I had literally the exact same experience as your first two paragraphs. Where my experience diverged is when I met a doctor of some kind who explained that it's the same kind of pain that truckers often get for resting their arms on the armrests. Turns out it was because I was resting my arms on the keyboard or the desk between me and the keyboard. Stopped doing that, the pain went away completely within a few days, and hasn't come back since. That was like 4 years ago. Just don't rest your arms on anything, that's the trick.

This helped me too. It was combination of desk edge and sleeping on the hand that was causing it. Started sleeping on back or the other side and resting full forearm on desk (so not on edge; at least pressure's distributed) or the actual proper posture (not resting forearm anywhere), and it went away fairly soon.

That makes a lot of sense, the best cure for my wrist pain I found was deep massage on certain places in my forearms. Thinking back the area I hit most often was the point where my forearms lay on the armrests.

Very helpful information, going to try this out, thanks!

Interesting. Could you be more specific about where your pain was located? Was it in you arms or wrists?

Anywhere from my pinky to my elbow, depending on the day and hour. Sometimes connecting them in a straight line.

Thanks for posting this. The article, and your post, also resonated with me.

I have small fiber neuropathy in my arms and legs, which causes constant pain and a feeling of weakness. I've had this for a few years now, and I'm very aware that it's only got worse over that period, and that I may later get damage to the larger nerves used for motor control.

Like you say, the pain and fear that coding (which is my livelihood and passion) may become impossible is quite terrifying, and a constant, nagging presence in the back of my mind.

I haven't tried any dictation software since the days of Dragan Dictate, possibly 1-2 decades ago, but I'd like to hope it's come in since then. It sounds like you really persisted with it, and I have a few questions about your experience if you don't mind:

1. Was the pace much slower, and did you get frustrated with it? A mouse and keyboard allows me to operate closer to the "speed of thought" than I would guess dictation software would

2. What do you say to move the cursor around, or switch between open files?

3. I'd guess there's a big difference between dictating a document and coding or working on the command line, as you're not always inputting "real" words. How well did dictation work in that regard?

4. Are any IDEs particular dictation-friendly?

1. It was slower and I was frustrated, yes. I don't know about the newer Talon software, but with VoiceCode I spent a lot of overhead just configuring my setup and tweaking it, to say nothing of the slower coding speeds while using it. But once you get going, it's faster than you might think, and it feels vaguely futuristic. In fact I'd say some things are faster. I used a lot more macros, for example. Scrolling is slow. I often cheated and would type or use my mouse.

2. Honestly I can't remember the specifics of my setup. It was too long ago.

3. Above, I'm only really talking about dictating for code. You need a bunch of custom commands for that. Dictating for writing prose was pretty straightforward. If memory serves, VoiceCode had a different mode you could switch into for that.

4. Not sure. I believe I was using Atom at the time. I now use VS Code.

To other readers: Be very careful about weight lifting. It has a lot of risks, both of immediate trauma and longer-term excessive strain. So seek the guidance of relevant professionals, including a physical therapist and/or an orthopedics specialist physician, either before or during weight lift training. This is doubly true if you have been in serious pain.

I'm not suggesting that you _not_ lift weights - just take care.

All exercise has risks. Walking has risks. The question is not what the risks are, but do the benefits of the exercise outweigh potential risks?

For lifting weights, the answer is absolutely yes. Strengthening bones, improving mental health, better sleep, lower blood pressure, less injury prone as you get older, etc. etc. These are the benefits of regular strength training.

For otherwise healthy people, you do not have to consult a professional before starting a weight lifting routine.

I'm sure that your caution is well meaning, and people should definitely ease into a new exercise routine slowly, but recommending that people talk to a doctor or PT before they go to the gym is an overabundance of caution that will lead people to skip out on it altogether out of a misplaced fear of injury.

I started to have knee pain in my early 20s and my dad had both knees replaces sometime in his 60s. I was afraid I'd end up that way and went to a sports clinic (I do a lot of dancing). I had patilla bilat; basically the knee cap was off to the side instead of sitting squarely.

