Fortunately I managed to find a combination that worked for me. The most important component was using a break program that made sure I took breaks to rest my arms and hands, and to do some exercises. I also switched to an ergonomic keyboard and mouse. I am now completely recovered, but it really made me realize that we need to pay attention to ergonomics.
I've written up my story in more detail here: http://henrikwarne.com/2012/02/18/how-i-beat-rsi/
In addition to what I mention in my post, I am now also using a height-adjustable desk (some people think they are expensive, but they're not). It's really good to be able to switch between sitting and standing. If you are like me for the first 10 years of my career (i.e. ignoring ergonomics), consider paying a little bit of attention now, otherwise it may become a problem later on.
Break program saved my ass, having been told by a doctor that I'd have to give up programming as a career. I had tried all sorts of other stuff (DataHands keyboard, a vertical keyboard, wrist rest, bla bla bla), but the enforced breaks were the game changer.
All the break programs I have used have a "manual override", and you can also turn them off. Occasionally I have done that if is something really critical that has to go out at once. But for me that happens maybe once or twice a year.
Is going for a stand-up desk worth it?
I have heard that they really improve your working.
There were also reports a while ago about how sitting all day lowers your life expectancy - another reason to try to stand up part of the day.
We can't really make this world a great place if we don't live long. So, lets stand up.
Posture. Back straight; elbows bent 90 degrees (no less); monitor at eye level so neck is straight.
Physical therapy. Deep-tissue massage; fascia massage with tennis or golf ball; theraputty ; hand exercise balls ; and stretching.
Standing desk. Went with the DIY model, though I hear the motorized ones are choice. I switched to standing because of general health concerns with sitting, not because of RSI. However it has had tangential benefits there in that it seems easier to get the right height so my elbows are bent 90 degrees.
Chair. I still sit some of the time I'm working. The greatest chair I've ever sat on is the Swopper .
Keyboard. I use the DAS Keyboard . It's clicky, but not ergonomic. I find the clickyness helps me use a lighter touch and still type fast.
Mouse. I use the Logitech Trackman Wheel . It's long since discontinued. I bought a new-in-box specimen on ebay to replace my old one when it became unreliable.
Also, when you got the RSI did you have symptoms before that you ignored or was it a binary affair (ie. it just hit you hard one day and you had RSI).
I ask since I am 38 now and have been using computers (gaming and coding mostly) multiple hours per day since I was 12 or so. However, I have always listened to my body and naturally get breaks by getting a glass of water every 30 to 60 minutes.
In retrospect, I should have done much more as soon as I felt the first symptoms. However, I didn't really know what to do, and I was sort of just hoping that it would go away by itself. Then I went to see several doctors, but none of them could help. It was only when I started doing my own research that I found effective ways to deal with it.
Also, it seems pretty clear from the research I did that not everybody will get RSI, even if they work just like I did. But the problem is that we don't know beforehand who will get it. Listening to your own body is a good precaution though. I wasn't very good at that I think.
In your write-up on your blog, you mentioned that you used a program called WorkPace on Linux and Windows. I looked into it, but I only see a Windows version on their website . After a little Googling, I found a similarly named WorkRave , which is available for Linux and Windows. I was wondering if you might have meant WorkRave.
I have also been saving up for a few months to buy an adjustable desk and ergnomic chair. Most easily-adjustable desks that I've found cost between $1k and $2k, such as the Humanscale Float desk . I don't mind paying that much if that's what it takes, but it seems excessive. I'd appreciate pointers to any other resources for adjustable desks.
As for desks, the two that I have used have both been from the companies I've been working for, so I never had to buy one myslef. However, where I worked before (www.tilgin.com), everybody got an adjustable height desk (electric motor). They only bought the legs (cost a bit over 100 Euro per desk I think), and had some guys go around switching the legs on all the desks.
The brand of my current desk is www.holmbergsbordet.se but it looks quite expensive.
I installed WorkRave this morning and have been trying it out while I work today. I like it. It seems like it would work really well with Gnome. I'm using XMonad. It's fully functional in XMonad, but the "tray" just floats on whichever desktop I start it on, which isn't ideal for XMonad.
