Controller/Gamepad Ergonomics and Accessibility

In recent years I've started to gravitate towards preferring to play with a controller instead of keyboard and mouse, because I find the overall posture of playing that way more relaxed. But with my xbox360 controllers I get joint pain in my right thumb after a while, because the right stick click requires a lot of force to activate and it seems my thumb can't handle that for long. I've googled for solutions or even aftermarket replacement parts, but so far I haven't found a solution. Apparently more people complain about the sticks of first gen xbone controllers not having enough tension than the other way around. I've found mods to increase the tension on those, but none to lower it. And after having seen one of the sticks disassembled in a video, it seems that the click button is more or less a separate part sitting at the bottom of the stick assembly. I couldn't find data on how the click threshold on those old xbone controllers compares to the 360 controller.

Roughly measured with a kitchen scale the movement resistance of an xbox 360 controller is ~ 90g, and the click threshold is around 700g on a used controller and closer to 900 on a rather fresh one. I have 3 xBox 360 controllers, so I wouldn't mind an attempt at modding one of them myself. I can solder if necessary, and there are plenty of aftermarket replacement parts for thumbsticks, but none of them come with specs how high their tension or click threshold actually is.

What about the steam controller? Could that be worth a try for me? I don't know a lot about it.

On my xBox360 controllers I'm using extension caps on both sticks. That makes them longer, gives me more leverage and lowers the force required to moving them, while also increasing precision. I like those quite a lot, and they reduce the tension for moving the sticks from ~90g to just below ~60g, but they don't do anything to make the click threshold be easier.

I've tried "wearing the stick buttons out" by holding them down with a clamp over night, but that doesn't seem to have done much.

I don't have a torx screwdriver that fits to open one controller up and take a good look, but I'd speculate there should be a way to replace the clicky button part of the sticks with a different generic replacement part from a hobby electronics store. Though I wonder if it wouldn't be better to just have that kind of interaction (stick click) mapped to a physically new button on the bottom side of the controller. The xbone elite controller seems to have those by default, but holy crap is that one expensive - 150,- Euro including the wireless connector. If I knew for a fact that it solves all my problems and lasts ~10 years like my xbox 360 controllers did, I would begrudgingly pay that kind of money, but I'm not sure of either of those things, so I'd like to look at other options first.

 

That won't work. To wear them down you'll need to repeatedly press it (if it is about clicking buttons) or press it with a palm and rapidly move in circular movement. Then MAYBE it'll become softer.

What game were you playing? I don't remember needing to press right analog stick often.

Either way, my advice would be to:
1. Visit a doctor who can take a look at your thumb. You shouldn't be getting joint pain.
2. Look for a repair center that handles gamepads and ask them to replace the right stick (thinking about it you could try to ping Microsoft support regarding the issue, perhaps something will happen because of it).

I'd also recommend to remove extension things from the gamepad, because they'll make the gamepad much harder to use. Basically with any sort of extension you'll need to do wider movements and put more force into pressing buttons. So those extensiosn most likely will make you tired faster.

That's all I can think of. I haven't experienced this kind of problem, and had opposite issue - repeatedly playing blazblue killed the left analog stick which became sensitive to the point where slightest touch can register as "up".

Also, how long were you playing the game? See, i'd expect most programmers to have grip of death due to constant typing on keyboard, but if you, say, picked the gamepad for the first time ever yesterday, then you'll probably need a week or two till your finger muscles get stronger. This is especially relevant to the thumb.

Anyway, that's how I see it. Joint pain and not muscle pain is worrying, and is something that you shouldn't be experiencing. It might be a good idea to see a doctor.

 

It's not often compared to other buttons but it's in every game I play at the moment. Dark Souls 2: camera lock on, Deus Ex: melee takedown, MGS5: camera zoom-in while using binoculars, most FPS games: melee or crouch.

