I’m a programmer and a gamer, so I spend most of my day using a keyboard and mouse. I haven’t had serious issues with repetitive strain injury, but my hands and forearms do get tired and uncomfortable after a long day on the computer or a number of days without a break. I’ve tried a lot of things to head off the risk.

First and easiest was switching to an ergonomic keyboard. Some people are afraid of split keyboard layouts, but you get used to it very quickly and it allows your arms to remain at your sides where they belong. You could start out with a cheap Microsoft Natural 4000, which also allows for negative tilt – you don’t want your wrists bent upward.

The next step to keyboard bliss is ditching the staggered layout, which requires you to twist your wrists at unnatural and asymmetric angles. Good options here include the Truly Ergonomic Keyboard or an ErgoDox, either in kit form or prebuilt. (Try the kit – I had a blast soldering it together.) One great benefit of the ErgoDox over the TEK is that you can “tent” the keyboard, meaning to raise the center so that your wrists don’t have to twist to lie unnaturally flat.

If you use a laptop keyboard consistently, you’re at greater risk of RSI because you’re contorting your wrist in multiple dimensions whenever you type. I recommend hooking up a keyboard, even for travel – you can get 40% or 60% keyboards or a compact split keyboard to take with you. And, if possible, don’t actually use your laptop on your lap where you’ll have to look down at a sharp angle for long periods.

Ok. Mice!

Mice have a lot of problems. One is that you generally either have to squeeze the mouse or move your whole arm to move the pointer, depending on your grip. Another is that you have to torque your wrist over to lay your hand flat on top of the mouse. Ergonomic mice tend to be right-handed only, and “solve” the problem by having the left side of the mouse be taller so that your hand can lie on it at a bit of an angle.

The logical extension to this is the vertical mouse – a type of mouse that lets your hand sit perpendicular to the desk. One good example of this is the Evoluent VerticalMouse 4, which I used for almost two years. It’s much more comfortable (at first) and doesn’t take much adjustment. The biggest adjustment for me was due to the fact that it’s taller than a regular mouse, so you have to lift your hand a bit more when switching between keyboard and mouse. I got over that and thought I had found mousing nirvana.

I’m still typing, so obviously it wasn’t nirvana.

The problem, which I only found after repetitive strain over the course of a year or so – you no longer have the benefit of the desk pushing up against your finger when you click. You have to squeeze your thumb against the mouse to keep it still when clicking. Essentially, you’re squeezing your whole hand to click, every time. I click a lot. My thumb is sore. I wasn’t expecting that.

The VerticalMouse also started missing a significant portion of my clicks after a year or so, and this happened with two of them, so there may be quality issues in the switch.

I decided it was time to try something different. An underappreciated classic. The trackball.

Sadly, there aren’t a lot of trackballs being made these days. I assume that’s because “gaming mice” have taken over the market and people don’t think trackballs can be used for gaming. (Not true!) In any case, I did a lot of research on what’s available.

My first stop was the cheap, well-reviewed Logitech M570. It’s got four buttons and a clickable wheel to go along with its thumb-controlled trackball. (Many trackballs lack extra buttons or a wheel, features I don’t think I could go without.) It’s wireless; I prefer wired, but Logitech’s solution works well and didn’t have any noticeable lag.

I used the M570 for about a week. It’s well made and comfortable to hold, being sculpted to fit a (small) hand. What a bargain, too! The trouble for me is that the thumb-controlled trackball doesn’t solve my problem from the vertical mouse – my thumb is overworked. I found my thumb getting rather tired after a day with the M570. Plus, thumbs aren’t as nimble as fingers, so you’re necessarily limited in how precise you can be with this style of trackball.

I decided I wanted to try the classic finger-controlled style of trackball. I looked into the top contenders today, models from Kensington, Logitech, Clearly Superior Technologies, and Elecom. (Elecom doesn’t have a great English site for their trackballs, sorry.)

A common recommendation is the Kensington Expert, which is now available in a wireless model as well. (It used to come in a “pro” model with extra buttons at the top; sadly, that’s discontinued.)

I didn’t buy this one, but I have played with it briefly and read a lot of reviews. You get a lot more precision with its large, finger-controlled trackball, and the buttons are still easy to reach. There’s a ring around the ball that you turn to scroll. Overall, I think it’s a good choice if you like the layout of its four buttons. (I’ll get back to the layout in a minute, since it’s the same for the Slimblade.)

One downside is the construction of the scroll ring, which grates a bit as it spins; they would do well to make it spin more smoothly. Another issue is the positive tilt, which forces you to bend your wrist upward; they do include a wrist rest, but it seems like you could avoid the problem altogether by making the surface level. Enter the Slimblade…

The Kensington Slimblade is similar to the Expert, but looks a bit classier, and trades the scroll ring for the ability to twist the ball to scroll. It’s also got a level base, which I consider a nice plus – you can choose a wrist rest if you want one, but it’s less likely to be required.

