We Have an Epidemic on our Hands

Karl Barksdale © 2001

Keyboards should come with warning labels from the Surgeon General reading, "Repetitive use of the keyboard and mouse can be painful and potentially hazardous to your hands, arms, shoulders, necks, backs, etc."

Carpal Tunnel Syndrome (CTS) and related Repetitive Strain Injuries (RSI) are reaching epidemic proportions due to poorly designed keyboards, a dramatic increase in the amount of typing and clicking people do, and a two-decade long educational push to encourage faster keyboarding at increasingly younger ages. Some schools even have kindergarteners learning to type!Gender Biased Nerve Disorders

Recently, while presenting speech recognition to teachers in Arizona, I asked, "How many are experiencing pain in their hands, arms, shoulders or necks due to keyboarding and mouse clicking?" About 11-12 hands went up. In a room roughly split between the genders, nearly everyone that raised their hand was a woman. Since there were approximately 45 people in the room, this reflected the national trend of 1 in 4 keyboarders suffering RSI symptoms. And nationally, women suffer RSI and carpal symptoms roughly 3 to 1 more than men.

Keyboard and mouse related CTS and RSI are gender biased physical and nerve disorders. I warned the teachers that women over 30 must be especially careful to reduce the number of keystrokes they make each day by at least 50%. But even this may not be enough. Many sufferers must cut their keyboard use by 90 to 95% or suffer the long-term medical consequences.

When You Feel the Pain . . . You’ll Understand

The more you type, the more at risk you are. And the more years that go by, the more likely you are to experience pain and even nerve damage. But for so many computer instructors, it’s business as usual; a – s – d – f – j – k – l – ;

Now, keyboarding is still very, very important and will continue to be essential for some years to come. But given the scope of this epidemic, keyboarding teachers need to approach computer instruction differently with a mind toward using voice to help reduce the potential for injury. Speaking Solutions is asking for a balance in our computer data entry workhabits. Reducing keystrokes is important, eventhough a few instructors don't seem to think so.

And why don't they think it is important?

Because some computer teachers and corporate trainers don’t suffer with RSI themselves, they can easily dismiss their responsibility to teach speech solutions to this growing problem. Normally, teachers don't experience high rates of RSI. Teachers are constantly interrupted by class breaks, calling role, helping students, and performing other instructional tasks. This (thankfully) takes them away from their keyboards, reducing the intensity of their typing experience. This is a nice bit of luck for teachers, but office workers who are chained to their keyboards cannot afford the luxury of frequent breaks. And the QWERTY keyboard is hurting them – by the millions.

When you feel the pain yourself, you will instinctively ask yourself this question, “Is this pain necessary?”

No!

Pain isn’t a “fact-of-life” in the information age. There is an alternative. This epidemic can end quickly if we effectively train students to use speech recognition software.Why Should Kids EVER Be At Risk for RSI?

The sad part is, these disorders are creeping down to younger and younger computer users. Once confined to a demographic between 30 and 55 years of age, hundreds of thousands are suffering RSI in their twenties and more than we care to admit are feeling the pain in their teens. (See the article Kids Wrists at Risk from U.S. News and World Report.)

The more we force keyboarding on young children, the greater their long-term risk for RSI and CTS. Ironically, by the time these young students reach college age, they will be talking to their computers as naturally as we talk on our telephones today. So why are we taking up valuable elementary and middle school instructional time on a skill that is rapidly declining in importance?

As for adults, in 1998, OSHA reported over 647,000 cases of RSI resulting in nearly $15-20 billion in lost work time and workman's compensation claims. Many experts believe the numbers are understated. The problem has increased dramatically since the mid-'80s when keyboards replaced typewriters. One company reported that it costs nearly $50,000 for every carpal tunnel injury an employee suffers.

Let’s not add today’s students to these RSI statistics. Let’s teach alternative ways to use a computer.The Lamentable Legacy of the Typewriter

Typewriters were not as guilty of giving users RSI because constant breaks were built into the typing routine. At the end of each sheet of paper, the typist had to remove the paper and insert a new sheet and adjust the various mechanisms on the machine. This broke up the keystroke routine. Typewriters also stood higher off the desktop, forcing the typist to avoid resting their hands directly on the carpal tunnel region at the base of their wrists. As I am fond of saying in my training sessions, "Today's mass-produced keyboards have few redeeming features. I long for the days of the electric typewriter."

Albeit, the typewriter left us an unfortunate legacy. Back in the days of mechanical typewriters, it was extremely easy for a fast typists to type too fast! This would cause the metal arms of the machine to jam together. Some of us older folks remember jamming the keys on our old portable Remington's or Underwood's.

To slow typists down, the keyboard was organized in the most awkward way possible. The keys we use most often are in the most unbelievable places! For example, the letter A is pressed with the weakest finger of the left hand. The letter E requires a reach of the middle finger on the left hand. Because most typists are right hand, the best way to slow down the greatest number of typists was to emphasize the left hand.

This scientifically designed inefficiency was inherited by the modern computer keyboard, and made worse by low-cost construction and bad keyboard design. Can anyone explain why do we use are weakest fingers to capitalize letters or to press Enter or Return?

