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A writer's life is not an inherently healthy one.
We sit for long periods of time, and studies show that sedentary behavior is bad for us. We hunch over keys, creating back problems. We stare at screens, giving us headaches and we type and mouse a lot. All of this can lead to Repetitive Strain Injury.
I had back problems in the last few years that were solved by using a Swiss ball instead of a chair, and moving a lot more. We don't have a car so naturally walk a lot anyway.
But in the last few months, after a heavy writing stint in a cafe with tables at the wrong height, I developed RSI in my right wrist, elbow and upper arm.
After some initial denial, I visited the doctor, went to a physio and had an ergonomic assessment at my home desk. Since then, I've been using an Evoluent sideways mouse, as well as using my left hand a lot more. I'm practically ambi-mouse-strous these days 🙂 I've also been doing exercises to strengthen the arm.
I tried Dragon Dictate but just found it frustrating to use. I considered moving to paid transcription as Kevin J Anderson does with his walking/talking approach, but with everything else I was doing, the pain lessened. It's a lot better now but we all need to be aware of the possible strain injuries we can develop.
Lots of people have emailed me with tips on various ways of dealing with RSI, because, unsurprisingly, so many of us suffer
with it. Marianne Sciucco emailed me with her own story that, while extreme, is important because it emphasizes how bad things can get.
Prevention will always be better than pain and (hopefully) cure later on, so this is your wake-up call, writers! Sort out your physical writing position and exercise and stretching routine BEFORE anything happens.
Here's Marianne's story and also her tips at the end. Please do leave a comment with your thoughts and experiences of having or treating RSI as this is something critically important to the health of the writing community.
“What about your writing?”
This was a question I had not considered after my visit with the thoracic surgeon in March 2007. He’d advised me I needed two surgeries – the removal of both first ribs – to relieve symptoms caused by thoracic outlet syndrome (TOS). This would necessitate a leave of absence from my job as a hospital nurse case manager for a minimum of six months.
Devastating news.
I'd suffered from TOS and a collection of other repetitive strain injuries for the last year, undergoing months of physical therapy which had not corrected the problem.
My biggest concern at the time was missing work. My department was undergoing great change as we moved into a fully computerized system to perform our duties. I was 100 percent in favor of these changes and looked forward to being a leader in the transition. A six-month leave of absence would effectively remove me from the process. Little did I know that once I took that leave of absence I would never return to that job.
But it was the question asked by a coworker who had a great interest in my writing that rattled me.
“What about your writing?”
This question stopped me in my tracks. What about my writing? These injuries had impacted my writing routine for months. I rarely spent time on my projects because typing and using a computer caused tremendous pain. Prior to my injuries, I had completed my first novel and was looking for an agent. I’d started a second book. One of my short stories had won a contest. I had another I was shopping around.
I am, by nature, stubborn, and refused to give in to the pain, revising my stories and querying agents whenever I could. I was also in denial. How absurd that something like this would keep me from pursuing my goals!
But these repetitive strain injuries threatened to take more from me than my 15-year career at this hospital. They would take away my ability to write for years, and leave me unable to use a computer for days on end.
My purpose in relating this story is not to gain sympathy but to let others know that repetitive strain injuries caused by computer use are real, scary, and difficult to treat.
Many things can cause repetitive strain injuries but in my case the problem was hours of keyboarding and data entry at a workstation that did not properly or ergonomically support my body mechanics. I traveled throughout the hospital pushing a utility cart with a laptop and a printer as I visited each unit to do chart review 35 hours each week. At first I laughed about waking up at night with numb hands, thinking I had somehow slept wrong.
Then the pain began in my right bicep, a tearing, almost ripping pain when I reached for or pulled something. I wondered if I had broken my arm – perhaps a hairline fracture? My doctor sent me for x-rays which were unremarkable, no fractures. By this time I was already using night splints to help reverse the mild carpal tunnel syndrome I had in both wrists.
The arm pain grew worse and began to affect my shoulder. The doctor ordered physical therapy, and while doing the exercises I realized that when I raised my arms up over my head they'd become completely numb and very heavy. I could not do this simple movement for more than 15 seconds.
Then came changes in my hands, fingers that turned blue, sometimes a blackish blue, or red and puffy, or white and ice cold. The numbness and tingling in my hands continued. The diagnosis: thoracic outlet syndrome, something I had never heard of although I analyzed medical records for a living. I also developed tendinitis in my right thumb and both elbows. My right shoulder became frozen. It was a collection of musculo-skeletal injuries which had to be addressed one at a time.
