|Reprinted from The
RSI Network - Issue 41 - September'99
Norman J. Kahan, MD
(408) 725-7277, Fax: (408) 725-2625
In recent years, the mouse has become an
integral tool for most computer programs as well as for working on line.
Unfortunately, as computer users have become more dependent on mouse input devices, the
number of repetitive strain injuries (RSI) related to the mouse has been on the rise. Most
of these injuries can be traced back to both faulty movements and awkward postures when
using the mouse. Typical trouble spots include the wrist, forearm, elbow, shoulder, and
neck, resulting in pain, impairment, and even disability.
To complicate matters, the number of mice now include many options,
including traditional a two or three button mouse, (mechanical or optical) trackball,
mouse pen, joy stick, touch pad and glide point. There are even foot and head mice. The
following pitfalls and guidelines apply to whichever mouse you choose to use. Remember,
gadgets alone wont prevent the development of RSI, but learning how to use
them properly can.
Most Common Risk Factors Associated
with the Mouse
Poor placement of the mousei.e., too high, low, or far from easy
The placement of your mouse is the most important aspect of mouse use! Bringing the
mouse as close as possible to the body minimizes strain to the shoulder, elbow and wrist.
· Use a keyboard tray with sufficient space for both
your keyboard and mouse. Never place your keyboard on your mouse tray while your mouse
sits on a desk surface that is higher than the keyboard and far from reach.
· Try using a keyboard tray which wraps around,
allowing the mouse to sit closer to the body.
· Try using a mouse bridge, a platform that sits
over the number pad of your keyboard. This dramatically minimizes the need to reach for
· Investigate a split keyboard or mini touch
keyboard which does not have the numerical pad attached. This will shorten your keyboard
by approximately three inches, therefore reducing your reach.
Grip force (aka "choking"):
How tightly do you grip your mouse? Do your hands or forearms tire after using the
mouse for a prolonged period of time?
· Bring the mouse as close to your body as possible.
· Lightly rest your hand and fingers on the mouse.
The weight of your hand is more than enough to maneuver a mechanical mouse. If you are
using a joystick or mouse pen, soften your muscles and keep your wrists loose.
· Check to see if your pinky, thumb, or middle
finger is tense. If so, relax them.
Initiating motions at the wristulnar and radial deviation:
· Bring the mouse as close to your body as possible.
· Rather than move the mouse only from the wrist,
allow your forearm, wrist, and hand to move together. Your fingers, wrist and hand should
feel loose and fluid.
· Make sure you have enough cord to allow for full
range of motion.
High "clicking" finger:
· Look down at your hand when you mouse. Do you see
either the index or middle finger raised up? If
so, settle them on the mouse. The mouse buttons are more resistant than you think.
· There is no reason to ever leave the surface of
the click button. The travel is small and requires minimum effort.
"Clicking and dragging":
Several mouse functions require you to click and drag, which can put undue strain on
· Try using a mouse input device that has a
click-lock feature. This will eliminate the need to click and drag.
· When highlighting text, pulling down menu bars, or
scrolling, use key commands instead.
Used Mousing Key Commands
Many tasks that you currently do with
the mouse can easily be done using key commands instead. You may elect to alternate
between key commands and mouse use, or over the next few weeks learn and use key commands
on a consistent basis. Key commands are easy to learn and are a lot easier on the body.
Cursorsto move the cursor around the screen, the following keys
· Arrow Keys (up, down, up & down)
· Page Up / Down (moves cursor half a screen
up or down)
· Home / End (moves cursor to beginning or
end of a line)
· Ctrl + Right or Left Arrow Keys (allows the
cursor to skip words)
Selecting Textto select or highlight text:
· Hold down the shift key and use the Arrow,
Page Up/Down, or Home/End keys.
Editingto cut, copy, and paste, select your text and use the
following key combinations:
· Ctrl + X = Cut
· Ctrl + C = Copy
· Ctrl + V = Paste
· Ctrl + B = Bold
· Ctrl + I = Italics
· Ctrl + U = Underline
Open Menusto go into a menu and select a task:
· Under each menu option you will find a letter in
each word that is underscored, i.e., File or Edit.
· ALT + Underscored letter opens file.
· ALT + F = File,
ALT + E = Edit etc.
· Once you are in the menu, you will see more
letters underscored. Simply strike the desired letter. There is no need to hit the ALT key
once you are in the menu.
· If you are in a dialogue box, then ALT + Letter
has to be used. The TAB key gets you from field to field. Enter will activate the OK or
· Ctrl + P = Print
· ALT + Space Bar + N = Minimize
Togglingto go between different programs that are already open:
· ALT + TAB (holding down the ALT button)
Navigating on the Web
· Use Arrows or Page Up / Down to scroll
· ALT + Right Arrow = Page Forward
· ALT + Left Arrow = Page Back
About the Authors:
Norman J. Kahan, MD, a physiatrist (specialist in physical medicine and
rehabilitation), and Vivienne Griffin, a concert pianist, have developed the Motion Based
Ergonomics (MBE) Keyboard Retraining Program, an innovative and effective
program designed to address RSI problems associated with improper use of the computer
keyboard and mouse. To date, this retraining program has helped over 1,000 patients
throughout Silicon Valley [Santa Clara County, California, U.S.Ed.].
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