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RSInetwork#9/December 92
========================
For People Concerned About Tendinitis, Carpal Tunnel Syndrome, and
Other Repetitive Strain Injuries
Produced by:
Caroline Rose, 970 Paradise Way, Palo Alto CA 94306
(crose@applelink.apple.com)
Apple Computer is in no way affiliated with this newsletter.
This document is in setext (structure-enhanced text) format.
To index, browse, and copy from collected setext documents,
use Easy View, written by M. Akif Eyler, Bilkent University,
06533 Ankara, Turkey
(eyler@trbilun.bitnet).
Setext formatting by:
Craig O'Donnell, Assistant Sysop, MacWEEK Forum on ZiffNet
(72511.240@compuserve.com).
Other issues of RSInetwork are available through ZiffNet/Mac
and Compuserve, in the "Reference" file library at location
ZMC:DOWNTECH. Easy View is in the "Applications" library at
the same location under filename EASYVW.SEA.
Video of RSI TV special
-----------------------
Kate Kelly and Sara Frankel produced a half-hour show in the "We
Do the Work" public TV series, called "Working Until It Hurts."
This excellent show focused on the human side of having an RSI
problem. The quote that stands out most in my mind is a woman
tearfully saying, "I don't know who I am anymore." If you didn't
catch this show and would like to purchase a copy of it, you can
do so for $40 (or $80, for corporations); for more information,
call (510)549-0775.
Workshops on Social Security disability claims process
------------------------------------------------------
Four-hour workshops on the Social Security Disability Claims
process will be held in San Jose CA on 1/7 and 1/14 from 7 to 9
PM; in San Leandro CA on 1/16 from noon to 4 PM; and in San Mateo
CA on 2/13 from noon to 4 PM. The cost is $30 (some scholarships
available). For more information, call (408)266-6516.
Input device news
-----------------
Help for Apple Mouse Users:
For those of you who are still using a mouse - why??!! (Just a
little joke from someone who has sworn off the mouse in favor of a
trackball with a foot pedal.) Seriously, if you do use a mouse,
you might consider buying the Mouse Topper from Contour Designs.
It replaces the top of the Apple mouse with a piece that's more
ergonomically designed. Look for it in your local computer store
or catalog.
Help for Nintendo players:
Power Clip is an inexpensive device that helps protect video game
players from RSI. It converts a slow, finger-tapping rhythm to the
full power needed to hit top scores in games. (Progressive
Products, Riverside IL, (708)442-5171). You can order it through
the Home Shopping Club by calling 1-800-284-3900 and referring to
order #181-057-680. (Use "Network #1" when asked.)
Impressions of the DataHand
---------------------------
(This is from Joan Stigliani, who can be reached on the Internet
at joan@netcom.netcom.com.)
I recently had the opportunity to try out a demo unit of the
DataHand, an alternative keyboard made by Industrial Innovations,
(602)860-8584. The unit, which works with a Macintosh or an IBM
PC, was displayed at the California Rehabilitation Professionals
conference by Professional Ergonomic Solutions, (916)368-4734, a
consulting company based in Sacramento CA. A "beta" version of
DataHand is shipping now but is made by hand and costs $1200
(minimum order of 2).
The DataHand looks like two upside-down catcher's mitts that you
lay your hands on top of to type. Your hands fit right into it,
and adjustments can be made to accommodate various sizes of hands
and fingers. The fingertips and the thumbs fit into little wells
where the keys are. Each finger well has five keys Q up, down,
right, left, and center. The thumb wells also have about five
keys. The combination of these keys in different function modes
gives you all the functions of a regular keyboard. All the
functions are clearly labeled. The DataHand also serves as a mouse
Q press the whole left unit down and move it around and it
controls the cursor. Press the whole right unit down and it
clicks.
At first the DataHand looks intimidating, but once you play around
with it a bit it's very easy to use. They keyboard layout is
similar to QWERTY, but this only becomes apparent when you go
through their typing tutorial. If you're a touch typist, you can
learn it quickly; if not, it'll take a while longer. Hunting and
pecking on the DataHand would be difficult. I'm a touch typist and
I managed to get through three lessons in the tutorial fairly
quickly, maybe 20 minutes total. By the time I finished the third
lesson, I was typing at close to normal speed. The center (press
down) keys were easy to use and learn - the surrounding keys took
more getting used to. It took a little while to get used to the
touch, but that also came with practice.