At this point, I was unable to continue working without more aggressive intervention and opted for surgery. Over the next four years, the two ribs were removed and the right shoulder explored. PT, OT, massage therapy, and chiropractic continued, along with all kinds of lotions, potions, and pills. Many of my symptoms gradually improved, however, the chronic pain continues to affect my right arm, both hands, and my neck and I suffer frequent severe headaches. I am permanently partially disabled.
Throughout all this, I had given up on my plans to become an author, putting my work aside.
Life passed me by as I watched every episode of Law and Order ever produced. I read hundreds of books, novels, in particular, but many dedicated to writing and publishing as I continued to hope that one day I would resume my writing career.
This would not happen until 2012. A friend had published a book on Kindle and suggested I do the same. I figured I had
This took a year. Yes, one year, as I struggled with the pain caused by keyboarding to complete my project followed by days and weeks of computer avoidance to recover.
If you experience numbness or tingling in your hands or fingers, or any kind of pain in your arms, shoulders, neck, or upper back after a writing session that is not relieved by simple stretching, please take it seriously.
Once these injuries set in, your muscle memory will adapt and this will become your new normal, close to impossible to reverse. In spite of three surgeries, countless therapy sessions, and umpteen medications this pain continues to control my life.
In April 2010, I was fortunate to return to work at a new job, part-time, but still chained to a computer most of the day. My two work days require a minimum one day’s rest from the computer. This leaves me with four days during the week with a maximum writing time of about two hours per day to write as much as I possibly can. This includes finishing the novel I’ve been working on for four years and tending to my website, social media, email, and all the other business that makes up an author’s life.
This is a writer’s life with RSI.
The frustrating part is that the mind continues to imagine and explore, to come up with new ideas, and the desire to write remains strong. It is a constant battle of mind over matter, a roller coaster of emotions intertwined with varying levels of pain and discomfort. There is constant acquiescence to disability. Imagine how difficult it is to complete a project under these conditions.
If you encounter RSI or TOS symptoms see your doctor immediately.
Here are some ways to help alleviate the discomfort and treat the pain:
- This means the avoidance of all keyboarding, even on a tablet or smartphone. [Note from Joanna: I have definitely found that I need to only use my left arm for texting/twitter etc in order to rest the right from the cellphone.]
- Ice the affected area to relieve pain and inflammation.
- Heat to the affected area is also helpful. You can alternate heat and ice.
- Advil and other OTC remedies can relieve pain and inflammation. This includes topical remedies such as Topricin, Thermacare Wraps, etc.
- Hand splints may ease the discomfort of carpal tunnel syndrome.
- Have realistic expectations. If you’re having a bad bout, alter your plans and goals to allow adequate time for rest and repair of injured tissues, muscles, tendons, etc. [Note from Joanna: I've found this has gone on for a lot longer than expected, and even though it's a lot better, I'll forget and pick something up the wrong way and the pain will kick off again. So be careful.]
- Mix it up. Switch from a PC, to a laptop, to a smartphone, to a tablet, offsetting the pressure on your damaged hands, neck, arms, etc. Go back to pencils and paper. Type up your work when you’ve recovered or ask someone else do it for you.
- Practice proper ergonomics: ears over shoulders, shoulders over hips. Be careful not to “turtle head,” thrusting your head forward to see the screen. This can become a permanent posture and strains your neck muscles. [Note from Joanna: I am totally guilty of turtle head. Have someone take a picture of you while you're working in your normal posture. It may be shocking.]
- Use a timer to remind you when it’s time to take a break.
- Dictation is a wonderful tool to write hands-free.
- Consider a new keyboard. I use a Logitech gaming keyboard which substitutes a glide pad for the mouse, eliminating mouse work, a primary cause of RSIs.
- Delegate, if possible. An author’s assistant can handle tasks that exacerbate your injuries. I offer an internship in self-publishing to students at my community college. It’s a win-win for both of us. A Virtual Assistant can also make life easier.
- If you experience pain STOP! Take a break. Stretch those muscles! Do something else: a load of laundry, the dishes, shopping, or a long walk.
- Physical and occupational therapy, chiropractic, and massage can correct problems, relieve pain, and eliminate the need for surgery, which is always a last resort.
For more information, here is an excellent explanation of computer-related RSI’s by Paul Marxhausen from the University of Nebraska – Lincoln.
