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I have managed RSI for decades, so consider this anecdotal of course.
The one thing that has always given me relief: changing my keyboard every 6 months or so.
For this reason I have a stack of different keyboards and whenever I start to feel the tugging pain gnawing in my hands muscles and tendons, I switch out the ol’ keyboard and get back to work.
Within a day, relief.
Seriously, it’s that simple. Just don’t get fixated on a single keyboard and you’ll be fine. Get yourself a small collection, swap them around.
This is a great idea and I wouldn't be surprised if it has brain benefits too. This reminds me of the recommendation to take different routes to daily destinations as a form of mental workout.
This works for me too, and I think it's the variation more than any particular board. I rotate between a split ortho, a low-profile Choc one, and an old Model M. The Model M is the one that feels worst on paper, but my hands never complain about it. Gotcha: the first day on a new layout always hurts more, so don't swap mid-deadline.
I thought I would share. I don't see this discussed much and thought it was interesting (it's my own post) when doing some introspection today. Is it from moving up in my career and I just type a little less? Has the movement from typing in a code editor all day to writing more prose helped? It's hard to say for sure, but a fun observation. :) I am curious if anyone else has experienced the same.
I have experienced exactly what you describe here. I am battling RSI for more than a decade, it has nearly cost me my career. Like you and many others, I have tried all sorts of things. I got the most improvement from:
- An ergonomic split keyboard, with a custom layout
- An ergonomic chair and desk setup
- Relearning to type from the home row
- Using dozens of custom shortcuts to reduce awkward hand movements
- Yoga and stretching
- Building a more active lifestyle with total body movement as a focus
- Improving diet to reduce inflammation
Despite all those interventions I still suffered debilitating hand and wrist pain, which eventually crept into my shoulder blades and back muscles. Doctors and physios were useless or clueless. One doctor refused to acknowledge that RSI exists. No amount of physiotherapy helped.
Using LLMs to do (almost) all of my coding tasks has reduced my RSI pain and stress by half or more. I feel so much better and healthier. I still have pain, and I still have to work hard to manage it, but I will never go back to writing everything by hand.
Thank you for sharing, and for reading. Wishing you good health.
The shortcuts one is underrated. I went through the same thing and what helped most was moving the stuff I did constantly (window switching, paren jumping, git commands) onto home-row layers so my hands never left position. Voice dictation for prose was the other big one, honestly. Cut my typing maybe 40%.
Long ago I worked on a project where the whole team was so productive I gave myself cubital tunnel from typing so fast for so long. I'd feel needle jabs in my forearms randomly. Like while standing around. Doctor recommended surgery.
Avoiding surgery involved months of finger stretches, forearm massage, 2 keyboards and 2 mice at different elevations, typing with my hands hanging slack like a zombie. It worked. But, even typing this out 20 years later I can still feel the RSI hiding in the shadows. Since then I've avoided RSI by spending 10x more time thinking about code than typing it.
All that is setup for: There have been many times recently where I've thought "I know exactly what I want this code to look like. But, damn. That's going to be a lot of keypresses..." The effort is nothing. Risking nerve damage is the concern.
In those cases I have been thrilled be able to tell AI exactly what to make, how to refactor it, how to clean it up, clean it up more, yet more, still not done. All in less than 10% of the keypresses that would have been required to type it by hand.
I'm not saying this to be snooty or whatever, but RSI is also solvable via a custom keyboard or learning Vim motions (or both). I had really bad RSI and it totally went away after the combo of learning to type properly (which you mentioned in your post) and switching to Vim full time. Vim motions reduce the amount of stretching you need to do by a LOT. Snippets also helped. I am of course talking about in The Before Times.
I am saying this to be a little snooty. Your take is very dismissive to a large group of people whose experiences you don't know. I agree that split/custom keyboards and vim are awesome; I have used them for 25 years. But the idea that you can reduce RSI treatment and everyone's situation to something so simple just isn't true. It is fine to recommend solutions to people who are suffering, but to dismiss their problems as being "solved" comes across as basically calling them stupid for not helping themselves.
