I swap back and forth between a thumb trackball and a regular mouse.Honestly, I can't figure out what mechanism makes them work (stabilization, heat, pressure, something else?) but they definitely do. I used to use bigger ones with the aluminum ribs, but these days I just use the smaller ones that just hook around the thumb and wrap the wrist. Have everything positioned right, arms straight forward elbows at 90s degrees, no weird angles. I have had wrist pain in both wrists and I did a few things to pretty much completely get rid of it. Will vary somewhat from person to person, and doctor's orders always take precedence over guidelines. *These were the latest guidelines I could find. And last, you generally want to have your monitor set so that when you focus straight ahead, you're focusing on a spot about 2-3 inches below the top edge of the monitor, to prevent neck strain. Again this is to keep from putting excess pressure on your knees to prevent all of the circulation and nerve issues associated with that. If setting the chair to do this causes you to be unable to place your feet firmly on the floor, get an underdesk foot rest that you can keep your feet on. Going a little further, the arm rest should be roughly even with the desk/mousing surface. They also need to be spaced far enough apart that they don't interfere with you sitting down, or standing up from, the chair. Too high and you can put pressure on your elbow and reduce blood flow and cause nerve issues. I think the current ergonomic guidelines for armrests are that your elbow should barely graze/touch them when your shoulder is in a relaxed position.
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