They said everything else on my knee looked good. Out of all the physically therapy exercises, the most significant was cycling. I started to do a lot of cycling after that, which builds the muscles on both sides of the knee and helps keep the kneecap centered.

I had a similar experience, where the knee pain would start to return if I slacked off on cycling. These days I cycle ~100km per week (12km per day to work and back and a bunch on the weekends) during the summer and still dance and haven't had the knee pain return in years.

Try doing some rock climbing either outdoors or at the rock gym. Fixed my hand pain real quick.

An alternative grip exercise that can be done anywhere and avoids the injury risk of climbing, is to alternately make a fist and then open your hands as far as possible while spreading your fingers apart. Start slowly and gradually increase the speed and repetitions. Be sure to have at least one rest day between sessions (I actually think two rest days is better). After a couple of weeks, you should be able to do it extremely quickly for hundreds of reps until your forearms are completely fatigued. In each workout, try to open and close your hand more quickly than the previous workout. Make your fingers look like a blur of motion. It is surprising how completely fatiguing this can be after just a few minutes.

I did something similar quite often in my aikido classes. There was also a twist exercise - start with your fingers together palm parallel to the ground facing down, and rotate the forearm rapidly so the palm is facing up, and then back again. Repeat until you can't. Go back to the open close motion. Do those pairs 3x daily.

I stopped akido due to a knee injury, but yikes were my wrists strong for a while.

Do you know what this exercise is called?

The closest thing I've found is called a "Fist Flex," so I just call this a "Rapid Fist Flex." I adapted it from a rehab exercise I was given after an injury, which instructed you to only do 10 to 20 slow repetitions. Once I was largely recovered from the injury, I found that doing 20 repetitions at a slow rate did little for me, so I experimented and determined that just increasing the rate and exercising to fatigue allowed me to continue to strengthen as effectively as any weight-bearing exercise I had done. I think of it as using acceleration/deceleration to generate force rather than using weights, which is similar to what sprinting does for the legs, core, and arms. Take a look at a 100m sprinter. Rapid movement is very effective at strengthening and it works your full range of motion. If you want some extra resistance, just put your hands underwater in the bathtub when doing it.

In my case too much bouldering caused forearm pain that lasted for two years. Didn't stop me from typing, but it did have a significant impact on my daily life :/

I also suffered from hand pain from typing and took up climbing both inside and a bit of outside for a good 8 years solid.

I found bouldering to be way more intense than just top rope (eventually getting into lead) climbing. Most of my hand/arm injuries were from bouldering.

I concur with the previous response though... climbing, done well and not over doing it... was the 100% solution to my pain problem.

Sitting and typing all day, you lose muscle and strength, not just in your hands, but your arms, shoulders and neck. Climbing builds it right back and really helped more than any special keyboards or posture changes I tried.

I don’t suppose this could be translated into specific exercises in the gym?

Not the same especially with grip style but you can go a long way by strengthening your back. I'm talking of horizontal and vertical pulls (heavy rows, pullups, lat pulldowns, deadlifts to an extent).

In my unscientific observation, a lot of people have very weak posterior chains. My wrist pain has always (so far) been the result of a knot in my upper back or a weakness there.

Don't forget to foam roll, stretch and perhaps add in some periodic deep tissue massage to keep things from getting too tight cos that also brings problems

Search for climbing fingerboard or hangboard.

Good for fixing or hang above a door way.

You don't need to actively climb on these, hanging from the holds will do the trick and reduce the possibility of dynamic loads.

I used this as well. Same issue as bouldering. It tends to stress the joints too much.

For whatever reason, regular climbing is better. Probably because there is more 'levels' and thus less immediate stress. You can't really climb to the top of an indoor route until you can learn and get the strength to do it.

With fingerboards you try to see how much you can tolerate and tend to over do it. It also is more of a static movement. Grab and hold. Where top rope climbing is more dynamic... you're constantly moving up the wall in various poses.

There are lots of different stories and reasons for RSI. I’ve saved a bunch of them in a Github repo:

https://github.com/melling/ErgonomicNotes/blob/master/README...

