
Ask HN: Avoiding carpal tunnel / repetitive stress injuries - wensing
I'm 26 and have been hitting keys since I was 6 or 7.  For the first time in 20 years I now have a burning pain in my right hand and wrist.  I think it has a lot to do with my mouse.  I've switched to an ergonomic keyboard, and have also begun using a keyboard tray, placing it low enough so that my shoulders are relaxed when I work.  But the pain persists.  MacSpeech Dictate has pretty sweet accuracy and can replace typing for IM conversations and email, but I still have to type to code.<p>What are any of you doing to prevent such injuries?  Do you think about the possibility?  I have a feeling it could end up being something of an 'unexpected' pandemic (three co-workers of similar age have also begun to see their first symptoms).
======
iamelgringo
Get religion about ergonomics. I've spend close to $1k on my workstation's
ergonomics at home (decent desk, chair, keyboard, tried a bunch of different
mice, adjustible monitor arms, etc...) I probably need to invest another
$500-1000 just to get it tuned even further. A small price to pay, to not have
to quit coding.

Is the pain in your R hand on your wrist (palmar side?) or is it in the back
of your hand? It' makes a difference. A doctor can help you sort things out.
All the tendons and nerves that control your hand flow through a narrow band
in your wrist. If you rest your arm's weight on your wrist for extended
periods of time (i.e. mousing on your R hand), you can put pressure on that
bundle of nerves and tendons. Do it too long, and you can end up like a friend
did and not be able to button a shirt for 4 months.

So, may I suggest a trackball, trackpad or vertical mouse. I actually have a
track ball and a mouse connected to my computer, and I switch back and forth
between them every so often. I'm probably going to purchase a vertical mouse
soon, because my wrist is aching a little bit.

~~~
pohart
before spending $1000, adjust your chair, keyboard, and mouse so that your
posture is good, your shoulders are relaxed and your wrists are in a neutral
position. You may not be able to do this with a standard keyboard, but a split
keyboard is less than $100. if your chair doesn't adjust, get one that does. I
personally like a chair that doesn't have armrests, as they sometimes cause me
to raise my shoulders or contort my wrists, and I am comfortable resting my
arms on my body/legs/

------
tortilla
1) Get a mouse that's flexible enough to use with either your left or right
hand. It might feel weird at first, but switching sides every hour will reduce
a lot the pain. Takes a bit to get used to but you'll eventually adjust.

2) Try to use the keyboard as much as possible for everything. Go into your
Keyboard & Mouse settings and enable full keyboard access (or ^fn F7 to toggle
on/off)

3) Use either Firefox/Camino for you main browsing because you can enable
"find as you type" which you can use to navigate the links on a web page.

4) Take regular/breaks. I use <http://tech.inhelsinki.nl/antirsi/> to remind
me at set intervals.

5) Exercise regularly (running, walking, golf, something to get you away from
you computer).

6) Meditate, relax, listen to music. Whenever I feel like I'm tired or
overstressed, I listen to this for about 20 minutes. I'll feel refreshed and
much more focused. <http://www.pzizz.com/> (Energizer track)

------
Stabback
I just went to a physiotherapist about this very issue, here's what I was
told.

First, I've been experiencing a dull pain shooting up the BACKS of my hands to
my wrists, following the middle finger. This may or may not be what you have,
and I recommend looking into this yourself. It cost me 80 CAD to visit a
physiotherapist and it was worth every penny. If you are going to be typing
for the next 5, 10 years or longer (here's hoping we get a better input
system...) I urge you to visit at the first bit of pain.

Onto the diagnoses. A primer on the human body: the nerves and blood vessels
that get to your hands come from your spinal cord. To get there they must pass
under the collarbone and above the first rib. My problem is that I have a
slight posture problem (no one has ever noticed it) where my shoulders slouch
forward a bit. This is very common for people that use the computer a lot, and
it was compounded by my height (6'3''). As I am a tall person, I slouch while
talking to people, inspecting things, pretty much whenever I do anything in a
world built for the average sized guy.

This posture problem results in a small constricting of the space between the
collarbone and the first rib - putting pressure on the blood vessels and
nerves going through there. This causes extra strain whenever you pull on
these items (which you do while moving the fingers). To make matters worse I
do not do a lot of upper body exercise. I run 3k a day and bike about an hour
and a half, but none of these tasks work my back muscles. While typing for
extended periods of time these muscles recognize they are not needed and 'shut
off' to conserve energy. If they were used more they would not be shut off as
quick. When they are shut off the shoulders slouch more.

I was recommended a series of stretches to help the constricting of the blood
vessels and nerves. I was also recommended to start swimming regularly to
build muscle. I have also started using the program "instant boss" (quick and
dirty program) to have a 10 and 2 schedule - 10 minutes on and 2 off. I follow
it religiously.

I'd define the stretches but my hands are hurting a bit and I need to stop
typing. I do recommend seeing a physiotherapist yourself though to get
customized stretches that fit your body type. Take breaks, really read up on
ergonomics.

Hope this helps.

------
andrewf
See a medical professional! That said, anecdotal not-medical-advice:

I had mousing-related pain, and I fixed it by mousing left handed. The first
couple of days were incredibly frustrating, but after a week I had probably
80% of my right handed dexterity.

To prevent the same issue from building up in my left hand, I started
alternating between left handed and right handed mousing every couple of
weeks.

I guess the worst case outcome here is severe damage to _both hands_ , so
proceed with caution.

------
delackner
Exercise.

You will probably ignore that, so let me say it differently.

Every day, at least 15 minutes, cycle, run, I don't care. Move.

Every week at least once, do something (I like Climbing) that gets your whole
body, but especially your ARMS dead tired.

You don't need any kind of special keyboard layout, just something with good
key response. It is far more important what you are doing with your body when
you aren't sitting.

------
timcederman
Exact same age and symptoms as me - 3M ergonomic mouse fixed it right up.
[http://www.google.com/url?sa=t&ct=res&cd=3&url=h...](http://www.google.com/url?sa=t&ct=res&cd=3&url=http%3A%2F%2Fwww.amazon.com%2F3M-EM500GPL-
Ergonomic-Mouse-
EM500GPLLARGE%2Fdp%2FB00008KWWF&ei=rjZfSIHeOoGEsQOn4pSEDA&usg=AFQjCNHxC7P7xoek3ZXYrGipseW7QaX9uA&sig2=KttDcIGyE5l6TAdrSWoecQ)

Also using my left hand for touchpads and wearing a brace helped get through
the worst of it.