What's your experience with RSI? Do you suffer from pain associated with writing? What have you done about it? Please do leave a comment below with your thoughts and experiences of having or treating RSI as this is something critically important to the health of the writing community.
About the Author
Marianne Sciucco is not a nurse who writes but a writer who happens to be a nurse. A lover of words and books, she dreamed of becoming an author when she grew up, but became a nurse to avoid poverty. She later brought her two passions together and writes about the intricate lives of people struggling with health and family issues.
Her debut novel, Blue Hydrangeas, an Alzheimer’s love story, is a Kindle bestseller, IndieReader Approved, a BookWorks featured book, winner of IndieReCon’s Best Indie Novel Award, 2014, and a Library Journal Self-e Selection. A native Bostonian, she lives in New York’s Hudson Valley, and when not writing works as a campus nurse at a community college.
You can find Marianne at her website or @mariannesciucco on twitter. Her books are available on all online stores and you can find Blue Hydrangeas here on Amazon.
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1 2 3 4 Next »I work at a desk all day, and then do writing. I'd have, on an off, problems with my arm, but more of a problem with my back. One of the basic issues is that the average desk is built for the average man, who is taller than me. The other was that people sit at the desk too long.
I couldn't fix the desk problem. I've tried looking around, and everything is a lot higher than works for me. So for work, I used a toner box as a footrest (and later an actual footrest) and jacked my chair up to fit the height. At home, I'm using two telephone books and I got a much better chair.
And I get up every hour and walk around. I will also do a bit of exercise while I'm doing this--calf raises, shoulder rolls, etc. If I'm carrying something, I might do some arm lifts (works great with a 12 pack of soda). My back pain went away almost within a week, and I felt a lot less worn out at the end of the day. It was hard to believe that sitting the way I was drained me so much, but it did.
Exactly Linda - I really do believe those studies that sitting will kill us :)
Sounds like you've got it under control, Linda. Rest periods are so important, as well as the right chair. Have you tried one without arms? Stops your shoulders from jacking up, and makes it easier to relax your arms.
I actually have one with adjustable arms. That was surprisingly hard to find. A lot chairs have fixed ones.
In addition to exercise, physio, using an ergonomic chair, incorporating stretching into my daily routine, and resting when I need to, I have learned to use voice-activated software (Dragon Naturally Speaking.) It takes a bit of getting used to but it is worth it.
I'm definitely going to revisit Dragon :)
Yes, Annie, dictation is a godsend. I find Dragon a bit cumbersome at times but it is accurate. I also think it slows down the editing process. I use dictation on my iPhone all the time for social media posts, emails, and text messages. But too much talking can strain your voice and vocal chords, so we have to watch that too.
I've dealt with bouts of carpal tunnel syndrome in the past, due to poor posture, but more recently, I experience a serious issue of bursitis in my shoulder. Incredible pain and limited mobility.
Some physical therapy helped a lot, primarily because I began to exercise shoulder/arm muscles that were no longer holding my joint in proper alignment. Bottom line is that the bursitis was caused by a combination of poor posture and lack of routine exercise.
Now I'm pain free and back in the game, with a dedication to taking better care of my body.
One tool that I find helpful is the Pomodoro app, which is a basic timer app telling me to take a break every 25 minutes. It keeps me on task, but also ensures that I don't sit for hours at a time.
Excellent advice, Dharma. The Pomodoro timer is a useful app. I often start my washer and dryer when I sit down to write. When the cycles finish, a buzzer goes off and lets me know it's time to take a break. Then attending to the laundry lets me use my muscles in a different way, relieving tightness. In many ways, we must adapt our activities to our RSI to reduce pain and flare-ups.
I've had two carpal tunnel surgeries, so I can relate to this post. I use Dragon Dictate and at night I cover my hands with an anti-inflammatory salve and I wear splints on both hands. I also have a wax machine so that I can wax my hands. The heat really helps. And I use BreakTime, an app that stops my computer at 30-minute intervals, forcing me to get up and exercise and stretch. With these strategies, I'm able to work and write, pain-free. This is such an important topic. Thank you for writing about it Marianne.
Great tips, Frances. I'd love to know the name of that anti-inflammatory salve you use. I use Voltaren gel; it's a prescription but works great. Love the paraffin treatment! I'll have to check out Break Time; haven't heard of it. I also tried the ball but never adjusted to it. I have a really comfy, adjustable chair with no arms both at work and at home. Proper posture is so important!
One more thing, I don't sit on a regular chair. Instead I sit on a ball!
