Health

RSI Prevention: How to Code for 20 Years Without Destroying Your Hands

October 24, 2025

“I used to repair hands surgically for $10,000. Now I prevent injuries for free. Larry Ellison would be disappointed, but even I have limits. Your hands generate code. Code generates money. Protect the assets.” - BasharAlCode, Room 336.5

The Medical Reality: Your Hands Are Dying

Before monetizing Derails from the Kremlin basement, I was a surgeon in Damascus. I’ve cut open more programmer wrists than I care to remember. Here’s what I found:

Inflamed tendons thick as sausages
Scar tissue everywhere
Nerve compression so bad people couldn’t feel their fingers
Carpal tunnels tighter than my Sidekiq adapter pricing

The worst part? 100% preventable.

Understanding RSI (The $50,000 Problem)

Repetitive Strain Injury isn’t one condition. It’s a family of disasters:

Carpal Tunnel Syndrome

What: Median nerve compression in wrist
Feel: Numbness in thumb, index, middle fingers
Cause: Wrist bent while typing
Surgery cost: $7,000 per wrist
Prevention cost: $0 (proper position)

Cubital Tunnel Syndrome

What: Ulnar nerve compression at elbow
Feel: Tingling in ring/pinky fingers
Cause: Leaning on elbows, bent elbows
Surgery cost: $8,000
Prevention cost: $50 (elbow pad)

De Quervain’s Tenosynovitis

What: Thumb tendon inflammation
Feel: Pain at thumb base
Cause: Spacebar abuse, phone scrolling
Surgery cost: $5,000
Prevention cost: $0 (technique change)

Trigger Finger

What: Tendon catching in sheath
Feel: Finger locks in bent position
Cause: Death grip on mouse
Surgery cost: $3,000
Prevention cost: $0 (relax your grip)

The BasharAlCode Ergonomic Setup ($2000 Investment, Saves $50,000)

Keyboard: Split or Die

Mandatory:

keyboard_requirements:
  type: Split mechanical
  angle: Shoulder width
  tenting: 10-15 degrees
  position: Elbow level

recommended_models:
  budget: Kinesis Freestyle2 ($90)
  optimal: Ergodox EZ ($350)
  supreme: Kinesis Advantage360 ($450)

worst_keyboards:
  - Apple Magic Keyboard (wrist destroyer)
  - Any laptop keyboard (RSI speedrun)
  - Gaming keyboards (unless split)

Your shoulders are wider than a laptop keyboard. Forcing your arms inward creates ulnar deviation. That’s how you end up paying me $10,000.

Mouse: Vertical Revolution

Traditional mice force pronation (palm down). Your arm naturally hangs thumb-up. Fighting this for 8 hours = inflammation.

The Prescription:

Vertical mouse (Logitech MX Vertical - $100)
Or trackball (thumb or finger)
Or trackpad (with proper positioning)
Mouse at same height as keyboard
Elbow at 90°

Chair: The $1000 Throne

Bad chair = bad posture = nerve compression = my waiting room.

Requirements:

Adjustable lumbar support
Armrests at elbow height
Seat depth adjustable
Can achieve 90° knee angle
Your feet flat on floor

Worth the money:

Herman Miller Aeron (used: $600)
Steelcase Leap (used: $500)
IKEA Järvfjället (budget: $230)

“But BasharAlCode, $1000 for a chair?”

You sit 2000 hours/year. That’s $0.50/hour to prevent $50,000 in medical bills. The math is clear.

Monitor Arms: Eye Level or Neck Death

Your laptop screen is too low. This forces neck flexion. 8 hours of this = cervical disc herniation = $30,000 surgery.

Solution:

Monitor arm ($100)
Top of screen at eye level
20-30 inches from face
Direct viewing angle (no twisting)

The Stretching Protocol (5 Minutes Saves 5 Months Recovery)

Perform every hour. I’ve timed it: 4 minutes 37 seconds total.

1. Wrist Flexor Stretch (30 seconds each)

1. Extend arm forward, palm up
2. Pull fingers back with other hand
3. Feel stretch in forearm
4. Hold 30 seconds
5. Repeat other arm

2. Wrist Extensor Stretch (30 seconds each)

1. Extend arm forward, palm down
2. Push hand down with other hand
3. Feel stretch on top of forearm
4. Hold 30 seconds
5. Repeat other arm

3. Nerve Glides (10 reps each)

Median nerve:
1. Arm out to side
2. Wrist back, fingers extended
3. Slowly bend/straighten elbow
4. 10 smooth reps

Ulnar nerve:
1. Make "OK" sign with fingers
2. Bring to eye like monocle
3. Rotate wrist in/out
4. 10 reps