From having A/B tested this (and I've used both variants for years each), I can not confirm any of this, except for making wider movements, since that is the whole point of using them. It's not necessarily transferable but I've found that in the RSI realm of strain injuries from drawing on Wacom tablets, wider motions cause less problems.

I don't use my right thumb at all during typing, drawing and mouse work puts significantly more strain on it. And I'm generally well used to playing with gamepads and do so regularly. I've fairly consistently gotten that kind of pain in thumb joints when playing with gamepads more than usual (like when I binged on Dark Souls 2 a while back).

I'm confident I've exhausted all reasonable options in the medical field. I seem to have some kind of genetic defect that causes tissue to be unusually stretchy, which leads to all support structures being worse at keeping things in place. I'm doing training and physiotherapy once a week. My physiotherapist says there's not much one can do against that kind of pain except eliminating the strain factor that causes it (which I'm trying to do as you see). You can hold the thumb with the other hand and pull slightly to relax the joint, but that alone doesn't cut it.
I have another theory that because I used to play guitar I might have developed certain muscles unusually one-sided in the right hand, which causes the thumb joints to bend slightly different under strain than they do in my left hand. But neither do doctors now about things like that, nor do they know how to fix it. It used to be worse many years ago and I managed to improve it to a degree, but that's really something no one can help me with.
Considering my genetic disposition to have problems with such things and that I intend to be gaming and using computers till I die, I figured I might as well start now to look for more ergonomic input devices, or mod them if need be.

 

On a bigger wacom tablet you'll be moving the whole hand.
On a right analog stick you'll be only able to use thumb, and it is not exactly moving a lot normally (unless you're playing piano). That's why I think that bigger motiosn will get your thumb tired faster.

If it is a supposedly unfixable problem, I'd externalize right trigger. Basically I'd try connect r3 trigger button to an external button and glue that button to some location on a gamepad where it would be easy to press it with a different finger. Possible locations are between the analog sticks, on the back of the gamepad, etc. The gamepad will look a bit frankensteinish, but if your thumb hurts otherwise, that would be the way to go.

 

I can certainly see where you're coming from but I don't think this is a problem for me.

If I can't find a better solution I might actually do that. For a start I've ordered an opening kit with the right torx screwdrivers to open a controller and I'll see what I can do with it. From another video I've seen it seems like there's a spring inside the stick assembly and spring tension can usually be tweaked by either shortening or bending them. And I've found an electronics store that sells micro switches with specs on how much force they need for activation. Maybe I can swap the stock switch for one that is a lot lighter to press. Thanks for your suggestions. I'll report how it goes.



I'm still interested in comments on other controllers like the steam controller. There must be some people here who have hands on experience with it.

 

The ergonomics on the Steam controller aren't terrible, but they aren't that great either. The biggest problem with it comes when you attempt to use it as a standard gamepad. That is to say, when you don't use the big trackpads and focus on using the analog sticks instead. The ergonomics for those analog sticks aren't very good, as the controller focuses on the trackpads as the primary focus.

If you are using the trackpads primarily, then the ergonomics improve considerably. Most notably, the trackpads are relatively easy on your thumbs. While they do require a certain degree of precision, they don't require any pressure or resistance, which means less actual effort and strain on your joints.

For ergonomic comfort, my first choice is the PS4 controller. One of my all-time favorite controllers for this is actually the GameCube controller. Recently, I've been leaning heavily toward using 8bitdo's line of controllers, though I can't actually recommend them for modern 3D games. (their analog sticks are their only weakpoint) But they are some of the absolute best options for retro games.

 

Now I'm curious, you said sticks (plural), but I only see one:


If I wanted to play something like Dark Souls with the trackpads, how would I access dpad functionality? Would the analog stick serve as a pseudo dpad then and does that work well enough to accurately switch items etc.? And what about the "stick click", can you press the whole trackpad in like a mouse button? And if yes, does that require more or less pressure than an xbox 360 controller? It doesn't have any buttons on the underside, right?

While I don't have much practice using trackpads, I have in the past won Quake 3 matches at a LAN party using the trackpad, so I could probably get used to it.

