Need serious help regarding issues with Hands,Wrist and mainly Fingers

[Shaqfosho]

Hello Geekhack community

Hi, my name is Shaqfosho and I am a 20 years old gamer. I'd like to tell you about the problems I have encountered recently since the launch of World of Warcraft: Warlords of Draenor.

I've always been a gamer, I've had a few hand injury and pain problems here and there but they've solved/disappeared by themself. But this time, things are not going the way they are supposed to be. It is very often I've had wrist issues in the left hand(the keyboard WSAD hand), but now I am struggling with pain in the fingers in BOTH hands. It is extremely frustrating, I bought hand bandages that supports the wrists, I bought keyboard wrest support which appears to almost have no effect only when writing.

I understand that the majority here not are doctors or physiologists, but I'd like to gain some knowledge of what to do, I'd LOVE to hear YOUR (happy)stories and (happy)experiences where something bad happened with your fingers, hands and wrists but ended well and where you came back to your normal routines. And I'd like to know HOW you solved the situation.

The reason why I mentioned World of Warcraft was because I began playing a lot after the launch. And now, two months after, I have hand injuries. I mean like, everywhere, here and there. It's different, sometimes it's passive, sometimes it's not, sometimes it is when I use the hand. Sometimes it's the thumb, sometimes its the long finger and so on. It's everywhere. I have NO issues lifting weight, my own body weight or anything - it feels great to do these things(though I do feel when taking push-ups, that my hands have been ''used'', but that kind of 'used pain' disappears). But now when I touch a keyboard or mouse I just feel pain and irritation.

I'd like to list the things(with explanation) I've tried over the last month to now - whereas some things have improved! But now it feels like things are getting worse or just stays the same. And I have to be honest, there is a lot of psychic in this, I end up being paranoid and I think that sometimes I do not know whether I am dealing with pain or not.

The list:
1 Take small breaks(5-15 min) when playing video games(1-4 days)
2 Take a long break playing video games with high intensity(FPS,WoW)(30 days)
3 Take a total break from touching keyboard(3-4 days)
4 Exercise Fingers, Hands and Wrists - watching this video:

and more from this guy
5 Been excercising with stress balls, elastic bands and weights
6 Bought new equipment: http://www.razerzone.com/gaming-mice/razer-naga - I had this mouse before: http://steelseries.com/products/mice/steelseries-rival - I realised that BOTH mices did not help. And I realised that Steelseries Rival is a terrible mice that insanely huge and not AT ALL ergonomically build despite written on the description. You should NEVER buy Rival especially if you have a small to medium size hand(Mine is medium). I bought this keyboard rest: http://www.grafical.dk/esselte-keyboard-haandledsstoette-med-gele-sort/ - It does almost nothing and it is not recommend to buy these, they are just a waste of money almost(It's better than nothing, it is more comfortable if you have a high standing keyboard). Now I use a completly standard mouse - It is the best atm.
7 I've visited my doctor twice who said I should take breaks, go for a walk, obviously someone who did not know what was wrong but I followed all her instructions and I told everything about my issues. She told me I could go to a psychiologist but that costs money.
8 I bought a hand Bandage to both hands - It helps the wrists a lot!
9 And finally. My Keyboard - http://steelseries.com/products/keyboards/steelseries-6gv2 It is a Mechanical Keyboard, I bought it 8 months ago and I do not use it anymore. Just today I switched to a standard keyboard. I felt that the Keyboard was extremely ''tall'' and the buttons were hard to press on.   

I guess that is the list. Current status is I use standard equipment, I do not mind buying new equipment or go to the phychiologist if that is the cure. I do not play ANY high intensity games like I use to, the only thing I play here and then is a digital card game Hearthstone. I know there is no magic pill that solves everything but at the moment I feel that I am lost. All my gaming buddies do not know what to do nor say because they have not tried it before. I hope you guys can tell me anything about what you feel, experienced, tried and struggled with. I'd appreciate any kind of help, hints or tips.
I am willing to do anything, from the longest breaks, to insane exercise, pro tips, though my budget is not that high unfortunately.
Thank you so much for reading this
Please help me

Kind regards,

Shaqfosho

[hoggy]

Hi Shaqfosho,

I'm glad you've seen the doctor already. 

I think you might need to give up gaming for a bit longer than just a few days. 

The physio should be able to help. They will be able to suggest exercises that actually help, and should work on helping with the diagnosis.  You seem to be very keen to get this fixed, but to self medicate can push things in the wrong direction.  I hope you don't mind, but I wonder if the anxiety of not knowing what is wrong, and not knowing what to do, is not exactly helping.

