Writing

My original problems had been with typing, but later writing also caused me pain and numbness in my fingers. My changes involved the following, with some of the ideas suggested to me by Dr Richard Wigley.

• Use a Roller Ball, or Fountain Pen (not a ball point). The write much smoother with less friction and require much less pressure.
• Use smooth / shiny good quality paper - once again makes writing smoother and easier.
• Use a sloping desk - 10^o-15^o is supposedly the right amount. I made up a sloping wooden board to put on my desk. Must be quite large to allow plenty of width and room for elbow to rest on the board (mine is approx. 60cm x 60cm).
• Make sure your entire forearm is supported on the desk, elbow and forearm should be resting on desk.
• Writing technique - hold pen loosely, pretend wrist is locked (don't tense it but pretend you can't bend it). Move in a smooth rhythmical motion 'wobbling' back and forth whilst resting on 'fat pad' on underside of forearm. Fingers and wrist should remain passive, with all movement coming from the elbow.

After practising this method (esp. the last bit) I quite like it. My writing is not so neat as it used to be, and I write larger now, in circular sweeping strokes. However, I can still write quite fast.

In order to take micropauses I use a small egg timer. Every 3 mins I put down my pen and drop my hands and lean back and relax (most of the time anyway).

Using a computer

It was only after about 6 months that I began to try and use a computer again. I started with only 6 mins a day, 3-5 days a week. This was then increased slowly over a period of another 5 months or so. Error! Reference source not found. shows the increase, plotted as taken from my training logbook. Basically I doubled the amount of typing on average every 4 weeks. Noticeable in this plot are the oscillations in hours per week. I would increase for one week, then back off a bit a few weeks later. This probably also means I was trying to increase faster than I should have, meaning that every few weeks I would be a bit sore and have to reduce a bit.

This next section is taken from the on-line help and manual for WorkPace. This is a computer package I and a friend have developed over several years to help prevent OOS on computers. During my recovery I saw the need for such a package and would love to have had it then. I now use this package all the time (I am using it right now whilst writing this). WorkPace is, I believe, a good part of the reason why I have suffered few further problems using a computer. Although I do put the package onto some pretty strict settings - e.g. Micro-pause every 2 mins for 30 secs, Rest Break every 15 mins for 20 mins, Typing speed limit of 36 words per min, and a limit of around 3 hrs typing a day. Below is a summary of this package.

WorkPace is a software package that monitors mouse and keyboard use. It advises the best times for micropauses and restbreaks; monitors typing speed and time worked; and reminds of scheduled breaks (eg. lunch). The package is designed to minimise work disruption and is highly flexible; it includes a Setup Wizard to assist in customising operation to suit different users. A manual and full on-line help are provided, both containing information on good working techniques, and workplace layout.

What follows is some of the information from the online help. Some of this is taken from books / sources I have read and spoken to, but a large portion is my own ideas, and based upon my own experiences.

Correct keyboard usage

Using the keyboard with good technique can have a significant impact on both productivity, and the likelihood of developing problems.

The key points for good keyboard technique are:

• A good quality keyboard
• Positioning of keyboard and forearm rest
• Usage of a forearm rest
• Typing style

A good quality keyboard

Often this point is overlooked these days. Computers are constantly improved, but keyboards are mass produced as cheaply as possible. If you do a lot of typing it is well worth paying extra for a good durable keyboard. Keyboards made by Digital, IBM and Compaq are often of much higher quality. The average person may be unable to detect a difference, but to an experienced typist it will be very noticeable. A good quality keyboard will be:

• Fairly thin, less than 25mm from table top to top-of-spacebar
• Separate from monitor (portable computer keyboards are not generally good for long typing)
• Keys should have a smooth, positive feeling travel
• Key movement should not be "mushy"
• Keys shouldn't stick or wobble
• SHIFT, CTRL, and ALT keys should be on both sides

Keyboard position and the forearm rest

Ideally you should use a forearm rest to take the weight of your arms off your shoulders, with the forearm rest being placed directly in front of the keyboard. The requirements for the forearm rest are:

• Wider than keyboard
• 10-15 cm deep
• Rubber feet or non-sliding under surface
• Soft non-stick top surface
• Top of rest should be level with top of spacebar
• Front of rest flush (in line) with edge of table
• Rest directly in front of keyboard - no gap in between

The keyboard itself should be as flat as possible, or sloping away from you. Keyboards that slope up tend to promote bending of the wrists. Any feet at the back of the keyboard should be folded away to eliminate the slope. These feet and the common sloping aspect of many keyboards is a hangover from old mechanical typewriters. The slope on these existed for mechanical, not ergonomic reasons. Some people actually find typing most comfortable with the keyboard on their knees.

Make sure your desktop is not too thick, and doesn't have a bar underneath it.

This allows you to get above the keyboard, without having your legs squashed under the table. Many computer desks have a separately adjustable keyboard section, made of thin wood. Make sure there is enough room for a forearm rest on this.

Using the forearm rest

Using a forearm rest properly requires practice and takes time to get used to. The key points are:

• Take off any watches, bracelets etc. that are on your wrist
• Drop your shoulders and rest the full weight of forearms on rest
• Make sure arms can move smoothly and easily on forearm pad
• Move hands from elbow - pretend your wrists are immovable

The key point to good forearm rest technique is moving your hands from your elbows and shoulders. There is often a tendency to leave the forearms in one place on the rest, then bend the wrist and hands to reach the keys. This must be avoided. Practice by pretending your wrist and hand is in a straightjacket and can't be moved sideways or up and down. When you are used to this, leave the wrists and hands relaxed, making all movement from the elbows. A good forearm rest surface is important for allowing this. Bare skin will stick to a forearm rest if it has a shiny smooth surface. Wear a shirt, jersey or top that extends to your wrists; alternatively place a piece of material on the rest. Experiment until your forearms move smoothly and easily on the rest.

Typing style

A number of style points are noted below.

• Don't bend your wrists sideways
• Let your elbows swing freely
• Keep your fingers in a curve
• Don't bend your wrists upwards too much
• Keep your thumbs relaxed
• Keep 4th and 5th finger relaxed
• Don't slap the keys - use finger press, not tapping action with hand and wrist
• Lastly and most importantly, try to type with rhythm, using smooth elegant movements.

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