Monday, May 7, 2012

CART Problem Solving: Ergonomics

CART Problem Solving Series

Sitting Apart
Handling Slides
Classroom Videos
Superscript and Subscript
Schlepping Gear
Late Hours
Expensive Machines
Communicating Sans Steno
Cash Flow
Test Nerves
Speech Recognition, Part I
Speech Recognition, Part II
Speech Recognition, Part III
Speech Recognition, Part IV

CART PROBLEM: Repetitive stress injuries can shorten a CART provider's career

Today I bought a 4-foot body pillow from Amazon. Why am I telling you this? What does it have to do with being a CART provider? Well, I've noticed recently that I've developed the habit of falling asleep with my arm underneath my head, and sometimes when I wake up my fingers tingle slightly. When it happened again this morning, I knew I needed to do something about it. If I have a body pillow to hang onto at night, I'll be less tempted to sleep on my arm, and hopefully that'll eliminate the worry that I might eventually start doing damage to the nerves in my arms and fingers overnight.

Ergonomics are no joke. Steno, by and large, is a much more ergonomic technology than qwerty typing (you can read my What Is Steno Good For? post about it), but anyone who does anything with their hands for several consecutive hours a day risks damaging them. When I started steno school, I was on a Stentura 400 SRT. 40 hours of qwerty typing every week for my day job at an offline captioning company, plus 10 hours at school on the Stentura, plus at least 10 to 15 additional hours practicing and doing weekend transcription work meant that my arms were screaming by the end of nearly every day. After a year, I knew I had to make a change, or my career would be over before it began. I bought a Gemini 2, and all the pain vanished in an instant. As soon as I felt a twinge, I'd make a slight adjustment to the angle and the fatigued muscles would get a rest while other muscles kicked in to relieve them. It was magical. I've since had a Revolution Grand and an Infinity Ergonomic (my current machine), and I haven't had any trouble since. I've been able to write up to 7 hours at a stretch without a break, and still the pain hasn't recurred. It's fantastic.

But I'm not here to sell you on the advantages of split-keyboard steno machines (though I'd encourage you to try one if you can; writing with both wrists parallel to the ground is an uncomfortable and unnatural position, but let your right hand tilt just a few degrees to the right and your left hand a few degrees to the left and feel how much difference it makes to your whole posture. You might be surprised.) I want to list a few things that have helped me make my work life more ergonomic apart from the steno machine. If you've got more ideas, please feel free to write them in the comments. Working through pain out of a misguided macho idea of toughness isn't smart. It can worsen your accuracy and overall endurance, make you feel a subliminal resentment towards your work, and even cut short an otherwise flourishing career. Pay attention to what your body tells you and adjust your environment accordingly. It's never a wasted effort.

* If you use a laptop on your lap, the built-in trackpad is probably fine to use, but if you put it on a desk, consider getting an external mouse and keyboard. Desk heights that are comfortable for the eyes are almost always very bad for the arms, hands, and shoulders. If you find yourself with an aching or knotted-up neck, shoulder, or wrist after using a laptop on a desk, try an external mouse -- either with a mousepad on your lap or on a pull-out keyboard tray significantly lower than the level of the desk. It'll make a huge difference. You don't need an expensive laptop port; I stuck an external USB port to my glass desk with double-sided tape, which always has a mouse, keyboard, scanner, and foot pedal plugged into it. That port outputs to a single USB lead, which I plug into the back of my computer whenever I sit down to my desk. It's much easier than manually connecting a mouse and keyboard each time.

* If you can, mix up your working positions. After a four-hour remote CART job at your desk, take your transcript editing to the couch, a comfortable chair, on the floor leaning against a wall, or even in bed. The more different positions you put yourself into over the course of the day, the less likely you are to freeze into any given one of them.

* If you use a backpack to carry your gear, like I do, always make sure to get one with chest and belly straps, and don't forget to buckle them each time you wear the bag. Otherwise your shoulders carry the lion's share of the weight, and they won't thank you for it that evening.

* This is probably only helpful for transcriptionists, but I've found since I started using Plover that my legs are less sore after a long session of transcription work, because I don't have to keep them poised to press the foot pedal whenever I need to rewind a section of audio; Plover allows me to send the rewind command right from the steno keyboard. Even if you don't have Plover, you can get a Kinesis Savant Elite single pedal rather than one of the big three-button floor pedals. It's lightweight enough that you can hold it under your armpit while writing rather than having to click it with your foot all the time. Don't laugh! I used it as an armpit pedal for a good two years, and it saved me from a lot of unnecessary leg pain.

* If you're CARTing a high speed job and your hands start cramping or getting sore, take advantage of the first available break to shake them out, roll your wrists back and forth, and then squeeze and release your fingers several times in a row. This helps to relax the muscles, restore blood flow, and subtly indicate to the person you're captioning that it might be nice if they slowed their pace just a touch. Not everyone picks up on it, but sometimes people get the hint.


  1. Very informative and educative blog post!! I'm a freelancer and I work before computer a lot. Sometime long time sitting causes me dizziness and back pain as well. Although above provided suggestions are seems to me quite helpful to get rid of such issues most ways. Thanks for helpful contribution.

  2. Your post led me to purchase and IE student. I am only on lesson 12 of Theory and have been using a school supplied 1970's manual stenograph. I have had my IE for exactly 3 days and can already type 25wpm faster and my accuracy is at 100%! Fantastic machine. Can't wait to finish training it.


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