Be Kind To Your Wrists (you’ll miss them when they’re gone)

1. Be Kind ToYour Wrists (you'll miss them when they're gone) Denise Paolucci Dreamwidth Studios denise@dreamwidth.org Tuesday, June 4, 13

2. Slides downloadable at end of talk Tuesday, June 4, 13

3. DISCLAIMERS • I am not a doctor • Or a physical therapist • If you're having symptoms, GO TO A DOCTOR • Cape does not enable wearer to ﬂy Tuesday, June 4, 13

4. Show of hands: Tuesday, June 4, 13

5. A cautionary tale Tuesday, June 4, 13

6. Age 10 Tuesday, June 4, 13

9. age 22 :( Tuesday, June 4, 13

10. • Carpal Tunnel Syndrome • Medial epicondylitis ("golfer's elbow") • Lateral epicondylitis ("tennis elbow") • Radial Tunnel Syndrome • Ulnar nerve entrapment (Cubital Tunnel Syndrome) • Thoracic Outlet Syndrome Tuesday, June 4, 13

11. Tuesday, June 4, 13

12. Carpal Tunnel Syndrome • Compression of the median nerve • Numbness/tingling in thumb, index, middle ﬁngers • Waking up with entirely numb hands • Poor ﬁst grip strength • Pain: possible, but not a key indicator Tuesday, June 4, 13

13. Radial Tunnel Syndrome • Compression of the radial nerve • Pain in top side of upper forearm • Very similar to "tennis elbow", but nerve- based, not tendon-based • Muscle weakness in back of wrist/forearm Tuesday, June 4, 13

14. Cubital Tunnel Syndrome • Compression of the ulnar nerve • Numbness/tingling in pinky and ring ﬁnger • Ulnar compression starts at elbow • Can manifest as pain in forearms Tuesday, June 4, 13

15. Lateral Epicondylitis • aka "Tennis elbow" • Tendon-based, not nerve-based • Pain in elbow and back of forearm Tuesday, June 4, 13

16. Medial Epicondylitis • aka "golfer's elbow" • Tendon-based, not nerve-based • Pain in underside of forearm, especially with resistance Tuesday, June 4, 13

17. This isn't an exhaustive list of either RSIs or symptoms Tuesday, June 4, 13

18. Ergonomics "scientiﬁc study of the efﬁciency of people in the workplace," coined from Greek ergon, "work" + second element of economics. (http://www.etymonline.com) Tuesday, June 4, 13

19. Kinesiology from kinesi-, combined form of Greek kinesis "movement, motion" + -ology. (http://www.etymonline.com) Tuesday, June 4, 13

20. Rapid Treatment GO TO THE DOCTOR. I MEAN IT. Tuesday, June 4, 13

21. Ergonomics Adapt your environment to your body, not your body to the environment. Tuesday, June 4, 13

22. Every body is different. Listen to your body and to the feedback it's giving you Tuesday, June 4, 13

26. (image credit: http://www.abates.org) Tuesday, June 4, 13

27. • Top of monitor at height of eyes • Keyboard height at or slightly below elbow height Two most important rules: Tuesday, June 4, 13

31. Ulnar deviation Tuesday, June 4, 13

32. Radial deviation Tuesday, June 4, 13

33. Dorsiﬂexion Tuesday, June 4, 13

34. If you take one thing home from this talk, make it this: Tuesday, June 4, 13

35. THROW OUT YOUR WRIST REST (they encourage awful habits) Tuesday, June 4, 13

36. Hands ﬂoating, wrists neutral, in line with shoulders Tuesday, June 4, 13

37. Obviously impossible with a standard keyboard, but get as close as you can. Or: Tuesday, June 4, 13

38. Input devices • Same principles • Neutral position • Vary your motions • Minimize elbow and forearm motions Tuesday, June 4, 13

39. Kinesiology Adapt your motions and condition your body Tuesday, June 4, 13

40. Stretches At least 2 minutes, every 15-20 minutes.Yes. I mean it. Even if you're deep in hack mode. Especially if you're deep in hack mode. Tuesday, June 4, 13

41. Inner wrist stretch • Interlace ﬁngers • Turn palms out • Extend arms to push palms away from you • Hold 10-15 seconds Tuesday, June 4, 13

42. Overhead stretch • From previous stretch, reach upward • Palms "pushing" against ceiling, shoulders pulled back • Stretch should be in shoulders, not biceps • Hold 10-15 seconds • (stop if your hands go numb) Tuesday, June 4, 13

43. Shoulderblades stretch • Hold hands ﬂat • Extend hands all the way out, at your sides • Rotate arms in small circles, keeping shoulders back Tuesday, June 4, 13

44. Cross-body arm stretch • Hold out one arm • Hook other arm around it and pull ﬁrst arm across your body • Leave your wrists relaxed! Tuesday, June 4, 13

45. Enforcing Stretch Breaks • Workrave (Linux,Windows): www.workrave.org • TimeOut (Mac): http://www.dejal.com/ timeout/ • Firefox: "Take a Break"; Chrome: "Break Helper", "Gimme a Break" • Trusted friends or signiﬁcant other :) Tuesday, June 4, 13

46. If it hurts: STOP TYPING You do not get prizes for being stoic! Tuesday, June 4, 13

47. What if you're already showing symptoms? (You know I'm going to say it: GO TO THE DOCTOR. But there are a few other things, too.) Tuesday, June 4, 13

48. Sleep in wrist braces • You do more damage to your wrists overnight than you think • Metal insert removable so you can wash them • (You'll really want to wash them.) • But don't use them to keep typing through the pain or numbness Tuesday, June 4, 13

49. Ice • Eight gazillion brands of reusable ice packs; gel style is most adaptable • In a pinch: ice cubes in a ziplock bag! • 20 minutes at a time, three to four times a day • Keep more than one in freezer so you always have one cold Tuesday, June 4, 13

50. Regular massage • Look for sports massage or neuromuscular massage therapists • Make sure your therapist is accredited and experienced with RSI treatment • American Massage Therapists Association: http://www.amtamassage.org/ﬁndamassage/ Tuesday, June 4, 13

51. All together, now: Tuesday, June 4, 13

52. GO TO THE DOCTOR • Not your GP: see an orthopedist who specializes in RSI treatment • There are other options than surgery -- sometimes rest alone will work! • Each case is different and sometimes there is no surgical treatment • Surgery is not the end of the world, though Tuesday, June 4, 13

53. Q&A (or grab me later) Slides available at: http://www.slideshare.net/dreamwidth/be-kind-to-your-hands or http://tinyurl.com/k8tys82 Tuesday, June 4, 13

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