repetitive stress injury (RSI) of forearm extensors - mousing + climbing

Just wondering if anyone has effectively dealt with overuse issues of the forearm extensors (muscle group on the top side of your upper forearm) before. 

My issues stem from bad computer ergonomics -- particularly with the mouse (scroll-wheel use really activates it) -- but then climbing/training activates/exacerbates the issue, and of course the issue limits my climbing. I recently had a few weeks of particularly poor ergonomics at work (was using a track pad instead of my trackball mouse) combined with an increase in training (namely, adding a pullup workout three days a week on my off days from climbing). 

Now I'm just looking for tips for getting over this. Unfortunately, I can't stop mousing. I am now using only a vertical mouse (not sure this is the best for me, actually), and a trackball mouse, and I'm wearing a wrist brace to prevent me from engaging the muscles my my hand up, but I'd like to throw everything I've got at this. I'm doing some myofascial release work as well (with a Beastie Ball, the Rolflex, and to a lesser extent a black foam roller), but I'm not sure if this is helping or maybe making things worse by possibly irritating the muscles. 

The last time I had a bad case of this (before I started climbing, though it was exacerbated by racquet sports at that time), it took me months to get over.

Thoughts? Thanks! 

I do a lot of mouse work also (AutoCAD) I have found that sometimes i tend to click with too much force and that adds a lot of tension to that region. I actually have a spare coffee cup that acts as my roller on days where my forearms are already tight from training. Also have you tried the Flexbar? There are some good exercises for the Flexbar that help a number of forearm/elbow problems.

I have a Flexbar from the last time this hit...I didn't use it diligently before, so I hadn't really thought about it, but I should give it a second try. 

Just to clarify, what exactly do you do with that spare coffee cup? Roll it on top of you arm with your other hand pushing down for force? I also imagined that maybe you put it under your arm when mousing? 

I experience something similar and the Dodgy Elbow Protocol helped me get over it.

Regarding the mouse: there are two options which are optimal for your problem: 1) get an opposite hand mouse and use that only and/or in conjunction with your usual mouse as long as you perform at least 70% of your mousing with the non-injured side, or 2) get a roller mouse. Both will take some time to learn but will help with your symptoms. Opposite-hand mousing will eliminate the repetitive strain on the offended area until it can heal, and a roller mouse eliminates the typical mousing movement experienced by your hand and arm. So either is an option for your problem. Also, you may consider some of the adaptive mice on the market. These are designed for people with motor movement issues like epilepsy or spinal cord injuries, but they could work since they eliminate typical repetitive fine motor movements and require whole-hand use for clicking instead. Some of them are large buttons you can press or joystick designs. I've seen a lot of options out there.   

Consider getting a new keyboard that can be vertically angled to help put your wrists into a more neutral position (which reduces the stretch put on the extensor tendons). For instance, the Goldtouch V2 Adjustable keyboard fits most women's hands and shoulder breadth well. I use it and love it. You can set it up traditionally or you can split and rotate the keyboard. Also, it has a separate plug-in key pad option so you aren't reaching for your mouse across the key pad, which can put subtle stretch and fatigue on the mousing arm. 

In general, you should review your computer set up and make sure that your chair, desk, and posture are as optimal as possible (this is easily looked up online for examples); otherwise consider making changes to correct your deficiencies since non-optimal posture "up stream" can also affect your elbow. For instance, many people sit too far back from their desk, forcing them to reach for the keyboard and mouse. They also tend to either slump in their chair or perch forward on the chair, neither of which you should do. Monitors are often too far away and too high or too low in height. All things to consider holistically.   

Have you tried Dr. Julian Saunders' Dodgy Elbows article? I think some of the stretches and exercises are very helpful. There is also the Armaid (and I second the Flexbar idea).    

I've had an issue like this after I hurt extensor carpi radialis while bouldering.

It eventually healed, but it took a long time. A few things that helped me, suggested by PT:

-I switched to using a mouse with my left hand for about 6 months, and then got a ball mouse (it is awesome)
-I have a foam/gel wrist support pad when I use my computer, even now, and I had tried a bunch of different keyboards to find the one that was less aggravating. It doesn't seem to matter now that everything is healed,  I don't have any issue using laptop anymore, but when i was hurting it made a big difference.
- I did a regular forearm massage, kinda digging in with my thumb. hard to explain, PT showed me. And  also, forearm extensor stretches. Eventually there were more exercises to strengthen, wrist rotations while holding weight-type things, but in the early stage just massage and stretching.
- I taped the forearm with kinesiotape when climbing, again, PT's suggestion, it seemed to help. Initially I was taping even just to go to work, but eventually just for climbing.