~~~
jcl
Seconded. I was doing 3D work, which involves a lot of mousing. The 3M
joystick-style mouse greatly increased the amount of time I could comfortably
work. The middle mouse button gummed up on me after about two years... I
couldn't figure out how to clean it out, so I just replaced it with the same
model.

I also recommend learning the keyboard shortcuts for whatever environment you
work in, to minimize switching between mouse and keyboard. If you find
yourself doing a lot of text cursor movement with the arrow keys or mouse, you
might want to try vim for a month or two. (I tried emacs, but found it
ergonomically uncomfortable, although I did not remap the keys from their
default positions, which I understand other people do. I have not heard any
statistics on the matter, but it would not surprise me to learn that emacs
users are more prone to RSI than vim users.)

Try to work in an environment that is not too cold (or wear fingerless
gloves). I found the cold made my joints uncomfortable and was bad for
circulation.

Also, install Workrave (or equivalent for your platform) in the most obnoxious
configuration you can stand. Even though my wrists are pretty good now, I
still keep it on in quiet mode in the corner of my screen, to help me keep
track of my breaks.

------
elai
For me, I was starting to get wrist pain with my mousing. I purchased 12
different mice, tried them all out, keeping note of how I felt in my hand. I
eventually found out that really large mice is what work for me. The M$
intellimouse explorer specifically. The MX revolution, and all the other fancy
mice weren't as good as the huge honking intellimouse explorer. The huge
thumball mice were also good, but I didn't have the patience to learn them.

~~~
wensing
This is really interesting, because right now I use a very small wireless
travel mouse.

Actually, I've ditched it and have begun mousing with my feet:
<http://www.bilila.com/foot_mouse_slipper_mouse>

From 2000-2006 I used the MS Intellimouse. I should have stuck with it.
Perhaps now if I must use a traditional mouse again I'll purchase another.
Great tip.

~~~
pohart
small mice always cause me problems

------
Prrometheus
Good thread from 6 months ago:

<http://news.ycombinator.com/item?id=104977>

Some of the tips given there took my pain away.

