
We have an epidemic of bad posture - pieterhg
https://levels.io/rsi
======
jholloway7
Lifting weights can help, but it can also cause more harm when your routine
isn't properly balanced. Doing only bench press and military press lifts for
upper body is going to be a chest/tricep push heavy routine.

If you're not balancing these pushes with pulls (chinups, pullups, rows, etc),
it can promote issues like rolled shoulders, forward neck, weak traps, weak
rhomboids or similar postural issues to those the author is trying to avoid in
the first place. In fact, many lifters will add more pulls than pushes,
because our day-to-day activities tend to be more push-oriented.

The point is, if you're going to lift, pick a beginner's routine designed by
someone who knows what they're doing that has push/pull balance programmed in
from the outset. Don't just pick a couple lifts that you enjoy and throw out
the rest.

~~~
jdpage
Do you have any specific beginner's routines you'd recommend? I was doing 5x5,
which has pulls in the form of barbell rows and deadlifts; I don't know if
that's sufficient.

~~~
Floegipoky
Always put technique first. Start with the basic compound lifts. These
represent idealized human movement. Use light loads while you learn what
proper technique feels like.

Deadlift- Be careful not to overdo this, especially when you're starting out

Squat- Overhead squat is probably the best variation to master, but goblet
squat is probably the easiest

Press

Bench Press

Dip

Pullup

Bent-over Row

You should also challenge your cardiovascular system in some way, preferably
one that physically moves your body through space.

In addition, I feel strongly that recreational lifters should always emphasize
mechanical alignment and efficiency over force production. So set aside the
time to address any movement restrictions, prioritizing those that interfere
with your ability to perform the above movements. For instance, if you have 0
degrees of internal rotation at the hip, you aren't going to be able to squat
correctly.

~~~
cholantesh
I agree. Spend a month or two (or more if you have severe mechanical
restrictions) familiarizing yourself with the proper form for the major
barbell lifts, and then put yourself through a beginner program such as
Starting Strength [1] , accompanied with good nutrition[2] and HIIT to keep
bodyfat in check.

On a side note, it's interesting to me that you singled out the deadlift, as I
found the (back) squat the most challenging lift to master.

[1] - SS prescribes power cleans; I think most people will get more desirable
results from rows

[2] - this varies significantly from person to person, and is probably the
biggest challenge, as it's a huge inner game

~~~
Floegipoky
> On a side note, it's interesting to me that you singled out the deadlift, as
> I found the (back) squat the most challenging lift to master.

I totally agree with you, I feel that the goblet squat, front squat, and
eventually the overhead squat are much better for beginners because they
emphasize good movement mechanics in a way that the back squat allows you to
cheat on (until you end up at the chiropractor).

The reason I put deadlifts first on the list is that I truly believe it to be
the most important lift to master- particularly for those who spend most of
their time in globally flexed positions while sitting on the primary movers of
the posterior chain. Plus, you can't deadlift and not develop bracing
technique, which is IMO the most important thing a beginner can learn.

~~~
cholantesh
I don't think I agree about the OHS; I think it's a move that is better suited
to aspiring Olympic lifters due to its complexity and application to the
snatch, but I'll leave that argument to the Contrerases of the world.

Very much with you on bracing and its essence in deadlifting, though.

------
henrik_w
I had pretty bad RSI some years ago, to the point where I thought I wouldn't
be able to program anymore. However, I got through it, and I don't have any
pains today.

The key thing for me was starting to use a break program on my computer. Every
5 minutes I take a 10 seconds micro-break (let go of the mouse and keyboard).
Every 45 minutes I take a 5 minute stretching break, and do 3 or 4 stretches.

That, together with a split keyboard (Goldtouch) and a pen-shaped mouse called
Penclic. Both those are great for me. Almost all regular keyboards are
terrible from an ergonomic standpoint (especially Apple's), not to mention
laptop keyboards.

More details here: [https://henrikwarne.com/2012/02/18/how-i-beat-
rsi/](https://henrikwarne.com/2012/02/18/how-i-beat-rsi/)

~~~
peteretep
Forced break programs saved my wrists. I use AntiRSI on the Mac and WorkRave
on anything else.

