RSI – CTS – My experiences and a solution that worked for me.


I have been typing since 1976. My mother was trained to be a secretary and learned to type on a keyboard without letters drawn on the keycaps. “Old school” trainers knew if you learned to type by looking at the keys you would never become as good as you could be. She made me learn on an old Royal manual typewriter without looking and with proper typing technique as well.

Years later when I graduated college and was having the age-old struggle to find a first job I did work with Manpower temporary services. My typing speed was tested at 98 wpm with 9 errors. I had moved on past electric typewriters and onto computers where errors were not as painful as the days of those little grey eraser pencils and holes in the paper. I was fast. I was in pain and didn’t even realize it at first dismissing it as my hands being tired.

Bring On The Hurt

In 1989 I started my first real job doing database programming and Win-PC support in the local city/county government. At that time I met a great lady named Pat that had endured several operations for Carpal Tunnels Syndrome (CTS) which I knew nothing of. Now I new why my hands and wrists hurt and they were getting worse.

Two years later, 1991, I met and fell for a girl that was deaf. Needless to say that was a whole new world of pain for me as I started using my hands to say everything I wanted to say to her – and that was a lot! It is a beautiful language I wished more people knew but people who are born signing usually have no issues with what is also called Repetitive Stress Injury (RSI) but the rest of us usually have trouble if we become signers as adults – and I had become certified to interpret so I was doing a lot of damage to my wrists.

At The Bottom Looking Up

In 2002 I was no longer using sign language and the only irritant to my wrists was typing, but computers were my job and hobby so I was doing that for the better part of about 12-18 hours a day. My wrists were killing me and I did not want needles full of steroids driven into the bones of my wrists or, worse yet, surgery.

In my research on CTS I read about a new keyboard layout that helped some people. This keyboard layout was created and patented in 1936 by August Dvorak and his brother-in-law Dr. William Dealey after study of the psychology and physiology of typing. It seems the QWERTY keyboard layout was designed to slow a typist’s speed to keep the keys from jamming on the old manual typewriters. This was accomplished by placing the letters far apart and putting often used letters under the weaker fingers that you just can’t go fast. Of course, this only makes RSI worse. The average professional typist’s fingers using QWERTY travel on average from 16 to 20 miles a day! With the “Dvorak Simplified Keyboard” that drops to about 1 mile!

* Fun Fact: The early typewriter salesmen loved to show how awesome the new devices were. The word “typewriter” is typed by selecting keys entirely on the top row in the QWERTY layout. At a time no one had ever seen typing it was quite impressive.

How Does Dvorak Work?

The whole idea behind the Dvorak layout is to make the keyboard work for us and not the other way around. The two men put the most commonly used keys under the fingers on “Home Row” and the others nearby, leaving the least used keys to the most difficult positions and furthest away from the resting position. With the new layout reducing finger travel a person who takes to this layout can actually improve their speed.

In the 1930’s a young Barbara Blackburn received an Inferior-minus grade in her QWERTY typing class in high school. A bit later when she was a freshman in business college the Royal Typewriter Company sent a representative to her school looking for someone to train as a demonstrator with the Dvorak layout. She decided to give it a shot and excelled. Within a few years she was up to 138 WPM and as of 2005 she was in the Guinness Book of World Records as the fastest English language typist in the world. She was typing 150 wpm sustained for 50 minutes! Imagine being able to maintain that speed for that long. She could type 170 wpm for shorter periods and was timed at a peak speed of 212 wpm. All of this with a near 100% accuracy. Granted she was an exception but on average the results are generally favorable.

What Happened to Me?

In 2002 after I became totally fed up with painful typing and had learned about the Dvorak Simplified Layout I decided to “go for it”. I refused to hunt and peck and even stayed with a regular keyboard with the QWERTY lettering to help me not cheat. Since typing was as natural as walking I felt like I was literally losing my mind for about 2 weeks. It was difficult to learn the new layout but by not cheating I was able to do it comfortably in about 3-4 weeks. Amazingly my wrists were better almost immediately! In 1 month there was significant improvement and after about 3 months my hands had stopped hurting almost completely.

Most people lose the ability to type well on QWERTY keyboards when they immerse themselves in Dvorak. In my case it was not that way. I could type well with Dvorak without thinking about it and then if I glanced at the letters on the keys I could switch to QWERTY mode and touchtype in that format almost equally well.

Trouble in Paradise

Here in Key West I used the Dvorak layout for a couple of years but then switched back to the IT department where I rarely worked at my own computer. It was just not worth the mental effort to maintain both layouts in my mind so I reluctantly switched back to QWERTY. I was fearful that the horrible pain would return soon after the switchv

End Results

After about 4 years I still have no pain in my wrists! I don’t know if my wrists adapted during that “off time” or if the break just gave them time to heal and my level of use is not making it bad again, but I type all day programming web pages now and have no pain from it.

My typing speed suffered a bit – I’m down to 71 wpm now, but that is more than enough for writing blog articles and programming where my mind is the bottleneck in speed. I can surely live with 71 and no pain!

I wondered if I remembered the Dvorak layout. The last 1/3 of this article was typed in that style and by now my mind has almost remembered it all. I make a mistake about every 2 words but haven’t had to look up where a key is – just remind myself to not use the habitual position. I am confident that should I start suffering again from RSI I could easily slide back into Dvorak competency in a day or two.

It seemed like a big mistake toward the end of the first week of trying to switch to Dvorak, but I honestly think it allowed me to avoid surgery and debilitating pain so it was well worth it! If you find yourself in a similar situation I would highly recommend you to consider it. Macs, Windows, and Linux have the layout built into the operating system so it’s easy to switch. If you are a hunt and peck typist I’m not sure how much help it would be. If you are not a touch typist or want help learning the new layout they do make keyboards with the keys printed in the Dvorak layout and even ones with a switch to go back and forth. I do suggest, however, that if you want to make the switch commit to one way only. Don’t do them both at the same time or you’ll never learn it!

If you have any questions or (respectful) comments I’d love to hear them! Jim