In particular, the Microsoft Ergonomic Keyboards with negative key pitch are
awesome, as are ergonomic mouse pads.

------
smanek
There was a thread a few years back on comp.lang.lisp about this very topic.

Peter Seibel (of 'Practical Common Lisp' fame) replied:

"Okay, here's how I do it. Of course I tend to overdo things--how do you think
I dorked up my wrists in the first place so I can't say this is necessarily
recommended practice:

a. Fill one pitcher with cold water and a tray or two of ice cubes, leaving
room for you to immerse you hand and wrist without overflowing.

b. Fill another pitcher with scalding hot water, again leaving room for as
much of your hand and wrist will fit into pitcher without bending your wrist
at some weird angle.

c. Stick affected hand in ice water. Scream in agony until the numbing takes
the edge off. Leave in for 1-4 minutes.

d. Move affected hand to hot water. If you timed it just right the water has
cooled just enough that you avoid parboiling your hand. Leave in for 1 minute.
Move your fingers around some.

e. Go to c until you get bored or the water in both pitchers has gone tepid.

I also periodically freshen up the hot water by filling a mug from the hot-
water pitcher and microwaving it for a minute while I'm soaking in the cold
water and then putting it back in the hot pitcher when I'm ready to switch.
But I'm pretty weird.

-Peter"

Or you could just get a reasonable keyboard. I've been lusting after a Kinesis
Contour for some time now ...

------
adrianwaj
My solution was to place a standard building sized block of wood measured to
the length of my standard keyboard under the keyboard so the nearest edge of
the keyboard sits up on the block, and the furthest edge of the keyboard sits
on the table as usual. This way, the wrists can rest on the flat upside
section of the wood with the fingers then drooping over onto the angulated
keyboard. It's meant to simulate how your arms and wrists feel when you hang
them down freely - no flexion of the wrists up or down, and relaxed.

Similarly, place a thick book near your mouse for your wrist to wrest upon,
leaving your palm to drop onto the mouse which slides on the pad that sits on
table. For me, smaller mice are better that can be moved with just the fingers
and highly sensitized.

This solved the RSI in my forearms.

Note: The wood block must be the correct size so that the keyboard slants
neither too high nor too low, and that the forearms do not touch.

I use: '2x4 (pronounced "two by four"), but few people realize that the actual
height and width of a 2x4 is really somewhere close to 1 1/2" x 3 1/2"'
<http://woodworking.about.com/od/typesofwood/p/WoodSizing.htm>

------
gcv
The following three things helped me tremendously.

(1) Stop using an external mouse. Right now. The sideways flick your wrist
does when you reach for it is murderous. Most laptops' integrated pointing
devices will help a lot. The Apple trackpad is great. IBM (Lenovo) trackpoints
work well too. Switch up hands you use for the pointing device.

I lucked out on this one: the last desktop computer I ever owned died just as
my RSI symptoms peaked. I then didn't regularly use a computer for around
three months, which let the symptoms subside. I've owned a laptop as a primary
machine ever since (eight years now), and have had very few recurring
symptoms.

(2) Exercise. This is huge topic, obviously, but in particular, core strength
development will help your body in surprising ways. Very specifically, use
light (<20 lb or <10 kg) dumbbells and do regular and reverse wrist curls.
Obviously go easy on these at first.

(3) Keep your wrists straight when you type. Easier said than done, of course,
but good posture and a good chair will help out here.

------
slackerIII
Things I've done:

    
    
      -switched the mouse to my left hand 
      -installed WorkRave, actually did what it said
      -switched the caps-lock and ctrl key
      -switched to dvorak
      -use the ergo microsoft keyboard
      -avoid laptops
      -learned to sit up straight and not cross my legs
      -stopped using the mouse scroll wheel
    

These days I'm trying to pay attention to my keystrokes. For example, using
the right shift to make (){} results in some stressful twisting, so I'm trying
to cut that out.

If you spend a lot of time coding, try to spend more time with a pencil and
paper designing before you hit the keyboard. That gives you a good break and
reduces the amount of typing and deleting you'll do.

~~~
palish
By the way, sitting up straight is actually worse for your back than leaning
back comfortably. <http://news.ycombinator.com/item?id=185187>

~~~
slackerIII
Dang.

You're right though, this is much more comfortable :)

------
DenisM
1\. Ergonomoc evaluation by a specialist to set up your desk, monitor etc. Ask
your employer, they should provide it.