I've hand problems for something like 5 years now, luckily its nowhere near as bad as when it first started.  I used to play games a bit, but gave them up very soon after the pain started.

There is hope.

Your posture and setup might be part of the problem, can you take some photos, and pref get someone to take some while you are using the computer?

Do you work with computers?

[Shaqfosho]

Hi Hoggy
Thanks for the great answer! The truth hurts, but I will try to take a longer break from gaming then - I was thinking today to try to play a little bit to see how it would go but I will change tactics and stop.
I agree with you about my anxiety and lack of knowledge which may put me in the wrong direction.

Though I have a question, you are recommending me to still stay away from gaming but what about typing on the keyboard like right now? I feel a very little bit of pain here and there when writing this. What I am asking is, what is the difference?

I will take some photos now and upload them right now. Should take 2 minutes.

Once again, thank you.

Kind regards

Shaqfosho

[hoggy]

One of the problems with gaming, is that its harder to take a break and you might be tense without realising because you ate focused on the game (after all that is kind of the point of games). 

You could try to reduce your typing.  The are programs called text expanders that could help make a large dent in the amount of typing you do. 

You might want to look at rest break software, workrave is quite good and is free.

[Shaqfosho]

I have downloaded workrave. That sounds really great!
I cant figure how to download text expander, it seems it is only for mac.
And how do you upload pictures?

Edit: Workrave is running now.

[Findecanor]

In my experience the word "ergonomic" is something that brands throw into their marketing as long as they can get away with it, and they do. It often means absolutely nothing.

Four-five years ago, I experienced pains in my fingers, in the the right hand and right wrist.
I was helped with the finger pain by switching from a hard Dell rubber dome to a keyboard with lighter switches.
I was helped with the hand and wrist pain by switching from regular mice (also, quite small ones) to a vertical mouse at work and a right-slanted almost-vertical mouse at home.
But most of all, I taught myself to sit up straight and relax in my wrist and hands and only actuate the hand and finger muscles precisely when I needed them to.

[Shaqfosho]

Thanks for your reply Findecanor

I agree with you regarding the word ergonomic, it has become a great buzz word for the companies.

May I ask you to please elaborate on how you were helped with your issues?

I used Steelseries Keyboard and Mice which both were failures. My Keyboard was with black mechanical switches which sucked. And my mice was too big for my hand. What do you mean by lighter switches?

I'd love to upload pictures of my workstation but I do not know how to.

[tufty]

My Keyboard was with black mechanical switches which sucked. And my mice was too big for my hand. What do you mean by lighter switches?

He means switches requiring a smaller actuation force.  Lighter switches == less effort.  MX Blacks are the "heaviest" MX switch out there. 

[Shaqfosho]

My Keyboard was with black mechanical switches which sucked. And my mice was too big for my hand. What do you mean by lighter switches?

He means switches requiring a smaller actuation force.  Lighter switches == less effort.  MX Blacks are the "heaviest" MX switch out there.

Aha. My keyboard had MX Blacks... I assume those are the worst. Could you please tell me about switches or link me to a decent guide about switches that prevent RSI?

Thanks

[spale]

Well if the key force is the only issue, I believe you must immediately move to MX Reds or Mx Brows, as they are really, really light to type on ( but for me personally, they are really bad solution). Topre also has keys with even lighter punctuation force (30g), they are the most expensive ( but again not very popular among Topre users as 55g proves to be the best experience).

[SonOfSonOfSpock]

Seeing a physical therapist helped me a lot. I got useful stretches and exercises. Also, applying heat before using the computer and then icing afterwards helps me.

[Oobly]

A few tips:

1. Buy a board with lighter switches. This may not always help, since if you are tense while playing you may be pressing / holding the movement keys down much harder than you need to to make them work, but if you're not doing that Reds and Browns have a softer spring, so you don't have to press very hard to make them work. Browns have a small tactile bump which is nice when typing as it let's you know when the key has actuated and prevents accidental presses, although if you're used to how Blacks feel, Reds will be more familiar to you as they're also linear (without the bump).

2. Use a "hard" wrist rest (hard core, like wood, with a thin softish cover, like leather is very good) when gaming (soft ones press on the nerves, blood vessels and tendons in the wrist, they should be banned from existence!), make sure it's high enough (so your wrist is at a good angle when pressing the keys) and rest only the hard "nub" of the palm (the part on the outside edge where the palm meets the wrist) on it, not the flat part of the wrist.