I get the impression all the adjustable-height desks are expensive. I'm not a big fan of motorized ones. I tried them out at the Relax-the-Back store. They're way too slow at raising and lowering the desk for my taste, which is why I'm leaning toward something manual like the Float table.
That's why exercise is great. It will help your remove the milk acid but also to release stress.
Lactic acid it not produced in any significant quantity during 'normal operation' of your body.
Your cells break down glucose into a molecule called pyruvate in a process called 'glycolysis'. This yields some 'energy' (in the form of ATP). This process requires some energy, so the net gain is only two ATP. It also requires a couple NAD- ions, which pick up some spare hydrogen protons that get kicked out. Those NAD- get turned into NADH, are are used later in the process (and turned back into NAD-, so they can facilitate more 'glycolysis').
If the cell has enough oxygen, it can then oxidize the pyruvate in the Citric Acid Cyle (aka the TCA cycle, aka the Kreb's cycle), gaining many times more ATP (34, in total).
If, however, the cell doesn't have enough oxygen, it can't run the TCA cycle. This isn't a big deal in the short term. Your cells can keep running through that glycolosis process to produce energy as long as they have enough glucose to break down, and enough NAD- to grab protons. The glucose isn't generally a problem. Your body keeps a fair amount of it in the blood, and the liver can release more pretty easily.
The problem is the limited number of NAD- ions in your cells. Once those are used up, glycolosis stops. Fortunately, your cells can 'free them up' by using them to turn pyruvate into lactate. This produces the 'milk acid' you talk about, but it frees up the NAD- for more glycolosis. The cell hangs on to the lactate for a while in the hopes of getting more oxygen it can use to turn it back into pyruvate and run it through the TCA cycle, and if that doesn't happen, it eventually diffuses out into the blood where it ends up in the liver, which uses it to build up its glycogen stores for the next time there's a sudden demand for a lot of glucose.
So, in short, unless you're exercising hard, your body will have no trouble meeting its oxygen demand, and no lactic acid will be produced. This has been an overly simplified (but mostly accurate) description of this process. I'd encourage you to do your own research to learn more (the search terms 'cellular respiration' 'glycolosis' and 'citric acid cycle' should all be useful)
You simply cannot have a (non-symmetric) staggered layout that is "ergonomic".
Real ergonomic keyboards are mostly symmetric: a Maltron or a Kinesys for example. Or a good split + matrix (symmetric) layout.
But a regular keyboard, no matter how good the keyswitch, like your keyboard or a Cherry MX-5000 or a IBM Model M15 (split) aren't ergonomic.
They're "less worse" than the typical keyboard in that they're split and they're easier to adapt to.
But you have to realize that your brain (just as mine) has been destroyed by years and years spent on typing on non-symmetric keyboard.
This makes zero sense from an ergonomist' point of view. Basically one half of your keyboard's rows are shifted "the wrong way". There's no logic to that and it's really bad.
For what it's worth: I'm on a HHKB Pro 2 + Aeron chair.
It's not perfect and it's not the most ergonomic, but it's not too bad either.
One part of the solution was physical therapy, which was mostly training me how to do the exercises I needed to do: reverse flies. First with a Theraband. Then with a stronger Theraband. Then with a stronger Theraband. And finally with dumbbells.
It was torturous! Especially since I was already in agony. But it ultimately worked like a charm.
What was also essential was getting a very good (i.e., expensive and highly adjustable) chair. And a Kinesis Contour keyboard. The Kinesis keyboard is the pinnacle of ergonomic keyboard design.
Reverse flies are, indeed, a great thing.
I can second the Kinesis recommendation. I like mine, especially the build-in Dvorak. The only downsides are the lame function keys and that it's harder to use one handed than a more conventional keyboard.
Also this PDF just ripped images off the Internet. I recognized some of them from youtube videos and books I have. The fact this was hastily put together is another reason to question its accuracy or the (uncredited) author's authority on the subject.
I began, for unrelated reasons, barbell strength training. Deadlifts, Squats, and Presses. They have had a dramatic effect on my posture.
