LLMs may have helped my RSI
vaughanhilts.me102 points by vaughands 2 days ago
102 points by vaughands 2 days ago
I have managed RSI for decades, so consider this anecdotal of course.
The one thing that has always given me relief: changing my keyboard every 6 months or so.
For this reason I have a stack of different keyboards and whenever I start to feel the tugging pain gnawing in my hands muscles and tendons, I switch out the ol’ keyboard and get back to work.
Within a day, relief.
Seriously, it’s that simple. Just don’t get fixated on a single keyboard and you’ll be fine. Get yourself a small collection, swap them around.
Same with shoes if you walk or run significant distances multiple times a week. Different models, different brands, different types of soles.
It both gives time for the soles to recover, lessening the permanent compaction over time, and helps reduce motion repetitiveness, which all your joints will be thankful for.
I also change my desk height ever so slightly each week
Yes, I do this as well, only daily since I have an open-plan situation, and when working on home office I move from the desk to the lounge and then the garden on a frequent basis ..
Changing ones environment really works for a great deal meany troubles.
This is a great idea and I wouldn't be surprised if it has brain benefits too. This reminds me of the recommendation to take different routes to daily destinations as a form of mental workout.
Just as an aside, I do that non-deterministic route thing on the regular, also.
Even if it's just a slightly different route through the city to get to work, it helps immensely with resisting the detrimental effects of the daily grind. I can still recall, with some degree of emotional pain, the constant and regular, monotonous walk to school in my youth - and the approach I have taken as an adult is to resist mono-paths as enthusiastically as possible.
Also, /r/desirepaths is my jam.
I thought I would share. I don't see this discussed much and thought it was interesting (it's my own post) when doing some introspection today. Is it from moving up in my career and I just type a little less? Has the movement from typing in a code editor all day to writing more prose helped? It's hard to say for sure, but a fun observation. :) I am curious if anyone else has experienced the same.
Hi Vaughan,
I have experienced exactly what you describe here. I am battling RSI for more than a decade, it has nearly cost me my career. Like you and many others, I have tried all sorts of things. I got the most improvement from:
- An ergonomic split keyboard, with a custom layout - An ergonomic chair and desk setup - Relearning to type from the home row - Using dozens of custom shortcuts to reduce awkward hand movements - Yoga and stretching - Building a more active lifestyle with total body movement as a focus - Improving diet to reduce inflammation
Despite all those interventions I still suffered debilitating hand and wrist pain, which eventually crept into my shoulder blades and back muscles. Doctors and physios were useless or clueless. One doctor refused to acknowledge that RSI exists. No amount of physiotherapy helped.
Using LLMs to do (almost) all of my coding tasks has reduced my RSI pain and stress by half or more. I feel so much better and healthier. I still have pain, and I still have to work hard to manage it, but I will never go back to writing everything by hand.
Thank you for sharing, and for reading. Wishing you good health.
One thing that helped me was to avoid chords with one hand.
In the past, I’d twist my left thumb for a single handed ctrl-c or the right fingers for shift-; (to type a colon in vim). Similar for ctrl-a and ctrl-b.
I switched to a single F12 key for tmux, semicolon for vim, and either use specialized macro keys for cut/paste or got in the habit of using two hands for them.
It made an enormous difference for me.
I've never seen anyone else do this, but I press left Ctrl with the fleshy pad under my pinky. So it's just a small flick of the wrist instead of a large rotation I'd need to use the finger.
I do this for control+alt+F1. Knuckle+thumb+middle finger. Also control+W: knuckle+middle finger. I, too, thought was the only one.
This. Chording is the enemy. Use the right control key for the common ctrl-c ctrl-v ctrl-a etc. that are all in the left hand.
This also relates to my most controversial opinion: The caps lock key is good, actually.
Out of curiosity, what did you do at physio, and did you try going to the gym and doing a significantly heavy back routine?
Long ago I worked on a project where the whole team was so productive I gave myself cubital tunnel from typing so fast for so long. I'd feel needle jabs in my forearms randomly. Like while standing around. Doctor recommended surgery.