 

It DOES actually have buttons on the underside. Though it would be more accurate to call them something else. I think of them as interactive panels. But they essentially function as buttons, you just use your other fingers to press/squeeze them. And yes, you can click the trackpads as though they were buttons for an additional interaction. (similar to click a thumbstick) The action on clicking the trackpads is lighter than the traditional thumbstick press, but not so light that you would use it by accident.

One of the really great things about the Steam controller is how much it can be customized. Steam's interface includes re-mapping for the controller. So you can re-assign any of the controllers interactions any way you want. If you want to move a particular function off of a face button and onto the back panels, you can.

 

That actually sounds pretty promising. I think I'll buy one in the next sale and see if it works better for me. Thanks for all the info.

 

Welp. Modding the xbox 360 controller didn't work. In fact I think I broke it. Oh well, still have 2 working controllers left. I'll buy a steam controller in the next sale (probably Helloween I guess).

 

Shouldn't repair shops handle this kind of stuff? I mean I'm pretty sure I'd be able to find some electronics-inclined guy if I couldn't do it myself.

 

It's not really an electronics problem, it's a mechanical problem with opening and modifying parts that weren't designed for either. I didn't even get to the soldering part, I seem to have broken one of the potentiometers with force while trying to get the parts out that have the spring below it. I didn't even get them out, they are just stuck too tight. I watched a video how someone opens it, it doesn't work the same way for me. If I had applied more force a plastic part would break. Top few comments under the video said they tried the same and that part broke in two.
I could order a replacement stick and solder that one on, but it'd be a waste of time if I can't get the replacement stick modified the way I had hoped was possible (doesn't seem to me it is), or it doesn't have different tension properties by default (didn't seem to exist based on my search).

Now I'm hoping for the steam controller to be an improvement.

 

...to be harder to break?

It may be a regional thing, but typically there are stores that repair electronics. They should know how to open it up, and how to mod it. As long as you're paying, of course. That's what I meant, mostly.

 

...to not require any modifications, because RichardKain said "The action on clicking the trackpads is lighter than the traditional thumbstick press, but not so light that you would use it by accident." and because it already has additional buttons on the underside that could be mapped to substitute stick presses.


I'm sure electronics repair shops exist here, though I've never actually seen one, but those probably specialize in stuff that is expensive enough to be worth repairing. Most regular consumer electronics is just cheaper to replace than to repair around here.

I'm generally reluctant to let other people do technical things that I could do myself, because even if they have more experience than me, they usually don't give a F*** and I've often enough thought I'd have done a better job myself, when I outsourced something like e.g. connecting a washing machine etc.

Maybe it's because in my school days I did a two week internship at a computer electronics store and saw firsthand how much stuff they F***ed up. Like one guy told me to open a notebook, I broke off a tiny functionally irrelevant plastic piece, told him I F***ed up, he went and broke off the corresponding piece on the other side and said "there you go, now it's symmetrical again and no one will notice". He then proceeded with opening the thing and shortly after he was cursing loudly because he had broken off a part of the mainboard... it was an infrared port if I remember correctly, and he disabled it in windows, hoping the client will never notice. I think he also broke a mouse and a keyboard, but that was out of pure rage because he had formatted a harddrive from another client that still had important data on it. I think the client was an architect and luckily he was able to restore the data. By the way that notebook still was under warranty and shouldn't have been opened anyway, but somehow he didn't know.

 

You've got to be gentle/careful with small electronics. I've opened and cleaned countless controllers and various other video game devices. I'm a little surprised you had trouble opening a 360 controller. I wouldn't have thought those would be that difficult. I don't think I've ever opened one of those though. I never bothered to buy one of them used, so there was never a need for me to clean one out.

