Emacs pinky - what's physiologically happening? (And a couple other questions.)

I've been dealing with this for about a month and a half now. I've taken extended periods away from the keyboard (up to a few weeks), but every time I feel it's healed and go to my keyboard, the pain returns within a couple hours of typing. I had no idea this was common enough to have a name until today. I'm not an Emacs user, but a couple of years ago, I discovered the magic of Vim. Then I discovered the magic of keyboard remapping. Soon after, I was blissfully navigating text in every program with just capslock and my trusty hjkl;0 keys. And now I have a capslock combination for every key on the right side of the keyboard (and alternate modes while holding caps and s,d, f, or g, which is I think what ultimately pushed my the stress in my pinky over the threshold) mapped to some IDE command, an application switcher, or some other vital function that I feel impaired without immediate access to. Anyway, it's clear how I screwed my finger up, but what exactly is happening physiologically here? What are the actual injuries that tend to occur with Emacs pinky? (I work freelance and was on my wife's insurance, which she just lost due to changing employment, so I'm not going to be able to go to a doctor immediately. I was hoping that someone here who's been treated might have some information to share.) I read someone else talking about ulnar nerve entrapment, but I'm not sure that's what's happening in my case. I'll describe it as best I can to see if this matches how it feels for other people. The pain is located on the dorsal (top) side of the DIP (last) joint of my left little finger. I don't know how to describe the pain. It's focused right at the joint, but not exactly sharp. I suppose I would say sore, but it's not a diffuse pain. I almost want to describe it as feeling similar to overstretching a muscle that's already sore from exercise, but with an exaggerated pain component. I haven't noticed any numbness or tingling, though I am feeling sharp pin pricks occasionally. It's not tender to the touch, there's no noticeable swelling, and I can move it normally. I could probably even push through the current pain and work normally, but I realize that will almost certainly make the problem much worse. I also have some tension in my wrists and forearms, but I'm not sure if that's part of it, or if it's just an effect of extra tension produced by my anxiety over this. Anyway, does that sound similar to what others who have had Emacs pinky experienced? If so, what was actually injured in your case? Was there structural damage, or was it just chronic inflammation? And were you able to treat it? (Sorry. I realize I'm asking a lot of questions.) In the meantime, I'm trying to set up my old transcription pedal to use as modifier keys, and I've ordered a low profile keyboard. I don't know if that will help. Anyway, thanks for taking the time to read this, and thanks in advance for anything you might want to share.

You could have saved yourself a lot of uncomfortable typing by searching for an orthopedic doctor in your area instead of trying to get healthcare advice from strangers on the internet. Go to the doctor. christ

I'm no doctor and have always been persuaded that the so called Emacs pinky has very little to do with Emacs specifically Have you checked that your chair was at the right height for both you and your desk? If you haven't looked into that area yet, read/watch a bit on good posture for typists. That together with less stressful motions like you've set up already should do a lot already It's also not impossible that you're one of the unlucky people who need more frequent breaks than most, and/or another control for modifiers (the pedals you mentioned) Again I'm no doctor, but I do spend a lot of time behind my keyboard

And all that in an editor that doesn't really encourage the use of the control key :D Nevertheless, seeing a doctor is the only right advice.. If you try enough weird folk remedies that cured aunt Edna's sore thumb 50 years ago, you might end up needing surgery for your fscked up digits.

Obvious `M-x doctor` joke.

I think you are absolutely smart to ask about this here. You stated clearly also you can't go to the doctor right off for insurance reasons. If you do go to the doctor, these days it's really important to get information from the internet before you go, anecdotal or not.

The only logical solution is to see the doctor immediately. You can also see https://www.reddit.com/r/emacs/comments/vw9uq5/emacs_pinky_after_the_damage_has_been_done/

> And all that in an editor that doesn't really encourage the use of the control key :D What broke the camel's hump is this... > And now I have a capslock combination for every key on the right side of the keyboard (and alternate modes while holding caps and s,d, f, or g, which is I think what ultimately pushed my the stress in my pinky over the threshold) mapped to some IDE command, an application switcher, or some other vital function that I feel impaired without immediate access to. Of course, your fingers/hands will beg you to be gentle if you do something insane like this. I would suggest OP to drop this and use the keyboard like it was meant to be used: with two hands.