4. Shoulder Rolls (10 reps)

1. Shoulders up to ears
2. Back
3. Down
4. Forward
5. Complete circle
6. 10 times, then reverse

5. Neck Stretches (Hold 20 seconds each)

1. Ear to shoulder (each side)
2. Chin to chest
3. Look up (gently)
4. Turn left/right

The LazyWork™ Break Enforcement System

# The RSI Prevention Daemon
# Run this or pay me $10,000 later

import time
import os
from datetime import datetime

class RSIPrevention:
    def __init__(self):
        self.work_minutes = 25
        self.break_minutes = 5
        self.long_break = 15
        self.cycles = 0

    def enforce_break(self):
        # Lock screen (Mac)
        os.system('pmset displaysleepnow')

        # Aggressive notification
        os.system("""
            osascript -e 'display alert "BREAK TIME"
            message "Stretch now or pay BasharAlCode $10,000 later.
            Your choice." as critical'
        """)

        print(f"[{datetime.now()}] Break enforced. Stretch for {self.break_minutes} minutes.")
        time.sleep(self.break_minutes * 60)

        os.system('say "You may resume destroying your hands now"')

    def run(self):
        while True:
            print(f"Working for {self.work_minutes} minutes...")
            time.sleep(self.work_minutes * 60)

            self.cycles += 1

            if self.cycles % 4 == 0:
                self.break_minutes = self.long_break
            else:
                self.break_minutes = 5

            self.enforce_break()

# Run at your own risk (of health)
if __name__ == "__main__":
    prevention = RSIPrevention()
    prevention.run()

Typing Technique: How to Not Destroy Yourself

The Float Method

Hands hover over keys
Wrists straight (neutral)
Fingers do the work, not wrists
Light touch (mechanical keyboards help)
No wrist rest while typing (only during breaks)

The Death Grips to Avoid

Claw grip on mouse (relax!)
Ulnar deviation (angled wrists)
Wrist extension (bent back)
Finger hyperextension (stretching for keys)

The Correct Posture

      Screen
        |
      __|__
     /     \    <- Eye level
    | 👁  👁 |
     \  👃  /
      \ 👄 /
        |
     [____]     <- Shoulders relaxed
      |  |
    💪  💪     <- Elbows at 90°
      |  |
    ✋  ✋     <- Wrists neutral
     ⌨️  🖱️      <- Tools at elbow height
      |  |
     🦵  🦵     <- Knees at 90°
    ___||___    <- Feet flat on floor

Early Warning Signs (Don’t Ignore These)

Stage 1: Mild Discomfort

Fatigue after typing
Slight stiffness
Action: Adjust setup immediately

Stage 2: Pain During Activity

Pain while typing
Weakness in grip
Action: Take 3 days off, see doctor

Stage 3: Pain at Rest

Constant pain
Night pain
Action: Medical intervention required

Stage 4: Loss of Function

Can’t type
Can’t hold things
Action: Surgery likely needed ($10,000+)

The Rule: Pain is not normal. Ever. Pain means damage occurring.

The Exercise Program (Strengthen to Prevent)

Do these 3x/week, not during acute pain:

1. Wrist Curls (2x15 reps)

Light weight (1-2 lbs)
Slow, controlled
Both directions

2. Finger Extensions (2x20)

Rubber band around fingers
Open against resistance
Balances all the gripping

3. Farmers Walk

Carry heavy things
Builds grip strength
30 seconds, 3 sets

4. Dead Hangs

Hang from pull-up bar
Decompresses everything
Work up to 60 seconds

The Nuclear Option: Voice Coding

If you’re already injured, voice coding can save your career:

Tools:

Talon Voice (free, powerful)
Dragon NaturallySpeaking ($150)
GitHub Copilot Voice (coming soon)

Reality: It’s slower at first but beats not coding at all.

The Cost-Benefit Analysis

Prevention costs:

Ergonomic keyboard: $350
Vertical mouse: $100
Good chair: $1000
Monitor arm: $100
Total: $1550

Treatment costs:

Doctor visits: $500-2000
Physical therapy: $3000-5000
Surgery: $10,000-30,000
Lost work: $20,000-100,000
Total: $33,500-137,000

ROI on prevention: 2,168%

Larry Ellison would be proud of these margins.

My Personal Setup (Room 336.5, Kremlin)

Keyboard: Kinesis Advantage360 ($450)
Mouse: Logitech MX Vertical ($100)
Chair: Herman Miller Embody ($1800, bought used)
Desk: Standing desk ($400)
Monitors: Dual arms, eye level ($200)
Breaks: Every 25 minutes (automated)
Stretches: Religious compliance
Current RSI: None (17 years coding)

The One Truth

Your hands are your money printers. A developer who can’t type is like a surgeon with no hands (I’ve seen both).

Spend $1550 now or $50,000 later. The choice is binary, like good code.

Resources

Workrave - Free break reminder
Ergodox EZ - Split keyboard
Physical therapy exercises
Your local orthopedic surgeon (hopefully never needed)

“Every dollar spent on ergonomics saves $100 in medical bills. That’s better ROI than my Sidekiq adapter tax. Protect your hands, or they become my hands (surgically speaking, for $10,000).” - BasharAlCode

P.S. - ServantOfLarry wants to sell you Oracle Ergonomics Suite™ for $5000/year. It’s just a timer app. Use Workrave for free.

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