Rocking a GoldTouch split foldable keyboard, Apple Trackpad, and the Roost
that levels mentioned in his post

------
venning
RSI stands for "repetitive strain injury":
[https://en.wikipedia.org/wiki/Repetitive_strain_injury](https://en.wikipedia.org/wiki/Repetitive_strain_injury)

 _(for those of us who didn 't just know this)_

------
freshfey
The article is a great starting point, but exercise in itself is not enough.

If you've worked for multiple years in a (seated) office setting, chances are
you have tight muscles. Muscle tissue then gets glued together and stuff like
forward rolled shoulders happens.

Now you go to a physical therapist with your neck or shoulder pain and he/she
recommends you physical therapy. The problem is just, the area is too tight to
react to the right kind of stimulus, so the trick is to first massage the area
and then fix it with the right exercises.

Simple tools like a lacrosse ball (5 bucks) or a foam roller (10-20ish bucks)
can work wonders IF used regularly and in the right fashion.

I've written about one part the issue here, called "text neck"
[https://bitehype.com/text-neck/](https://bitehype.com/text-neck/) \- I've
also compiled some of these lessons into a free email course, where I dive
into the topic a bit deeper: [https://www.dailybitsof.com/courses/fix-your-
posture](https://www.dailybitsof.com/courses/fix-your-posture)

I hope that helps - open to any questions in that area (my expertise comes
from years of injury/self experimentation, bunch of interviews with doctors,
physical therapists and massage therapists as well as visits to sports
clinics. Oh and of course interest).

~~~
trhway
>If you've worked for multiple years in a (seated) office setting

and an year ago, after more than 2 decades (not counting university and
before) of sitting i started to work standing. Wonderful. Besides posture and
better breathing position, gone away some issues that started to appear during
recent years due to bad circulation when sitting.

------
Animats
This is a consequence of laptop usage. You should have your screen at eye
height, sit in a chair with arms, and have wrist support. Before laptops took
over, there was a lot of concern about keyboard ergonomics. That seems to have
disappeared. You can't even get the Microsoft Natural Keyboard any more.

~~~
vmarsy
>You can't even get the Microsoft Natural Keyboard any more.

Wow, are they Out of stock temporarily or permanently?

[https://www.microsoftstore.com/store/msusa/en_US/pdp/Natural...](https://www.microsoftstore.com/store/msusa/en_US/pdp/Natural-
Ergonomic-Keyboard-4000-for-Business/productID.278184200)

EDIT: They still offer plenty of Ergonomic keyboards, but only wireless one it
seems. (For instance:
[https://www.microsoftstore.com/store/msusa/en_US/pdp/Wireles...](https://www.microsoftstore.com/store/msusa/en_US/pdp/Wireless-
Comfort-Desktop-5050/productID.326222500) )

~~~
to3m
You've got 2 options at the moment I think:

Cheap MS Natural 4000: [https://www.microsoft.com/accessories/en-
us/products/keyboar...](https://www.microsoft.com/accessories/en-
us/products/keyboards/natural-ergonomic-keyboard-4000/b2m-00012) (rubber domes
- actually I think the space bar is OK, but tends to be stiff until it's had a
couple of weeks of use)

More expensive MS Sculpt Ergonomic: [https://www.microsoft.com/accessories/en-
us/products/keyboar...](https://www.microsoft.com/accessories/en-
us/products/keyboards/sculpt-ergonomic-desktop/l5v-00001) (scissor switches +
clicky buttons for F keys and Esc)

Both are OK, I'd say. The 4000 has slightly nasty keyswitches, but in exchange
it's got all the keys in traditional places. The Sculpt is nicer to type on,
if you don't mind that sort of thing, but the non-standard keyboard layout
leaves something to be desired.

(One note of caution: I've had 5 of the MS 4000s now, and the newest one,
bought a month ago, has a much squishier, quieter key action - presumably a
new recipe with improved cost-effectiveness. I don't think this is any worse
than what was there already, but some might disagree...)

------
runin2k1
All the ergo adjustments in the world won't help you if you sit in one
position all day long with one small set of muscles engaged while the rest are
disengaged and slowly atrophying.

The best solution is touched on in the article, but it can't be overstated
that actual exercise is the best preventative.

