# Repetitive Strain Injury from WASD during gaming



## JLarsen (Apr 5, 2012)

I've been looking all over the web for info about wrist pain related with gaming on a keyboard, but everything I've found has been about pain associated with typing, not gaming. I play almost exclusively PC FPS games where the movement is controlled by WASD. I tend to get very excited and push down really hard on the keys and it's really been bothering my left hand. This combined with cubing and my job as a fry cook put me out of work for about a month now - hence the inactivity on speedsolving recently. Has anyone else had this issue? If so, did you ever come up with a solution? I use  this Logitech keyboard. The keys have pretty low resistance. My old Dell one used to give me hardcore claw hand.


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## Zarxrax (Apr 6, 2012)

Well, the information you can find about wrist strain from typing should be mostly relevant. I mean there isn't that much difference. You wanna make sure you are all ergonomic and stuff, and have plenty of support for your wrist. And if you feel pain, you need to STOP, and rest.


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## Jostle (Apr 6, 2012)

Stretch more, take breaks, look into a keyboard with less resistance, be on skype more often...


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## FatBoyXPC (Apr 6, 2012)

Get a Data Hand keyboard.


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## ben1996123 (Apr 6, 2012)

I'd say just take a break until you stop feeling pain for a while. Try not to spend as long on your computer maybe? I've never had any problems with repetitive strain injury, even though I'm on my computer for several hours every day.


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## teller (Apr 6, 2012)

Your diet probably promotes inflammation. Lay off the fried food.


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## JLarsen (Apr 6, 2012)

The obvious solution is to take it easy of course....but that's easier said than done. I'm sure all of you cubing addicts can understand. I was hoping someone might have had similar experiences and switched keyboards or something. I remember switching from the stock Dell to the one in my post helped a lot. I've seen pro gamers put towels on their keyboards before too.

Edit: 

@ fatboy: Checked out Data Hand. Looks expensive! I was thinking about that razer WASD thing for MMOs but I doubt it's much of an improvement. Something standalone is along the right lines though. 

@Teller: My diet is definitely not so great. Aren't there like anti inflammatory supplements you can take?


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## teller (Apr 6, 2012)

JLarsen said:


> @Teller: My diet is definitely not so great. Aren't there like anti inflammatory supplements you can take?


Supplements can help, but it's far better to get rid of the cause. Most people don't start to get sick until they get older, but if you're having issues with your muscle tissue you can totally do something about it now by eating real food instead of processed grains and oils.

But to answer your question, ok...eat more seafood. Not fried. Butter and olvie oil are safe to cook with and eat. Vegetable oil (McDonalds fries) is inflammatory. They actually sell "Fish oil" supplements to get the Omega-3 fats that are anti-inflammatory if you want to take the weakest route. Sardines are great. Salmon is great.


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## Carson (Apr 6, 2012)

I spent about two years playing Unreal Tournament competitively. At the peek of my "career" I was playing 16+ hours per day. I was not one of the naturally amazing players, and to me it seemed that I had to work twice as hard to be half as good. There were days that I had to ice down both of my wrists and my right elbow as well. Personally, I had way more trouble out of my "mouse elbow" than I did out of either of my wrists. I played with a super low sensitivity... If I recall correctly, a 180 degree turn took like an 18" movement of the mouse. (Mouse acceleration was off, so moving faster didn't decrease the travel distance)

From my experiences, here are a few tips:
Pressing down hard on the keys isn't just bad for your body, it's bad for your game as well. You need to be fluid and use minimal motion. I used a Saitek Eclipse Version 1 keyboard. To this day, I have never seen a keyboard that even compared to the feel and motion of the keys. There are others with much better features, but the feel just isn't the same. It is unfortunate that these are no longer manufactured. As long as the keyboard is comfortable, it should be fine. The most comfortable position I found for my left arm, was to have my left elbow resting on the arm of my chair and my left wrist on the palm rest of the keyboard. This required no tension to maintain arm position. You should also choose your keymapping carefully to avoid having to pick up the left hand.

For my right hand, I rested my elbow on the arm of the chair lightly, but with my low sensitivity, it was necessary to pick it up often to sweep the mouse. The trick to aiming is to use the arm and not the wrist, so it's basically impossible to avoid stress on this arm and wrist with so much motion.


My arm issues were compounded with being a music major (percussion) at the time and playing constantly. I didn't get into cubing until around the time that I retired from competitive gaming (and dropped out of college) so that didn't factor into my problems. I currently spend a lot of time on my computer and even more time cubing. I find that I still have wrist issues, but nothing like I used to.