See. A. Doctor. Also, next time, build yourself a keyboard with thumb keys for all your modifier tinkering. The pinky really doesn’t like being stretched out for hundreds of milliseconds necessary for you to press the other key of the combo.

Emacs pinky comes from pronating your wrist to hit the control key. You solve that by doing wrist exercises to strengthen the muscles on the back of your hand that extend your fingers, and on the back of your forearm. 1) Hold your arm straight out from your body. Bend your wrist up like you're telling someone to halt. Make a fist and then rapidly flick your fingers like you're flicking water on someone. Repeat 20-25 times in quick succession. 2) Get an old towel or tshirt and twist it tightly until it offers considerable resistance. With your arm extended straight from your body twist your wrist like you're revving a motor cycle. 10-15 twists for each arm should do it. Mix these in with some wrist stretches and your issue should be resolved in a few days.

Not a physician, but this could be focal dystonia that plagues some musicians.

Sharing a personal anecdote here that i hope others will find useful. A few years ago I was suffering from what i would call the beginnings of RSI. I have been an avid Emacs user for a long while now and have been interfacing with computers using a keyboard for a much longer time still, since the age of 9, and always for long continuous periods of time on a daily basis. For this reason I cannot blame Emacs for the pain that eventually begun to creep up in my hands and some fingers, which made it very uncomfortable to type, sometimes even painful. I never went to a doctor to get it diagnosed and, after some digging around the interwebs and reading up on ergonomic keyboards, I resolved instead to invest in a Kinesis Advantage keyboard. Overall it took me about a week to relearn how to touch-type; also remapped the left CTRL key so i could hit it with my left thumb when C-x in Emacs. The result of this is that I have not had pain since i started using this keyboard, and I will never again own a traditional keyboard. Typing speed has also improved substantially; certainly no downsides beyond the initial relearning period. Hope you find relief soon. PS: also recommend exercises with a hand gripper for relief. Still use it at times for instant relief from tiredness in hands after intense 12h at computer.

To add to the advice to go to a doctor, I also recommend that you consider seeing a physical therapist. Physiatrists only diagnose you but PTs will treat you and they also know what’s up.

Use evil mode. My pain went away in 2 days.

I was in a similar situation 2 years a ago. I switched to Ergodox, my pinky pain was gone almost immediately. However, my thumbs becomes very tired after a few month. After that I switched a lots of keyboard layout, and settled with a 34 keys layout. Never feel any hand pain again. It’s all about posture.

I've been putting serious consideration into buying a real ergonomic keyboard recently. I had one of the old Microsoft ergonomic keyboards growing up, but I hadn't put much thought into it until recently. I've been leaning heavily toward to ErgoDox EZ or Moonlander. Have you had any experience with those in comparison to the Kinesis? Anyway, thanks for your feedback. I'm glad you were able to find a solution.

I've had general RSI. This is my experience. This helps (in approximate order of importance): * Reduction of what causes the pain * Believing that you'll get better * Stretching and warming up * General health improvements. Move more, go to the gym. At my worst I couldn't type for 5 minutes, but I could deadlift 400lbs and my hands felt awesome * Ergonomic changes. This includes height of desk, choice of keyboard, and so on What doesn't help: * Going to a general practitioner doctor (maybe a physio specializing in this can help!!) * NSAIDs >Was there structural damage, or was it just chronic inflammation? Just inflammation, for me. >And were you able to treat it? Yes. I didn't do much, rested for extended periods of time. Did the stuff I wrote that helped and didn't help. PS. You might want to stop posting on reddit and so on, it's a waste of a valuable resource (typing time).

