Question: I always read that tennis elbow is caused by heavy lifting, banging nails (carpenters), etc. I had surgery to both elbows and I feel it was from typing. I have also developed carpel tunnel which the doctor has not even addressed yet. My thumbs have always hurt (driving, reading a book, holding a hair brush), but in the past year was when my elbows began to bother me. I guess my question is this. Can you develop tennis elbow from typing or do you think I had the carpel tunnel and it spread to my elbows? If anyone has had this similar injury I would like to hear from you.

Answer 1: I get Tennis Elbow pains if I use the mouse a lot. Fortunately this is not often. I know of other people who have mild Tennis Elbow through typing. When you get Tennis Elbow through heavy lifting or playing tennis it is because you overload the muscles in the back of the forearm and therefore the attachment point just below the elbow. By changing the way you use the muscles in the forearm, in these cases, you can take a lot of the load off the particular muscles. I am not sure how you can help Tennis Elbow as a result of typing. Do you keep your arm/wrist/hand in a straight line or do you have your wrist bent back slightly? This would overload the muscles a bit. Also bending your wrist outwards like you do when you type will affect the relevant muscle group, this also the position tennis players use when they get Tennis Elbow. I guess the outwards bend of the wrist that you do to move the mouse is what sets my mild Tennis Elbow off.

Carpal tunnel syndrome is where the tendons get inflamed and press on the nerves in the wrist. Although carpal tunnel cannot ’cause’ Tennis Elbow your posture and arm use could well cause both conditions rather than just the one. Have you seen a physiotherapist who has experience of treating RSI? Although you may well have tendonitis there are a number of conditions that can mimic it. ‘Adverse Neural Dynamics’ (sometimes called ‘Adverse Neural Tension’ or ‘Adverse Mechanical Tension‘) can create the same symptoms as Carpal Tunnel Syndrome; Trigger Points in the upper arm or shoulder can create the same symptoms as Tennis Elbow and can cause pains in the thumb. If you surgeon is considers Carpal Tunnel release make sure you have a nerve conduction test done first to make sure it is CTS. See the FAQ for a brief introduction to AND and Trigger Points.

Answer 2: First contact with RSI UK. I’ve just been diagnosed with acute tendonitis. Started with one finger triggering, then over the course of a few weeks progressed to aching pains in my finger joints, and muscles in my hands, then sharper wrist pains, and it’s now progressed to aching forearm muscles and pains in my elbows. I’m on an anti-inflammatory from my GP (Arthrotec 75) and getting physio, which is being targeted at stretching the tendons and massaging the forearm muscles. I’d like to hear from anyone who has had similar symptoms to me, and what treatments they found effective. I’d also like to hear about people’s experiences with voice recognition software. Has anyone has tried more than one of the *latest* packages, and what they found best. I’m thinking of either ViaVoice Pro or NaturallySpeaking Pro. I’ve got a fast NT-based PC, and ideally I would like full voice control of the desktop. Finally, I’d like to hear of any recommendations regarding wrist splints (do, don’t, and if so where in the UK supplies them). My thinking is that if I can keep my wrists straight without any pressure being placed on the inside of the wrist, then I’d be better off with them, at least initially.

Answer 3: I have both Dragon NaturallySpeaking Pro. 4.01 and ViaVoice Millennium Pro – latest version available here. You can find reviews in various magazines, but they compare VVM Pro and NaturallySpeaking Preferred. Normally the Dragon program “wins” even when VVM is found more accurate (that tends to be for versions of Dragon prior to 4.0) as its correction capabilities are superior. NT isn’t the OS of choice for either program, as for full control you need MSAA. So far, W2000 seems to provide NT‘s stability and MSAA — a man I know has been testing it out (he still I think has W98, too). I use NaturallySpeaking. It supports WordPerfect and Word, VVM concentrates on Word. NaturallySpeaking is now almost hands-free — some people do run it hands free — I think that isn’t true of VVM. But I know people who prefer VVM. If you say more about your computer, I can probably comment further.

You can get the wrist splints on the NHS. Or you can buy them from your local Able Living Centre or whatever it’s called. The NHS here only has one kind of splint and they don’t measure any more precisely than you can yourself. What you might want to do is trying for an NHS appointment and also buys splints to wear while you’re waiting. **Don’t wear them while working especially if they’re the kind that curve up to hold your hand in a resting position. The physio. who prescribed them told me to do exactly that. I soon realised he was very wrong. (I’m still grateful to him for suggesting them.) If you need support while working, some kind of softer and flatter splint would do. You might be OK typing while wearing them if anyway you hold your hands poised upward when you type.**

I found before I knew about splints that I was putting a ruler along my inside arm and wrist, holding it there with tape. Splints don’t work for everybody. They changed my life from one of desperate pain at the end work, each and every single day, to something a lot more bearable. But worn the suggested way they were hurting me. I’ve now worked out my own way of wearing them. **By the time I began wearing them it was too late for anything but an operation, I could not be “cured” any other way: my condition is different from yours. Bear that in mind before taking my advice!**

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