I know you didn't say that, and you softened your language, but many people with disabilities or chronic conditions have to deal with everyone they share their problems with telling them their "cure". Its exhausting.
It's generally also just less typing if you are using long running agents, you can input the goals, steer it a bit then go for a nice walk and check in again on it in 30-40mins. I hope we can normalise this workflow as it will be much better for everyones health and longevity in the field.
IMO LLMs are the best thing to happen to coding in my ~15 years of being in the game.
I wager they have probably added on another 5-10 years to my engineering career as I was contemplating getting out before they showed up.
Have also been convincing some friends that have "gone woods" over the years to put the woodworking tools down for a day or two and give them a go. So far so good, a few folks have found the spark again and it's been awesome to see them make digital things again too.
That's been my experience as well. I remember the pain from the keyboard and also doing too much clicking when making wordpress websites. Now that I do more agentic development, I type a lot less and am working to dictate more with voice also.
- Learning to type better (I still suck, but speed is fast enough, and I don't get a soar neck or fingers from my previous glance at KB then back to monitor and smash keys)
- Positioning top of monitor to eye level
- Gradually transitioning from programming through rapid trial and error, to building and exploring logical models of programs in my head, then type out some code that usually works.
All my experiments and usage of AI if anything lead to more typing rather than less.
For folks experiencing RSI, I recommend Talon voice and Cursorless extension. I experienced thumb pain that I kind of ignored for a while - look into prehab exercises before it becomes a concern since any aggravating motion could make it worse quickly.
I haven't read it yet but folks might benefit from this recent book, Body Electric: The Hidden Health Costs of the Digital Age and New Science to Reclaim Your Well-Being.
I find Talon super cool and I so want it to work.
But my understanding is, that wayland won't work ever.
It makes me sad as otherwise wayland seems cool and future too.
Also my english pronunciation sounding like bucket full of rusty nails being dragged on motorway, makes the freeform so frusturating.
Naming things is such paain at that point.
But oh, how much do I wish I could get it working.
What helped my RSI was learning a new computer layout (dvorak in my case). It went away and has stayed gone for 25-ish years. Keeping bikeyboardal between qwerty and dvorak probably helps.
LLMs have not changed how much I type and mouse, I think.
I second the "change input devices up once in a while" suggestion. And I would say that Apple Trackpads and Keyboards are the ones that work best for me most of the time. Especially the Trackpads work incredibly well because with the sensitivity turned way up, I have to barely move my hand and use almost no force when using a cursor and clicking. I can also vary how I hold/rotate my wrist and compensate by adjusting my input finger(s) and/or changing which finger I use. With the keyboard, it's mostly about having very short travel and actuation force as well as a little bit of dampening. I do have a collection of ergo and mechanical keyboards, mice and trackballs but especially when I feel pain, I always go back to the Magic Trackpad and Keyboard. Wrist rests are a no-no and trying to keep your wrists floating is good.
I solved (managed) my computer-use-related RSI. Here’s how:
1. Multiple mouse input methods: I switch between a vertical mouse and a Wacom tablet throughout the day.
2. Good armrests: I have an ergo chair with some of the most adjustable armrests you can get. Armrest position is a big factor. You want your arms close to in plane with the desk.
3. Mouse and keyboard wrist rests.
4. Stretching: I do forearm stretches every hour or so.
5. Grip trainers: just like it’s not good for your eyes to only look at a screen inches away continuously, it’s not good for your muscles to only do fine, precision work for hours. Break it up with some strength training. I’m fond of the gyroball style or the basic spring tension trainers.
Biggest thing that helped with mine was moving to a more ergonomic keyboard. Usually split between using my datahand and my planck. Honestly even just switching to a 40% ortholinear was a huge change, it eliminated way too many awkward movements.