With no built-in mechanical need for breaks to remove paper or to adjust the typing mechanism, today's modern keyboard is a devastating tool. Because we failed to change the method of keyboarding at the dawn of the computer age, the current "QWERTY" method lives on, and incidents of carpal tunnel and repetitive strain injuries have skyrocketed from the mid-1980s, reaching epidemic proportions by the dawn of the new millennium.

While I am not advocating the end of keyboarding, prudence dictates that the entire Business Education and workplace training communities to follow these dictums:

• Moderation in all things.
• Reduce keyboard use by 50 percent.
• Don't teach the QWERTY keyboard method before the fourth grade.
• Teach the most efficient tool for the job!
• Recognize that continuous speech recognition software is simply a more efficient and productive way to enter most types of data into computers.

Our Mission

We are launching a national-level training campaign to help reduce repetitive strain injuries (RSI) such as carpal tunnel syndrome (CTS) and other work-related musculoskeletal disorders (WMSDs) caused by the common keyboard and the mouse. Over 200,000 carpal tunnel surgeries are performed in the United States each year. Hundreds of thousands of workers toil with unnecessary pain at their workstations. Computer input devices are particularly harmful to women, who suffer WMSDs at a rate more than three times that of men. The human hand simply was not designed for the constant repetitive motion required by constant keyboard and mouse data entry. WMSDs are dramatically increasing. Eventually, one in every four computer users may be afflicted by workplace computer related injuries — unless something is done.So what are we to do?

For a start, we must reduce the number keystrokes and mouse clicks our fingers make as we enter data into our computers. Continuous speech recognition (CSR) offers a way to increase productivity while reducing keystrokes and mouse clicks dramatically. The astounding improvements in speech recognition software made by Lernout & Hauspie (L&H VoiceXpress), IBM (ViaVoice), and Dragon Systems (NaturallySpeaking), now make it possible to reduce our dependence on the keyboard and the mouse. Users of these software packages routinely voice-type at speeds in excess of 140 words per minute with over 90 percent or better accuracy. Clearly, CSR is more efficient than the keyboard at routine data entry.

We are seeking to retrain 25 to 50 million workers in North America within the next five years in the use of speech software. Our training attacks this health and safety problem in three ways:

• Re-trains employees currently on the job
• Prepares young people to use continuous speech recognition K-12
• Reinforces ergonomic instruction regarding keyboard and mouse use and dispel myths about current keyboarding methods and techniques

To accomplish this initiative we must start by retraining Business Educators and Human Resource Trainers. These are the two training groups that have the greatest reach. Reports are that for every one dollar spent in prevention, four dollars can be saved in lost productivity. Help support the effort to find a win-win solution to this growing problem. It is time to dispel some critical myths.The Proper Technique Myth

For decades and decades we keyboarding/typing instructors have uttered our mantras:

• Sit up Straight
• Feet on the Floor
• Wrists off the Table
• Arms in Position
• Eyes on Copy
• Do It Right and Avoid Injury

If only this were a formula to avoid RSI -- but it isn't. Too many students leave their typing classes thinking that if they just type properly, they can avoid injury.

This is a myth.

For those who are susceptible, the "proper technique" only delays the inevitable and typing in the same position constantly can actually accelerate the problem.

For those who type on-the-job the pattern has been set. How many hundreds of thousands of people will follow these seven simple steps to discomfort, numbness, and pain:

• Type Lots and Lots
• Notice Discomfort, Numbness, and Pain
• Acquire Wrist Bands
• Get Worse
• Start Cortisone Treatments
• Get Worse
• End up in the Operating Room

While it is essential that keyboarding/typing teachers emphasize proper workstation ergonomics, hand and wrist position, and to notice the signs of RSI and carpal tunnel, they shouldn't believe for a second that proper technique will in any way make a significant difference in this problem over the long-term.

The body was not made to work in the same position every hour of every day. Move around, take breaks, fidget, adjust your chair if it helps; but remember, if you type and click too much, you will be susceptible. And the most effective injury prevention technique is to reduce keystrokes and mouse clicks significantly.

There are five training goals that we are pushing with all of our energy. If you feel you can endorse our efforts toward attaining these goals, please email Speaking Solutions at http://www.speakingsolutions.com/news/epidemic.html.

Five Goals

1. Reduce keystrokes and mouse clicks among healthy computer users by 50% in 5 years while improving their overall productivity.
2. Reduce keystrokes and mouse clicks among WMSD sufferers by 95% in 5 years while improving their productivity.
3. Encourage continuous speech recognition (CSR) instruction into every K -12 school and college by 2005.
4. Establish a CSR Trainer of Trainers program for Business Education teachers in every state and province.
5. Assist corporate Human Resource departments as they implement much needed CSR training on-the-job.

Note: Are their problems associated with talking too much to your computer? Absolutely. Students need to bring water bottles to voice-typing class and sip water constantly. If they talk too much, they should stop talking and type for a while. Don’t forget the dictum, “Moderation in all things.”