SteveStreeting.com

Laptops are great, of course, whether you’re travelling or just enjoying the flexibility of having a PC wherever you want in the house at any one time, instead of closeted in a fixed location. But if there’s one dimension in which they suck (barring upgradability – but then modern laptops are pretty nippy these days), it’s ergonomics. Laptops are excluded from the design standards that regular PCs have to adhere to, simply because it’s hard for them to comply within the form factor we expect.

I’m a little sensitive to ergonomics, having had bouts of RSI over the years, and of course my back problems.  However, I still love my laptops – particularly since right now the only Mac I have is a laptop, so that’s where all my testing for OS X has to happen. The reason I’m raising this today is that, despite having limited my laptop time in recent months because of my back, I decided it was feeling good enough in recent weeks to try to finish the OS X support for CMake this weekend. It took quite a lot of time over 2 days to get everything sorted out, but I did manage it, and was pretty happy about it. My back though – not so much; today it’s more painful than it’s been in a while.

The trouble is that I can either use the laptop on the dining room table, which places the keyboard and screen at about chest height – which strains my mid-back because I have to sit up pretty straight to use it (ie exactly what my physio says I shouldn’t do), or, I can use it at my stand-up desk or on my lap, which then hurts my upper back because you have to hunch your neck over quite far instead. For me, mid-to-upper back strain is the main problem, not lower back as is more common (trust me to be different), so this is straining the exact area I don’t want to.

Of course the usual way to resolve it is to use a laptop stand and connect a separate keyboard and mouse, but that pretty much defeats the object of having a laptop in the first place if you have to cart those things around & have cables trailing about. There are other more modest stands just for the laptop itself but I’m not entirely convinced about their effectiveness given how little they can change the configuration (if you’ve used one, please shout )

It would be nice if laptops could start trying to address this. Maybe incorporating some kind of telescopic housing for the LCD, so you can put the keyboard and screen at the right height simultaneously. The main challenges with that are strength, space requirements and the centre of gravity I guess, but it would be nice. Or, maybe a simpler approach of just a detachable screen with fold-out legs or something. Am I nuts?

Since I keep getting asked this question by friends, existing business partners and prospects, I figured I’d just confirm it here – I won’t be attending GDC this year. It’s a shame, because I’d love to meet up with all the people I know who are going, but the primary reason is the 5,000 miles between here and there. Given the issues I’ve had with my back over the last few months (the worst episode of which emerged just after I made it back from California last time), I decided to have a break from long-haul travel to allow it time to recover. It would be different if I could afford to travel anything other than economy class, where I have to spend 10 hours wedged in a space PETA would find objectionable, but that’s not really an option. So for the moment, I’m limiting myself to 2 hours flights or less, which lets me get to most places in Europe (in May I’ll be at FMX in Stuttgart doing a talk), but rules out the US of A except in the unlikely event that Concorde makes a return and is curiously both faster and cheaper.

On the back issue, I can tentatively report that things are improving. It’s slow, but the number of ‘incidents’ where I do something that takes me out for a few days with major pain are decreasing; it’s been a couple of weeks now since the last one (touch wood), and before that I had a fairly good couple of weeks. It’s still sore a lot of the time, but sore is a big improvement Having been back to the doctor & physio again, they both appear to be convinced now that my spine is ok structurally (which is very good news), the problem is in the soft tissues – specifically that the muscles in my mid-back have become way too dominant, caused by years of spending too much time sitting relatively motionless and a bit too upright (aka my usual typing position). The result is that the multitude of muscles and ligaments down my mid-back are a bit too short, a bit too tense all the time, and poorly balanced by all the other muscles that would have been doing more if I wasn’t sitting at the desk so much. That means that they have a tendency to over-tense and jam the ‘fins’ at the back of my  spine in awkward ways, which means inflammation and aggravation on the clusters of nerves running between them.

The symptoms I’ve had can be caused by much more serious problems, but the fact that mine recovers in between the ‘incidents’, and doesn’t seem to react to prodding once the inflammation has gone down, means that it’s not serious, apparently. I have to say, it’s easily the most painful and prolonged non-serious condition I’ve had in my 35 years!