I’ve also saved a bunch of Programming by Voice links:

https://github.com/melling/ErgonomicNotes/blob/master/progra...

"Make or Break" by David MacLeod has helped me fix a handful of climbing related strains - https://www.davemacleod.com/shop/makeorbreak - might not be relevant for you anymore, but I would recommend it for anybody who climbs

How much was too much? I can certainly imagine that bouldering could cause wrist injuries. But in my case, like above, it strengthened my wrists and improved the pain I was having from typing.

It just depends on how you are built. I tried to get into climbing for a while but the constant strain on the fingers caused more and more pain over time until I could barely use my hands. Took many years to get back to normal.

That’s why you should test a lot of advice if it works for you. Things that work for one person can be damaging for another.

Same position here - going on 2 years now. Did you ever get a diagnosis?

The current theory of my doctor is that it’s a brachial plexus injury - just waiting on some MRI results to confirm.

No diagnosis, but I did receive some exercises from a physical-therapist which helped significantly.

On a bad day I could barely hold a cup of tea with the affected arm. Now I just have a tense muscle now and again.

As someone whose had RSI for about 6 years and managed it well enough for work; bouldering would be literally impossible for me.

Microsoft split keyboard, footrest and proper chair with adjustable armrests allow me to work with minimal pain, and I work long/after hours frequently. Prior to sorting out that setup I took a month of work because I was in so much pain, which returned as soon as I returned to work (without the ergo setup).

Playing games, playing guitar (sadly) or using tools like screwdrivers for even a short period of time does not end well for me. I absolutely still do each of these in moderation, and I would love to go rock climbing! It's just highly unlikely to be enjoyable after the first few minutes.

I had mild pain in my wrists in the late 90's I switched to ergonomic keyboard, got a good office chair, and switched to Dvorak layout. I did this for my work and home environment.

One additional step I had to take. I removed they armrests from each chair and have continued to do so with all chairs. I found myself leaning into the armrests too much to the extent of causing abrasions on my elbows. With removal of the armrests I work and play at the computer with better posture. I mention this only because what works will vary between people and I think it's an important change.

Also, I have no idea what to credit with the pain of my wrists going away. I suspect Dvorak, but it was probably a combination of factors.

>I mention this only because what works will vary between people and I think it's an important change.

I really like this because I took an alternative option. I decided "home row" thinking was too confining when writing code (I probably write more scripts), and I can't think as fast as I can type with that sort of approach. My colleagues call me a "hunt and pecker," while I actually simply refuse the home row. Muscle memory is quite odd and can be cultivated to encourage less repetition.

Learning to play the guitar is a surprisingly good way to increase your hand strength - mostly the left/off hand, but not exclusively. Learning to play the piano has similar hand strength benefits. Obviously overdoing it in both cases can lead to it's own RSI issues. But just getting past the beginner stage really adds a lot of strength & dexterity.

I've certainly read this before, however are there any studies that back this up?

I played guitar before I got RSI. Now, I can't play for more than a few minutes at a time without ending up in pain - despite my RSI being under control for work purposes.

Actually, there's nothing quite like playing guitar in terms of causing me pain well after finishing the activity. Certain things like lifting heavy furniture, or using a screwdriver cause pain quicker but it also goes away pretty fast. 5 minutes of guitar will result in pain and weakness until the next day. Granted, it's not an enormous amount of pain, but it's certainly enough to be annoying. It sucks, because despite not being very good, I've always enjoyed playing guitar.

I should add that I also certainly never overdid playing either; I've never played a live show in my life and have never taken it too seriously, was just a hobby.

I wasn't trying to say that playing guitar was a treatment or therapy for RSI symptoms. Obviously any type of hand exercise can make things worse while your hand/wrist/ligaments are inflamed or you're otherwise subject to flareups of RSI.

The general idea in this thread was that increasing finger/hand strength could be a preventative action for people worried about RSI, and I think that's a reasonable train of thought - and playing guitar certainly does improve hand strength.

