Typing - Carpal Tunnel Syndrome
There is a hidden human cost to high-volume data entry that we are just beginning to realize. Prolonged use of the keyboard, such as in high-volume data entry, or high-volume typing, can cause Repetitive Strain Injury. (RSI). Technically, RSI can be caused by any repetitive motion. However, since touch typing - keyboarding is one of the most dominant office activities, RSI is commonly associated with this activity.
RSI occurs because the muscles of the forearm do most of the work moving the fingers and wrists, in high volume repetitive activities. Over time repetitive motions can cause soft-tissue damage in which nerves, or tendons may become irritated or inflamed.
"Injury is even more likely to occur if the stronger muscles of the back, shoulder, and upper arm are impaired because of poor posture, or poorly fitted office equipment, forcing the forearm and hand muscles to do more work." [See A]Reducing RSI
You can reduce the risk of Repetitive Strain Injury (RSI) by taking a close look at the posture pictures below and by using these pictures to correct your posture.
Keep your fingers on their assigned home row keys. Fingers should be slightly curved with the pad of the finger square on each key.
Wrists should be slightly curved and off the bottom frame of the keyboard. This will minimize the amount of "finger-reaching" required and reduce fatigue.
Keep your elbows close in, next to your side. This will accomplish several things. First, with your fingers on the home row keys, you will be able to "train your fingers" in the correct finger touch typing key reaches.
Be relaxed, but don't slouch in your chair. Sit square in the chair with your feet flat on the floor.
If your elbows are correctly "tucked in, next to your side" your fingers then have a more consistant "platform" from which to reach out and strike the key. If your elbows are not tucked in, close to your side, this places a "twist" on your wrists which is fatiguing.
When keying data, your wrists should be sloping upward, at the same slope as the keyboard.
Do not allow your wrists to become "lazy" as shown. Do NOT let your wrists rest on the desk. This transfer the additional "workload" to your fingers.
"RSI is not new. In 1713 Bernardino Ramazzini, the father of occupational medicine, described pain in the hands of scribes." [See B]
RSI can occur in any repetitive motion injury, but with the increased usage of the computer keyboard, an increase in RSI related injuries is reported. The key layout forces the operator into an unnatural position with palms-down, and wrists cocked. This may strain the muscles of the fingers and wrists, reducing circulation. Unfortunately, when RSI damage occurs, the pain may not go away even after rest because the area is inflamed and painful. When this occurs, medical attention is needed.
To reduce the stress and strain of high-volume data entry, it is highly recommended that work breaks be taken, at least once an hour, Also, evaluate and take corrective action on the ergonomics involved in the key layout and computer related equipment.
A bright room may produce excessive glare, which will cause eye strain. Eye strain results in fatigue, which may increase the likelihood of RSI injury.
In short, common sence measures can help you minimize RSI type of injuries in touch typing - keyboarding activities. Tensions and fatigue can "build up" throughout the day which "beats you down" and increases the likelyhood of injuries. Try to avoid this by performing alternative tasks whenever possible.
Treatment should be under a doctor's direction. Underlying causes such as diabetes or arthritis should be treated first. Initial treatment generally involves resting the affected hand and wrist for at least 2 weeks, avoiding activities that may worsen symptoms. This includes immobilizing the wrist in a splint to avoid further damage from twisting or bending.
If there is inflammation, applying cool packs can help reduce swelling.
Drugs can ease the pain and swelling associated with carpal tunnel syndrome.
Exercise Include stretching and strengthening exercises can be helpful in people whose symptoms have abated. These exercises may be supervised by a physical therapist, who is trained to use exercise to treat physical impairments, or an occupational therapist, who is trained to evaluate people with physical impairments and help them build skills to improve their health and well-being.
Alternative therapies - Acupuncture and chiropractic care have benefited some patients but their effectiveness remains unproved. An exception is yoga, which has been shown to reduce pain and improve grip strength among patients.
Surgery Treatment Surgery involves severing the band of tissue around the wrist to reduce pressure on the median nerve. Surgery is done under local anesthesia and does not require an overnight hospital stay. Many patients require surgery on both hands.
Open release surgery is the traditional procedure used to correct carpal tunnel syndrome. It consists of making an incision up to 2 inches in the wrist and then cutting the carpal ligament to enlarge the carpal tunnel.
Endoscopic surgery may allow faster functional recovery and less postoperative discomfort than traditional open release surgery. The surgeon makes two incisions (about Ĺ" each) in the wrist and palm.
They then insert a camera attached to a tube, observes the tissue on a screen, and cuts the carpal ligament (the tissue that holds joints together).
Full recovery from carpal tunnel surgery can take months. Some patients may have infection, nerve damage, stiffness, and pain at the scar. Occasionally the wrist loses strength because the carpal ligament is cut. Some patients may need to adjust job duties or even change jobs after recovery from surgery.
Recurrence following treatment is rare. The majority of patients recover completely.
This subject is of great interest to a lot of people. A recent "Google" key word search showed 110,000 citations.
Carpal tunnel syndrome is a "particularly painful" form of an RSI injury. This disabling disorder characterized by inflammation and swelling in the tendons that run through the narrow carpal tunnels in the wrist."
It is caused by excessive repetition of movements and often lack of rest periods. Carpal tunnel syndrome have been frequently reported by meat cutters, and by high-volume data entry operators.
Symptoms usually start gradually, with frequent burning, tingling, or itching numbness in the palm of the hand and the fingers, especially the thumb and the index and middle fingers. Some sufferers say their fingers feel useless and swollen, even though little or no swelling is apparent.
Symptoms often first appear in one or both hands during the night, since many people sleep with flexed wrists. A person with carpal tunnel syndrome may wake up feeling the need to "shake out" the hand or wrist. As symptoms worsen, people might feel tingling during the day. (See NIH study for more information.)
Treatment includes rest, exercises, wrists splints, anti-inflammatory medications and adjustments to the work station. Extreme cases require surgery to reduce pressure on the afflicted nerve. Carpal tunnel syndrome is responsible for 30 to 40 percent of worker's compensation claims in the 1990's and effects many workers, not just office workers.
Links & References
[A] "Carpal Tunnel Syndrome," Microsoft Encarta 98 Encyclopedia
[B] "Repetitive Strain Injuries - The Hidden Cost of Computing" Hidden Cost
[C] "Carpal Tunnel Syndrome: Symptoms" Symptoms
[D] "Carpal Tunnel Syndrome: NIOSH Facts" Facts
[E] Excellent National Institute of Health Health Article
[F] Another NIH Health Article
[G] A good general reference Carpal Tunnel Exercises
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Typing - TipsSit erect. Your feet should be flat on the floor. Poor posture is tiring and leads to errors.
Do not look at your fingers when keyboarding. If you start looking at your fingers, you will never learn how to type quickly and accurately. Once started, this poor habit is extremely difficult to correct. The computer will provide a beep for an incorrect keystroke. This immediate feedback will assist you in quickly learning the correct keystrokes. Just concentrate on using the correct finger to strike the key.
Learning to type. You learn how to type by developing motor reflex patterns that enable your fingers to strike the correct keys automatically. If the keyboard or posture position changes, sound skills will not develop. Always maintain correct posture. If you do not sit up straight and keep your feet flat on the floor, the angle of your arms will change; thus changing the keystroke reach. This throws off your speed and accuracy.
Develop a routine. Set the work environment like you want it to optimize your learning sessions. Donít let the chair height; tilt of the monitor, location of the keyboard or posture vary from session to session.
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