This week I’m adding the gym to my schedule of activities, for the first time in a lot of years. I’ve got a list from the physio of the things I should and shouldn’t do, but it’s time to take my recovery to the next stage (that is, Stage 1-2: Moderate Discomfort Overworld), and to redevelop the bits of me not related to adopting the keyboard position. Here goes…

I’ve had the HAG Capisco for a little over two weeks now, which is not really long enough to give a definitive verdict, but it is just about long enough to give some initial impressions of it.

Let’s get something out of the way right off the bat – this is not an instantly comfortable chair. It’s most definitely not the kind of chair you can buy, plonk yourself into and be immediately at ease – far from it. It might seem crazy to spend this amount of money on a chair that initially makes you rather saddle-sore, but if you’ve ever had recurring back problems, you’ll know that the word ‘comfort’ is relatively alien to you anyway, and having sore thighs for a while really isn’t a big deal in comparison to something sawing away at your spinal column day-in day-out.

The saddle seat means your weight distribution is very different to a normal chair, shifted from the back of your pelvis (which can remove the healthy ‘S’ shape of your spine and put you off your centre of gravity when you use a desk, despite lumbar supports and other ergonomics) to the  middle of your pelvis instead, largely mimicking the way weight is carried when you’re standing up but mostly taking your legs out of the equation. It takes a while to get used to that. I still can’t sit on it for long periods of time (maybe an hour) before I need to switch to standing up for a while, but that’s actually a good thing, since variety and movement is precisely what my back needs. Going back and forth means that I can do almost a regular day at the desk again, so long as I keep moving and stick to my exercise regimen.

I also like the way you can spin the chair around and use it backwards (the back is designed so you can lean against it, and put  your elbows on the arm rests which work both ways). I don’t use it like this myself, but I can see some people might like it. Lastly, the fact that the gas lift goes way high and is still super-stable is ideal for me with my stand-up desk setup.

So, what about results so far? Well, I think it’s helping. My back has been a bit variable this month; starting pretty bad – the ogre3d.org hack probably had a lot to do with this, since I was stressed out and putting loads of hours in- but improving a lot in the last 2 weeks. I’m not sure if this improvement is just down to the chair, since I made some other changes too. After the problems I had after recovering the OGRE server, I changed my routine so that it’s much more strictly focussed on health rather than work again, because that really is more important. I go for a brisk walk of a couple of miles every morning without fail (previously I’d leave it until a variable time later in the day which didn’t work very well), followed by 30-45 minutes of careful stretching and strengthening exercises.  I use the stand-up desk and chair all day, and switch between postures at least once an hour and generally try to keep active. In the evenings, I have to make sure I switch things up a lot. No sitting / standing at the PC/laptop all evening like I used to, or indeed doing any one thing for long periods – sorry to those wanting more work on OGRE, but I have to be realistic. I might catch up for an hour standing at the PC, do some guitar practice, play on the 360 a little bit (Rock Band is interesting because it’s active enough to actually help rather than hinder like most other things).  Basically, I’m forced into being a delittante in just about everything these days! I seem to have to avoid using the laptop very much, because sitting at the dining table for a long time really sucks the next day.

Still, awkward regime or no I’ve definitely noticed my back getting stronger overall. It is still susceptible to occasional upsets – I had one this week for example when I either lifted something I shouldn’t have, or spent too much time using the laptop one evening, and I’ve really paid for it these last 2 days. Not as badly as I once might have done – it doesn’t hurt most of the time, but exercising it (like I have to for the longer term!) or moving in certain ways can set off a pretty nasty bout of pain if I’m not careful.

Blips aside, I do think I’m on an overall upward trajectory, and I think the Capisco is one positive facet in that process. I’ve lost a stone in weight since mid last year and in these last 2 weeks, for the first time in around 4 months I’ve been able to get up in the morning without a good chance it’ll feel like I have a rusty, barbed chain running down my back. The trick is to maintain that improvement without accidentally overdoing it, which is a lot harder than it sounds and I don’t always get the balance quite right. Still, there are definitely positive signs here that I’m trying very much to remember whenever one of the ‘blips’ occurs. As my wife keeps reminding me, I’m light-years away from the situation 4 months ago which included being in hospital jacked up on morphine, hobbling around the house at 4am trying not to scream too loud, and laying in a crumpled heap on the floor wondering how I was ever going to get up, none of which I’ve done for ages. So, big improvements since then, and improvements even compared to a month ago. It’s hard when you’re as impatient as I am, but staying the course for the long term is clearly the way to go.

