Dealing with Repetitive Strain Injury: Part One — Choosing between gaming, coding, and lifting

For the past sixteen years, I’ve been a self-employed freelance web developer. I start most workdays at the gym getting in a lift and a swim. Then I’m in the office from nine till five writing code, working on servers, and designing page layouts. But, one thing I’m not is a gamer. I can’t play games and expect to stay healthy enough to also code and lift. Here’s the story of how I found that balance.

One Saturday back in 1990-something, my brothers and I convened at my brother’s office to play Command and Conquer on the network. Back then, networked gaming was a novel concept. We spent the better part of the day building armies and destroying each other’s bases. Also around this time, via an IT job I’d landed with the help of the other brother, I realized that I wanted my career to include working with computers. Finally, my brothers also got me into lifting weights. While I was an undergrad, four days a week, we’d meet at the gym to lift from five to six.

Gaming, coding, and lifting — these were my three great pursuits during my college years. However, by the time graduation rolled around, I was beginning to notice a tingling in my palms. It felt like I was always clutching an invisible pebble. It didn’t take long for me to realize I had a problem. Was it Carpal Tunnel?

My search for answers led me to Dr. Emil Pascarelli’s Repetitive Strain Injury: A Computer User’s Guide. Dr. Pascarelli explained how the area where your hand and forearm meet is a tight squeeze. All of the nerves, tendons, and ligaments that allow your hands to move are compressed into a tunnel of bone formed by your meta-carpels. The slightest inflammation of any of those tissues can put pressure on your nerves leading to symptoms much like my invisible pebble.

In my case, I was regularly typing on a computer keyboard, point-and-clicking with a mouse, and lifting weights. The delicate tissues in my wrists couldn’t handle it. At first I tried switching my mouse to a thumb-ball style. That helped for a while, but eventually my symptoms just moved into my thumb. I was at a loss. My love for coding and designing was growing, but so was my pain.

Dr. Pascarelli’s book showed me the way out. First off, I needed to rest my hands. Secondly, I needed to develop a plan for the long term health of my wrists, arms, and back.

As far as resting my hands was concerned, I was starting digital media school. This meant I my hours on computers would be increasing, but I could rest my hands considerably by not gaming. I also cut out lifting. Gripping weights was aggravating things.

Now that I had a handle on the amount of strain I was putting on my hands and wrists, I developed a maintenance plan. One of Dr. Pascarelli’s key ideas about repetitive strain injuries is that the problem isn’t just in your wrists. Carpal Tunnel Syndrome (CTS) is often a mis-diagnosis. CTS treatment strategies tend to deal with reliving the pressure in the carpel tunnel between your hand and forearm. However, the real problem often lies elsewhere.

Dr. Pascarelli prefers to deal in the broader arena of Repetitive Strain Injury. Our hands weren’t designed to be held in the same position while repeating precise movements hundreds of times a day. This can create undue tension in your back, arms, and hands leading to inflammation and nerve damage.

At this point you might be thinking a good wrist brace would help, but you’d be wrong. Putting your wrist(s) on lockdown can often prolong your problems. The key for me was letting my hands be free. No more rigidly holding my hands in the same position for hours while clicking a mouse. Instead, I learned to be aware of my body. If I felt discomfort I got up and moved. I learned to stretch my wrists.

Another trick I learned came courtesy of Dr. Frank Jobe, the first doctor to perform “Tommy John surgery”. He developed exercises which target the smaller muscles in your shoulders. I found that strengthening these relieved tension in my arms, wrists, and back. It was as if I was redistributing the tension throughout my upper body.

To target these muscles, Dr. Jobe prescribes using small weights (5lbs or less) and high-rep sets (~20 reps) of lifting my arms at various angles. The principle here being that using light weight targets the smaller muscles that stabilize your rotators cuffs.

Slowly, over a period of two years, my symptoms lessened and eventually went away. I was able to start lifting again, being careful to take it easy on my hands and wrists. I’ve now been lifting in the mornings and coding during the day, pain-free for sixteen years. During all this time, I’ve taken what I learned from Dr. Pascarelli and used it to develop long-term habits that have kept my wrists, arms, and back healthy. I’ll be going over those in Part Two of this series.