I think it's fair to say that no preventative action is 100% effective for the kinds of things we're talking about. I'm pretty sure other activities and factors, including genetics and luck play a lot into whether that increased hand strength is enough to prevent RSI in any individual case.

I do think it's good to bring it up as a warning though - it's very possible for any activity that uses the hands a lot to contribute to RSI symptoms rather than help, and people should really pay attention to what their body is telling them :)

Sorry to hear you're not able to play as much as you'd like - it's been one of my favorite things to do when I need to get away from the computer, and I'm super grateful it hasn't caused my RSI to return.

Same

If you have carpal tunnel, lifting weights can make things worse. It puts more stress in the narrow canal that your tendons go through, which cause the pain.

At the worst, I had continuous wrist pain and woke up in the morning unable to feel my arms. I couldn’t physically hold a mouse for more than about 15 minutes. When this happened I was also lifting weights.

I spent thousands of dollars on ergonomic chairs, keyboards, mice. It helped but didn’t solve the symptoms completely. I was unable to do things like use a laptop without pain.

Several years later I started doing basic body strength exercises. I thought I had permanent nerve damage by that point, but within about 4 weeks all symptoms were gone. That was 10 years ago.

I think a lot of these problems are related to shoulder, neck, and arm muscles. Stress, cold, seem to exacerbate the symptoms. Nothing I read in years of research had the right answer.

Can you describe what body weight exercises you found helpful? Why do you think those were different than what you were accomplishing with traditional gym weightlifting?

I think it was something related to the tight grip used in lifting weights.

I started with the beginning workouts from the book You Are Your Own Gym. In retrospect, 90% of the benefit was from the pushups, which I had completely avoided doing once I started getting severe wrist pain.

Re: dragonfly

Surely a bespoke and custom solution is do-able with ML anymore?

At least for me, I’m down to Python, and Go as my daily driver languages. I lean heavily into reusable code and can solve a lot of problems with imports from git sources (everyone all on about DRY and write less code, right?)

Feels like a reasonably constrained problem set to organize a few sequences of voice commands around.

I once had a similar experience, except it was the muscles in my back, between my shoulder blades, that were causing great pain. I eventually realized that 1) the issue was due to long hours of keyboard work, and 2) when I added seated cable rows to my lifting routine, the pain went away completely.

>After a little experimentation and observation, it was clear that my recovery was positively correlated with consistency in going to the gym for heavy weightlifting sessions

This was my experience as well. Started getting inflammation and pain on the top of both forearms that made typing for longer than 15 minutes very painful. I was convinced for a while that I had some sort of nerve entrapment that would need surgery to fix.

Ibuprofen helped a little, as did wrapping my forearms in braces, but the only thing that alleviated the pain long term was lifting heavy weights.

I don't have pain in my hands, but I get severe back pain from time to time. It's difficult to sit or stand (or be in any position, really) for a few days at a time.

I can do some things just fine, like type, but I certainly can't concentrate long enough to do any programming tasks because the pain is so distracting.

same here, and I will repeat csallen's solution: going to the gym and lifting heavy things (squat/deadlifts/etc with good form and comfortable pace) has turned my decades long back pain around completely.

It took about 6 months to really be sure it had improved, but it's been amazing, plus there have been significant cognitive benefits. Couple the gym with less sitting, and more standing -- couldnt be happier, wish I had done it earlier.

I can regularly workout and deadlift 500lbs - it has certainly helped but hasn’t eliminated the pain.

Going to add more anecdata to the thread. Going to the gym and swimming both helped with my neck and back pain.

When not going for some weeks (like when traveling) I can tell it becomes worse.

Plus you get in shape which is neat. I started out for health benefits but would be lying if I said I did not enjoy the visual benefits. :P

> It also relied on Dragon's NaturallySpeaking software, which I was dismayed to learn was still the best desktop software out there.

Sounds like a business opportunity especially with the barrier to AI being lowered. But I guess there is some real value in having been doing it as long as the Dragon team has.

So was this post written by speaking or typing?