Using a ball instead of a chair is a good idea. At least in general, but doesn't work for everybody. I tried a ball more than once, and discarded it after a few day again and again.
What I miss when using a ball is lumbar support. I can't work for several hours without it.
A ball can't give me this support and my back muscles get real stiff in this area without it. That's why I defaulted back to my chair each time. I guess, it's because my L2 and L3 are trashed from many years of sport.
As for RSI, I had to deal with it not so long ago. It's always a matter of ergonomic height and angle between keyboard and chair. I improvised for a while and had to pay for it. The treatment took almost half a year, but I could prevent to wear a cast.
Switched from a regular mouse to an ergonomically shaped anti-RSI mouse like others did. Yet, I have Windows as an OS instead of a Mac. For those who are interested, search for 'Anker' mouse. It's available as both wireless and wired.
I've become one of those annoying people who wear a Fitbit all the time and can tell you EXACTLY how long they slept...Living in a Midwest suburb where I have to get in the car for everything means I have to be very intentional about getting out of a sitting position and going outdoors. The time away from the computer and the movement are incredibly helpful with my back, my digestion, just everything really. When I was in London I got my 10,000 steps done just walking around--here I have to work at it but it's worth it.
Simply moving is paramount to overall wellness. We live such sedentary lives these days, contributing to a host of medical problems. Thanks for pointing this out.
I'm sorry to hear about your struggle. Working as a software engineer I had my moments of struggle as well. I found better computer keyboards and mice, and also posture at work. I use the evoluent mouse and a Microsoft Sculpt keyboard (http://www.microsoft.com/hardware/en-us/p/sculpt-ergonomic-desktop), which takes a bit of practice to use but it's definitely worth it!
Happy writing
I'll have to check out this mouse you and Joanna are talking about, but I'm hooked on my mouseless keyboard with the glide pad. It's been a lifesaver!
I got my wake up call when I was 21. Yep. 21. At the time, I was positive I wouldn't have problems with carpel tunnel until I was 40 (which sounds terribly old when you're 21). But I was in college writing papers while working as a secretary while writing. That February, the pain in my wrists got so bad I was losing grip strength in my right hand and it hurt to even hold a toothbrush. Finally I stopped gutting it out and talked to my mom (who happens to be an occupational therapist). I now use braces when I type on a laptop, and I've been working to set up my desk at work more and more ergonomically. One thing that helped me was indoor rock climbing. The exercise strengthens hand and arm muscles, as well as heating and loosening everything that gets tight all day. It also strengthens back and leg muscles, which makes sitting with better posture easier.
Wow! The rock climbing sounds great. I'd love to try something like that but my upper body is too weak. I used to workout all the time before the RSIs but right now I'm limited. I love to swim and take aquasize classes, which really help to relieve stress and give a great cardio workout, but it's easy to over do it. I find there is collateral damage from all of this because my lack of activity has caused additional injuries, such as Achilles tendinitis and plantar fasciitis. Has anyone else experienced other musculoskeletal issues from lack of activity?
Hi Marianne. Yes, I've had severe muscularoskeletal issues caused by writing. despite hiking every morning and being meticulous about stretching, taking breaks, and doing other exercise. As you've pointed out, I ignored too much for too long, sending messages to my brain that this was my new normal. Not only that, if we ignore these signals too long, the brain stops receiving them. What we often think of as writers block is actually a resistance to sit down and deal with very real pain we no longer feel but our bodies react to. Writing hurts and is horribly exhausting. I also have a rare form of RA that keeps me constantly moving to break down the adhesions on my spine. It's not enough movement. Long term compression of nerves from muscles and bone that don't move enough have caused the nerves in my lower extremities to dissolve (I had a punch biopsy done when my legs started giving out). I'm currently on high doses of B Vitamins, especially sublingual B12, and waiting out the 18 months in hopes of some nerve regeneration. So far the pain in my feet has eased, but I'm still putting my foot into the dog's food bowl because it feels the same as my slipper :-) In the meantime, I'm sleeping on a 22" air mattress to cool the inflammation in my spine, neck and shoulders. I'm surrounded by farmers who did so-called backbreaking work all their lives, yet at 80 years old they're climbing trees and cutting down large limbs while I'm losing mine (carpal tunnel is the least of my worries--I've had several surgeries on one hand already and a gazillion cortisone shots in the other). Something I want to stress is if we have inflammation in our joints, we probably have it in our gut and all through our bodies. Our gut is not only the largest part of our immune system, it also contains as many neurotransmitters as our brains. An inflamed gut can cause