Watch out for your pinky finger (AND elbow posture)

2022-07-08

I have, for several months, suffered a twinge in my left pinky finger from excessive strain due to hand contortions largely caused by keyboard use.

Particularly troublesome in my opinion has been the use of the left-ctrl key for keyboard shortcuts.

Update Sep 2022: I have also come to realize that this can be strongly related to elbow posture, so I added sections on this.

#Programs that are particularly troublesome for the left pinky

• many programs: ctrl+c, ctrl+v, ctrl+x, ctrl+f
• terminal: shift+ctrl+v to paste
• tmux: default ctrl+somekey as leader
• chrome: ctrl+w to close tab, ctrl+t for new tab, ctrl+r for refresh, shift+ctrl+r for cache-cleared refresh
• vim: using esc key on the far left, custom configurations using ctrl key e.g. ctrl+p (I also had ctrl+g, ctrl+f for custom file finders for awhile but no longer)

In order to make these movements, particularly if you use the left hand to do it, you have to contort your hand pretty drastically. Chrome is particularly bad because it is not possible(?) to reconfigure their keyboard shortcuts.

Unfortunately, I did not really listen to warning signs from my hand. It started out with tingling like my hand "fell asleep", but now there is a mild pain from almost any keyboard usage.

#General approaches to help out

• Take time out of my day e.g. pomodoro to take rests
• Do hand exercises and stretches when idle
• Massages to the muscles
• Using touch typing, making my hands float above the keyboard when typing
• Avoiding curling up the pinky while typing, keep hand relaxed
• Use both hands to execute shortcuts instead of contorting left hand

#Update: Avoiding elbow/ulnar nerve strain

Picture from Wikipedia https://en.wikipedia.org/wiki/Ulnar_tunnel_syndrome

I have come to realize that the pinky finger and ring finger are strongly related to the elbow and ulnar nerve, also known as your funnybone. This can cause issues sometimes called "ulnar tunnel" or "cubital tunnel" which is relatively distinct from "carpal tunnel" and is more strongly related to the ring and pinky fingers! You can get ring/pinky pain from compression of the nerve near the wrist or near the elbow, but the elbow is quite common.

Some notes about improving elbow ergonomics

• Avoid applying too much pressure to elbows on armrests (ulnar nerve) while at desk
• Avoid typing with elbows bent e.g. straighten arms
• Avoid sleeping with elbows super bent e.g. I get this sleeping on my stomach with my elbows under my body. Use ulnar/elbow brace for sleeping. I am ordering one of these to try out

#Technical approaches and key remappings for pinky ergonomics

• Remap caps lock to left+ctrl. This is a common one you hear recommended and it may help, and it has less contortion, particularly for chrome with one hand use. So you can say capslock+w, capslock+t, but it is still using pinky and can be stressful if not careful (capslock+w fine, capslock+t still contortion if done with one hand)
• More use of the right-hand-only shortcuts or at least avoiding using the left pinky for shortcuts. I don't have many of these but will look into retraining myself for some of these. I am testing out right ctrl+] for leader in tmux, and - and = for split window horizontal and vertical

#Things still to try: better ergonomics and gadgets

In truth, I type a lot on a laptop with a poor keyboard layout, and often use it away from a desk. I think improving my desk ergonomics could help, and getting a fancy keyboard and maybe mouse (though I much prefer a touchpad) could be a next frontier, along with ensuring proper desk height, chair height, etc.

#Conclusion

It is not great to get to this point. My hand posture and body posture at the keyboard has been bad for years, and it has caught up to me. Learning the connection with my elbow and ulnar nerve was very enlightening for my situation. The common problem many people discuss is carpal tunnel related, but the ulnar is actually a relatively separate problem, though related in many ways too. I recommend people be aware of contorting their hand or applying pressure on their elbows too much, lest they suffer the same!

#Any more ideas?

Let me know of ways you take care of your hands (hardware, software, or otherwise)

#Other resources

• See this post by Matt Might for some more resources https://matt.might.net/articles/preventing-and-managing-rsi/

• Ulnar tunnel https://en.wikipedia.org/wiki/Ulnar_tunnel_syndrome