I've opened and maintained numerous Sony peripherals. I've cleaned out a huge number of PS1 and PS2 controllers. I've cleaned and replaced the batteries in PS3 controllers. I've even completely dismantled and reassembled a PSP. Boy, that one was a complicated chore. I've swapped out the shells for Game Boy Advances, Game Boy Advance SPs, and even original and Lite model DSs. It's all manageable, you just have to be careful.

You shouldn't have any problem with the Steam Controller. Valve designed it to be mod-able and customizable. I don't think you will need to crack it open, but it shouldn't be difficult if you ever did feel like it.

Another option, considerably more expensive, would be the Xbox One Elite controller. The thing is very pricey. But it also has all sorts of customization options, including the kind of back-paddles that you described. I still think the Steam controller will do you proper, but the Xbox One Elite is supposed to be quite keen if you ever have the spare money.

 

Getting thie controller open is easy. I've had problem with getting the innards out of this thing:

https://images-na.ssl-images-amazon.com/images/I/31-+3pIoEdL.jpg

That flimsy copper/metal thing, through which the grey plastic stick in the middle sticks out, isn't very flexible so it's hard to get it back in in a shape that allows it to expand enough again to remain fixed in the right position. And the plastic parts under the metal thing sit so tight I just couldn't get them out. I did managed to put it back together in a way that looks like it should work fine, but the x axis of that stick does not seem to register anymore. Since the middle part of the pot is spinning with movement like the others do, I assume I must have somehow broke the pot itself (still not quite sure how).
Desoldering the whole part would have been much easier, but also possibly pointless to do. You can open the metal casing of the whole component, but that requires bending open quite a few things and I would have estimated chances of me F***ing that up a lot higher.
If you have any advice I'll gladly take it for the next time it's applicable.

Edit: is it possible that the replacement part for PS2 controllers and xbox360 controllers is interchangable? Same pin placement and same resistance in the pots? If so, that could mean the mechanical properties are different. Does anyone know how the click resistance and stick tension of a PS2 controler compares to the xbox 360? I'm not quite sure where my PS2 controller is to be honest. I only bought a PS2 used and barely used it.

http://www.ebay.com/itm/Replacement...ox-360-Controller-Grade-A-Parts-/250986876706

 

So I've bought the steam controller and I my first impression is that it's 1 step forward, 2 steps back. The new button panels on the bottom side and the extensive configuration options allow me to get rid of a need to do thumb clicks on high-resistance sticks, but the bumper buttons LB and RB feel terrible. They are much harder to press than on the 360 controller and I don't like the sound they make. At the pressure I'm used to use the bumpers with, they don't even register a click. That alone might be enough to make me not want to use the steam controller. It's something one has to try themselves to see if it's a dealbreaker. Also the ABXY buttons are tiny and their position isn't comfortable for me to reach. It is true that the trackpads as stick replacements are easy on the thumb joints (interestingly a friend claimed the opposite but he seems to cramp up while using it, which doesn't happen to me), but I find them frustrating and imprecise to use because of the inherent flaws of trackpad/touch tech. Interestingly even as a pure desktop mouse replacement my xbox 360 controller with the help of the tool "controller companion" (available on steam) seems to be much easier to use for me than the steam controllers trackpad - both faster and more precise. I think a lot of that is to blame on the software, which in spite of its truly impressive customization options doesn't seem to allow for that specific combination of low cursor speed and high but slowly added mouse acceleration that controller companion allows. The software is not all bad though. You can use the steam controller software to do rebinding tasks that so far I have not been able to reproduce with controller companion. E.g. for a soulslike game you can configure a soft-press of LT to be a mode-shift button that remaps X to LS click and B to RS click, and only triggers LT to the game when it's fully pressed. LT is something I rather rarely use in soulslike games and never accidentally would use with X and B, so this kind of rebinding seems to work pretty well. I likely wouldn't ever have found that option without buying the steam controller, so it was good for something I guess.
Another thing that I just saw, is that controller companion has an embedded download link for something called "xbox 360 controller emulator". So maybe the lack of options to do direct controller to controller remapping is something that can be solved with installing that tool as well (steam's controller settings support generic controllers too btw). I need to check it out once I have a bit more time to spare. Theoretically this also opens up purchase decisions towards all kinds of 3rd party controllers, but honestly except for the stick issues I'm so happy with the xbox 360 controller I'll probably just stick with it. Maybe if I'll ever buy a PS4 I'll see if I like that controller more. Steam seems to support PS4 controller remapping too.

