The HAND Book - KeyMoves Training Program

1 KeyMovesElectronicEditionERGONOME P R E V E N T I N GC O M P U T E R I N J U R YTHEHANDBOOKThe Powerful, hands -On Guide to Safe Computer UseS T E P H A N I E B R O W NVIEWPRINT Each chapter number below is hyperlinked to its respective OF CONTENTSP reface ..3 Part One: At Your Keyboard1. The Natural Line and the Dangerous Angle ..62. Do You Need a New Keyboard?..83. Sitting Well ..104. Ungluing Your Elbows ..125. Thawing Your Wrists ..136. The Spider Position ..147. Sore Relaxing Your Rings and Pinkies ..189. Butterfly Fingers ..2010. Resting at Home ..2111. The Evils of Lifting and Snapping ..2312. Think hands , Not Fingers ..2513. Travelling Don't Squeeze the Mouse ..29 Part Two: Caring for Your Hands15. Listen to Your The Four Stretches ..3317. The Five-Minute Warmup ..3518. Taking a Break ..3719. Massaging Your hands ..4220. Hot and Cold and Other Tips ..45 Bibliography ..46 Acknowledgments and Author Biography ..48 Preventing Computer Injury:The HAND BookKeyMoves Electronic EditionPublished byERGONOME INCORPORATED145 West 96th StreetNew York, NY (212) 222-9600 telephone(212) 222-6699 faxe-mail: 1992-93 Stephanie BrownCopyright 1994-2005 Ergonome IncorporatedAll rights reservedThis book is available only under valid license agreement with is the subject of multiple copyright registrations, and no part of it may becopied, reproduced or transmitted in any form or by any means whatsoeverwithout the prior written permission of Ergonome.

2 The Method of Prevent-ing Repetitive Stress Injuries During Computer Keyboard Usage embodied inPart One is patented by Ergonome under Patent Number 5,638, Users of this book are entitled to practice such Method, withoutrestriction, in perpetuity. Unlicensed teaching of such Method is prohibitedunder Patent HAND book is intended to help prevent Repetitive Stress Injuries, suchas Carpal Tunnel Syndrome, acquired from typing at computer is not represented or warranted to provide a cure for existing injury, norshould it be used as a substitute for medical advice; please be sure to con-sult your physician if you suspect that you may have a Repetitive StressInjury. Due to the fact that all individuals interpret and use informationdifferently, neither the author nor the publisher can be held responsible orliable to any person or entity with respect to any consequences caused oralleged to be caused, directly or indirectly, by the use of this of Congress Catalog Card Number: 93-73771 ISBN 1-884388-01-9 Made in the United States of AmericaFor optimal viewing, go to Acrobat View menu and choose Fit Page.

3 Return to Table of Contents3 PREFACEI decided to write this book when I learned of the rapid increasein the number of people who suffer from computer-related hand inju-ries. Known as Repetitive Stress Injuries (RSI) or Cumulative TraumaDisorders (CTD), these conditions include tendonitis, carpal tunnelsyndrome, cysts and bursitis. Symptoms can range from feelings of numb-ness, tingling, burning and throbbing to weakness and even paralysis inthe fingers, hands and arms. Afflicted people face possible surgery,extensive loss of time at work, and, in some cases, even eventual unem-ployment. Often the simplest of tasks, such as picking up a fork, will beexcruciatingly painful for three-year study by the National Institute for Occupational Safetyand Health estimated that more than 20 percent of people whose workis primarily at a computer keyboard are a pianist, I have been aware of such injuries since the mid-70 swhen I was a student at The Juilliard School of Music.

4 Approximatelyone-quarter of the piano students there suffered from the very same dis-orders. My roommate, for example, would have red streaks running upand down her arms after playing for an hour, and she was in so muchpain that it was often difficult for her to brush her motions used in playing the piano are almost identical to thoseused in typing on a computer keyboard; a pianist will use more weight,and obviously needs to cover a wider keyboard, but the finger and armmovements are basically the same. Indeed, before the use of computersbecame widespread, these problems were usually thought of as pianists problems. Although about 25 percent of those piano students experienced pain,there were many who played all day without feeling the slightest everyone who uses a computer suffers either. Why can some peopletype all day with no difficulty, while others will feel acute pain? Is therea crucial difference between the way these two groups of people areusing their keyboards?