My primary goal for 2009 is to recover enough to take a holiday back to Canada this year, which is about both being able to tolerate a 10 hour flight in economy class again, and be fit enough to get around and have fun when we get there. You certainly won’t see me horse riding or white-water rafting any time soon though

My new chair arrived today, packed into a surprisingly small box thanks to the marvels of German engineering (or something). A deft bit of allen key action later, and it was ready to go. Initial impressions are that it’s going to take some getting used to. The gas lift does indeed go high enough to use with a standing height desk, and it’s very solidly built and very stable, which is good when you’re perched that high.

It’s adjustable in more ways than I can get my head around right now so will take some time to get right, and my jury-rigged elevated desk isn’t so great with this set-up since your legs are cramped by the original desk surface (which is now at thigh height), so I’ll need to look for a more permanent setup. And the saddle seat – well, it certainly does alter your posture so that it’s like a horse riding or skiing pose (bend zee knees!) rather than sitting, but the initial downside of the saddle-like configuration is that it can make your inner thighs a little sore to begin with – but at least that prompts a return to the standing posture. At least it doesn’t bounce around like a real horse does though – I know from experience how sore that can make you after a few hours! I’ll see how it goes.

Oh, and I have a hundred and one things to catch up on this week after last week’s unplanned diversions, so bear with me if I’ve missed things in the forum or am otherwise slow to respond. There just aren’t enough hours in the day to make up for the time lost in a short time, especially when my back still limits the amount of desk time I have available.

Despite my initial positive reaction to working standing up, since I made that post my back has gone steadily downhill again, starting with a dodgy weekend that I hoped was a blip, but grumbled on for pretty much all last week, before taking a rapid decline this week. This morning I’ve been in the kind of pain I haven’t had since late last year. So, coupled with the ogre3d.org hack, colour me extraordinarily pissed off this week.

One aspect is that I hadn’t been out walking this week until this morning, since it’s been icy and since my back was already bad, I didn’t feel it was worth risking a slip. I’ve been out this morning but it hasn’t helped – it was even too painful to do my stretching exercises afterwards. But I know it’s not just that, because it was dodgy last week too and I was going out every day. Still, the steep decline this week clearly indicates I can’t get back to normal work yet, even when an emergency prompts me to try.

So, I dunno. I’m trying to track it, trying to observe cause and effect, but it still seems elusive. I’m just going to have to keep trying (what other option is there?). If there’s one thing I hate, it’s illogical things, and this is like hooking yourself up to a 20,000 volt cable with a random number generator controlling the on switch.

I think I’m going to think twice about blogging about positive progress on my back problems, because whenever I do it, I seem to have a small relapse the day after! I’m not a superstitious person, but it does seem to be a bit of a coincidence. Or, maybe it’s just that when things are starting to feel really good, I go a bit overboard and push it too much.

I was feeling great on Saturday after my week with a stand-up desk, so maybe I was a little too adventuruous with my activities that day, being in a good mood and feeling generally positive. First thing Sunday, still feeling fine, I’m rummaging about in a drawer for a T-shirt and I suddenly feel a horrible crackly sensation in my mid-back (not crackly in terms of sound, that’s just how it feels, like little lightning bolts crawling across the affected area), and from then on it was really painful. B*st*rd. Sleeping last night and getting up this morning was particularly difficult after that – when you’re not moving you feel like you’ve been kicked by a mule, and moving runs the risk of upgrading it to ‘meat cleaver class’, even though you have to do it because being stationary for too long guarantees more problems.

At least once I got moving this morning I started to feel better, but I’m super-paranoid about it again which is distracting. Hopefully it’ll improve again this week.

It’s been a whole week since I discarded my office chair and switched to a stand-up desk so, I’m guessing some of you are wondering how it’s gone.