2\. Inquire about work-place injury laws in your state. Your employer will
likely have to pay the expenses.

3\. Record all expenses no matter who pays for them. If you become disabled
reciepts may help to make employer shoulder part of the weight.

4\. Physical therapy. It's important to continue excersizing until, well,
forever.

5\. If mouse is source of your problems try using two mouses alternating left
and right hands. You'll get used to it.

6\. Carpal tunnel and RSI are two very different things. It's important to see
specialist to tell one form the other. Carpal tunnel is actually quite rare,
but consequences are severe.

------
rtf
Things that have worked for me:

-Stop using a mouse. Use a trackball or a trackpad or anything else. I have a death grip on mice and I bet others do too.

-If you have to use a mouse switch your mousing hand. Deal with the fumbling and inaccuracy. You'll figure it out.

-Lean farr back in your chair(legs propped up) and rest your keyboard in your lap. Shift position occasionally.

-Move your monitor so that you look in different directions. Laptops are great for this and that compensates for their other ergonomic problems. You can usually find a way to move them higher or lower and correspondingly shift the strain.

------
eyudkowsky
Dvorak solved this for me permanently.

~~~
dshah
How did Dvorak solve this for you? And, how was it permanent?

~~~
Hexstream
The difference between Dvorak and Qwerty, in a nutshell, is that Dvorak was
designed scientifically while Qwerty was designed in a mostly arbitrary way to
avoid jamming in the early designs of typewriters.

Dvorak optimizes alternating hands (ever felt dumb typing "street" or "states"
in Qwerty?), useful keys on the home row (aoeuidhtns VS asdfghjkl;), typing
inwards (try tapping your fingers in rapid succession inwards on your desk.
Now try outwards or in a random order...) and typing with the strong fingers
(The farther from the pinky the better) and the right hand (usually the
strongest one), among other things.