5 Are some people using positions and motionsthat virtually guarantee they will injure themselves? The answer to thelast two questions is, unfortunately, idea that certain motions or positions can cause injury is knownin virtually every field of sports. If you play golf or tennis, or swim,chances are you ve had lessons to learn the right way to perform astroke. You ve worked on it and you ve learned how to avoid positionsand motions which are dangerous and are known to cause painfulconditions like tennis-elbow, bursitis or tendonitis. You have also atone time or another had the experience of watching someone swing atennis racquet or a golf-club, and thinking to yourself, Ouch! It justlooks at a computer keyboard may not be a sport, but with RSI sbecoming so prevalent, it is clear that it must be seen as an athleticactivity, with many of the risks and dangers of any athletic activity. Typingmay be micro-athletic, but it is athletic nonetheless.

6 The actual motionsused in typing are small and so are the muscles involved, but that justmakes the muscles all the more prone to injury. A shoulder or a thighmuscle can take a great deal more use (and abuse) than can a tiny ten-don in your hand. The slightest swelling of these tendons, or in thesheaths which protect them, can lead to debilitating pain and make itvirtually impossible for one to type, or do much as we would take lessons to fix something in our golf ortennis game, we need to learn a better way to type if we re experiencingpain, or even slight strain, at the keyboard. The connection has to bemade between harmful positions and motions at the keyboard andconsequent injury. Many of us learned little more than a-s-d-f-g andsemi-l-k-j-h when we studied typing, if we studied it at all. It is notenough. We need to learn how to work at our computers now there have been several solutions for sufferers of RSI s:Firstly, inventors have been rushing to design new keyboards, some ofthem requiring that the user learn a totally new typing system.

7 Althoughothers of the new keyboards use the traditional key layout, they areexpensive, and while some of them may be beneficial, this book willdemonstrate that they are not necessary for safe the already injured there is no substitute for the counsel andcare of skilled physicians, and the medical profession has developedextensive means of helping such people to manage their injuries. Theseinclude physical therapy, anti-inflammatory drugs, anesthetics, musclerelaxants, cryotherapy (cold treatment) and thermotherapy (heat treat-ment).Return to Table of Contents4 Splints can be placed on the hands and forearms of some victimsto prevent them from getting into unnatural positions while they re , however, these are effective on only a few of the dan-gerous positions, and they can sometimes even be harmful because theylock the forearms and wrists into stationary positions. The hand sur-geon Peter A. Nathan was quoted in CTD News, an occupational healthnewsletter, as having said, The benefits of immobilization through splintsand braces is an old wives tale.

8 Splinting can cause a weakness inforearm muscles that bend and straighten the wrist and fingers. The constriction of natural motion can be as dangerous to the armsas the unnatural positions which the splints are intended to are a temporary solution, at best, and when they re off thewearers often go back to the habits that brought them to grief in thefirst remedies include the injection of cortisone to reduce swell-ing and, in cases of carpal tunnel syndrome, surgery to cut the ligamentat the base of the wrist. Obviously, neither is without its unwantedcon- sequences, and even after such serious treatment patients who havenot learned safer ways to work at their computers will revert to oldhabits, with the expectable result. As the Mayo Clinic reported in itsProceedings of July, 1989, If followed by a return to the same traumaticenvironment, the operation is often unsuccessful in controlling symp-toms. Still another solution is to find a new occupation one which doesn tinvolve working at a computer.

9 Although sometimes companies canoffer their employees alternative jobs, obviously this is simply not apossibility for most people. It also leads to another extremely unfortu-nate phenomenon, namely that some people are afraid to report theseproblems for fear of being thought difficult or even getting fired. Here theafflicted are caught in a double bind, because by putting off treatmentthey only insure that their problems will grow still oldest cure of all is, of course, rest, and sometimes doctors arecompelled to advise people that they face a lifetime of pain and perhapspermanent crippling if they don t take off from work for anywhere froma few months to several years. Unfortunately, however, the economicrepercussions of this prescription are usually at least as severe as tryingto find a new line of extreme as these solutions are, they do not attack the problemat its origin namely, what people are doing at their computers tohurt themselves.

10 They are all responses to the effects of Repetitive StressInjuries. The solution proposed in this book is to attack the causes. Theseproblems can be drastically reduced by showing people how to work attheir computers safely. RSI begins at the keyboard and must be solvedat the Training is quick and very simple in fact, its success is duein part to its ease of comprehension and the speed with which it can beput into practice. It is my experience that it is effective both in prevent-ing initial injury and in teaching the already injured how to avoidre-injury after medical HAND book consists of two sections: Part One, At YourKeyboard , and Part Two, Caring for Your hands .In Part One, you will learn to identify the common positions andmotions you may be using at your keyboard which are dangerous foryour hands . The illustrations and photographs will help you torecognize the dangerous positions and to learn what the correct and safepositions are.