The DataHand requires very little force to press the keys. Plus,
the range of motion required to reach the keys is very small, so
you don't have to extend your fingers. Because you rest your hands
on it, there's no tension in the hands, wrists, or forearms, and
the wrists are kept in a neutral position. I found myself able to
relax easily from my neck and shoulders on down to my hands.
The unit I tried had some bugs. The thumb wells were too big and
needed to adjust to smaller sizes. The adjustment mechanisms need
to be smoother. Pressing the units down to use them as the mouse
required too much force. Apparently these problems are being
fixed.
Overall I was very impressed with the DataHand. I found it easy
and fun to learn once I went through the typing tutorial, and it
didn't take long to attain my usual typing speed. I could relax my
upper body and arms while I typed. I think the DataHand could
allow a lot of injured people to type without problems, and could
prevent a lot of people from getting injured (my opinion based
only on gut feeling from my limited experience with it). Once they
get the bugs out and the price down, I think they'll have a great
product.
I watched a lot of people try out the DataHand that day. Some took
to it quickly, some refused to even touch it. When people started
going through the tutorial, they tensed up, leaned forward in the
chair, and held their breath. I told them to relax, breathe, lean
back in the chair, and just press the keys lightly. Once they did
that, their enjoyment and speed picked right up.
I haven't tried other alternative keyboards, but I have read about
a lot of them and seen pictures of them. Of these, the DataHand is
truly an alternative keyboard, and one of the most innovative. My
feeling is that for an alternative keyboard to be successful, it
needs to be completely adjustable so you can fit it to your hands
and your typing style. It also needs to require a minimum of force
and extension to use the keys.
Software news
-------------
New Macintosh Disability Resources Stack: Issue 6 mentioned that,
for Macintosh users who have HyperCard 2.0 or later, Apple
Computer offers the Macintosh Disability Resources (MDR) stack for
finding accessibility solutions for the Macintosh. A new version,
2.0, is now available. Contact Marianne Wydeven at (408)862-6488,
at wydeven.m@applelink.apple.com on the Internet, or at AppleLink
WYDEVEN.M.
Software for DOS and Windows Users: User Friendly Exercises
reminds you to take a break from work at regular intervals. It
demonstrates exercises designed to reduce eye fatigue, back pain,
and hand and wrist damage. It costs $59.95 and was developed by
FingerTip Info, a division of Technically Innovative Computer
Accessories, 1-800-274-8422; it's distributed by PM Ware,
(619)738-6633. Eyercise is a similar product, $69.95 from RAN
Enterprises, 1-800-451-4487.
Other products
--------------
Aqua-Cel Pain Relief Pads: These were mentioned in Issue 7. The
cervical pad is 6" x 30" and fits around the neck and shoulders;
the back pad is 12" x 13". We've just been given a holiday offer:
$10 each (+ tax and handling) for orders of six or more, until
December 20. Contact the Aqua-Cel Corp. at (714)962-2776, and
mention the RSI Network.
The latest Museum of Modern Art, NY, catalog includes a 2-page
section called "Designs for Independent Living," with many
products for people with limited use of their hands (products with
"sensible" handles, for example). I don't know whether future
editions will continue to include this section, but for more
information and to order the catalog (which costs $3.00), call
1-800-447-6662.
The telephone company in your area may be willing to give you
hand-saving devices free of charge. In California, at least,
temporarily or permanently disabled people can get a form from the
phone company that, with their doctor's signature, will entitle
them to things like a free speakerphone headset from the phone
company store - or even free 411 service (because of difficulty
picking up a phone book). For more information, call the phone
company number on your phone bill.
Practitioners
-------------
These practitioners support this newsletter and have sent in some
information about themselves and their approach to the problem of
RSI. Even if they're not located in your area, you may find some
food for thought or useful information here.
Massage Therapist and Tai Chi Instructor
----------------------------------------
Listening to Your Body
Glen Kohler of Health Arts, Berkeley CA, (510)845-8485.
You can contact Glen for personal instruction or for information
about his program for corporations. Also note that Glen will be
the speaker at the January meeting of the East Bay RSI Support
Group (details are given on the last page).
I am a massage therapist who specializes in Asian medical and
physiotherapy. I have about 17 years of training and experience
and am also an advanced practitioner and instructor of Tai Chi
Chuan. For the last five or six years, I've been faced with
massage clients and martial art students who complain of tension
and pain in their back, neck, and shoulders, which many of them
attribute to overlong sessions at a computer.
