![[info]](http://l-stat.livejournal.com/img/userinfo.gif){kind=small}
Bevan Loon asked me about my RSI the other day.
I started to reply then and there but the answer got way too long, and
besides it's kind of relevant here because it's (somewhat indirectly) why
I got into shiatsu in the first place.
A brief rundown: I started getting pain from typing in 2001, and after a lot of procrastination and denial I ended up seeing some specialists. Their prognosis was that my nerves were too short; various actions associated with computer use were causing them to stretch and snag, and this had damaged my ulnar nerves where they pass under the elbow. It was recommended I have surgery to move the nerves to the tops of my elbows where they would be less prone to damage and be allowed time to heal.
I declined the operation. I couldn't say why — I don't fully know even now — but it just didn't feel right. Here's what I did instead, in no particular order:
Ok, I think that's it!
A brief rundown: I started getting pain from typing in 2001, and after a lot of procrastination and denial I ended up seeing some specialists. Their prognosis was that my nerves were too short; various actions associated with computer use were causing them to stretch and snag, and this had damaged my ulnar nerves where they pass under the elbow. It was recommended I have surgery to move the nerves to the tops of my elbows where they would be less prone to damage and be allowed time to heal.
I declined the operation. I couldn't say why — I don't fully know even now — but it just didn't feel right. Here's what I did instead, in no particular order:
Read up
This basically provided the context for everything else I did.
There's all kinds of stuff on the net, but what did it for me was It's
Not Carpal Tunnel Syndrome. I cannot recommend this book highly
enough.
Breaks
I use Workrave to
enforce 30 second breaks every three minutes and five minute breaks
every fifteen. You need to stop and move your arms to allow your
muscles to untense. Locked muscles from periods of typing or mousing
without otherwise moving inhibit the smooth movement of tendons and
nerves.
Keyboard
I use a Kinesis
Advantage keyboard. I tried a couple of other keyboards first,
but a major part of my problem is that I flatten my hands as I type
and the Kinesis makes this impossible.
Mouse
There's a variety of options if holding the mouse hurts your hand
— different sized mice, trackballs, etc — but this wasn't
a problem for me. What does me in is reaching for the thing:
it trashes my rhomboids. The Kinesis helps here — there's no
numeric keypad between my hand and the mouse — and I make heavy
use of keyboard shortcuts. I try and remember to type these with two hands so I'm
not stretching unnaturally.
Desk
It's standard advice that you should adjust your chair so that your
forearms and thighs are horizontal. The problem here is that you
probably only have chair height to play with and you cannot set two
things with one adjustment — one of them is going to be wrong.
I have an adjustable desk. You set the chair to get your
legs right, then you set the desk to get your arms right.
This would not be such an issue if desks were roughly the right height
to start with, but most desks are too high for most people. I'm 5'10"
and the top of my desk is 26" from the floor. My old desk was nearer
30".
Physiotherapy
It was my physiotherapist who first figured out that the pain was
snagging nerves. She did some stretches and trigger-point stuff to
release locked muscles along the path of the ulnar nerve, and showed
me some I could do myself. I supplemented these with some nerve
glides from the book I mentioned earlier. We also figured out that
cold made it worse and heat made it better, so I started having a bath
after work each day to loosen everything out. Sometimes if I get sore
hands I run them under the hot tap for a minute or two.
Posture
The physio and baths provided some relief but they weren't addressing
the underlying problems. My nerves may well be shorter than average,
but this wasn't helped by my posture. When you sit upright your
nerves have a nice straight path through your shoulders and your
muscles don't need to work much to keep you upright. Slouching means
the nerves have to kink a little and so cover a longer distance, and
the tensed muscles supporting you are take up more space and are less pliable than
relaxed muscle; they fill the spaces your nerves should be able to
move freely through. The physiotherapist gave me a load of exercises
to improve my core stability — when you've slouched forever the
muscles you sit up straight with need a kick-start. The book
recommended some shoulder strengthening exercises which I also did.
Sleep
This is an odd one, but it's hard to sit up straight when you're
tired. I try to make sure I get good quality sleep because everything
hurts a lot more when I don't.
Yoga
Back then I thought that yoga was all about stretches and posture, and
since my treatment was all about stretches and posture it seemed
natural to me to try some. And it did help these areas some, but the
major benefits were not what I was expecting. Firstly, it made me
aware of what was going on in my body. Part of the reason my
RSI got so bad was that I spent so much time in my head that I only
paid attention to my body when it started going seriously wrong. And
secondly, most importantly, it started the long, slow process of
calming me down and chilling me out.
Alexander technique
Yoga is only incidentally about tension and posture; in Alexander
that's all there is. I was recommended a teacher who'd got
into Alexander because of RSI and spent an obscene amount of
money learning how to sit down and stand up and pick things up off a
table. It was totally worth it.
Shiatsu
Yoga was for me a huge step change in relaxation and posture and body
awareness. Alexander was a change of a similar order of magnitude,
and starting to learn shiatsu was another order of magnitude again.
Obviously I'm not finished with this one yet!
Let go
The yoga and Alexander and shiatsu started me learning just how much
of RSI is from the mind. Not in the mind, but from it. It's
Not Carpal Tunnel Syndrome actually covers this in great detail,
but for some reason it passed me by until years later. A major cause
of RSI is mental attitude.
It's about letting go of perfection, about letting go of getting things done right now. Sometimes when I'm working I'll not be happy with something. It's not 100% right, so I'll fiddle and fiddle and fiddle for hours on end. Then I'll decide that the original way was better and I'll revert all my changes. Then I'll think of another way to do it and start fiddling all over again. A big part of letting myself recover is recognising when I'm in this state and being able to walk away.
It's about letting go of perfection, about letting go of getting things done right now. Sometimes when I'm working I'll not be happy with something. It's not 100% right, so I'll fiddle and fiddle and fiddle for hours on end. Then I'll decide that the original way was better and I'll revert all my changes. Then I'll think of another way to do it and start fiddling all over again. A big part of letting myself recover is recognising when I'm in this state and being able to walk away.
Ok, I think that's it!