~~~
cylinder
Easiest solution for an office worker is to just run up and own the stairwell
a few times a day. I don't know how so many people just sit still all day,
with a big lunch too, then wonder why they feel tired in the afternoons. Their
only solution seems to be more garbage Keurig coffee!

~~~
kjsthree
One of the most frustrating things about working in New York is the ample
amount of potential stairs to climb with almost every door locked from the
stairwell.

~~~
mikestew
The epidemic has long since spread to the west coast. The Seattle building I
currently work in has some limited, well-defined accessible stairwells, but
AFAICT the majority are one-way, emergency-only. I've worked in buildings as
you describe: one-way, down-only. Sucks when you don't know this yet, think
you'll take the stairs to the fourth floor only to discover that you need to
climb all the way to the bottom then take an elevator up. Security? Yeah,
maybe, but that's bare-minimum-to-meet-the-spec lazy security.

~~~
cholantesh
I can confirm that the Royal Bank building in Toronto is the same, so I
wouldn't doubt that this is a malaise in much of this city's office space.

------
300bps
About eleven years ago I started having crippling RSI in my hands and wrists.
I fit the typical patient... Type all day sitting at a desk.

Posted about it on Slashdot and someone told me to look up TMS. Changed my
life. After years of problems it completely went away in weeks. After years of
searching for ergonomic solutions it was bizarre that following TMS treatment
cured it in weeks and now I don't do anything ergonomic and I have had no
problems for over a decade.

More info...
[http://www.rsi.deas.harvard.edu/mb_what_is.html](http://www.rsi.deas.harvard.edu/mb_what_is.html)

[http://m.youtube.com/watch?v=vsR4wydiIBI](http://m.youtube.com/watch?v=vsR4wydiIBI)

~~~
felixpl
Did you do specific exercises, or just read and re-read Sarno's books to make
the concept stick?

------
frankus
It's probably not great for my wrists, but I particularly like the location of
the built-in trackpad on my MacBook.

So instead of raising the laptop in a stand and getting an external keyboard
and mouse, I use an external display (24" 4K) at an ergonomic height/distance
and keep the built-in monitor as a secondary screen (for example, running the
iOS simulator on the MacBook screen and Xcode full screen on the external
display).

I arrange the screens so the built-in display is below the external one (i.e.
the same arrangement as they are physically) and keep my dock on the left of
the main display.

------
melling
He's still not using an ergonomic keyboard. Typical keyboards require the user
to press the key to the bottom to activate it, like pushing your finger into
the desk. A mechanical keyboard switch activates halfway from the bottom,
reducing the extra stress on your fingers.

Here's a collection of other RSI stories, along with other ergonomic
information:

[https://github.com/melling/ErgonomicNotes](https://github.com/melling/ErgonomicNotes)

~~~
WalterSear
Fwiw, I was disabled for 8 years with RSI, and the best keyboard I've found,
for me, is the Apple one displayed in this article. It has the lightest touch
of any keyboard I've used except for actual touchpad style ergonomic
keyboards, which can be worse, since they can be difficult to use and require
static pressure - like the keyboard of the screen of a tablet. Not to mention
being unobtainable.

~~~
melling
There are a lot of switches. Reddit has a great guide:

[https://www.reddit.com/r/MechanicalKeyboards/wiki/switch_gui...](https://www.reddit.com/r/MechanicalKeyboards/wiki/switch_guides)

There's a table with activation forces:

    
    
        MX Red		Linear		45cN
        MX Black		Linear		60cN
        MX Dark Grey		Linear		80cN
        MX Brown

------
gadders
On top of the exercises recommended in the article, I would also suggest "Band
Pull-Aparts". These help undo some of the posture issues from working at a
desk.