other catastrophic diseases and mood disturbances we mistakenly call mental illness. The betas for my new series all wanted to know where they could buy the fermented food products my protagonist makes. They can't, at least not yet with ease. You have to make it. I just might ditch bringing the books to market in favor of a web site devoted to making fermented foods and recipes using foods known to be probiotics (pineapple is a godsend) .Watch out for probiotic pills. They often don't have a large enough range and can cause one type of gut bacteria to grow wild. Been there, suffered something fierce. Until I started building my supplies and developing recipes using kimichi and other fermented foods, I knocked back a tablespoon of apple cider vinegar "with the mother" mixed with honey three times a day, and quit eating dinner in favor of pineapple smoothies. Wow, what a reduction in the joint pain! The big surprise was that I was able to cut my very expensive stomach meds for gastritis in half. When they scoped my stomach, I had to lay on my hip, which hurt like hell, then they raised the gurney, putting more pressure on my hip that caused me to pass out before they could knock me out. Pretty cool, huh. (They still charged for anesthesia, the bums.) After nearly a month of vinegar, pineapple and fermented foods, I now roll over on that hip without waking up in agony. No kidding. But it's not over. It never will be. Once the damage is done, it's done. The best you can do is cope with it and manage the pain and stop further damage. What I've learned from this is to dream big and dream wide. Cultivate lots of interests and vigorous activities. One more bad night because of pain, and I'm going back to sculpting and hauling hundreds of pounds of clay for architectural ceramics. I'll dance in the kitchen as I make beer and pickles and kimichi. I'm also unsubscribing from all blogs that advocate high production and have removed myself from groups, online and in the real world, where extreme output is the expected norm and I'm made to feel I'm not measuring up. Done. Over. For what it's worth, I took three breaks writing this to stretch and dance and things were popping all over my body. It's getting better, but I'll always be on alert. Thank you Marianne for sharing your story. I hope people will listen. And thank you Joanna for raising a red flag on this issue. You rock.
Hi Cyd, I'm so sorry about your pain - I think you'd be onto a massive winner with the books on probiotic food - this is a rising need as people are starting to learn more about the biome. I've just read GUT by Giulia Enders http://www.amazon.com/dp/1771641495/ Great book about – obviously – the gut, and those types of probiotic foods are touched on but it's more science than self-help.
I agree on being careful about the 'high production' groups that seems to be the new normal in self-publishing right now - for some people, that might work, but not for most of us. We have to have a LIFE, not just a living :)
Powerful story Cyd, so sorry for your suffering. All of this is a myriad of problems that tend to cascade into more pain and misery. I'll have to look into the fermentation regimen. I've used vinegar and honey in the past and the pineapple sounds both restorative and yummy. I agree it's a good idea to avoid people who push you beyond your limits. That's most people, who can't understand how something so simple as keyboarding, which millions of people do every day without any issue, can lead to complete debilitation. Sometimes it's friends and family who don't understand and push us past our breaking points. We have to be strong in all matters, which makes everything even more difficult. Hang in there.
Putting in the time required for the word count I desire is hard on my body, too. To cope, I switch the mouse from hand to hand. I alternate sitting with standing at a counter and working at my FitDesk bike. And I walk or jog a few times a week. I also take summers off from my books. Not by choice, but because I can't get anything done with kids home. But it does wonders to heal my body from those long writing winters.
Yes, it's good to mix things up, Michelle. A daily word count is dangerous for me because I'm one of those stubborn individuals who won't stop. I've worked myself into some major flare-ups trying to meet self-imposed deadlines and word counts. I'd love to write 2,000 words at a clip but if I can only manage 200 I have to feel I've accomplished something. Sometimes I don't write for weeks. But at least I'm writing and achieving my goals.
I'm glad to hear you're feeling better, Joanna! You're providing a wake up call for me to take my aches and pains seriously.
I don't have RSI, but I have had arthritis in my hands for over ten years already, as well as two separate bouts with tendonitis, once in each arm. So I have already invested in Dragon software, and I use it when working on first drafts. It works surprisingly well, even with my NY accent. I know it helps, because when I put in a lot of typing time, my hands ache more.
I also have read the reports about sitting, and believe it contributes to my constant back pain. So I use the timer on my phone to get me to up and walking around while at the office. I like your suggestion to mix it up. That's sounds smart. And I may have to consider getting a ball to sit on instead of a chair.
Thanks so much for sharing!
Thanks for writing Monica. Looks like you've figured it out.