Well, let’s start with the difficulties. Standing up for 8+ hours a day is tough on the feet, or at least on feet that have gotten used to taking it easy for most of the day – even with the odd break I’ve found my feet are extremely painful by the evening (those who work in retail are no doubt rolling their eyes by now and calling me a wuss).  Also, certain muscles (some in the back, some in the backs of the legs etc) that are not usually used for such long periods of time can get a bit tired after a whole week of doing it. At first, this made me think standing up was hurting my back, but it was really just a muscle fatigue issue and nothing like the back pain I get from my recurring problems. I’m sure my feet and muscles will toughen up with time though, once I become more accustomed to it. Obviously my Capisco will allow me to perch & rest for short periods at the right height once it arrives, but maybe it’s good that I’m having to take the tougher route initially.

So how about the benefits? So far, I’m really positive about this set-up. My back has been so much better this week; it’s felt much more stable and flexible, and first thing in the morning I’ve been less stiff. I feel much more energised too – standing up definitely improves my concentration and alertness, as well as not being so distracted by back pain, and having to get up to stretch all the time etc. In short, so far it’s fantastic, despite the sore feet, hamstrings and other muscles. I’m hoping this isn’t some kind of placebo effect and that long term, this is the way forward.

Based on what I’ve read though, it seems to make sense. Sitting down for long periods is said to have many detrimental effects on your body:

1. It puts anywhere up to 70% more strain on your back than standing or squatting, which are the 2 natural positions the human spine was actually designed for
2. It restricts the bloodflow to the legs, which as well as the DVT risks can make you more lethargic
3. It encourages sedentary behaviour – this is bad anytime, but in the case of backs it encourages dehydration of the disc walls, which can lead to stiff spinal segments (which can lead to instability)

Conversely, while working standing I’ve noticed these benefits:

1. Motion is built-in to your day – when you’re sitting down, you’re inclined not to move about much because it’s inconvenient to do so (beyond swiveling the chair). You generally need to have a reason to get up, and when you do so, the fact that your work can’t be done until you sit down again encourages you to minimise this time so you can get back to sitting down again to work. And for me with my back, each transition would involve stretching a bit when getting up, and spending some time getting settled comfortably back in the chair again. Having everything at a standing height completely eliminates this problem.
2. Seamless transitions – stepping away from the desk and back again incurs no ‘overhead’, in terms of needing to get out of the chair, get settled again afterward etc. Maybe it’s just a mental thing, but I found that when getting out of my chair, my ‘flow’ would often be interrupted, and I’d have to regain it when I got back again. This would discourage me from taking breaks, as well as penalising me (productivity-wise) when I did take them. Somehow, being in a standing position already seems to get rid of that, and I can happily walk away from the machine for a few minutes, come back to fix a build issue, wander away again to the bookshelf etc and never feel like my chain of thought is being interrupted. It’s like my day is altogether more fluid than it was before.
3. My ‘core stability’ muscles are being engaged pretty much all day to keep me upright, in varying configurations as I shift positions. For me, this seems much like doing mild exercise all day for the most important muscles when it comes to back trouble, which I’m sure has led to my back feeling less ‘fragile’. Usually I do specific exercises designed to stretch & strengthen these muscles without straining my back (which I’m still doing), but it appears simply standing around for a long time achieves much the same thing.
4. My concentration is much better. I’m sure this is down to a lot of factors – less pain (which is always distracting, even when you’ve learned to live with it in the background most of the time), better blood-flow, more actively maintained posture etc. Whatever blend of things it is, I’ve felt more productive and positive in the last week than I have at any time in the last 3 months.
5. I seem to need to drink a lot more water than usual, which is a good sign, since as noted many back problems result from a dehydration of your spinal discs (caused by compression and lack of activity over a long period). That probably helps concentration too.