 

Steam supports the PS4 controller, but game support is per-title and most I've played don't seem to have it.

It might be worth trying to various different versions of Xbox One controllers. I've got an old one and a new one, slightly different models, and while they're the same shape some of the buttons feel a bit different. I don't think it's an age thing. If you're sensitive to that kind of stuff it could be worth checking out.

There's also the "elite" controller, and a variety of supposedly compatible 3rd-party variants with alternative buttons. For example, I briefly tried one the other day that had paddles under the hand grips for ABXY, so that you could use them without taking your finger off the right thumb stick.

 

I believe you have to see a doctor for that thumb strain. In my case, I have soft cartilages that contributed to my dislocated shoulder. When you feel some kind of strain that a normal person would not experience otherwise, ask for medical help. You may need to change controllers or buy premium ones to be sure but you have to really test it as the stiffness of controls may be per batch and does not equate to all manufactured ones.

 

Give it a few years and tracked room scale controllers are the norm

 

I appreciate your concern. I did talk again about it with a doctor and he said basically everyone gets pain in their thumb joints because we all use it in ways that nature didn't intend. He said it'd go away if I just train really hard, and through all pain, with these grip strength trainers. He said the pain gets worse a few months before it gets better and claims it has fixed his own thumb joint pain too. To be frank, I call bullshit on that, and all the other 4 physiotherapists and professional trainers that I told what he said gave me weird looks too.
I did a lot of work on a wacom tablet recently, which caused the joint to hurt again, and I'm taking a short vacation over the holidays and now I'm playing Prey with a gamepad. That game seems to put far less strain on my thumb than working with a Wacom Tablet does. Figuring out how I can improve the tablet situation through a different way of holding the pen is the next priority on the list because I can game with a mouse if I need to give the thumb a rest, but I can't paint with a mouse, I need the tablet for some of my work.

The "soft cartilages" thing that you have, do you have full-blown EDS, or something else? Did you find anything that helps you deal with it? During my research I've seen the "Cusack Protocol" being mentionend a few times, but I haven't looked into it myself yet. I don't have full EDS, just some degree of hypermobility. Here is a video talking about it, but I haven't watched it myself yet:

Even a few years won't magically make my room big enough for proper roomscale vr.

 

I only have 2x1.5 meters in my home office, works well, offcourse it would be nice with even more space

 

Necro Warning: this is an update on my 2 year old thread, because it's still the 3rd result when I google "gamepad ergonomics".

I'm digging this out to update it with my recent experiences and discovery in hopes that it might even help someone who isn't part of this community and stumbles over this from a google search on thumb joint pain, gaming injuries, tendonitis, mouse arm, rsi, etc..


I've recently had some issues with tendonitis in my mostly right but also left arm (didn't actually see a doctor to get that diagnosis because I've had so many different kinds of pain in my arms before and by now I'm confident I can tell them all apart). I googled for treatments - most said rest and nonsteroidal anti-inflammatory painkillers are all you can do. I did that for about a week, didn't get any better. I even had bought a left-hand mouse to take some strain from my right arm. So I asked a doctor (friend of mine and avid gamer too) and he too said there's not much I can do except rest and improve workplace ergonomics.