I believe that by spending time lifting barbells, I gained better control over and awareness of my upper-back muscles, and that plus the improved muscle tone means I no longer slump the way I used to do.
I'm 29 now, and have never had repetitive strain problems. I believe I'm less likely to do so now than before I began strength training.
So, there's some anecdata.
Specifically, the PT walked me through primarily thoracic foam rolling exercises, lat and pec stretches, a variation on the bench stretch (more like an elevated child's pose), scapular wall slides, dislocates and rotational dislocates, and chin tuck exercises including lying chin tucks. She also had me do lat pulldowns with conscious chin tucking with a thera-band looped around a door handle, and lying vertically along a foam roller doing snow angels, arm press-downs with barbie weights, and moving alternating hands from head to hip.
On top of this as general mobility work (I am/was a runner predisposed to hip tightness) I have been regularly doing many of the lower back exercises, though my PT didn't focus on them. Specifically hip flexor and pigeon stretches, especially if I can grab one of the machines at the gym for it; glute raises and roll-downs; clams and walking clams; cat-cow and dead bug, and plenty of foam rolling.
I do not have continuous before/after photos but after 3 months of weekly physical therapy (biweekly for the 3rd month) and daily or near-daily practice, the therapist cleared me from PT with greatly increased upper back movement, noticeable differences in range of motion both overhead and side to side, and generally better comfort/quality of posture while working. I'm sorry I have nothing quantitative to back this up, and I'm also not "cured" yet -- but vastly improved, and no longer on a path to become a doubled-over hunchback before I'm 40.
I have been doing many of the exercises for some time now. Not only do they feel good, I can really notice the difference they make. Many thanks to Reddit-user troublesome.
Props for the document go to the fitness community on reddit, where a bunch popular posts have inspired me to make this.
If you have any questions, feel free to ask them here.
As the article notes, weakness of the glutes and hamstrings, combined with a relative over-activation of quads and spinal erectors, is part of the problem.
Most people with poor posture, especially past their mid-20s, are suffering from underdeveloped musculature generally.
While several of the exercises noted are helpful at targeting muscle activation, if you really want to develop the posterior chain, and other muscles, in a balanced fashion, focusing on major lifts is going to do far more for you in less workout time than a bunch of small/isolated movements.
Deadlifts, squats, rows and chins, and yes, some mirror-muscle upper-body work with bench and overhead press. The recently posted "Everything you know about fitness is a lie" article (http://www.mensjournal.com/magazine/everything-you-know-abou...) details this pretty well.
For acute treatment, the PDF is handy, but you'd be far better off to invest in Starting Strength. (http://startingstrength.com/index.php/site/about)
And yes, foam rolling also helps.
For my tastes, I find rowing the perfect counterbalance to a sedentary lifestyle. The full-body compression/extension cycle just feels like the direct opposite of sitting fixed at a desk all day. It may be psychological, but it's very common for me to sense a relative weakening in my posture control muscles if I miss a week of rowing for holidays or illness.
Related tip: if you find long (6+ hr) flights physically taxing (yes, first world problems etc.), improving your posture control musculature can provide noticeable relief. Even as a teenager I used to dread having to sit upright and mostly fixed in place on transatlantic flights, but ever since I took up rowing in my early 20s I almost never feel cramped or fatigued anymore even on long haul 15+hr flights.
A rowing machine is cardio (and it's good cardio), but, other than some very modest strength and hypertrophy response, you're not going to do much muscle development. My experience with it and kettlebell swings suggests that they may help with activation, particularly doing high-tension sets (damper set to 10, 20-40 pulls). Rowing pretty much is "the anti-desk", with the exception that you're performing the activity in a seated position. The main target is improving your cardiovascular performance, capability, and endurance.
What strength training does specifically is recruit muscle motor units (bundles of muscle cells). These are differentiated largely by size and response time, and activating a given bundle requires triggering its controlling nerve. Higher loads trigger larger motor units. Stimulus is usually classified by sets, reps, percent of one rep maximum load (1RM), "tempo" (how long you take raising and lowering the weight), and power vs. strength lifts ("Olympic" lifts are, confusingly, based on power, "powerlifts" are, confusingly, based on strength).