In this field as in other fields, the self-help solution is
underplayed. Dr. David Rempel at the UCSF Ergonomics Laboratory
(the speaker at the 12/14 San Francisco Support Group meeting -
Ed.) has expressed agreement with the idea that training in body
mechanics would ideally be the solution for resolving many
people's problems with static work postures - but he said it's too
hard to get people to use their bodies differently. (In my
experience, it is rather easy to get people to use their bodies
differently, or maybe it just seems easy after 15 years of
teaching martial arts.) Dr. Rempel listed training as the number-
one solution to ergonomic health and safety, and went on to add
"learning how to listen to the body" to his list of essential
training concepts.
It makes perfect sense to obtain the very best work environment
possible. But in the end, it is how we use our bodies, and how we
respond to stress stimuli, that decides whether or not we get
hurt. In every case of RSI, if the person had desisted as soon as
their tissues were threatened by the activities in question,
whether meat-packing, letter sorting, data entry, or production
line assembly, the injury could have been avoided. You may
recognize this as a fundamental theme in the martial arts.
Attaining natural, constant monitoring of relevant messages from
the muscles, tendons, and senses creates awareness, and awareness
is what safety is all about.
Myofascial pain
---------------
Dr. Ruth Lowengart of the Occupational Health Center, Alta Bates
Medical Center, Berkeley CA, (510)204-4455.
I'm an occupational medicine physician (board certified in
occupational and internal medicine) at Alta Bates and an assistant
professor at UCSF in the Occupational Medicine Department. I see
and treat a wide variety of work-related injuries and illnesses,
and conduct medical and ergonomic evaluations. My special interest
is in RSI, which makes up a significant proportion of my practice.
I myself have experienced bilateral carpal tunnel syndrome and
deQuervain's tendinitis and have recovered.
My approach to treatment of RSI is a stepped one aimed at
maintaining and improving function and preventing disability or
need for surgery. I've found that many RSI sufferers have not only
the common disorders that you read about such as CTS and
tendinitis but also a variety of other tendon, muscle, and nerve
conditions. I'm convinced that many RSI sufferers have a condition
known as myofascial pain which results in muscle tightness and
trigger points. In the neck and shoulder region myofascial pain
contributes to symptoms of numbness and/or pain in the arms and
hands, and is occasionally diagnosed as thoracic outlet syndrome
or cervical radiculopathy.
I use a variety of techniques to treat RSI. In addition to the
usual conservative approaches of rest, splinting, and anti-
inflammatory medication, I do injections if needed, use
occupational and physical therapists, and do worksite
modifications. I try to look at the person as a whole and take
into consideration their individual needs, fears, concerns, and
questions. I do not do surgery; if surgery is required, I make
recommendations to surgeons whom I think are competent and
sensitive to the problem.
Job accommodation
-----------------
By now most of you know about the Americans With Disabilities Act
(ADA) and its provision that reasonable accommodations be made for
disabled employees. The Job Accommodation Network (JAN), a service
of the President's Committee on Employment of People with
Disabilities operating out of West Virginia University, offers a
toll-free information service to people in the U.S. and Canada who
need information about possible solutions for particular
situations.
After asking callers about job requirements and the work
environment, JAN consultants will search their files to find
readily available solutions and may engage other experts to help
determine appropriate accommodations. They may also provide names
and phone numbers of employers or workers who have made such
accommodations, as well as lists of other helpful information such
as funding resources and (for employers) tax incentives. Calls are
answered from 8 AM to 8 PM Eastern Time Monday through Thursday,
and on Friday from 8 to 5. All lines are voice/TDD. The numbers
are: outside West Virginia, 1-800-526-7234; West Virginia, 1-800-
526-4698; Canada, 1-800/-26-2262; ADA information, 1-800-ADA-WORK;
ADA computer bulletin board, 1-800-DIAL-JAN.
Speaking of job accommodation, here are some books that might be
of interest:
Job Hunting Tips for the So-Called Handicapped or
People with Disabilities
Richard Nelson Bolles (Berkeley: 10-Speed Press)
Job Strategies for People with Disabilities
Melanie Witt (Peterson's Guide).
Member letters
--------------
Please send in your letters, questions, or personal story
(preferably on a 3 1/2" disk). Other members can reply to you via
this newsletter or directly (indicate which you prefer in your
letter). Please take the time to reply if you can help someone
out!