This is a good instructional video on them:
[https://www.youtube.com/watch?v=dd9VoT1BPAY](https://www.youtube.com/watch?v=dd9VoT1BPAY)

------
schmichael
People aren't static. Many of us fidget quite a lot which does wonders for
preventing RSI!

I once had an ergonomics consultant confirm that despite my ridiculously poor
posture, my constant fidgeting did wonders for preventing RSI and other forms
of strain that occur when you hold a single position for too long.

(Also I barely touch a mouse which probably helps.)

~~~
GoToRO
I did that too. Then I stopped because I saw it as a.. defect? And then I had
to pick it up again :) It gives me some "exercise" while sitting. All the time
when I really have to think hard I do it more. For sure there is a link there.
Brain needs more blood, muscles deliver it?

------
zeveb
> Make sure _[the mouse is]_ wireless.

I disagree there — wireless mice & keyboards are terribly insecure.

Other than that, seems like some good advice here.

~~~
dragonwriter
Ergonomics and security are different concerns; the best mechanism for
addressing one, considered on its own, may be suboptimal from the perspective
of the other.

~~~
zeveb
True enough, but security is a _sine qua non_ : a system _must_ be
sufficiently secure before one even begins to consider ergonomics or anything
else.

------
Mithaldu
For people looking for a cheaper option than the roost stand, i can strongly
recommend book stands like this:

[https://www.amazon.de/gp/customer-
reviews/R1MVD7C55Q9ZKD/ref...](https://www.amazon.de/gp/customer-
reviews/R1MVD7C55Q9ZKD/ref=cm_cr_arp_d_rvw_ttl?ie=UTF8&ASIN=B0012E0S00)

It can fit literally any machine, won't break from a puny laptop under any
circumstance, folds very flat so fits in most bags, and can bring the screen
_really_ high.

------
josephjrobison
100% agree with this article - I also don't know how more people aren't in the
chiropractor's office weekly. I went through a particularly intense period of
working on my laptop and it resulted in a neck spasm so sever it was like
daggers trying to move my neck.

The doctor prescribed Vicodin it was that bad. But only when I went in for a
series of chiropractic sessions did I improve my neck at the source.
Thankfully now I'm more aware of just how important it is to not crane the
neck, and I catch myself if I do it for more than 15 minutes at a time.

It definitely is becoming an epidemic, and there needs to be a lot more public
awareness around this. Not everyone can afford multiple chiro sessions a week
for weeks at a time to correct something preventable!

~~~
yodsanklai
> I also don't know how more people aren't in the chiropractor's office weekly

Maybe because there are no evidence that it's effective.

[https://www.sciencebasedmedicine.org/reference/chiropractic/](https://www.sciencebasedmedicine.org/reference/chiropractic/)

~~~
gooseus
Chiropractors don't fall just into "straights" and "mixers", there are entire
schools which focus on evidence-based biomechanic adjustments and others that
get way more woo-woo about it with energy healing and whatnot.

[https://www.sciencebasedmedicine.org/science-based-
chiroprac...](https://www.sciencebasedmedicine.org/science-based-chiropractic-
an-oxymoron/)

That guy spent years being a chiropractor and while he acknowledges that the
postulates of vertebral subluxation theory is implausible, he was also able to
spend years helping people with spinal manipulations working as a
chiropractor. It was only until recently that physical therapists began doing
adjustments which began competing with chiropractics

Like with anything, there are good and bad actors and even a bad actor may
help people even if their justification for why something is helping is
fundamentally flawed.

Don't throw the baby out with the bathwater.

~~~
dpark
> _That guy spent years being a chiropractor and while he acknowledges that
> the postulates of vertebral subluxation theory is implausible, he was also
> able to spend years helping people with spinal manipulations working as a
> chiropractor._

Did he help them or did he deliver placebos? "Most cases of back pain are self
limiting, and spinal manipulation is not often more effective than other
physical treatment modalities in affecting the final outcome."