Well, I found the term "Emacs pinky" when I was trying to find instances of people with pinky injuries from typing. I found an article by someone who described how his "hyper key infatuation" led to pinky problems. I was surprised by how similar it sounded to what I've been going through, as I kind of went nuts using capslock because it increased my efficiency so dramatically. That led me to search specifically for pinky injuries related to capslock remapping, and that led me to the term. (Ironically, remapping capslock was suggested as one of the solutions to "Emacs pinky" in the post where I encountered it.) But the belief there is that, due to a heavier use of modifiers compared to other keyboard users, Emacs users would develop this specific type of injury to the pinky, as it's the weakest finger, and it's being given the majority of the work. This may be a result of awkward positions and movements, but I think, at least for me, the primary component is probably the increased cumulative stress applied to the finger tip from holding keys, which none of the other fingers have to do as frequently as the pinky. But you're right. desk and chair setup are important, and I've let myself develop some bad habits recently. I actually bought a Leap V2 about a year ago, and I noticed that my typing speed immediately improved by about 20 wpm. It was because the arms on the chair I'd been using were too far apart, and the angle of my arms was causing me to unconsciously hold my shoulders up, which was producing extra tension in my arms and hands. The hands are part of a complicated mechanical system, and I think we all tend to not put too much thought into how the rest of our body is supporting or adding strain to our hands until something goes wrong. It's good advice regardless of the root problem. I'm hoping that when I get to see a doctor, it is as simple as being more mindful of correct posture or taking breaks. As long as it isn't a permanent injury that will render me unable to type, no matter what I do, I'll be okay. ​ Tanks for your respone!

I intend to once my health insurance is reactivated. That's a very useful thread. Thank you!

Pain just doesn't work that way. Pain is more like an emotion. Sometimes you're sad because your goldfish died, and sometimes you're sad for no discernable reason. Maybe there's something physiological there, maybe not. Most likely you just need to figure out some strategies to be able to work without provoking it until it goes away.

I've been considering the ErgoDox (I already have a pretty good ergonomic setup with my chair and desk). It's quite expensive, but from everything I've heard, it seems like it's worth it. Did you experiment with any other boards before getting that one? I was considering getting a hot swappable low-profile keyboard and replacing all of the keys under my pinky with the lightest switches available. I'm not sure if that will help, but it's a more accessible solution for the time being that I'm hoping will allow me to function again so I can afford an ideal ergonomic setup.

I've actually been posting from my phone, with my right hand only. Right now, I'm typing on a low-profile keyboard with the keycaps of keys under my pinky removed (so I'm typing on bare switches). It seems to be helping in terms of pain, but it's very awkward and unpleasant, as I'm sure you can imagine. May I ask why the doctor was unhelpful? I'm often a bit pessimistic when I see doctors, mainly because I know their knowledge has to cover a broad range, and the specific way my own body has fucked up might not be part of that. (This is partially why I posted, so I could be better prepared to provide more accurate information to a doctor. It can be hard to clearly describe certain types of pain, and it's easy to leave out important details or observations that might be relevant if I have no idea what's going on.) This would be less of a problem if doctors weren't so expensive (even with insurance). I'll probably be required to go through a GP to get a referral to a specialist anyway. Your other suggestions are very helpful. I definitely need to improve my general health, especially. I've become very inactive over the past two years due to the pandemic, and I'm sure that's played more than a small part in whatever deterioration I'm experiencing now. I started with push-ups in the morning a few days ago. I'll add stretching and core exercises to that, since that should help regardless of the underlying problem. Thank you for the suggestions! I'm glad you were able to recover.

Wish I could provide some helpful input to help you decide but I have only ever owned the Kinesis Advantage model. Good luck in your quest!

You can find an used one in r/mechmarket to try it out. Low Profile or light switch is not that important. FYI, I used only Cherry MX Red on my [Pragmatic 34](https://github.com/jamessa/Pragmatic). I don't like to play those switches because I've got works to do.

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Try to cover your pinky finger with a finger tip, https://www.staples.ca/products/12373-en-westcott-ventilated-finger-tips-medium-12-pack I use evil mode but still recently I had this problem and wearing those finger tips does help for me. I'm using a split keyboard Kinesis Freestyle 2 which I would recommend to anyone because they are affordable and their layout is the same as a conventional keyboard but I will go to one with dedicated thumb clusters like Kinesis Advantage 2 if that won't help. Xah's guide is also a great resource http://xahlee.info/emacs/emacs/emacs_pinky.html

Dunno about vim but in emacs it is very important to turn capslock into ctrl. The time I thought I was getting RSI turned out to be bursitis. But I think my many decades programming have been possible without injury in part because I switched to DVORAK years ago. Much less impact on the hands.