So, while I’m nursing sore feet and muscles, I’m feeling good about this experiment, and hopeful that it might lead to a magical situation where I can both spend time at a computer and keep my back healthy. That’s nirvana for me, especially after a rocky few months. Hindsight is a wonderful thing, but I wish I knew 10 years ago what I know now, that no matter how expensive your chair, sitting in it for 10-12+ hours a day is very likely to screw your back up eventually. In my experience obsessing over the ergonomic aspects of your sitting position does no more than delay the problem (I’ve certainly done loads of adjustments over the last 5 years, and only succeeded in slowing the degeneration), and the only real answer is to eliminate the sitting position altogether. We apes just weren’t engineered to sit in chairs!

So, following on from my thoughts last week, I spent a little time today rearranging my main work area to accommodate working standing up. I’m just aiming for a temporary solution for the moment, so I can experiment with it and evaluate whether it’s going to help. Luckily, I have a ton of sturdy boxes left over from various technical purchases, so after trying out various combinations I came up with this:

Thanks go to my MacBook Pro, XBox 360, Pod and Netgear router (among others) for generously donating their boxes to the cause

Actually since that picture was taken I’ve put a couple of books under the keyboard / mouse shelf since my forearms were a little too much below the horizontal. Getting pictures taken of myself at the keyboard was very useful in determining the appropriate setup actually, the first attempt felt right when I was setting it up, but once Marie took a photo, I realised that the monitor was at least 10cm too low (your head is supposed to be pitched slightly downwards, only up to about 30 degrees, when looking at the middle of the screen).

Right now it’s pretty weird, and my feet start hurting far too quickly, but I’m going to stick with it and see how it goes. My back hurts a bit right now, but that may be down to moving stuff about and/or unfamiliarity with sustaining this position. I’ve ordered a Capisco which will allow me to take the weight off my feet while still being out of the demon sitting position, but I’ve been told it’ll take about 4 weeks for delivery, so I’m going to have to manage without it for now, perhaps sitting with the Macbook somewhere if I really need a rest.

I’ll let you know how it goes.

I’ve been thinking for a while that I needed to get a new chair for my home office – the one I have now is 15 years old and doesn’t even have a lumbar support (so I supplement it with cushions). However, good chairs are expensive, and I wasn’t entirely sure what I wanted – I had a more modern chair when I used to work in an office, and that still didn’t stop me getting back problems, and most recently I’ve had thorasic-region problems which aren’t directly addressed by a lumbar support anyway.

The issue is that sitting places far more stress on the back than standing/walking, and most back problems are made worse by immobility. I can definitely attest to both of these assertions from my recent experience, it’s just that addressing those issues has meant interruptions to my work schedule, a general loss of productivity, and some frustration at not being able to do all that I want to do.

I want to thank Martin for triggering off a thought chain last week about stand-up desk set-ups, which I hadn’t heard much about before. People like Churchill used these all their lives, where you stand at the desk most of the time, or perhaps use a tall chair like a draughtman’s stool if you want to take the weight off your legs for a while. As well as the general position being better for the back, you’re more likely to move about as a matter of course while standing up, and many people have cited productivity gains because the posture makes them more alert.

Finding these set-ups is another matter though. Most of the dedicated set-ups are rather old-fashioned, podium/writing desk sort of style, and not really the configuration I’m looking for, but a number of people around the internet have built their own, either by modding existing desks or going the whole hog. There are also height-adjustable desks that you can buy, a small number of which go up to the sort of height I need to stand at (about 1m), but unfortunately no-one I’ve talked to so far seems to do them over here; the best I found so far locally was an adjustable one to 85cm, which is still too low for standing at, and a mainland UK provider that won’t ship to the Channel Islands for fear of the mechanism being damaged in transit. I’ll keep looking, but I think I’m going to try retrofitting my existing desk instead, perhaps starting with a rough setup of a few bits of wood to make a raised surface on top of what I have, and refining it later if it works.

I still want a better chair though, since I don’t want to stand all of the day. The draughtsman’s stool idea isn’t bad, but I thought I could do better. Then I found lots of good reviews of the HAG Capisco. It’s pretty odd looking, compared to more traditional ergonomic chairs like the Herman Miller Aeron and will undoubtedly take some getting used to, but the key thing about it is that it’s a ’saddle seat’ -  your legs are much more vertical, which puts your spine in a far better position than regular sitting does. The other nice thing about the Capisco is that you can reverse it and sit backwards if you need to lean forward with extra support (that’s why the back is such a weird shape – it’s a combination of back and arm-rests for both set-ups. The seat design also makes you use your muscles more actively which encourages more mobility. Back sufferers seem to be raving about it, which is what attracted me to it. Finally, it has the option to go high enough that you can use it with a standing-height desk as well as a regular height desk, which ticks the final box if I intend to turn my desk into a standing area too.