Then I searched further online and found a couple (she's a doctor and he's an engineer) that specialize in pain treatment. They have close to half a million followers on youtube (which I think is a lot considering all their videos are German without subtitles) and seem to be quite active with selling training courses for physiotherapists, video guides for self-treatment, training equipment on amazon, and their following has a slight "cult-like" vibe to it. I was skeptical and it doesn't quite help that in a talk that he's given he basically starts with "Science can't prove yet that I'm right, but just trust me on this one, it'll save us so much time. The thousands of people we were able to help with our method is all the proof you should need.". He was so sure of himself it made the video hard to watch for a friend of mine to whom I recommended it because he has tendonitis too. So take it all with a grain of salt or two... None of my post is medical advice, you need to make your own responsible choices.

The gist of it is that they assume that most pain symptoms are caused by frequent one-sided muscle contractions that lead to issues with the fasciae ( https://en.wikipedia.org/wiki/Fascia ). As a treatment they recommend targeted stretching excercises for the the affected muscles and tendons that are to be performed in a very specific way. That's bascially all. Here's a video of the excercise that targets the area where my arm hurt:

Spoiler

Doing the excercise really hurt! It's supposed to hurt, if it doesn't you're likely doing it wrong. But you're only supposed to do it on a "pain scale" between 8 and 9.9, where 10 would be the threshold where you no longer can do it with a tortured smile and mentally disconnect yourself from the pain. So when I did it at first it hurt, a lot. You're supposed to do these stretching excercises extremely slowly. Doing it once should last between 2 and 2 and 1/2 minutes, where you very slowly and gradually increase the stretch. He said in another video that under 30 seconds the affected tissue doesn't even enter into the restructuring process with lasting results and he said the yoga people that do stretches for 4 minutes have the right idea but 2 to 2 and 1/2 minutes would be the most time-effective duration that they found through experimentation. Would also recommend slowly easing out of it again, as that can feel quite painful and potentially damaging otherwise.

I did those painful excercises several times a day and for at least those 2 minutes at a time, and 48 hours later I had considerably(!) less pain and was already using my arms normally again. Now about 10 days later I'm almost pain-free (and have totally been slacking with doing the stretches the last few days because I've been mostly pain free for a couple days already)

The thing they present is literally one of these "Do this one little trick to..." and "Doctors HATE him..." kind of deals. About the only way I could think of, how it could raise more red flags and look more suspicious would be to lock all content behind a paywall, charge 499$ with a limited time only 90% off offer (that will never really expire of course), and market it with a 30 minute brainwashing video that doesn't actually show a single excercise but has 2 dozen fake testimonials from celebrities. So, if you think this must all be bullsh1t I understand. But I was kinda desperate, very open to the fact that all the doctors are wrong, because even among licensed medical professionals I've been getting wildly conflicting recommendations for many of my issues my entire life, applying this method didn't require me to buy any of their stuff, the youtube comment sections are mostly positive comments but with a few very negative ones here and there too, so I don't think they censor them, his theories seem logical to me, and it all is 100% consistent with my personal anecdotal experience of strain-related pain syndromes that I've had for half my life.

I do think I have overdone it a little with the stretching intensity and either damaged or "unevenly repaired" something in my right arm. When I do the stretching excersice (and only then, it's completely unnoticable during normal use of my arm), I feel a sharp focused pull at the edge of my palm that borders on pain. Kinda gives me the mental image of one single thread under tension that doesn't even belong there in the first place. I have never felt anything like this in this location, so I think it's not right. As I stretch slowly it goes away quickly and if I don't force it, it doesn't really hurt even. I'm hoping it will go away with regular stretching on its own. If it doesn't maybe I'll ask a doctor what it could be, but I'm 60% sure they won't be able to tell for sure and 90% sure they won't know how to fix it or recommend just doing more stretching. But even if it doesn't ever go away I could live with it perfectly fine, I just wouldn't want it to get much worse or cause other problems.

So if you're feeling brave and want to try out this experimental approach, I personally would recommend to stay closer to the 8 than to the 10 on the pain spectrum and instead apply more longterm patience.

Personally I do believe that the assumption that there is "one right approach" that fits everyone, is fundamentally wrong. I'm a strong believer that everyone needs to figure out for themselves what works and what doesn't and needs to apply caution and reasonably experiment with different methods. There are good examples of this in nutritional science where people seem to get the same results with wildly different approaches and wildly different results from the same approach.