Those features reduce stress injury because they result in less finger
movement and more natural dynamics.

~~~
Tichy
However, I think Dvorak actually puts some fingers to even more use than
QWERTY? I had pain in my index finger, and it seemed to me with DVORAK I would
use it even more, as the most common keys would be put on the index finger. I
haven't actually tried Dvorak, though, only looked into it.

------
dreish
<http://www.jwz.org/gruntle/wrists.html>

Step one is to see a doctor about it. Or as jwz puts it, "Do not fuck around.
If you are experiencing any kind of pain, get to a doctor and get it
diagnosed." Your hands are your livelihood and you do not want to be cavalier
about this. Nobody here is qualified to diagnose you from across the Internet.
Quoting jwz again, "... think what your life is going to be like if you can't
type at all. I have friends this has happened to. You seriously do not want to
go there."

Mice with high click resistance have caused me the most tendon pain in my
right hand. They seem to be getting much worse in recent years -- I had to
replace one recently that took a feather-light touch, and I haven't found
anything that comes close. The best one I've been able to find unfortunately
doesn't have all the features I would like, but hands that aren't crippled are
more important than features:

[http://www.amazon.com/Logitech-MX518-Gaming-Optical-
Mouse/dp...](http://www.amazon.com/Logitech-MX518-Gaming-Optical-
Mouse/dp/B0007Z1M50/ref=sr_1_45?ie=UTF8&s=electronics&qid=1214240266&sr=1-45)

------
yummyfajitas
First thing: figure out where your problem is. Next time you feel pain, try to
determine exactly where it is. Also useful when you talk to a doctor about it.

Then find a map of the nerves in your hand (Grey's Anatomy has one). Find the
joints that that nerve goes through, probably one of those is squeezing it.
Adjust your position/workspace to avoid stressing that particular nerve.

------
Tichy
Yoga (in a workout variant) seems to help the most. A lot of exercises stretch
the wrists.

Also, I had a cyst in my index finger and had to get surgery to remove it. The
doctor almost didn't discover it, because he wasn't sure if the "common RSI"
symptoms would even warrant taking an x-ray. Luckily he decided for it.

------
talkaboutadate
This won't help with the current symptoms you have, but when you've recovered:

The best thing you can do is to switch hands frequently through the day. The
second best thing you can do is work out in the gym regularly. This will
strengthen your fingers, wrists and arms.

------
JFred
I've had it, and it did get better slowly. It cost me many thousands of
dollars of lost work. The doctors are pretty useless in many cases.

0\. Proper sleep, exercise and nutrition are important.

1\. Hit the keyboard more gently.

2\. If you're a wide person, like me, your elbows are out to the sides and
your hands come in from the sides. So get a split keyboard like the Microsoft
Natural. There are plenty of other keyboards that are split and "Ergonomic".

3\. I had to drop Emacs, as it overused the ^X and meta-x keys. I mapped them
to Function keys but that wasn't enough.

4\. Not all RSI is carpal tunnel. There are even other tunnels. The thing
about tunnels is that both a nerve and a tendon will go through the same
tunnel in bone. When the tendon inflames it enlarges and squeezes the nerve
against the bone. Misery ensues. You're body has lots of tunnels. There's even
a pair in the head.

5\. The best voice software is or was from a company from "Dragon Systems".
The business history of this company is fascinating. Their "Naturally
Speaking" product might still be the best.

6\. Find and talk to some people in your state who have been on Disability. In
some states, your Disability claims get paid by the last company you worked
for. This results in you being blackballed by the business community. The
companies seem to share information on employees and this might be legal.
That's what those industry organizations are for, among other things. People
who go on Disability are likely to sue. They don't want that. In the US, it
varies from State to State. Get local information.

7\. In some times and places, Disability is a big con and the bureaucracy has
learned to treat all claimants as crooks; you are guilty until proven
innocent. This is an important psychological injury and leads to trouble.

8\. RSI can cause people to hate their jobs, and hate computers, they become
the enemy. Work attitude suffers. Some management knows this and will head of
trouble by getting rid of injured employees at the first excuse.

9\. Get three different styles of keyboard and two or three mice. You an
actually plug them all in at the same time if they're all USB.

10\. See a hand specialist and an orthopedist. There is also a chance that
what you really have is some outlier; like cancer of the bone in the hands, or
something weird. Nerve damage can also be caused by bone weakness or
osteoporosis. Have it all checked.

11\. Docs tend to look at bilateral problems (both hands) differently. The
trouble might be in the common parts, the spinal cord or the brain. This could
be good news if they're right, as some mental problems and neurological
conditions are easier to treat than soft tissue injuries.

12\. Physical therapy can be very annoying but also be very, very useful. Do
whatever they say as if it is God Himself commanding you from the Mountain. Do
it every day, if they say so.

13\. Going Dvorak means a new keyboard for both home and work. Give up game-
playing and some web surfing. TV is also bad for you. You need basic exercise,
walk or run. No handball, racquetball, tennis, ping-pong, hammering. Make sure
you have an electric screwdriver or don't do that at all. I found that
swimming stressed my hands.

14\. If you take as many breaks as the RSI experts say, your whole level of
intensity will go down. I don't even know if it's possible to relax your body
as you work your mind unless your a Zen master, or something.

15\. If you research the subject, you can terrify yourself and be paralyzed
with anxiety. If you research RSD/RSI together, you'll leave work and become a
monk out on a mountaintop, and starve to death. Okay, I'm exaggerating, here.

16\. Proper sleep, exercise and nutrition are STILL important.

17\. You might checkout <http://www.rsirescue.com/>, I haven't looked that
stuff for years...

18\. The only way to sit up straight is to raise the monitor screens. If you
raise them too high, you'll be looking up, which is just as bad.

19\. The most expensive chairs, keyboards, and so on are worth it,
financially, if they work. Lost work is more expensive than any of those.

20\. In some states, employers have to assume that if you were out of work for
a while, you must have been in prison. This is because prison records get
sealed after a few years so that ex-prisoners can get jobs and rehabilitate.
So if you've been out of work a few years ago and don't have a prison record,
you look just like somebody who actually was in prison.

~~~
jcl
_4\. Not all RSI is carpal tunnel._

It's funny, but the RSI book a friend recommended to me is titled "It's Not
Carpal Tunnel Syndrome!":

[http://www.amazon.com/Carpal-Syndrome-Therapy-Computer-
Profe...](http://www.amazon.com/Carpal-Syndrome-Therapy-Computer-
Professionals/dp/0965510999/ref=pd_bbs_sr_3?ie=UTF8&s=books&qid=1214239287&sr=1-3)

Contrary to the title, the book doesn't rule out the possibility of carpal
tunnel, but it correctly points out that carpal tunnel only applies to a small
set of RSI-related symptoms. I found the book helpful.