The strength training concept of "specificity" (also given as "SAID": specific adaptation to imposed demand) says that you'll get a training response that corresponds to the training stimulus. This means both the specific muscles, and type of lift determine the training response. If you want stronger legs, do squats, not bicep curls. If you want to get stronger, lift heavier (80-95% 1RM) weights for fewer reps. If you want endurance, lighter (30-50% 1RM) weights for more reps (15-20 or so). Hypertrophy (increased mass) is maximized by moderate resistance and reps maximizing time under tension.
Wikipedia's Strength Training article summarizes this nicely: http://en.wikipedia.org/wiki/Strength_training#Realization_o...
The best I've found is a Cochrane review that says that specific neck stretches (NB as far as I can tell not those in the article) are effective in the intermediate term for relieving neck pain. A different review says that there is no evidence that stretching is effective in preventing injuries in runners.
Perhaps this is what you meant and just didn't word it well.
Are there some interesting studies? Yes, a few, and some trainers are aware of those. (I challenge you/anyone to provide a list of 5 great fitness papers! For funsies, I'm not saying it can't be done.)
However, in general, we're all flying seat of our pants.
I'd love to see some examples of the bedrock research that you believe trainers rely upon.
(De)-Constructing Computer Guy
(De)-Constructing Computer Guy part 2
Possibly nsfw imagery on the site.
and a great video
But if you have bad posture, and your flexibility is limited as a result, you will be unable to squat with good technique, and you will either not even try to lift all that heavy (certainly not doing full squats with all that much weight) or hurt yourself.
A tight posterior chain, for example, prevents a lot of people from keeping their back tight at the bottom of the movement. As a result you see a lot of people either rounding (and hurting their back - I did that a few times) or resorting to half or quarter squats and making excuses.
Now I round my squats at 1.5x bodyweight, but not before... working on it.
But if you for example go to the gym with a tight posterior chain, you will squat with a form that either hurts your lower back (been there, done that) or makes you emphasise the wrong muscles (been there, done that) and leave you with progressively bigger problems lifting correctly.
Similarly, it is very easy to get used to lifting with a form that is bad for you because it feels easier, which often means emphasising the muscle groups that already feels stronger. E.g. with a weak core a lot of people will lean forwards in the squat and load the spine too much.
I got to about 60kg on my back squats before I kept slamming into a wall because of how bad posture had severely limited my mobility and left me with various weaknesses. I'd repeatedly either fail or hurt my back badly enough I had to back off for 2-3 weeks. As a result after the second time I started hesitating, and kept my weight low, but eventually I'd hit it again.
When I realized what was wrong, it took me 2-3 months of stretches and modified exercises before I had loosened up enough that I flew past 100kg. 6 months later I did 160kg. Now my personal best is 187.5k (which I did at a body weight of 98, so it's no amazing feat, but it's certainly a big difference from struggling with 60%-65% of my body weight...).
Not to say that what you ended up doing was wrong, but to me this just indicates the need for a coach, or at least doing a lot more reading before you start lifting. If you have a structurally weak and tight posterior chain, you need to add romanian deadlifts to your program. Nobody (except Rippetoe) advocates blindly following a program like like starting strength. You can lift heavy while you correct imbalances, you just need to make sure the exercises you're doing are correcting the imbalances you have.
And I did see a coach, who was also a qualified physiotherapist. What I was recommended was pretty much the stretches in the linked article.
Yes, for people with posture problems a good coach is even more necessary than for your average Joe who can get away with just watching a few youtube videos, reading a book, and some practice.
However I don't know how accurate or correct that may be.
This ain't rocket science. You don't need to spend an hour a day with 10 different exercises. You can fix the muscular weaknesses in 30 minutes, once a week.
You don't need to spend an hour a day, but not nearly all posture issues are down to muscular weakness.
For my part, I discovered my posture problems as a result of deadlifts and squats, that eventually got to sufficient weight that I was unable to compensate or work around the underlying lack of flexibility and ended up dangerously close to properly hurting my back.
Doing full ROM lifts will improve your flexibility. I find this holds true more for squats than deads, specifically (you're getting pressed down with the bar, and have to retain proper back/spine alignment), but it's all useful.