Avoiding surgery involved months of finger stretches, forearm massage, 2 keyboards and 2 mice at different elevations, typing with my hands hanging slack like a zombie. It worked. But, even typing this out 20 years later I can still feel the RSI hiding in the shadows. Since then I've avoided RSI by spending 10x more time thinking about code than typing it.
All that is setup for: There have been many times recently where I've thought "I know exactly what I want this code to look like. But, damn. That's going to be a lot of keypresses..." The effort is nothing. Risking nerve damage is the concern.
In those cases I have been thrilled be able to tell AI exactly what to make, how to refactor it, how to clean it up, clean it up more, yet more, still not done. All in less than 10% of the keypresses that would have been required to type it by hand.
Thanks for sharing. I feel the same way but did not express it in my post. I've sat down to do some side projects in the past and realized that even though my mind has energy (I hear this can be rare.. but it is true for me!) the hands would be tired. I've probably completed more side projects this year than in the last few, even if the total amount of time spent on them is higher.
Like you, there was always this specter of "don't overdo it".
I'm not saying this to be snooty or whatever, but RSI is also solvable via a custom keyboard or learning Vim motions (or both). I had really bad RSI and it totally went away after the combo of learning to type properly (which you mentioned in your post) and switching to Vim full time. Vim motions reduce the amount of stretching you need to do by a LOT. Snippets also helped. I am of course talking about in The Before Times.
I am saying this to be a little snooty. Your take is very dismissive to a large group of people whose experiences you don't know. I agree that split/custom keyboards and vim are awesome; I have used them for 25 years. But the idea that you can reduce RSI treatment and everyone's situation to something so simple just isn't true. It is fine to recommend solutions to people who are suffering, but to dismiss their problems as being "solved" comes across as basically calling them stupid for not helping themselves.
I know you didn't say that, and you softened your language, but many people with disabilities or chronic conditions have to deal with everyone they share their problems with telling them their "cure". Its exhausting.
Thanks for saying this. I already use Vim (in my browser too). I've used it on and off in an editor as well. I've tried reading books (like I mentioned in the post) which is something you only do when you're truly desperate. For some of us, our body will only allow so much.
I am sure the OP was just trying to help. I, too, when I started having such problems chalked it up to "surely some adjustments will help". And they did! But it never quite ceased.
First off, I'm not going for a "gotcha" reply here, I hear all of what you said and I don't see your reply as adversarial.
> but to dismiss their problems as being "solved" comes across as basically calling them stupid for not helping themselves.
Yep, I did kind of say that now that I re-read it. It does come from a point of aggravation (again, in The Before Times) of people expressing, with pride, how little they know of their tools (editor and VCS mainly). And for sure, they probably made/are making a lot more money than I am, so I guess they win?
I must take exception, though, with you bringing up disabilities. This article never mentioned them, so I didn't either. This is a whole other can of worms, but I will say that after working with a couple of people who have pretty extreme disabilities, there are some extremely good (non-"AI"... although of course we know they have some sort of "pre-AI"-AI in them) tools out there are extremely good, and they rocked the f^ck out of them (yes, I intentionally used "extreme" three times there).
So ya, I guess I was being a bit snooty as I was always annoyed how few people learned their tools. Not even just their tools, but their programming language of choice as well! It's all a spectrum, of course. But, as I must admit, it turns out they were right so... ¯\_(ツ)_/¯
Also, as far as exhausting goes, I've never been more exhausted than trying to follow what these awful f^cking companies are doing.
It's generally also just less typing if you are using long running agents, you can input the goals, steer it a bit then go for a nice walk and check in again on it in 30-40mins. I hope we can normalise this workflow as it will be much better for everyones health and longevity in the field.
IMO LLMs are the best thing to happen to coding in my ~15 years of being in the game.
I wager they have probably added on another 5-10 years to my engineering career as I was contemplating getting out before they showed up.
Have also been convincing some friends that have "gone woods" over the years to put the woodworking tools down for a day or two and give them a go. So far so good, a few folks have found the spark again and it's been awesome to see them make digital things again too.
except management expectation will be that you spawn 30 different things and check them every 2 minutes
I'm so confused at how people think that this will be a reality, like, what kind of boss would look at this and go: yep sure my people will only work for a few minutes here and there, let's keep paying them their huge 6 figure salaries ??
am I missing something here..?
