all radial wrist deviation as a factor from your typing setup, by using a split keyboard (ideally, in two separate pieces). It will likely be a major, if not the main, contributing issue.

Why I know

When I first started work out of college, I worked in a data entry job and developed severe RSI within a matter of weeks. I had numbness and pain up through my forearms, all the way up to my shoulders. I could no longer play guitar outside of work, which was the only reason I was doing that job in that location in the first place.

I quit that job after 2 months and traveled through Eastern Europe for 6 weeks, but the issue was back at work waiting for me as soon as I started typing again. I struggled with it for some years until I took a step back and truly diagnosed and understood the cause of my isuse, so I could treat that rather than the symptoms.

I now type pain free - unless I inadvertently re-introduce any of the actual causes. Some of these may be unique to the individual, but I believe most of the below will still help you.

What it isn’t

One book I bought early on was It’s not Carpal Tunnel Syndrome!, which was useful for helping me understand that I hadn’t developed some pathological condition now requiring ‘treatment’ - especially of the surgical variety. However, from memory it still focused on how to treat the symptoms you had bafflingly found yourself with (work out these wrist muscles to become stronger, do these stretches and nerve glide exercises) rather than analyzing the noxious stimulus at source and removing it.

Of course, if the negative stimulus is simply typing, and your job requires typing, how can this be removed?

Your keyboard is forcing you to type wrong

We can’t remove typing from our lives. However, we can massively improve how we type.

You can get a more than useful-enough guide to general ergonomics and workplace setup from ChatGPT, which will also tell you to adopt a ‘neutral wrist position’. However, I am convinced that most people suffer from their wrists specifically being kinked in one specific plane of motion - where the wrist bends towards the thumb (called radial wrist deviation). This is the norm for most people whenever typing on either a laptop or regular keyboard:

With your arms by yours shoulders, your hands are square to the keyboard. However, as the hands move together to conform to the dimensions of these keyboards, the hands move diagonally inboard of the shoulders, and so the wrists must kink outward in order to square up your hands to the keyboard again.

Of course, the taller you are, the more extreme the resulting wrist angle, and therefore the more severely this impingement occurs and affects you. My wrists are therefore hugely kinked to allow me to achieve a square typing position on a regular keyboard. This requires continual tension in the forearm muscles to hold this unnatural position.

Once I realized this, I switched to a split keyboard and immediately relieved maybe 75% of my pain.

Other fixes

I also made several other adjustments, which I can roughly rank in terms of impact, and how they help, below:

Switching to a split keyboard: 70%

This removes most or all radial deviation, depending on size of split.

The other side of the coin in making such a switch is: don’t type on your laptop for extended periods of time! From now being in a pretty good spot with my RSI, I have some leeway whereby I can now type for a day or two on my laptop once in a while if needed, but will immediately feel the tension and tingling start creeping back in, which reminds me I should be switching back to my normal ergonomic desktop setup as soon as possible.

DVORAK typing layout: 20%

Changing your typing layout is the only part of my overall solution that is not a mechanical fix with immediate results. There is a high upfront cost in terms of re-training - I consider it massively worthwhile, having now typed using DVORAK for 15 or so years after a few months retraining, so it continues to pay dividends. However, you could just try one of the keyboards below and then analyze the impact to see if it is required for you.

The QWERTY layout was actually designed with no regard to typing ergonomics - rather it was designed to reduce the likelihood of jamming by spacing out commonly used letters so that their corresponding typebars wouldn’t collide.

This layout massively improves typing ergonomics. It allows for far more words to be typed from the home row and far less awkward usage and stretching of weaker fingers versus QWERTY.

The DVORAK layout specifically still has some flaws with respect to use of special characters for programming, so if in this realm you may also be interested in checking out alternative layouts like COLEMAK. However, I found DVORAK to be such a vast improvement that I’ve never felt the need to switch again since. Also, importantly DVORAK is a standard layout in the Windows/MacOS/Linux operating systems, so if you go to a more custom layout you might find yourself on a new computer suddenly unable to choose your regular layout!

For more information and a path to DVORAK, you can use A Basic Course in DVORAK which is how I made my switch some 15 years ago.

Switching to columnar layout keyboard: 5%

If your’e going to switch to a split keyboard, I don’t see any reason to not move to a columnar layout at the same time, given you’re signing up for a small readjustment period regardless.

Once again, the traditional staggered layout only exists as a vestigial tail of of when keys in typewriters had to be staggered to avoid jamming their individual typebars.

A columnar layout allows fingers to more efficently move in the natural plane of motion, whereby you move a finger directly up or down to hit a key on a different row, versus up and randomly stretching to the left or right as well.

Using mechanical keys: 5%

Mechanical keys have a longer travel than a chiclet-style laptop keyboard, and so the point at which the key is activated is further away from the bottom of the range of travel. This may help to prevent ‘bottoming out’ of keys versus the micro shocks inherent on typing on a laptop keyboard and hitting a hard stop on each keystroke.

In my case I think their impact was minimal (since I can bottom out on mechanical keyboard as well and so could still use a lighter touch). I also think if there was a fully-split chiclet-style keyboard, I think I would be quite happy using it.

However, such a combination doesn’t really exist, and so if you’re moving to a split keyboard, you’re likely moving to a mechanical one as well. Once you go this path, what is important is to understand and select (if a choice is available) is the key switch activation type. This determines how a key feels; some of the most common ones are:

• red: linear activation, smooth travel from top to bottom of stroke
• blue: makes an audible ‘click’ at the activation point of the stroke
• brown: has an noticeable activation point, but less audible than blues

Reds are generally used for gaming. Some people like them for typing, but as a non-gamer, every time I have bought a linear keyboard primarily for typing, I have regretted it. I recommend brown-style keys for most people, and usually they are the default in most commercially-available mechanical keyboards.

Bonus 10% (110%): type less, think more

I was reminded of my RSI 10 years after I thought it was gone for good after I switched careers and found myself programming as an intern for a year. This involved a lot of typing, deleting, and more typing, because I sucked at programming then.

The amount of typing, combined with lack of ergonomic setup (being in ‘war rooms’ hunched over the laptop) meant that my RSI came back with a vengeance.

As I got better at programming, the issue arising purely from typing volume resolved itself, but it was also helped by me making better use of available tools. This would be a different article, but suffice it to say here that you should make sure you are minimizing all possible typing of ‘boilerplate’ code in your chosen development environment - use syntax plugins to avoid every redundant keystroke you can. VIM also helps here, but definitely another article…

Summary

Again, ChatGPT can summarize each of the titled improvements further if you’re interested in pursuing any individually. But most importantly, all of these fixes besides learning DVORAK are mechanical solutions and thus all immediately implementable by choosing a better keyboard. So for an 80/20 solution, buying a split keyboard is the first thing I recommend.