> _Like with anything, there are good and bad actors and even a bad actor may
> help people even if their justification for why something is helping is
> fundamentally flawed._

Is there actual science supporting the claims? Not the mechanism claims, which
are clearly bullshit. Is there even any support in the science for the claims
of _effectiveness_?

~~~
gooseus
Effectiveness in treating what? And what do you mean when you say
chiropractics?

You want a study on effectiveness in treating asthma or deafness, then it's
probably not available.

Effectiveness in treating something like scoliiosis? Yep, there is a study for
that[1]. How about headaches? Seems to be some positive research on it[2].

Now I'm no scientist or statistician and there are also studies point to non-
effectiveness in things like lower back-pain[3], yet even that study
acknowledges that it's difficult to ascertain since most chiropractic packages
aren't limited to simply adjustments.

I find it interesting how many people denounce sweeping generalizations when
it comes to programming paradigms and approaches to infrastructure and
application development... yet still fall victim to it when it's a topic
outside their domain.

We're still just talking about problem solving here, so how come it's not a
matter of defining the problem and assessing each approach in context of that
problem?

[1]
[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3259989/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3259989/)

[2]
[http://www.ncbi.nlm.nih.gov/pubmed/8775024](http://www.ncbi.nlm.nih.gov/pubmed/8775024)

[3]
[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447290/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447290/)

------
ravenstine
How often do you find that a person with a low body-fat ratio with negative
effects caused by bad posture? The people who I've seen with obvious problems
caused by poor posture, like a hump or sore back or joints, are usually
moderately to highly overweight. Kind of like how women with large breasts can
have problems with soreness or neck humps. I suspect that it's not so much
about good posture as it is about having a variety of postures throughout the
day and not having bodyweight stressing one's joints. Granted, I have no
scientific evidence for this. It's just from my own observations(and my own
experience of being a former fat guy).

~~~
nabla9
I'm a tall (1.86 m) and fit middle aged man. I have neck problems from using
laptop or bad chair. I started to have lower back problems but I fixed them
with a chair.

I realized nearly two years ago that almost all tall people in my office use
external monitors and it clicked. The taller you are the worse the laptop
ergonomy is. Human head weighs 4.5kg-5kg. If you have to bend your neck even a
little bit your muscles have to do lot of static work. You can compensate by
bending your back, tall people have to bend their back more.

My hypothesis is that short or fit people can get away more than tall or
unfit, but things will show up after 20-30 years of bad posture for everyone.

~~~
dragonwriter
> If you have to bend your neck even a little bit your muscles have to do lot
> of static work. You can compensate by bending your back, tall people have to
> bend their back more.

Or you could (with the right chair and foot rest) angle your _seat_ instead of
bending your back.

~~~
nabla9
I don't see how you can fix things with just chair if you work with laptop
that is in the table and your are tall.

External monitor and keyboard is must.

------
tom_wilde
fyi: a vertical mouse can help with lower arm issues. I swap between this and
a normal one and simply varying the motion helped with my issues....

~~~
gglitch
Thank you for this. I didn't even know vertical mice exist, but I've often
remarked to myself how strange it feels to rotate my lower arm 45-90° to use
the mouse. Purchased.

------
ryanmarsh
I have two slipped disks, sciatica, piriformis syndrome and I'm 6'3\. Most
work spaces are pure torture for me without my protocol:

* Yoga or daily stretching

* Walking (properly)

* Epidural steroid injections every six months (for the disks)

What would be better (for people who don't want to end up like me):

A) Don't do dumb shit with your body (obvi)

B) If facilities departments would stop buying torture devices just cuz that's
what everyone's used to sitting in

------
artur_makly
#1 PSA.

I wonder what happens to all those bearded 20+year vets after all that neck
carnage..scary..

so i just built one of these: [http://www.latesthandmade.com/pvc-laptop-stand-
diy-ideas/](http://www.latesthandmade.com/pvc-laptop-stand-diy-ideas/)

And now EVERYONE in the office wants one. Best investment of the year. +Also
fun to paint/customize them.

and YOGA YOGA YOGA!

------
dmansen
Pete Egoscue's book "Pain Free" is IMO, the best book for understanding
correct posture and how to achieve it. [https://www.amazon.com/Pain-Free-
Revolutionary-Stopping-Chro...](https://www.amazon.com/Pain-Free-
Revolutionary-Stopping-Chronic/dp/0553379887/ref=sr_1_1)

------
fabiogo
Walking a few minutes every hour is a simple way to clear your head, be more
productive, and save your posture.

