Mouse Sensitivity, Gaming & RSI

The mouse is undoubtedly an integral aspect of any gamer’s arsenal, and it has most certainly evolved over the years. Many attempts to address the perpetual threat of repetitive stress injury have been made, ranging from the relatively archaic track ball, to a multitude of ergonomic mice.

Though there are some benefits to ergonomic mice, at the end of the day, as the title of the condition infers, most common conditions arise from repetition, poor posture/ergonomic alignment, lack of rest for the tendons, muscles and joints being used, as well as a lack of stretching/pre-emptive warm-ups. It is also important to note that, even if a mouse is labeled as ergonomic, it may work for one person’s anatomy, but for another, it may actually be detrimental.

In this article, I will touch upon two commonly asked questions/subjects. Firstly, we will discuss the topic of ergonomic mice, and secondly, we will briefly discuss the effects of mouse sensitivity on hand, and upper extremity health. I would like to sincerely thank everyone on social media for catalyzing this discussion!

Ergonomic Mice

As previously discussed, there are undoubtedly benefits to the ergonomic mouse, but it is absolutely crucial to note several points:

• Not all ergonomic mice are created equal.

• One ergonomic mouse may work for you, but not for an individual with a different hand size, finger length, and general hand/wrist structure.

Unfortunately for many gamers, mice are often ordered online, and as result, gamers don’t get a chance to test drive them before use. Regardless, if possible, before purchasing a mouse, you want to ensure that your hand fits comfortably, in a linear fashion, with the wrist in a neutral position across the mouse.

Ideally, you want your fingertips to line up with the edge of the clicking point. Many RSI conditions develop because of hyperextension or hyperflexion, in which your fingers and wrist must flex, or reach an unnatural distance based on their current position. Overreaching on a mouse can cause tension on the tendons and anatomical structures of the hand, and as you can imagine, those micro stressors can add up over the course of a long gaming session. This also causes extreme fatigue of the small muscles of the hand, hence allowing for the possibility of developing RSI. At the end of the day, this may be a perpetuating component of RSI, but may also inhibit your efficiency in accurate and efficient clicking.

In summary, make sure the mouse fits your hand, so you don’t have to overextend your hand, fingers and wrist. Also, remember, you want your hand in the following position on your mouse:

Neutral Hand Position

If you find that the mouse forces your hand into a high arching position, then it is not truly ergonomic, and neither its flashiness, or the glowing red dragon embedded on its peak will save you.

Lastly, while on the subject of ergonomics, even if you are using a suitable, fitted, ergonomic mouse and you find yourself slouching, or reaching for your mouse from a heightened angle, or a lower angle, rather than a level position, you will be putting additional stress on your hand and wrist.

Make sure your desk/chair height allows for you to maintain a level wrist position, and then sit up straight, while engaging your core, and maintaining this position. This will allow for much longer gaming sessions, and may also prevent neck and lower back pain.

If you have additional questions regarding posture, and ergonomic mice, please forward them to me on Twitter and Facebook! I will also address some of the questions on my weekly podcast and YouTube channel. Also, as previously mentioned, all ergonomic mice are not created equal, as such, if you would like me to evaluate a particular model, please send me a link to the mouse, and I will do my best to evaluate it digitally.

Mouse Sensitivity: High Vs. Low

Firstly, I would like to thank @SelflessRyu for this particular question. From what I have observed, mouse sensitivity preferences vary greatly from game to game. Perhaps in a game like Starcraft II, due to the macro nature of the game, competitors may prefer high sensitivity for rapid map observation/large scale macro management. I’ve had patients/gamers also mention that they prefer lower sensitivity, claiming it to be more accurate. Regardless, as a physician, I will comment specifically on the health aspects of the two aforementioned styles.

Personally, I have found, at least anecdotally, that many individuals with RSI also happen to play on a high DPI setting, while I have observed less RSI on individuals who have claimed to use lower sensitivity. In observing high sensitivity play, it is clear that there is more of an isolation of the hand and wrist in regards to movement. These players will flick their wrists aggressively, hence engaging the anatomical structures that are at risk for developing RSI including the carpal tunnel, the wrist, joints, tendons, etc. Often, these fast wrist movements can cause the hand position to remain in an unnatural, strained, or obtuse angle, which in turn, may incite inflammation from this aggravating motion.

Low sensitivity on the other hand seems to encourage a more controlled style of play, which is conducive to keeping the wrist in a neutral position, hence promoting proper ergonomics. Also, it seemed as if individuals using lower DPI were engaging their shoulder, forearm, and upper extremity in more of a natural, evenly distributed fashion, hence, distributing the workload across the upper extremity, rather than focusing all of the strain on a rapid, sharp wrist movement.

I hope this provides some clarity in regards to high sensitivity & low sensitivity mouse settings. If you find that you strongly prefer high sensitivity, do your best to take perpetual breaks, and perform the preventative exercises on my YouTube channel, to minimize your risk of developing RSI! Remember, the mouse is only one piece of the puzzle in regards to your hand and wrist health. It is extremely important to maintain proper posture, have a well balanced gaming station with proper chair height, and a well fitted mouse. I would also recommend a lower backrest pillow.

Also, you will want to ensure that your mouse responds easily to your clicks; if your mouse is not responsive to clicks, and is difficult to press, this may expedite the development of RSI, and should be addressed immediately. Remember; treat your mouse like a runner would treat their training shoes!

In summary, here are some final points:

1. Maintain proper posture, desk height and ergonomics while gaming! Sit up straight; do not slouch/hunch your shoulders forward.

2. Take a 5-10 minute break ever hour, and perform hand, wrist, forearm, shoulder, and neck stretches (Demonstrations can be found on my YouTube channel)

3. Make sure your mouse ergonomically fits your hand and wrist.

4. Keep your hand to elbow alignment in a neutral position.

5. If an issue persists, I would recommend visiting a hand specialist! If you’re in the Los Angeles area, I would be more than happy to evaluate you at my office!

6. Make sure your mouse clicks easily; more resistance on a click may put unnecessary strain on your hand and wrist.

Again, I would like to sincerely thank you all for your kind words. I look forward to working with you all, to spread a message of health and wellbeing in the gaming and E-Sports community!

Best,

-Dr. Levi Harrison

The Gamers & eSports Doctor