Solved: Elbow Pain Caused by Improper Keyboard and Mouse Position

I’m a moderately active person. I play volleyball once a week in a bar league, lift some weights and enjoy water/snow sports on the weekends, depending on the season. So when my forearm and elbow started to become inflamed and painful, I assumed it was the result of a sports injury.

I put up with the pain for about 3 months, thinking it was just some damaged tissue that would heal up if I took it easy. That didn’t happen. At that point, I tried physical therapy.

My physical therapist loosely diagnosed it as a pinched nerve in my neck, due to poor posture or injury. I did therapy for 4 weeks, which involved various neck & wrist exercises in attempt to shift my vertebrae in a way that relieves pressure on the nerve. After 4 weeks of no results, I stopped therapy and set an appointment to see a shoulder & elbow specialist.

The Diagnosis

The MD, after pushing on my elbow and separating my fingers, diagnosed my issue as medial epicondylitis (golfer’s elbow). I was happy with that diagnosis as it aligned with my own research on the symptoms I’d been having.

• Pain and tenderness on the inside of my elbow.
• Weakness in the right hand.
• An occasional feeling of numbness in my ring and little finger, especially after a couple hours at the computer desk.

The doctor wasn’t very helpful at identifying possible causes though. I informed him about my occupation as a web developer.

“Could it be repeated stress from typing?”, I asked.

“Probably not”, replied the doc.

“How about weight lifting, was it an injury?”, I continued.

“Not likely, I don’t think it was the result of repeated stress or an injury. Give it a couple months and it should start to resolve itself. If not, make a follow-up appointment.”, the doc said.

I wasn’t satisfied, but thought it promising that it would self-resolve after a couple months.

Six Months Later

Still have elbow pain! It has not gotten any better, or worse. Though now I’m starting to worry about long-term damage, as suggested by many medical posts on the topic of medial epicondylitis.

My family and I had a 10-day vacation planned about six months after seeing the doctor. On vacation I’ll typically work just a few minutes each morning, a far cry from my usual 10 hour days using a keyboard/mouse.

During the last couple days of the trip, I noticed that my elbow pain had started to subside a little bit. The reason was obvious!

I started looking at ergonomics.

The Solution

I purchased a vertical mouse and a “tented” keyboard…

Spoiler alert – these two products solved my elbow pain!

 

At time of writing, I’m now 6 weeks in. My elbow pain is all but gone! I still feel faint traces of it when I need to do some heavy mouse/keyboard work. But the pain afterwards is both manageable and temporary.

I’m lifting weights again, picking up my kids without pain, working around the house with little complaint. Boom – ergonomics!

Before I toss out my recommendation that you drop $250 on a new keyboard and mouse. Let me justify my claim a bit…

Why new equipment solved my golfer’s elbow

Take your mouse hand and hold it out in front of you, elbow bent, thumb on top (almost like a karate chop position).

Now, slowly turn your wrist until your palm is facing the floor (see video below). Do you feel that slight tension in the tendons near your elbow?

That exact strain is what your body is enduring 8+ hours per day when using a “flat” mouse and keyboard. Over time, those tendons become inflamed and, in my case, turned into epicondylitis.

That unnatural position of my wrist is exactly what my new mouse and keyboard prevent.

I may not be susceptible, so why change equipment?

I can think of two reasons immediately:

1. Once the inflammation starts and you have developed the epicondylitis, it can take months to heal. I’m six weeks into my improved ergonomic situation and the improvement is very noticeable. But at this point, I still feel the pain on a day of intense typing, mouse movement or lifting.
   
2. I’ve been at a computer 8+ hours per day for almost 20 years. The elbow pain only became noticeable a year ago. With the wrong equipment, you could be putting unnecessary stress on the tendons in your forearm, leading to a eventual inflammation.

How medial epicondylitis affects your life

If you’re still not convinced that a more ergonomic workstation is worth the time and expense, let me reveal exactly how it has affected my life:

1. Weakness.
   
   I had hit a point where I was bench pressing 235 lbs and bicep curling 115. I watched those numbers drop to almost nothing over the past 6 months, especially my curling strength.
   
   At the worst point, I was only able to curl 15 lbs in my right arm without feeling a decent amount of pain.
   
2. Home / Family.
   
   My ability to do projects around the house became limited to light duty work.
   
   I could still pick up my 5 year old, but I hesitated before doing it as there was always a little pain involved.
   
3. Socially.
   
   I’d be exaggerating if I told you that golfer’s elbow affected my social life in any major way. It doesn’t, it just takes it down a notch.
   
   Certain activities are a little painful. Golfing, of course. Tennis, bowling, various water & snow sports and even swimming involve just enough pain to sour the experience a bit.

Healing

I’ve already touched on the ergonomic changes I made to resolve my epicondylitis, so let’s return to that.

Obviously, you want to put the steps in place to solve your problem first, which means different computer peripherals that fit with your body’s anatomical positions and movements better.

But while those products are being shipped to your home… let’s talk about what you can do to cope with this pain. Don’t worry, I’ll reveal my entire new setup and exact products used at the end of this post.

My guess is that you landed on this article because you already have elbow pain. You may or may not have changed your daily routine because you are still holding out hope that it will get better.