From Joe Newcomer:
In June 1991 I had carpal tunnel release surgery. I had all the
classic symptoms: numbness in fingers, loss of hand strength, etc.
The cattle prod analysis did not show any CTS compression, but I
was told that in 20% of the cases this result is negative even
when there is a problem. During the surgery, my surgeon (an
orthopedic/plastic/reconstructive surgeon specializing in hands)
said that there was definite compression. However, a year later I
still have not regained strength in the hand, using any kind of
mouse is painful (but see below), and I'm having incidents of
numbness. There appears to be an additional compression about 2"
behind the wrist, and I was told I would need to undergo further
surgery to relieve this. However, at my first session with a
chiropractor, attempting to avoid subsequent surgery, I was told
that given that I've already had carpal tunnel release surgery,
the remaining problems can be treated without surgery (time will
tell).
My normal mouse usage these days is a Mouse Systems optical mouse,
where I place the mouse pad on my stomach and strum it like a
guitar. The chiropractor observed that from a biomechanical point
of view I have placed my arm in an optimal position to minimize
stress. So I pass this on as somewhat uninterpreted raw data;
perhaps it will save someone else from mouse-RSI. (For info on
this mouse, call (408)248-1279 - Ed.) I should point out that my
problems seem to be related not to my current mouse usage but from
my original use of an IBM-RT mouse and from the surgery. My
surgeon claimed that I didn't need any physical therapy after the
surgery, but my experience suggests and my chiropractor confirms
that therapy was in fact needed, and I'm now starting it.
Joe can be reached at (412)243-8492, on Compuserve at
71174,3464, on the Internet at jn11+@andrew.cmu.edu, or at 610
Kirtland St., Pittsburgh PA 15208
From Debra Krolick:
I recommend "The Body Electric," a half-hour muscle toning show
aired on public television. The instructor, Margaret Richards, is
very careful about form, and encourages viewers to customize the
workout by working at their own level, substituting variations of
exercises if necessary. In Chicago, the show is on WYCC Channel
20; it's supposedly aired in 300 cities.
I also recommend the Cuisinart Mini-Prep processor. The 21-ounce
work bowl rests on, rather than locks on, the base. It doesn't
slice, but it's great for chopping and mincing everything from
herbs to nuts. Cost is about $35. Another favorite kitchen toy is
the Good Grips vegetable peeler. There's a whole line of Good
Grips gadgets, costing from about $6-$17 each. Both of these items
are available at many department stores, or through an ordering
service at 1-800-338-3232.
RSI support groups (California)
-------------------------------
San Francisco:
Judy Doane, (415)931-8780, or Yari Leski, (415)759-0140.
Alternate Mondays, 7:30 PM, at the California Pacific Medical
Center (3773 Sacramento St., at Maple, SF), rooms G and H.
1/18: Ilana Parker, physical therapist specializing in the
Feldenkrais method
1/4/93 and 2/1/93: no speaker, general support meeting.
East Bay:
Joan Lichterman, (510)653-1802.
Meets monthly, 7 to 9 PM, usually on the second Wednesday, at
CalARM 400 29th Street, #105 (at summit), Oakland.
1/8/93: Glen Kohler, Using Tai Chi to Prevent RSIs
North Bay:
Stephanie Barnes, (707)571-0397.
Tuesday evenings in Santa Rosa, 7 to 9 PM, Round Table Pizza 550
Montecito Blvd., between Middle Rincon and Mission Blvd.
South Bay:
Pat Roggy, (408)297-8725, or Petzoldt Hand Center, (408)261-
7660.
Los Angeles area
Samantha Greenberg, (213)207-1653.
A "computer injury network".
Contributions & Subscriptions
-----------------------------
This newsletter relies on contributions from its readers: please
contribute your questions, stories, and any information that may
be of interest to people with RSI.
Where possible please submit contributions on diskette or via
Email. Xeroxes of interesting articles from anywhere are always
welcome. Mail disks or xeroxes to:
Caroline Rose, 970 Paradise Way, Palo Alto CA 94306
Electronic subscriptions are free.
Formatted setexts are found on ZiffNet/Mac via Compuserve.
Other issues of RSInetwork are available through ZiffNet/Mac
and Compuserve, in the "Reference" file library at location
ZMC:DOWNTECH.
For Internet mailing list distribution, send your Internet
address to:
crose@applelink.apple.com
and you'll receive the newsletter (plain ASCII).
..