If your form's breaking down, you're lifting too heavy.
What causes other than muscle weakness do you identify as causing posture issues?
Once you're flexible enough to actually do the lifts properly, I agree you will see it improving further. But if you're flexible to do the lifts properly, you don't really have a problem.
When I started was not physically able at all to get reasonable depth in my squats before I would either need to stop or curve my back, no matter the weight. I also could hardly bend over while keeping my back firm - it'd be like stretching a violin string along the back of my legs.
A couple of months of stretches from my pysiotherapist got my squats from about 60kg to about 140kg in less than 6 months, after I'd spent the previous 6 months stalled completely because any attempt to go higher led to total form breakdown, and a lot of time before that with abysmally slow progress.
Doing light / BW / goblet squats is very low risk, and will help iron out your form.
My point is that if your form is crap, and you're using any added load, then you're going too heavy. If your form is crap at BW (and adding a modest load, 45-95# for most trainees) doesn't iron that out (sometimes a bit of "bar discipline" does help sort out form), then, yes, work on form.
My experience is that you want to eliminate the obvious and simple stuff first (Occam's Razor), and that for most trainees I've seen, starting with simple cues and light weights addresses form issues sufficiently. KISS.
here is an example about how to "hold your head up"
It does not happen all at once. Boiling frog, eta 5 years. The warning signs are pain after a coding session, maybe a 2 or 3 on a scale of ten. However, eventually it gets worse. And your youth will act as such that the pain goes away. After a long weekend, you are recharged and re-healthy. That is a falsehood. Eventually, it gets to the point where the pain never goes away, it just subsides, constant background soreness, maybe on a 2 to 3 on a scale of ten.
Don't take your typing ability for granted. RSI can be managed but never completely cured.
The same traits that may make us good problem solvers (focus - as in not getting up, breaking that slippery, seductive state called "Flow", OCD - ignoring some things to focus, sometimes right, sometimes wrong on certain aspects, sedentary habits (biking FTW)) can make RSI an eventuality for a few.
Edit: I stand up and code every now and then, and also use Dvorak!
I had a horribly seized neck a while ago where I couldn't look over my left shoulder. This had come on after visiting a physio for a very stiff upper back (a legacy of military service and lots of programming). I bought the book after reading about it in the 4 hour body and did 1 set of the exercises. My neck had more range of motion after 25 minutes than it had for months and several hundred pounds worth of physio appointments.
This and other information on self treating trigger points (http://saveyourself.ca/tutorials/trigger-points.php) has got my back in better shape than before I joined the marines!
> Unfortunately, the laptop’s compact design, with attached screen and keyboard, forces laptop users into awkward postures. When the screen is at the right height, the keyboard position is too high; and when the keyboard is at the right height, the screen is too low.
> Laptops pose less risk when used for short periods of time, but nowadays, many people use laptops as their main computer. This creates an ongoing tradeoff between poor neck/head posture and poor hand/wrist posture.
In your case, you are simply avoiding poor hand/wrist posture at the expense of having poor neck/head posture. However, having the laptop on your lap is better than having it on a desk. But even then, it should only be used occasionally, and not full-time.
It is an instant cure. If you have a really good teacher (there are lots of clowns out there, look for someone who is gentle and runs advanced classes as well, then go to the beginner class) Make sure that you let them know that you have issues, and don't be afraid to stop and miss exercises that you feel uncomfortable with or worried about.
These sets look very familiar to me as similar core exercises to ones I've done as part of rowing and yoga, but there are a few new ideas here I can't wait to try. Thanks!
PS. And don't get me started on the strain on the eyes by all those "vivid colors" reflecting displays -- I still remember using a screen filter to avoid reflections on an already matte display!
In short, if you've never addressed your own posture issues, consider doing so! Back pain is worse than pain in the extremities because it is continuous and affects everything you do.
I started weight training and yoga, and my wrist and back pain disappeared. I thought I was done and everything was fine.