3. Use the correct wrist angle when typing and gaming. You can rest your palms (on the hard "nub") in between actively typing, but when you're moving your fingers you should have your wrists raised off the rest and have a relatively straight angle from your arm to your hand (never "anchor" your hands when actively typing, allow your hands to float over the board), never have your hands bent "up" or "back" while typing. For gaming this gets tiring quickly, so it's good to have a high rest for the left hand that allows you to keep this wrist angle without putting strain on anything. Again, make sure you only rest the "nub" on the actual rest.

4. Don't use any kind of rest for your mouse hand. Rest the "nub" of that hand on the desk / mousepad when needed. keep it off the ground when moving the mouse, again try to get your wrist straight while moving / pressing buttons. Try to find a mouse that has a slight angle to it, with the inside higher than the outside. Also that isn't too small so you're not squeezing it all the time. Lighter mice (cabled are usually a lot lighter than wireless) use less effort to move and this can help a little, too.

5. When gaming, twist your keyboard so the left side is further away from you and the right side closer, so the board is perpendicular to your left forearm. This helps by keeping the muscle movements simpler.

6. Adjust your desk and chair height so that your upper arms hang close to vertical with your forearms parallel to the ground, making about a 90 degree angle. Adjust your keyboard angle (tilt, with the legs that most boards have) so that when your wrists are straight it feels comfortable to type. You'll probably find that this is quite "flat", with the legs retracted and possibly even needing a thin wedge under the front of the keyboard to raise the front edge. Some people even use backward tilt, so the front keycaps are higher than the back, depending on their setup.

Then do the other things the doctor recommended. Take breaks, do exercises, etc. You should find your wrists / hands / fingers starting to feel better after a couple of weeks. If you don't, then definitely look for more professional advice from an ergonomics / physiology specialist.

[Shaqfosho]

A few tips:

1. Buy a board with lighter switches. This may not always help, since if you are tense while playing you may be pressing / holding the movement keys down much harder than you need to to make them work, but if you're not doing that Reds and Browns have a softer spring, so you don't have to press very hard to make them work. Browns have a small tactile bump which is nice when typing as it let's you know when the key has actuated and prevents accidental presses, although if you're used to how Blacks feel, Reds will be more familiar to you as they're also linear (without the bump).

2. Use a "hard" wrist rest (hard core, like wood, with a thin softish cover, like leather is very good) when gaming (soft ones press on the nerves, blood vessels and tendons in the wrist, they should be banned from existence!), make sure it's high enough (so your wrist is at a good angle when pressing the keys) and rest only the hard "nub" of the palm (the part on the outside edge where the palm meets the wrist) on it, not the flat part of the wrist.

3. Use the correct wrist angle when typing and gaming. You can rest your palms (on the hard "nub") in between actively typing, but when you're moving your fingers you should have your wrists raised off the rest and have a relatively straight angle from your arm to your hand (never "anchor" your hands when actively typing, allow your hands to float over the board), never have your hands bent "up" or "back" while typing. For gaming this gets tiring quickly, so it's good to have a high rest for the left hand that allows you to keep this wrist angle without putting strain on anything. Again, make sure you only rest the "nub" on the actual rest.

4. Don't use any kind of rest for your mouse hand. Rest the "nub" of that hand on the desk / mousepad when needed. keep it off the ground when moving the mouse, again try to get your wrist straight while moving / pressing buttons. Try to find a mouse that has a slight angle to it, with the inside higher than the outside. Also that isn't too small so you're not squeezing it all the time. Lighter mice (cabled are usually a lot lighter than wireless) use less effort to move and this can help a little, too.

5. When gaming, twist your keyboard so the left side is further away from you and the right side closer, so the board is perpendicular to your left forearm. This helps by keeping the muscle movements simpler.

6. Adjust your desk and chair height so that your upper arms hang close to vertical with your forearms parallel to the ground, making about a 90 degree angle. Adjust your keyboard angle (tilt, with the legs that most boards have) so that when your wrists are straight it feels comfortable to type. You'll probably find that this is quite "flat", with the legs retracted and possibly even needing a thin wedge under the front of the keyboard to raise the front edge. Some people even use backward tilt, so the front keycaps are higher than the back, depending on their setup.

Then do the other things the doctor recommended. Take breaks, do exercises, etc. You should find your wrists / hands / fingers starting to feel better after a couple of weeks. If you don't, then definitely look for more professional advice from an ergonomics / physiology specialist.