What this discovery has given me is a kind of hope that I hadn't had in a long time - that I can maybe both do what I enjoy and still lead a mostly pain free life. I looked to see if they have a video on the kind of thumb pain that caused me to make this thread originally, and they actually have:

Spoiler

I currently have no issues with those joints because I haven't been doing large amounts of gamepad/console gaming, but I intend to do the kind of thumb muscle stretching excercise that targets the muscles involved in clicking the thumbsticks semi regularly or when I feel like I'm getting this pain in the joint area again. So far this seems to work fine, but I haven't yet put the amount of strain on it from which I could comfortably conclude that it actually works. Maybe I can do that when I buy Sekiro or a PS5 one day.


One final thing: I do think that it's reasonable to assume this primarily works for people who have a "normal" body, meaning no very specific injuries, illnesses, genetic defects, special ocupational strains etc.. If for example the base tension you have on muscles and tendons is so low, that you will reach the point of overstretching joints before the tendons and muscles reach their limit, you'll likely just overstretch or damage the joint capsule which could lead to severe problems. I have seen some very few reports in the comments sections under a few of their videos where people where like "this totally fvcked me up, what the hell?" and the official reply usually was along the lines of "You might have done it wrong or too hard, please consult with a medical professional familiar with our program, here is a list where you can find one [...]". I would be especially careful with everything related to back/spine/neck, because a slipped or ruptured disc is quite serious with permanent consequences.

Everything has a risk attached. Doing nothing has a risk attached too. In one of their videos they say even sleeping in the wrong (most common) position will mess up your back in the longterm. Based on the hypothesis that they present, the recommendation by the doctor that I originally consulted because of the thumb pain (orthopedist with 17 out of 20 reviews giving him an "A" on the doctor review site where I found him), would have exacerbated the issue that caused the thumb pain. So... no matter what you choose, your mileage may vary...

I might report back once I have gathered more long term experience with this approach. It will be interesting to see if or when this method sees more widespread and/or international adoption. If anyone finds contradicting approaches that gave them personally good results though, please share them here.

I believe the thing that pushed me over the edge to get tendonitis symptoms again was having written a bunch of unusually long emails in the recent weeks, and it's widely accepted that these things are an occupational hazard for everyone who works a lot with computers, so I think it's quite relevant for the gamedev community as a whole.

Good luck and stay/get healthy!

 

I've been a hard core gamer all my life, now 39 years old, no problem with RSI. I think it's important to minimize using the mouse for tasks that don't need it.

I use ReSharper at work and use the mouse below 1 procent. I only use the mouse for gaming.

 

Glad to hear you found a way that works for you! Though that might be an "in spite of" or "in your case" kind of deal. As far as I could find out the statistically most solid recommendation is to use input methods that create the biggest possible range of motions and spread the strain instead of loading it all off onto the least straineous device, which in your case might be the keyboard. So the general recommendation from RSI sufferers seems to be to mix it up and regularly switch between mouse, pen, trackball, keyboard, touchscreen or whatever else you can get your hands on.
Though I've also seen a couple of reports from people who tried all kinds of things and just when they were ready to give up they found one specific exotic type of keyboard or input device that turned out to be the only one that worked for them. Everyone is different.

 

I have acute RSI. In my case switching from mouse to trackball (solely Logitech M570, unfortunately right-hand only) helped. I switched in 2010 completely, no more inflammation in my joints. I also only work sitting at desk. When I'm laying around and sitting at the front of the TV only casual browsing allowed. So I'm trying to minimize the stress on my joints. Sadly trackball isn't the best device to play multiplayer shooters, so I have gradually gave up them over the years. But it's enough to play single player shooters regardless.

 

I also regarly switch from sitting to standing so I get some variation in my "stance", mostly for my back, but I guess it helps getting little variations also for RSI