I bought the Slimblade and used it for a couple days. The construction is pretty good, and it’s comfortable to hold. It’s got the same basic button layout as the Expert, but the buttons are part of the single piece of plastic that makes up the body; the practical effect is that it takes very little effort to push the buttons near the ball and progressively more effort to push them away from the ball. I don’t like this, because it means you either need to use your pointer finger to push the primary button on the left, near the ball, or you use your thumb to press further away from the ball and have to push pretty hard. This gets tiring quickly.

I had a couple mechanical issues with the Slimblade. One is that twisting the ball made an annoying grating sound, plus a generated clicking sound. Another is that the top right button felt different than the others; you could feel two clicks before it activated. These are common complaints for the product.

My main complaint with the Kensingtons, however, is their button layout. I don’t want to stress my thumb, but the button placement almost demands it. You can’t comfortably press the bottom left button with your index finger unless you twist your hand, so you’re limited in terms of hand placement and button configuration. Hence my final two options…

The Elecom M-DT2URBK looks a lot more like a standard mouse, but has a finger trackball where the primary buttons would be. The primary button and wheel are moved to the thumb, off on the left, along with back/forward buttons. There’s a slim button to the right of the ball for right clicking, and a few programmable buttons on the left.

I haven’t tried the Elecom in person, but I really like the design, and it’s unique in the field today. You’re not giving up any useful controls. (It’s reminiscent of the beloved, discontinued Microsoft Trackball Explorer, which can now sell for over $600.) Even though the primary button is under your thumb, and I’m wary of tiring out my thumb, it’s activated by a squeeze rather than a lateral downward push. If I had to pick one, I’d pick the squeeze, since that’s a more natural movement.

Still, in the end, I was turned off by all the controls on the thumb. Worse, though, is the size of the trackball – it’s the same as the M570, a smaller ball meant for the thumb. You’re intended to use it with just your index finger, with your middle finger on the right button and your ring and pinky fingers in the grooves on the side. I wasn’t willing to trade a tired thumb for a tired index finger, while getting less precision than a typical finger trackball.

Ok, the grand reveal… my new trackball!

The Clearly Superior Technologies CST2545-5W. It’s a beast, made to last, with replaceable parts. It feels solid on the desk. It uses steel rollers, rather than the tiny jewels in the Kensington trackballs, and rolling the trackball around feels smoother to me. I love the precision of rolling around the large, smooth trackball. It’s just fun, and I was quickly able to tell it was more comfortable.

In terms of configuration, it’s trivial – no drivers needed. I set the DPI to medium (just hold the right mouse button and press the left to switch) and added some acceleration on the cursor, and I can hit a single pixel or glide across the screen, all without lifting my hand.

I like the button layout. The left and right buttons are long – they span the full height of the trackball and then some. This means you can press them with your index finger at the top, or your thumb at the bottom, and they’re pretty easy to push in either spot. Having that flexibility reduces the chance of stressing out any one muscle. The middle button is above the wheel, easy to find with a little bump.

The scroll wheel sits above the middle button. It’s very smooth and feels nice to operate. It doesn’t spin freely, but doesn’t resist either. It may be a little hard to reach if you have small hands, but mine are average and I’ve found a comfortable spot where I can move the trackball or operate the wheel without moving my hand.

The “5W” in “CST2545-5W” indicates that this model supports 5 buttons. See those two jacks on the back? You can plug in extra buttons and place them wherever you like. You can buy them if you want, but they’re also trivial to make; I’m building my own out of Lego and keyboard switches with inspiration from this guide by ripster.

(Ripster is also a prominent figure in /r/trackballs and /r/mechanicalkeyboards, two great sources of information. He’s posted a number of other guides to modifying the CST, since it’s well designed for modding and repair.)

One downside to the CST, similar to the Kensington Expert, is the angle of the base. It encourages upward tilt of the wrists. I’d prefer the whole body be shorter, but I use a wrist rest for comfort anyway and it raises up my hand enough to avoid the issue.

There are a number of available models; one without a wheel, one with switch jacks that replace the primary buttons instead of complementing them (the SAW model), one without switch jacks, and a couple with glowing trackballs.

I hope this helps. Even if you’re not interested in a trackball, please consider the strain you’re putting on your hands if you use a computer all day. Make sure to take breaks, and stretch regularly.

One easy stretch you can do is to spread all of your fingers apart, like you were showing someone the number 5. Hold them there for a few seconds, and gradually use your hand muscles to spread your fingers further so you feel a slight tension. I feel my skin stretch a bit when I do this. Afterward, I can feel the tendons relax a bit. I think it counteracts my tendency to curl my fingers onto the keyboard all day long.

Don’t use your other hand or anything else to force your fingers to stretch, or you could hurt yourself. It should feel natural. If anything hurts even remotely, stop. I’m not a doctor, I’m just saying what helps me. Take care of yourself.