Thank you so much for your well described answer and solution. I'll read this over and over again to remember it. This was the answer I was looking for!

Thanks!!!

[Lanx]

Take a picture of your setup, take a pic of you playing, post pics, well tell you what you need to do and probably buy.

[Melvang]

One other think to keep in mind is these kind of injuries take a long time to heal.  Months or years is not unheard of depending on how much you can avoid using the PC for recreation or work.  No matter what you do, there is not going to be a quick fix.

One thing I can't stress enough is the keeping your wrist off the table top when typing.  This made a huge difference to me in terms of comfort.  For me what got me to do this was switching to an IBM F XT keyboard.  I don't know what it is with this board but I just naturally started hovering my hands without thinking about it.  Granted I am making more typing mistakes, probably due to different hand position and different switches but that will come with a bit of time.

Also, from what I have seen the switches are rarely the cause of pain.  More often than not it is due to posture/positioning issues.  The few times I have seen it the issue was RSI being aggravated my the hard impact at the bottom of the keystroke partly due to having light switches.  This can be helped by going to heavier springs or slowing down and teaching yourself to not bottom out the keys as most keyboards with mechanical switches do not need to be bottomed out.

[melling]

Seeing a physical therapist helped me a lot. I got useful stretches and exercises. Also, applying heat before using the computer and then icing afterwards helps me.

How do you apply heat? What is effective?

[Oobly]

One other think to keep in mind is these kind of injuries take a long time to heal.  Months or years is not unheard of depending on how much you can avoid using the PC for recreation or work.  No matter what you do, there is not going to be a quick fix.

One thing I can't stress enough is the keeping your wrist off the table top when typing.  This made a huge difference to me in terms of comfort.  For me what got me to do this was switching to an IBM F XT keyboard.  I don't know what it is with this board but I just naturally started hovering my hands without thinking about it.  Granted I am making more typing mistakes, probably due to different hand position and different switches but that will come with a bit of time.

Also, from what I have seen the switches are rarely the cause of pain.  More often than not it is due to posture/positioning issues.  The few times I have seen it the issue was RSI being aggravated my the hard impact at the bottom of the keystroke partly due to having light switches.  This can be helped by going to heavier springs or slowing down and teaching yourself to not bottom out the keys as most keyboards with mechanical switches do not need to be bottomed out.

The Model F is a good board for both these points, the hovering and not bottoming out Buckling springs have a fairly strong increase in force after "clicking". Model F is still the king of keyboards, IMHO. I wish they were easier to find and use with modern PC's and had more common layouts. Thanks to some fellow Geekhackers, though, it's at least possible

[Melvang]

One other think to keep in mind is these kind of injuries take a long time to heal.  Months or years is not unheard of depending on how much you can avoid using the PC for recreation or work.  No matter what you do, there is not going to be a quick fix.

One thing I can't stress enough is the keeping your wrist off the table top when typing.  This made a huge difference to me in terms of comfort.  For me what got me to do this was switching to an IBM F XT keyboard.  I don't know what it is with this board but I just naturally started hovering my hands without thinking about it.  Granted I am making more typing mistakes, probably due to different hand position and different switches but that will come with a bit of time.

Also, from what I have seen the switches are rarely the cause of pain.  More often than not it is due to posture/positioning issues.  The few times I have seen it the issue was RSI being aggravated my the hard impact at the bottom of the keystroke partly due to having light switches.  This can be helped by going to heavier springs or slowing down and teaching yourself to not bottom out the keys as most keyboards with mechanical switches do not need to be bottomed out.

The Model F is a good board for both these points, the hovering and not bottoming out Buckling springs have a fairly strong increase in force after "clicking". Model F is still the king of keyboards, IMHO. I wish they were easier to find and use with modern PC's and had more common layouts. Thanks to some fellow Geekhackers, though, it's at least possible

Finding is the hard part.  I got mine converted and working on USB in about an hour, and it was my first one.

[SonOfSonOfSpock]

Seeing a physical therapist helped me a lot. I got useful stretches and exercises. Also, applying heat before using the computer and then icing afterwards helps me.

How do you apply heat? What is effective?

Hot shower is one of the simpler ones. Plus, you don't have to buy anything.

There are heating pads you can buy. Electric ones you plug in or various types you can heat up in the microwave.

[SeverelyJetlagged]

You might also consider finding a practitioner of Active Release Techniques, if you can afford it (some medical insurance will cover it). It has definitely provided relief to my hands and forearms and helps keep my tendonitis in check, though it's not a cure.