The walk is usually work too, just instead of staring at the screen and trying to think I take a walk and actually think. So when I get back I can provide input to the robot that will result in meaningful output.
Companies that pay people to hit enter instead of using auto-approve/bypass are going to lose to companies that pay people to think and produce results, regardless of how much time they spend in front of the screen or how many prompts they input.
Before I learned any programming skills, I worked with a bunch of great coders and learned a lot from them. I remember being impressed with the guy that would log on to start his day, but then sit back and have some coffee, M&Ms and read the Calvin & Hobbes comic strip from the newspaper (yeah this was long ago.) When I asked him about it, he explained that it was one of the important aspects of the life of a programmer to be aware of: if they are walking around the office with a distracted look on their face, you still want to sort of "knock" before walking right up and dropping a big issue or request on them, they might be doing the most difficult work of their day!
I eventually learned to code and would often find it to be my favorite part of the job--the looking out the window and planning the attack phase.
I’m paying for business value creation, not for the tappy-tappy sounds.
The tappy-tappy is necessary(-ish) but isn’t the thing I care about.
There is definitely a limit to how many things you can manage at a time. Maybe 3 or 4 depending on how much context switching you do.
This has been a welcome benefit from the agentic coding era for my RSI. Thanks for sharing.
That's been my experience as well. I remember the pain from the keyboard and also doing too much clicking when making wordpress websites. Now that I do more agentic development, I type a lot less and am working to dictate more with voice also.
For folks experiencing RSI, I recommend Talon voice and Cursorless extension. I experienced thumb pain that I kind of ignored for a while - look into prehab exercises before it becomes a concern since any aggravating motion could make it worse quickly.
I haven't read it yet but folks might benefit from this recent book, Body Electric: The Hidden Health Costs of the Digital Age and New Science to Reclaim Your Well-Being.
I find Talon super cool and I so want it to work. But my understanding is, that wayland won't work ever. It makes me sad as otherwise wayland seems cool and future too.
Also my english pronunciation sounding like bucket full of rusty nails being dragged on motorway, makes the freeform so frusturating. Naming things is such paain at that point.
But oh, how much do I wish I could get it working.
What helped my RSI:
- Using mouse less
- Ergonomic keyboard
- Learning to type better (I still suck, but speed is fast enough, and I don't get a soar neck or fingers from my previous glance at KB then back to monitor and smash keys)
- Positioning top of monitor to eye level
- Gradually transitioning from programming through rapid trial and error, to building and exploring logical models of programs in my head, then type out some code that usually works.
All my experiments and usage of AI if anything lead to more typing rather than less.
I solved (managed) my computer-use-related RSI. Here’s how:
1. Multiple mouse input methods: I switch between a vertical mouse and a Wacom tablet throughout the day.
2. Good armrests: I have an ergo chair with some of the most adjustable armrests you can get. Armrest position is a big factor. You want your arms close to in plane with the desk.
3. Mouse and keyboard wrist rests.
4. Stretching: I do forearm stretches every hour or so.
5. Grip trainers: just like it’s not good for your eyes to only look at a screen inches away continuously, it’s not good for your muscles to only do fine, precision work for hours. Break it up with some strength training. I’m fond of the gyroball style or the basic spring tension trainers.
What helped my RSI was learning a new computer layout (dvorak in my case). It went away and has stayed gone for 25-ish years. Keeping bikeyboardal between qwerty and dvorak probably helps.
LLMs have not changed how much I type and mouse, I think.
I second the "change input devices up once in a while" suggestion. And I would say that Apple Trackpads and Keyboards are the ones that work best for me most of the time. Especially the Trackpads work incredibly well because with the sensitivity turned way up, I have to barely move my hand and use almost no force when using a cursor and clicking. I can also vary how I hold/rotate my wrist and compensate by adjusting my input finger(s) and/or changing which finger I use. With the keyboard, it's mostly about having very short travel and actuation force as well as a little bit of dampening. I do have a collection of ergo and mechanical keyboards, mice and trackballs but especially when I feel pain, I always go back to the Magic Trackpad and Keyboard. Wrist rests are a no-no and trying to keep your wrists floating is good.