------
sb
hi there,

i am 27, and just have had the worst tendonitis ever. adding to the already
brought up advices, my doctor provided the following important insight: if
your blood contains too high values for uric acid, or you are a candidate for
urarthritis, then you also might take some concern for minimizing purines in
your diet. so in the long run, you should be interested in keeping your uric
acid values low.

ps: usual stuff here too: kensington expert mouse trackball, kinesis freestyle
keyboard, xwrits, cycling, using stairs, checking posture, etc. -- switching
to dvorak soon...

------
quellhorst
I switched to dvorak, got an Aeron chair and Humanscale KB tray when my hand
started to show signs of RSI... 3 years later I haven't had any more symptoms
of RSI.

------
DenisM
Mind telling us which machines do you and your friends use? Are those MacBook
Pro's by chance? I starteted having quite a bit of problems soon after buying
one.

~~~
wensing
It's a 50/50 split between typical Win PC's, and yes, MacBook Pros. I use a
MacBook Pro. Perhaps there is a correlation.

------
nunb
One thing cured my RSI carpal tunnel problems: the dyna-flex ball. You can
find it in sports shops and sometimes golf or tennis pro shops.

Edit: found a mention of dyno-flex ball above. This thing is awesome! Plus the
usual things of course. I recently bought a Dvorak keyboard but haven't yet
started using it. I always use a trackball (Logitech thumb-trackball, the only
REAL trackball on the market). Joystick mouse sounds about right too.

------
rtra
What I did, after my 2 years away from computers. It sucked, but I was in real
pain.

\- Switched to a big logitech trackball, which I use with my left hand \-
Negative tilt splitted keyboard (microsoft natural 4000, I higly recommend it)
\- setup my chair/screen height \- Xmonad (proper window _manager_ ) \-
minimize GUI usage.

I've been doing ok. I even started drumming (hard!)

------
keefe
I have had the beginnings of that unpleasant tingling at 27, and I make a
conscious effort to keep my wrists straight. After a few years, it didn't even
feel like an effort. Remember, it's compressing this little tunnel through
which a nerve runs that is the problem - that doesn't HAVE to happen while you
type.

------
axod
"hitting keys"

Stop hitting them then. Only use a laptop, and touch them lightly. Don't use a
mouse, use a trackpad.

------
wensing
Thanks everyone--some really awesome, useful advice. I really appreciate it!

------
gtani
see keyboard review threads:

<http://news.ycombinator.com/item?id=185743>

<http://developerlife.com/reviews/?p=46>

<http://news.ycombinator.com/item?id=221434>

<http://news.ycombinator.com/item?id=199493>

<http://news.ycombinator.com/item?id=104977>

That's about 3 days' reading material: some bullets as i dimly remember:

1\. laptop keyboards: avoid, especially for emacs/textmate control/alt/command
key combo's. These 2-key to 4-key combo's are hell on your wrists if you
always have to do them on the left side. If you do COntrol_C and X and V to
cut/past in windows, same deal. I think it helps to use both short-travel
scissors mechanism keyboards, like the new aluminum mac KB's and older-style
long-travel sprung keyboards taht logitech , Matias and kensington make. I
especially like the Matias' feel.

2\. hourly breaks and wrist exercises: wrist curls, reverse wrist curls, the
Dyno-flex ball , powerWeb exercises. The latter is expanding your semi-closed
fingers out against resistance, which is one that I rarely read about, but
it's important.

<http://www.fitter1.com/Catalog/Category/35/HandWrist.aspx>
[http://www.amazon.com/Roller-Strength-Gripper-Forearm-
Stainl...](http://www.amazon.com/Roller-Strength-Gripper-Forearm-
Stainless/dp/B00192N172/)

3\. always have your elbows and heels of hand supported weight-wise when
mousing and keyboarding (kinda like Formula 1 designers trying to minimize
unsprung weight). Try to mouse with undominant hand (I'm not too good at this)

4\. consider other factors: cocking your wrists when you drive or ride a bike
or work power tools, shovel snow, brush your teeth, sleeping on your side. The
combination of weight-bearing, pressure/shock/vibration and closing off the
outside or inside of wrist joint is insidious .

5\. Aside: i think JFred has enough material for a book. all my upmod points
to him/her!