Anyone had any experience trying stand-up desking or the Capisco? Unfortunately again there are no places locally I can try out the Capisco, although reports from users on the web suggest that’s not a good way to evaluate it anyway, since it seems weird for a few days until you get used to it, so I’m probably going to have to order blind.

Yeah, it’s another personal / health post. Tsk.

It’s been a month since I started a new, more informed regime designed to address my back problems – regular walks, stretching & strengthening exercises and so forth. Generally, it’s gone well, although I did have a couple of ‘blips’ around Christmas and New Year. I’ve discovered some interesting facts from analysing what I’ve been doing and the results.

1. Variety is hugely important. Sitting at the desk too long is bad (as I now know), but equally lie-ins in bed, sitting on sofas playing games, watching films or just socialising (like over xmas) also set it off if I do any of it too much. Switching what I’m doing on a regular basis is vital. I now try to make sure that I’m always mixing up my routine, both within the day and between days. Exercise is part of that, but it’s no good just doing the same sedentary things all the time in between the 30-60 minutes daily exercise. That’s why you won’t see me on the 360 every night, and when you do, it’s usually for no more than a couple of hours at a time. Happily Rock Band is good variety to regular games, since it involves a mixture of postures depending on the instrument and drums are particularly active. The human body was designed for a large range of movement, and not using it is encouraging it to seize up. But no, I don’t intend to take up modern interpretive dance any time soon. Nor am I much of a fan of Wii Fit – I find the ‘trainers’ patronising and would much rather exercise in the real world.
2. Calibrating your limits, and pushing on them gently. After having so many disproportionately bad reactions from doing seemingly innocuous things, I became paranoid of doing almost anything potentially damaging to my back, avoiding anything I thought might come back to bite me the next day. I still have some moments like that on bad days, but I’ve come to realise that taking self-imposed limitations too far can in fact contribute to the problem, because motion & moderate stress are an important part of the spinal recovery process. Muscle tissue needs to be put under strain to get stronger, and discs can only absorb enough water & nutrients to repair themselves through motion. What the book’s regime has helped me do is become gradually more confident of where my limits are, and how much I can push them. I avoided drumming for a while for example, but I’ve found now that while it does still make me sore, I seem to be able to take a little more each time. The same goes for playing my relatively heavy electric guitar standing up with a strap – it adds some strain, but if I’m careful it’s manageable. Doing these things is also good because they add more variety (see 1).
3. Learning to pay attention to what your body tells you. Ok, that’s verging dangerously on hippie vegan talk, but it’s surprising how much information your body gives you that you generally ignore. When everything’s working generally ok, unless you’re of a certain disposition already you tend not to pay that much attention to the signals your fleshy transportation device sends to the master computer perched on top of your neck, aside from the more ‘extreme’ ones, so you’re just not used to processing the information when it suddenly becomes important to have to do so. Maybe that’s mostly a male thing. Anyway, learning to pay close attention certainly helps; what hurts, what doesn’t, what it feels like to stretch a particular muscle or ligament, how much force and at what angle stretches the right parts of the skeleton, how many clicks and where do you tend to get out of the spine when fully relaxed in a stretching position, etc. It’s particularly useful after having read the anatomy section & the related advice of the book I have, since it helps to know what’s good and what’s not, and why.
4. The Hitchhikers Guide was right – a towel is indeed your most versatile friend. Plenty of places sell all kinds of weird & wonderful devices designed to help you stretch your back for exorbitant prices, but in fact a large bath towel, folded or rolled in various configurations, is flexible enough to do everything you need. It’s no accident that physios have loads of them around. Ford was right; “If you want to survive out here, you’ve got to know where your towel is.“.

So there we go – the learning process continues, and hopefully so will the recovery.