Other than limiting your time with each activity, using the most ergonomic setup possible, and taking breaks, there really isn't much you can do. You can try icing your arms... it can be beneficial. Don't wait until there is pain, it is too late then. Ice them for a few minutes after finishing a long session of cubing or gaming. It can keep down the inflammation somewhat. If the pain gets too bad, ibuprofen based pain relievers are the best to use. (advil, motrin, etc) These aren't daily drugs and shouldn't be used to keep down the pain so you can keep cubing/gaming though, as they can cause stomach, kidney, liver damage over time if used in excessive quantities.


On a side note: What games do you play? I've been looking to get back into gaming somewhat, but I really only like PC FPS games, and there aren't many that I like. I'm really not into the COD type games.

Edit:
In response to the comments about muscle issues... with gaming/cubing, the chances that this is muscle related are extremely slim. Check out the symptoms of carpel tunnel syndrome, this was the suspected culprit with both of my wrists.


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## ThomasJE (Apr 6, 2012)

ben1996123 said:


> I've never had any problems with repetitive strain injury, though I'm on my computer for several hours every day.



Same here.

What you could do is try squeezing a tennis ball/soft ball (not the sport, a _*SOFT*_ ball) in your hand; that apparently strengthens your muscles and tendons in your wrist.


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## Godmil (Apr 6, 2012)

First up, go to a doctor, you may get reffered to a specialist. I went to a physio for treatment for my RSI, my main issue was posture (and of course too much typing/gaming/cubing/playing guitar). I had to cut down a LOT (like I bearly used a pc for a year, and took a 7 year break from cubing). Most important thing is, if it hurts stop immediately, pushing through the pain just does more damange.


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## soldii3runit (Apr 6, 2012)

When playing online computer games, I personally love using the PC controller so I can play it like a PS3 or Xbox. But some times I use a personalized keyboard that I rearranged the button layouts to make it more comfortable and I use trackball mouses that not only help relax your other hand but frees up more room on your desktop as you don't move the mouse but only the ball on top. Plus you can use it wirelessly on your bed so you can lay back and play on your TV.


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## JLarsen (Apr 7, 2012)

Carson said:


> Spoiler
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> ...



I played Quake 3/ Quake Live for about 4 years and nowadays I'm playing Tribes:Ascend which is still in beta. Both are very, VERY fast shooters that are very movement based. I haven't had issues until I started Tribes either. It's that 5 on 1 running with the flag moment where you're physically dodging around in you chair like "NOOOOOO RUNNNNNNNN". The skiing mechanic makes for a lot of close calls. Nonetheless, I've been working on relaxing a bit. It's tough, I get really into it =P. My S key is completely gone. My posture is better than most. I've actually drilled another rocketfish hard mousemat into my desk as an armrest and my left forearm rests almost perfectly level on the desk. Low sens for the win as well. I had more thoughts but I'm too lazy to convey them at the moment as I just got out of work. 



Godmil said:


> First up, go to a doctor, you may get reffered to a specialist. I went to a physio for treatment for my RSI, my main issue was posture (and of course too much typing/gaming/cubing/playing guitar). I had to cut down a LOT (like I bearly used a pc for a year, and took a 7 year break from cubing). Most important thing is, if it hurts stop immediately, pushing through the pain just does more damange.


 I did go to an occupational therapist. She seemed to think it wasn't the keyboard but I think she just didn't really understand what 5 hours of heavy pressure on a few fingers over the course of 5 years combined with cubing is like. I doubt she's ever done either.


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## maderito (Apr 9, 2012)

1. Correct your ergonomics: raise chair height or lower keyboard so that wrists are below elbows.
2. Use a wrist immobilizer (as used for carpal tunnel) until pain is gone.
3 For pain, occasional NSAID (e.g. motrin).
4. If no improvement in 1-2 weeks, see a doc.
5. If still no improvement, repeat 1-4.

Opinions vary widely about rest vs. working through pain.


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## Godmil (Apr 9, 2012)

maderito said:


> Opinions vary widely about rest vs. working through pain.



Really? I've never seen anyone say working through the pain for RSI was anything but bad.
I'll need to do some research.


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## maderito (Apr 9, 2012)

Godmil said:


> Really? I've never seen anyone say working through the pain for RSI was anything but bad.
> I'll need to do some research.



I oversimplified a complex issue. In the past, most musculoskeletal injuries - acute and chronic - where treated first and foremost with rest. More recently, active rehabilitation is started much earlier, even in the presence of mild discomfort, especially for injuries in which inflammation is a major problem. Using a splint or immobilizer provides rest to the injured joint or tendon while permitting the continuation of exercise for muscles that will ultimately prevent re-injury.

From "UpToDate" on "management of overuse (chronic) tendinopathy"


> The success of conservative treatment frequently depends upon a coordinated program of *relative rest*, correction of any underlying biomechanical faults, active rehabilitation, and a gradual return to tendon-loading activities.


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## Godmil (Apr 9, 2012)

Ok, cool, thanks for clearing that up.


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