Oh, andI'd say , you should lay off those pull-ups on your "rest days"!

Mike Mellenthin wrote:

For what it's worth the split keyboard didn't really help me, but you should for sure try one. I personally used the Kinesis Freestyle 2 because you can separate it completely unlike the Goldtouch, but both are good.

Regardless of what you do, I agree that getting a keyboard without a numpad is a really good idea.

I'm not surprised the Goldtouch didn't work for you since you're a man and the Goldtouch is usually too small for most men. The Kinesis definitely is a better fit for the average man due to shoulder breadth differences. But I think stephaniet is a woman, and that's why I suggested the Goldtouch. That said, the Kinesis is a pretty good all-rounder.  

I actually don't use a keyboard very much -- so I don't think that's the problem. 

Really, it's that I scroll through thousands of pages of documents routinely (with the scroll-wheel -- I hadn't actually isolated this as a problem until just now and can certainly change it), and then also spend a fair amount of time doing precise mousing in Adobe Illustrator/InDesign. And then the lack of recovery days as of late with the extra pullups, not to mention adding 4 hrs a week of bike commuting time (also as of late) which puts my hands in the same wrists flexed position and involves using the extensors when I brake. 

In any case, I've already found my Flexbar in the basement, am ordering a gel wrist rest, and will certainly implement some of these other tips. 

Now I know exactly what you are experiencing. I get pain from that movement as well. Try scrolling with your left hand using the arrows or trackpad and save the precision mousing for your right (assuming you are right dominant).

stephaniet wrote:

Really, it's that I scroll through thousands of pages of documents routinely (with the scroll-wheel -- I hadn't actually isolated this as a problem until just now and can certainly change it), and then also spend a fair amount of time doing precise mousing in Adobe Illustrator/InDesign. 

Consider purchasing a Wacom pen computer or tablet for the Adobe work. No mouse involved. 

Have you seen a physical therapist?

I use the spare coffee cup for a roller (just like the lacrosse above ^^^). 

All good stuff to try here. 

I guess the real problem is that we are spending too much time in the office and not enough in the mountains

I wanted to report back that I have essentially solved this, without taking time off from climbing. What I did: 

• cut back from 4 to 3 gym sessions a week (2.5-3 hrs each)
• stopped 1x/wk top rope endurance sessions
• stopped extra pullups
• initially used a combination of the Rolflex, Beastie Ball, and lacrosse ball for myofascial release/to get the knots out
• continued to use the Rolflex more sporadically once things were smoothed out
• self-massage with opposite hand sporadically
• for about 3 days in a row, iced something like 8x/day (with an ice pack that you could strap on)
• outside of that, iced 3ish x/day
• bought and used a gel wrist rest for my mouse
• used a trackball mouse exclusively
• wore a wrist brace while mousing
• sometimes slept in a Pil-o-splint 
• did Tyler Twists with green Flexbar
• eventually bought a blue Flexbar and did the Tyler Twists with that

I went from having a lot of pain when I tried to pull the sheets up in bed the morning after climbing to being 95% recovered in about two weeks. The 8x/day icing REALLY helped, and I think that the blue Flexbar also made a significant difference in going from, I think I'm going to get over this to I'm definitely getting over this. Gel mouse pad was also critical. I feel like the Rolflex was very useful initially, but less so once I no longer had major trigger points in my forearm extensors. 

Hope this is useful for someone!

A few months later and actually healed. Real secret: digitizing tablet and pen for mousing. (Not just graphics work, but ALL mousing.) Everything else got me to 50% recovered, and when I switched to a tablet I got to 95% within two weeks.

moved to an ergonomic mouse years ago and made all the pain go away. I used a 3M ergonomic mouse for a long time but recently switched to this: https://www.amazon.com/Wow-WP-012-BK-Vertical-Ergonomic-Optical/dp/B001FWKA7A/ref=sr_1_1?ie=UTF8&qid=1514058757&sr=8-1&keywords=joy+pen+wow. Way cheaper, and I liked the angle better. I also switched the left/right mouse clicks and I use my ring and middle finger to left click- it is way more natural and reduces stress on pointer finger that causes the inflammation.