Biggest thing that helped with mine was moving to a more ergonomic keyboard. Usually split between using my datahand and my planck. Honestly even just switching to a 40% ortholinear was a huge change, it eliminated way too many awkward movements.
Guess I've just been lucky. 40 years ago used to take 800 ibu before going to work each day. Over time, less typing lead to less problems. But yeah, people I've known have had surgery that sometimes helped, sometimes not.
Two things helped me. First is easiest to explain: cutting back or eliminating caffeine. Seriously. And my carpal was fairly bad, so I know what a troubling (literal) pain it can be. I found it was made much worse by my 4 cups a day habit back then.
Number two is more complicated to explain, but it is a mighty powerful keyboard skill that can sometimes go a long way to reducing the "awkward reach" keystrokes. Specifically, copy and paste! Read on:
(TLDR: learn Ctrl-Ins, Shift-Ins, and Shift-Del, maybe. Instead of Ctrl-C, Ctrl-V, and Ctrl-X):
In the past I often found myself doing long sessions of paging up and down documents and source files, and doing complex copy and paste actions, for reasons. Ctrl-C and Ctrl-V were not so awkward on the original IBM-PC keyboard, because Control was right where it should have stayed, ha (where your CapsLock key is now.) When they moved it to the lower left and lower right spots, it made it a tough reach with just your left hand. You could learn to do RightControl + LeftC for copy, but I never did. Instead, when I need to do a lot of copy and paste with paging up and down also, I get my right hand at the home position on the (full sized) numeric keypad (in arrow mode not number mode), and I get my left thumb and forefinger on left shift and control. Then PgUp, PgDn, Home, End, Ctrl-Home, Ctrl-End are all lightning fast. But most importantly, and the point of this rant, LeftCtrl + NumericKeypad-Ins is COPY, LeftShift + NumericKeypad-Ins is INSERT, and LeftShift + NumericKeypad-Del is CUT. I have never met anybody that could do cut, copy, and paste faster than I, in a long career, if I must say so. Try it for a moment, your fingers barely move when you learn the technique. But I never could talk more than one or two people into learning the skill, much to my disappointment. And now I'll probably never do any long sessions like that again (because AI mostly like you said), oh well.
Caffeine is an interesting one, maybe it caused unnecessary muscle tension?
I've tweaked my keyboard layout so that caps lock is left ctrl (with KDE this is just one click away in the settings). I never need caps lock anyway. That helps a lot with different keyboard shortcuts. The default ctrl position is awful.
I would guess that it directly affects the nerves where they travel through the wrist tunnel, but I’m just guessing.
I do know that after days where I have had caffeine, that night I have a tendency to sleep with my hands curled up under my chin, instead of a more relaxed sleeping pose, which I think is probably bad for the blood flow in my hands.
> TLDR: learn Ctrl-Ins, Shift-Ins, and Shift-Del, maybe. Instead of Ctrl-C, Ctrl-V, and Ctrl-X
This is funny, because it was the opposite for me: retraining from Ctrl/Shift+Ins/Del to Ctrl+C/V/X helped reduce the pain in my right hand, which is already overloaded by the navigation keys.
But cording with two hands is a good point, I’m doing that as well.
I’m also using a curved ergonomic keyboard where the Ctrl keys are wider and less badly placed due to the curve.
Get a BFO9000 and Colemak DH Mod
I recursively self-improve my shoe-tying powers every morning.
I could believe it. Honest to goodness, they might save my eyesight. No more marathon sessions staring at the screen for hours editing text.
I'm glad for you. What I see is that some people ask the LLM to code for them while they are doomscrolling on their phones
That's the other tough bit is cutting out the extraneous computer/phone use when dealing with RSI - it adds up.
The thing that helped stop my RSI was going to the gym. As soon as I was really doing a heavy back routine it went away entirely
I'm not saying this to you argue or disagree with you at all but just one thing I want to point out is that when you are doing your back exercises it was likely engaging your finger, forearm, and other muscles used for typing and so strengthening those is what might have helped even more than strengthening your back itself
I don’t think so, often pain in a muscle is due to weakness in supporting muscles. For example I had knee pain due to lack of muscle strength in the rest of my leg and back. I was also diagnosed with a specific deficiency in the trapezoidal muscles which was causing both RSI and lower back pain. It’s kinda a rule of thumb in physio to look for lack of strength where the pain isn’t
Which exercises did you like most for the traps?