~~~
BeautifulData
By all means do that, but in the long run it is not enough. 8 hours of sitting
isn't countered by walking for 1 hour. There are many good exercises you can
do with little to no equipment, the recommended routine of
/r/bodyweightfitness is a good place to start
[https://www.reddit.com/r/bodyweightfitness/wiki/kb/recommend...](https://www.reddit.com/r/bodyweightfitness/wiki/kb/recommended_routine)

------
magicalpony
An epidemic you say, doctor?

Mostly I liked how you reconciled your personal pains with your expert domain
knowledge about human biomechanics and health to provide medical advice, even
providing Googled images that unequivocally demonstrate your claim and truly
the extent of this epidemic.

Sorry your arms hurt.

------
sjustinas
Does anyone have an idea why, according to the author, a mouse being wireless
is so essential?

~~~
dangerlibrary
I can't think of any reason why a wireless mouse would have an ergonomic
benefit over a wired one. They are the same size, shape, and orientation, and
any decrease in drag from the lack of a cord is more than offset by the
increased weight of the batteries.

~~~
wcarss
When I'm reading a web page or code, I occasionally stand or sit with my mouse
in my hand and my arm relaxed at my side, or across my chest. It changes the
extension of my arm considerably and sometimes makes things much more
comfortable.

------
andrewaylett
The very biggest thing for me -- having started suffering from wrist pain
about ten years ago -- was switching from QWERTY to Dvorak for typing. It was
quite a lot of work, but the wrist pain completely disappeared and hasn't been
back.

------
overcast
I had the Herman Miller Aeron chair for a decade, and I recently upgraded to
the Embody from them. It's leagues better in the ergonomic department. So
comfortable, and no back issues sitting for extremely long periods of time.

------
GoToRO
Good tips. I may add:

1\. A second mouse for my other hand. Pick a corporate mouse because those are
symmetric. Use it to browse the web when you are not really working.

2\. A desk with a dull (chamfer) edge.

------
NDizzle
My solution is to use a lap desk. I have what is called an ePad which is going
on 6 years old. I should probably replace it.

I limit my desk time to 3 hours a day.

------
NerdBuddha
Have someone tried BetterBack?

I purchased mine but still have not received it.

------
JustUhThought
Yoga!!! Don't knock it till you've tried it.

------
hackaflocka
I haven't read all the other comments so not sure if this has been mentioned
already.

The modern concepts of posture may be wrong.

I have a curved butt to shoulder area. It makes me look somewhat duck like.

However, I never have any back aches etc.

I know of people who are straight as a plank, and complain constantly of aches
and pains.

This TED talk will explain why curved is better than straight:

[https://youtu.be/k1luKAS_Xcg?t=224](https://youtu.be/k1luKAS_Xcg?t=224)

------
joesmo
I disagree with his suggestions about keyboards and mice completely. It's not
that simple. What helps the author might hurt someone else. I personally can't
use a mouse or flat keyboard. Making these suggestions categorical destroys an
otherwise good article.

~~~
heisenbit
Same here. While the author has a point about laptops as a workspace he fails
to distinguish between generally accepted best practices and his personal
opinion. I've yet to see any totally flat keyboard to be recommended as
ergonomic.

------
kapauldo
This is a great write-up. Thanks for sharing.