Guess I've just been lucky. 40 years ago used to take 800 ibu before going to work each day. Over time, less typing lead to less problems. But yeah, people I've known have had surgery that sometimes helped, sometimes not.
Two things helped me. First is easiest to explain: cutting back or eliminating caffeine. Seriously. And my carpal was fairly bad, so I know what a troubling (literal) pain it can be. I found it was made much worse by my 4 cups a day habit back then.
Number two is more complicated to explain, but it is a mighty powerful keyboard skill that can sometimes go a long way to reducing the "awkward reach" keystrokes. Specifically, copy and paste! Read on:
(TLDR: learn Ctrl-Ins, Shift-Ins, and Shift-Del, maybe. Instead of Ctrl-C, Ctrl-V, and Ctrl-X):
In the past I often found myself doing long sessions of paging up and down documents and source files, and doing complex copy and paste actions, for reasons. Ctrl-C and Ctrl-V were not so awkward on the original IBM-PC keyboard, because Control was right where it should have stayed, ha (where your CapsLock key is now.) When they moved it to the lower left and lower right spots, it made it a tough reach with just your left hand. You could learn to do RightControl + LeftC for copy, but I never did. Instead, when I need to do a lot of copy and paste with paging up and down also, I get my right hand at the home position on the (full sized) numeric keypad (in arrow mode not number mode), and I get my left thumb and forefinger on left shift and control. Then PgUp, PgDn, Home, End, Ctrl-Home, Ctrl-End are all lightning fast. But most importantly, and the point of this rant, LeftCtrl + NumericKeypad-Ins is COPY, LeftShift + NumericKeypad-Ins is INSERT, and LeftShift + NumericKeypad-Del is CUT. I have never met anybody that could do cut, copy, and paste faster than I, in a long career, if I must say so. Try it for a moment, your fingers barely move when you learn the technique. But I never could talk more than one or two people into learning the skill, much to my disappointment. And now I'll probably never do any long sessions like that again (because AI mostly like you said), oh well.
Caffeine is an interesting one, maybe it caused unnecessary muscle tension?
I've tweaked my keyboard layout so that caps lock is left ctrl (with KDE this is just one click away in the settings). I never need caps lock anyway. That helps a lot with different keyboard shortcuts. The default ctrl position is awful.
I would guess that it directly affects the nerves where they travel through the wrist tunnel, but I’m just guessing.
I do know that after days where I have had caffeine, that night I have a tendency to sleep with my hands curled up under my chin, instead of a more relaxed sleeping pose, which I think is probably bad for the blood flow in my hands.
> TLDR: learn Ctrl-Ins, Shift-Ins, and Shift-Del, maybe. Instead of Ctrl-C, Ctrl-V, and Ctrl-X
This is funny, because it was the opposite for me: retraining from Ctrl/Shift+Ins/Del to Ctrl+C/V/X helped reduce the pain in my right hand, which is already overloaded by the navigation keys.
But cording with two hands is a good point, I’m doing that as well.
I’m also using a curved ergonomic keyboard where the Ctrl keys are wider and less badly placed due to the curve.
We had three devs with wrist pain at our old shop. The two who started lifting got better within a couple months. The one who dropped $300 on a split keyboard and a vertical mouse didn't. Tiny sample, but I'd try the gym before buying gear.
I'm not saying this to you argue or disagree with you at all but just one thing I want to point out is that when you are doing your back exercises it was likely engaging your finger, forearm, and other muscles used for typing and so strengthening those is what might have helped even more than strengthening your back itself
I don’t think so, often pain in a muscle is due to weakness in supporting muscles. For example I had knee pain due to lack of muscle strength in the rest of my leg and back. I was also diagnosed with a specific deficiency in the trapezoidal muscles which was causing both RSI and lower back pain. It’s kinda a rule of thumb in physio to look for lack of strength where the pain isn’t
I set up a custom keyboard in software years ago and it’s much better than the terrible European layout family for coding. So I can type all code comfortably. I can also type all the special characters that I want comfortably. All those “typographic” characters that make technical people go “that must be LLM, 95% confidence”.