Lateral raises, one arm rows, incline raises
Funny enough these are already part of my upper body routine. The problem is I worked through my RSI issues for so long that it's still lingering for a long time even with years of regular gym work and seeing lots of physics
If you set up speech to text like voxtype, you won't even have to type the prompt into the AI and can do your programming almost entirely by voice.
I don't have RSI, but I do this whenever my arms get tired to make sure I don't end up with it.
oh yeah, Wispr Flow/similar STT software ftw!
Definitely helped my RSI as well. Another anecdotal point.
I set up a custom keyboard in software years ago and it’s much better than the terrible European layout family for coding. So I can type all code comfortably. I can also type all the special characters that I want comfortably. All those “typographic” characters that make technical people go “that must be LLM, 95% confidence”.
I have considered dedicating time to stenography but it likely won’t happen (95% confidence).
I have tried to set up foot pedals but the crap that I bought wasn’t really that helpful.
I have had some success with an auxiliary little keyboard for special functions. I really like having auxiliaries. Because then I don’t need crazy key combos. I can even have visuals for those auxiliaries.
Going beyond that. I have not RSI issues with my hands which can make typing annoying. So I would definitely be interested in other things to make me type less. Like voice dictation. But truly bless the obiquity of the Open Office, the facilitator of so much collaboration and I don’t know what.
> This was even more common when I was a junior. This would normally involve trying to type special characters all over the keyboard. Hitting angled brackets, hitting various FN keys, striking home, end, tons of modifier keys, contorting my wrist in all sorts of ways that I really should not be. This was part of the motivation to learn to type “the right way”: to reduce these types of problems. Probably something that made it worse is that my hands are much smaller than average as a male. My finger span could barely reach an octave if I tried and much more than this is tough:
Setting up this keyboard software and having learned touch typing 20 years ago[1], avoiding wrist contortion was essential. For example: for single-modifier keys I never strain, I just press the key. And then the other hand presses whatever key is to be modified. I do have multiple-modifier setups. But for those I never have to strain. For example: the equivalent of “Shift AltGr” might be two keys right next to each other that can be pressed by the index and the middle finger. It doesn’t get more comfortable than that for me.
Linux Xkb has the accessibility feature “sticky keys”. Of course, like any “accessibility” there’s nothing that says that people who do not strictly need it cannot have use for it too. I use it all the time. Being able to Shift and then hit A-Z keys is very nice.
[1] A separate topic. But touch typing might not be good ergonomically. Maybe some people who do not touch type have less issues. Ergonomics is really about adjusting a primate body from Africa to fit into an office space. So who knows what the correct objective answer is.
> I have my own set of complicated feelings of LLMs (gone are the bouts of satisfaction I would get hammering out code in an afternoon and watching it work at the end of the day). However, it seems increasingly more likely that from a health perspective perhaps they have been a boon to me. Or perhaps I am just senior enough now that it’s no longer a problem. At any rate, if the machines ultimately let me live a healthier life, then so be it. Without your health, you are nothing after all.
Really? You’re going to use the health truism to wave away any concerns? The “complicated feelings”? There are in fact ways to type more comfortably, and less.
This is all fine if the LLM use is incidental to the typing. We all have to either appease investors as businesses or increase shareholer value as laborers. But as an end in itself, using LLMs to type less is the most banal use case.
> I set up a custom keyboard in software years ago and it’s much better than the terrible European layout family for coding. So I can type all code comfortably. I can also type all the special characters that I want comfortably. All those “typographic” characters that make technical people go “that must be LLM, 95% confidence”.
Been doing this for years as well, "in software" being a custom layout in xkb in my case. Though for me the concern was limited to making it easy and quick to type []{}|<>. The only downside I've ran into more frequently than you would expect is that I feel more than a little lost without the xkb config.
Still suffer from RSI but I have to assume that it would be a lot worse with the Swedish/Finnish layout I'd be using otherwise. The placement of AltGr practically ensures that typing say [ is torturous, and RSI etc. aside, for sure this has to have had at least some sort of economical impact over the years across Europe.
LLMs have indeed done wonders for recursive self-improvement. /s