Writing with an overuse injury

Writing by hand when you have RSI can be an awkward, painful task, but it’s often preferable to using a keyboard. Here are some tips to make it a bit easier.

Use the right pen

Cheap and tacky pens are everywhere. Avoid them. Choose a pen that writes easily – try the Artline “ErgoLine” it has a nice thick grip, and requires very little pressure, as does the Uniball “Micro Deluxe”. Most fountain pens are like this too. Pens with gel ink are generally easy to write with, and it is best to avoid ballpoints. Pen grips, available from newsagents and stationers, are cheap and ease the strain required to hold the pen (though you may need help putting them on the pen in the first place). Another trick is to wrap Bradflex, a type of plumbing material available from hardware stores, around the pen.

A quick alternative is to wrap a bubble-wrap around the pen and secure it with tape or a rubber band.

Adapt your workspace

A slope-board angled at about 10 degrees makes writing much easier, as it minimises neck strain.

Adapt your writing style

One form of RSI, focal dystonia, otherwise known as writer’s cramp, is caused by misfired signals in the brain that make your hand involuntarily cramp. It makes writing painful and jerky.

One way to manage the problem is to write using your shoulder joint, rather than your wrist and fingers. Grip the pen lightly, and move your whole arm to create the letters. Write large letters and use large pads of paper. This requires less fine-motor control.

• Take breaks to allow your hand and arm muscles to relax
• Use printed address labels and get people to help you fill in forms
• Instead of trying to create an imprint on carbon copy forms, use a photocopier to make multiple copies
• If you must take notes, a tape recorder will do it for you. Try and find one with buttons that are easy to operate.

Get a new grip

This grip reduces the tension in the thumb and balances the use of tendons crossing the wrist and small muscles in the hand.

With this grip you hold the pen between the index and middle finger. Mastering this grip requires lots of patience and practice: Bring the tips of the thumb, index, and middle finger together in the most extended position. Now gently insert a pen, separating those fingertips (it is unlikely this is your normal pen grip).

The pen grip test

Dr Hunter Fry says that most of us use more force than necessary when writing. He offers this experiment:

Holding the pen as described above and as lightly as possible, write two or three words slowly on a piece of paper. This will demonstrate how really little muscular effort is required to move the pen. Retain that memory and then compare your muscular effort after writing half a page in your normal way as fast as possible.

Dr Fry’s rough calculation indicated that many writers would use perhaps 100 times the muscle power actually needed.

Only write what you need to

A quirk of modern society is its excess of information. Try to restrict yourself to only noting down important information.

For example, if you’re a student, only write down the relevant points in lectures. Remember that they are supposed to be listened to. You don’t need a record of every word that’s said. If you restrict yourself to only writing down the important points, not only will you save your hand from unnecessary activity, you’ll also develop important listening and memory skills, and probably enjoy the lectures more.

Don’t write at all

Even if you can write for prolonged periods, it’s going to get painful eventually. Of course, when it is painful the best thing to do is avoid it.

Other ideas

• Look at the area you write in – is there enough space, is it free from clutter?
• Would an inclined surface help?

Hints from RSI Association members

Activity	Old way	Suggestions
Writing letters and cards	Pen and paper	Write a progressive letter (do a little bit at a time) or photocopy a general letter for all your pen pals, adding a little extra to each to make it more personal. Send a card or postcard instead of a letter. For holiday seasons or celebrations have pre-printed labels from your mailing list for repeated use and photocopy invitations rather than writing them. Make an audio or video tape. Make a telephone call. Try using pre-stamped envelopes; a self-inking stamp or address labels for your return address; and computer-generated bulk address labels for frequent addressees.
Diary/planner	Pen and paper or Hand-held electronic organiser	Get a large diary that your writing fits into. Staple appointment reminder cards into your diary. Try a hand-held electronic organiser and use a pointer held in a hammer grip to press keys. Use abbreviations or codes rather than writing in full.
Note-taking	Pen and paper or Word-processing	Audio tape. Consciously limit the amount of pen-holding and handwriting you do to reduce static load. Try writing with your non-dominant hand. Use a scribe.
Keeping a journal/diary	Pen and paper	See hints for note-taking. Talk to others as a means of clarifying your thoughts or about your problems. Use other methods to record your ideas and feelings (eg, mind maps, dot points, draw a picture of how you feel about something).
Lists	Pen and paper	Prepare master lists to photocopy. For example, list the main items you shop for on your shopping master list and highlight or tick items needed. Use fridge magnets with pre-written reminder messages on them, which will also stick to filing cabinets or white-boards. Set up a tickler file to help you stay organised. Set up reusable reminder cards that you can take with you or pin to a cork board (eg, on blank business cards). For example “Withdraw money”, “Pay electricity bill”, “Buy bus tickets”.
Paying bills and filling in forms	Pen and paper	Get help from friends, family or staff. Take advantage of your bank’s services and/or technology if this is cost-effective for you. For example, regular cheque payments, telephone banking, automatic teller machines, EFTPOS, direct debit. Use cash instead of cheques (post offices are agents for most essential services).

For more information take a look at our Helping Hand sheet on Writing and Pens.

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