Here are a few of my suggestions to help mitigate the pain while you wait for your tendons and epicondyle to heal:

1. Take more breaks at work.
   
   • Use an app that reminds you to stand up and stretch every hour.
   • When you start feeling that pain in your forearm, wrap up what you’re doing and take a break.
   • Slow yourself down. Take those words per minute at the keyboard down a notch! Think more, type less.
     
2. Alter your workouts.
   
   • If you weight train, shift a bit to cardio. If you’re not a fan of cardio, eat less.
   • Take a break from mass building and go for low weight, high reps.
   • Opt for push-ups to replace bench pressing and back exercises that irritate your elbow.
   • Try one of those Beach Body videos! Shaun T., Tony Horton — yeah, those guys. The vast majority of the videos in that program are elbow-friendly.
     
3. Manage the pain.
   
   • If you absolutely need put stress on your forearm, try medicated patches. You can get them online, but you might save a few bucks at your local drug or grocery store.
     
     I found that that menthol patches work quite a bit better than the capsaicin patches. The store brand menthol patches I use, while they work great, are a bit large. So I just cut them in half.
     
     If I were to purchase them online, I’d probably go with this product. The cost per patch is low, the size is perfect and the amount of menthol compares well to the brand I use.
     
     I found that wrapping the patch around the elbow leads to the patch falling off more quickly. I typically place it right on the upper forearm, just before the elbow. The menthol targets the tendons, radiates to the elbow a bit and the patch stays on much longer.
     
4. Get a brace.
   
   • I went through 3 different braces before I finally settled on one that I thought actually relieved the pressure on my elbow and upper forearm. The recommendation came from the doctor I originally consulted about the injury.
     
     I had been using elbow wraps before I saw the doctor. He suggested using a dedicated golfer’s elbow brace, which did a lot more to take the strain off my elbow than the wraps did.
     
     I believe I found my brace at Walmart. You can also find them on Amazon, of course. This one is closest to the one I was using.

Pain Free

The Mouse

Before I close, I want to be sure to go in more detail about the vertical mouse and tented keyboard that I purchased.

I evaluated about a dozen keyboards and a few different mice. I was looking for the one that caused the smallest (or zero) strain on my tendons/elbow (that strain I described earlier when you turn your palm to the floor).

Choosing a mouse was easy. There are a number of brands that make a “vertical” mouse but only one (that I could find), which offered an angle close to 90°. I can still feel the tension in my elbow when I turn my palm even few degrees towards the floor, so I wanted to go as vertical as possible.

The one I chose, and am happy with to this day, is the Evoluent VM4SW Wireless Vertical Mouse. The mouse was not cheap at $110 and it took a couple days to get used to it, but that was nothing compared to a year of tendinitis.

The mouse performs far better than expected. No issues on a white table top. It’s extremely comfortable, as long as your chair/desk height allows your wrist, forearm & elbow to be completely in line with the mouse. Basically, your forearm should not be higher or lower than the mouse.

The only thing I didn’t like is that the “right” mouse button (which is actually the bottom button on a vertical mouse) is a bit difficult to click with your little finger. To solve this, I used the software the came with the mouse to simply change the right click action to the middle button of the mouse, where my much stronger middle finger can make the click.

The Keyboard

I had a feeling that the new vertical mouse would solve most of my issues, but I didn’t want to stop there. After I became comfortable with the mouse, I started thinking about a new keyboard.

I hopped over to Office Depot, then to Best Buy. I tried out a bunch of new “ergonomic” keyboards, but nothing really felt right. I started thinking about the position of my hand when using the vertical mouse.

What if there was a keyboard that offered the same vertical hand positioning?

It turns out there is, but it’s not at all what you would expect and reviews are not that great!

There are a couple vertical keyboard manufacturers out there. The concept is that your primary keys are vertical, leaving your lesser used arrow and number keys horizontal in the center. The difficulty in finding keys actually pushed the keyboard designers to add mirrors!

So if vertical is not the way, what’s left?

Enter the “tented keyboard”…

Keyboard Tenting

Keyboard tenting is the process by which a keyboard is split in half, allowing the center to lift (or tent) up to 15 degrees.

By splitting and tenting the keyboard, not only do you allow yourself to position your left and right hands optimally next to your sides, but you’re also able to turn your wrists closer to an ergonomic position.

The advantages don’t stop there. By splitting the keyboard, you’re able to position it so your mouse is hugged as tight as possible next to your keyboard, while still keeping your arms at your sides.

You can even add a standalone number pad in the center of the keyboard if you like (I haven’t done this).

The keyboard I selected is the Kinesis Freestyle2 Ergonomic Keyboard. Off the shelf, this keyboard does not come with the lifters or wrist pads as shown in the photo above. But I found a reasonably priced package that did come with those items (shown below).

I’ll be honest, it took over a week to get used to this keyboard. And now that I have adjusted to it, I find myself needing to reacquaint myself each time I use a traditional keyboard. But it was totally worth it!

The only negative to this product is that a wireless model is not offered. This really hasn’t been an issue for me though (one less battery to replace) and they make up for it with their excellent support.

The shift key on my new keyboard broke after about 10 days. I contacted the manufacturer directly and they sent me a new keyboard (with return label for the old one) with no questions asked.

 

I could ramble on about ergonomics and I do have more to share. But I’m going to save it for another post. For now, I encourage you to at least try switching to a vertical mouse. It was life changing for me!