I have considered dedicating time to stenography but it likely won’t happen (95% confidence).
I have tried to set up foot pedals but the crap that I bought wasn’t really that helpful.
I have had some success with an auxiliary little keyboard for special functions. I really like having auxiliaries. Because then I don’t need crazy key combos. I can even have visuals for those auxiliaries.
Going beyond that. I have not RSI issues with my hands which can make typing annoying. So I would definitely be interested in other things to make me type less. Like voice dictation. But truly bless the obiquity of the Open Office, the facilitator of so much collaboration and I don’t know what.
> This was even more common when I was a junior. This would normally involve trying to type special characters all over the keyboard. Hitting angled brackets, hitting various FN keys, striking home, end, tons of modifier keys, contorting my wrist in all sorts of ways that I really should not be. This was part of the motivation to learn to type “the right way”: to reduce these types of problems. Probably something that made it worse is that my hands are much smaller than average as a male. My finger span could barely reach an octave if I tried and much more than this is tough:
Setting up this keyboard software and having learned touch typing 20 years ago[1], avoiding wrist contortion was essential. For example: for single-modifier keys I never strain, I just press the key. And then the other hand presses whatever key is to be modified. I do have multiple-modifier setups. But for those I never have to strain. For example: the equivalent of “Shift AltGr” might be two keys right next to each other that can be pressed by the index and the middle finger. It doesn’t get more comfortable than that for me.
Linux Xkb has the accessibility feature “sticky keys”. Of course, like any “accessibility” there’s nothing that says that people who do not strictly need it cannot have use for it too. I use it all the time. Being able to Shift and then hit A-Z keys is very nice.
[1] A separate topic. But touch typing might not be good ergonomically. Maybe some people who do not touch type have less issues. Ergonomics is really about adjusting a primate body from Africa to fit into an office space. So who knows what the correct objective answer is.
> I have my own set of complicated feelings of LLMs (gone are the bouts of satisfaction I would get hammering out code in an afternoon and watching it work at the end of the day). However, it seems increasingly more likely that from a health perspective perhaps they have been a boon to me. Or perhaps I am just senior enough now that it’s no longer a problem. At any rate, if the machines ultimately let me live a healthier life, then so be it. Without your health, you are nothing after all.
Really? You’re going to use the health truism to wave away any concerns? The “complicated feelings”? There are in fact ways to type more comfortably, and less.
This is all fine if the LLM use is incidental to the typing. We all have to either appease investors as businesses or increase shareholer value as laborers. But as an end in itself, using LLMs to type less is the most banal use case.
> I set up a custom keyboard in software years ago and it’s much better than the terrible European layout family for coding. So I can type all code comfortably. I can also type all the special characters that I want comfortably. All those “typographic” characters that make technical people go “that must be LLM, 95% confidence”.
Been doing this for years as well, "in software" being a custom layout in xkb in my case. Though for me the concern was limited to making it easy and quick to type []{}|<>. The only downside I've ran into more frequently than you would expect is that I feel more than a little lost without the xkb config.
Still suffer from RSI but I have to assume that it would be a lot worse with the Swedish/Finnish layout I'd be using otherwise. The placement of AltGr practically ensures that typing say [ is torturous, and RSI etc. aside, for sure this has to have had at least some sort of economical impact over the years across Europe.
The one thing that has always given me relief: changing my keyboard every 6 months or so.
For this reason I have a stack of different keyboards and whenever I start to feel the tugging pain gnawing in my hands muscles and tendons, I switch out the ol’ keyboard and get back to work.
Within a day, relief.
Seriously, it’s that simple. Just don’t get fixated on a single keyboard and you’ll be fine. Get yourself a small collection, swap them around.