But I was still sitting in a chair all day every day, and more than a decade like that herniated a disc in my neck. The initial symptoms were a persistent pain in my upper shoulder blade for months. The doctor said this would not have happened if I had just got up once an hour, and he sees tons of desk workers end up the same.
Since then I have seen some improvement by using a program to force me to look away from the screen at intervals, and to get up once an hour.
My posture is still horrible, but now the remaining struggle is simply staying aware enough to avoid bad habits (slouching, letting my head fall forward, etc).
When I first came across the idea of treadmill desks I thought they were rather silly, but now I'm seriously considering getting one. They aren't cheap though (unless you do a hacky DIY job).
I ended up creating a software solution that included break reminders but also uses your webcam to check your posture and remind you whenever you sit in a bad posture (or even a good one, since sitting rigidly in any posture for long periods is part of the problem).
It's not a substitute for exercise, but it is a simple, low-cost way to keep good posture in mind throughout the working day, without being overly intrusive. It's called Postureminder and there's a 30-day free download on my website, http://www.postureminder.co.uk
For what its worth, I've been following along with his MobilityWOD project  for some time and it has immensely helped with my strength training pursuits.
Try bending over with your back in a slight upwards arch while keeping your legs completely straight and together.
Can you get below 90 degrees? If not, your flexibility along your posterior chain is poor. Can you effortlessly reach your toes with your fingers (you can bend your back this time)? If not, same.
Strength training alone won't fix those. And in fact, that poor flexibility will make it very hard to maintain proper form when lifting weights, and you're putting yourself at greater risk of hurting yourself.
On the upside, only a couple of months of stretches is enough to see a substantial improvement.
Removing even trivial hurdles can sometimes drastically impact behaviour.
edit: Forgot to mention: juststand.org
Also, is APT the same as lordosis or is there a medical distinction?
I've done a lot of research into correcting my issues and it seems like this is what is happening with me. After reading Mary Bond's New Rules of Posture and Esther Gokhale's book, I realized that the way I do everything is pretty much wrong. I walk wrong, sit wrong, lie down wrong, and stand wrong (which is why a standing desk also didn't help). A great example is after implementing what I thought were really healthy changes to my lifestyle- the standing desk and walking to work, I developed an unpleasant heel pain and a rather ugly callus on my right side. After reading the Bond book I figured out that it was because that side is my dominant foot, but I was getting all my energy from walking from the heel strike there, rather than pushing off from the non-dominant foot through the hamstring/toes. Correcting that got rid of the pain and also had the side effect that my rear is more toned. That's just one example, and I'm not done with improving my posture, but it has made a great difference in my life. I also have implemented more systematic weight training (making sure I get ALL areas worked out) and core training (pilates). I still do yoga for the mobility benefits. I also have seen a Rolfing and Feldenkrais coach, but I think those services are generally over-rated and overpriced and you can get similar benefits from taking an adult dance class. I would like to try Alexander too.
Yoga has 8 levels (limbs).
Most western classes do not venture beyond level 4.
Thank you anikepant!
Although not everyone likes them I do recommend shelling $$$ for an Herman Miller (or similar) chair.
The Mira seems to be great for the back. Me, I can't live without the "pellicle mesh" of the Aeron so the Mira is a no go for me. Hence I bought an Aeron with the adjustable posture fit (the new one, with the adjustable stuff that gently "pushes" the low-end of your back).
I realize HN is filled with negativity and a lot of people are going to criticize the Aeron (dot com symbol, not that ergonomic, bad for your health, bla bla bla) but honestly if you know how to adjust it it's a great chair. You hardly sweat in it and (when adjusted correctly), by pulling your arms behind your head the chair gently falls in "relax-mode".
The 12-year warranty is great too. I use that and a HHKB Pro 2 as my keyboard.
Ultimately, you pay a lot of money for Herman Miller products that could be spent on better ergonomic features instead.
At work I have a Teknion Contessa and I love it. It is infinitely adjustable and very comfortable. I hardly ever think about my chair while at work. The only problem is that the fabric is not very durable; mine is a year old and it looks just awful. My Embody is much older and looks almost brand new.
Some of these look kind of cool: http://www.amazon.com/s/?_encoding=UTF8&tag=produc05-20&...