I saw this in the paper, I haven't experienced anything like this. It was accompanied by a photo-illustrated to-do and not-to-do saying never type one-handed. I do it all the time. Is this happening to anyone?

By Nicole C. Wong
Knight Ridder Newspapers

SAN JOSE, Calif. - Doris Mosblechís boss at Embarcadero Systems bought her a BlackBerry in January so she could instantly read and reply 24/7 to all the e-mails funneling in from the Alameda, Calif., companyís 2,500 employees.
The 53-year-old network manager, who already works 14-hour days, now has even less leisure time to garden and scrapbook. But the biggest pain isnít receiving the round-the-clock disruptions - itís replying to them.

Mosblech torques her wrists and curls her fingers to clutch the 4.69-inch handheld device while scrunching her thumbs to type 50 to 100 e-mails a day on the keyboardís popcorn kernel-size buttons.

"My fingers get crampy, my hands hurt, and I have problems grasping things," the San Mateo, Calif., woman said. Sometimes "it will hurt all the way up to my neck."

Repetitive stress injuries - a common curse of desktop and laptop computer users - are now afflicting people who type on handheld devices. As the sizes and prices of handheld typing devices continue to shrink, doctors and therapists caution that consumers need to treat their on-the-go text messaging work as a physical workout.

"If I tell you to run a marathon and youíre not in shape for it, youíd think Iím crazy," said Dr. Jules Steimnitz, a San Francisco physiatrist who treats repetitive stress injuries. But when it comes to text messaging, "people donít know what they can and canít do. People donít think of it as an activity using the muscles and tendons and ligaments."

As with kickboxing classes and pickup games of basketball, itís important to warm up and cool down by stretching. Dr. Daniel Tintor says even time-crunched consumers can carve out stretching sessions during their commutes.

"Every morning on the drive to work when theyíre sitting at the red light or in traffic, stretch the wrist backward, stretch the wrist forward, take an exercise ball and squeeze it - just like when donating blood," said the Redwood City, Calif., chiropractor, who in the past six months has treated three software engineers with painfully swollen thumb tendons thanks to their addiction to the aptly nicknamed "CrackBerry." "The idea is to get blood into the tendons and into the small muscles of the hands."

Experts say repetitive stress injuries can develop by using any tool - whether itís a computer keyboard or a garden rake - in an ergonomically unfriendly fashion too often and too long. While thereís hardly an epidemic of BlackBerry-induced injuries, typing on little electronic devices can take a toll on tendons because it requires forceful micromovements from hand muscles. The miniature keypad leaves little room to use the stronger shoulder muscles, which would alleviate some strain.

"The endurance runs out in the smaller muscles faster," said Stacey Doyon, a certified hand therapist and registered occupational therapist in Portland, Maine. And when those muscles grow exhausted, the body compensates by tightening the tendons, which connect muscles to bones.

Doyon, vice president of the American Society of Hand Therapists, helped draft a January alert warning consumers they may injure themselves by using the BlackBerry and other handheld electronics. It recommended preventive measures, such as spreading the fingers as far as possible for 10 seconds and switching which hands and fingers do the taxing work.

"Itís better to alternate your fingers and thumbs so youíre not using the same ones all the time," Doyon said.

Itís not just the BlackBerry that contributes to complaints of tendinitis - although the ailment is dubbed "BlackBerry Thumb." Techies bent on staying in touch also compose e-mails and update their blogs using the tiny keyboards on palmOne Treos and T-Mobile Sidekicks. And teenagers zing text messages and conquer computer games with rapid-fire button-bashing on Nokia and Motorola cell phones.

"BlackBerry tends to get the attention because itís the most popular," wrote Mark Guibert, vice president of corporate marketing at Research In Motion, the Canadian company that created the BlackBerry. "I guess thatís the price of success," he continued in the e-mail typed on - what else? - his BlackBerry. "(And yes, my thumbs feel fine)."

Several San Francisco Bay Area doctors say the BlackBerry bears too much blame for techie tendinitis. Most mobile e-mailers also type on desktop computers somewhere, sometimes on laptops, too. All that typing - if done improperly, such as with poor posture - can contribute to repetitive stress injuries.

But experts say typing on handheld devices can push latent injuries over the edge and further aggravate them, as happened with Mosblech. Users often hold their wrists in awkward positions while hunching over and craning their necks to see the small script.

"We call it turtle-necking," said Vivienne Fleischer, co-founder of Performance Based Ergonomics in Oakland, Calif. Instead, mobile-text messagers should hold the device at a height where they can type without tilting their neck up or down.

Fleischer recently started including handheld typing tips in the ergonomic computer classes she conducts at Cisco Systems, Juniper Networks and Pixar Animation Studios. She instructs users to loosely cradle the BlackBerry or cell phone in the palm of one hand and type with the other.

"What most people do is hold their cell phones and use the thumb of the same hand to push the buttons," Fleischer said. They clutch the devices with a death grip while twisting the thumb to tap the buttons. "That can be very strenuous and cause some tendinitis in the thumb."

The solution, said physiatrist Norman Kahan at Sports and Occupation Medical Associates in Cupertino, Calif., is to shift the workload from the fingers to the elbows and shoulders.

"You want to make your arms function like the pendulums of a clock, moving back and forth," said Kahan, who developed the MouseKeyDo computer keyboarding technique to retrain typists suffering from repetitive stress injuries. "Imagine putting a device in your left hand and allowing the whole right arm to move from the shoulder side to side, kind of like a windshield wiper, and up and down...almost be like a light hammer tapping a nail."

Mosblech has found ways to assuage her ailment without changing the way she types or seeking medical help. Every other week she visits a manicurist for therapeutic paraffin wax treatments. She also treats herself to a weekly one-hour massage to stretch stiff muscles.

Susan Herder, a neuromuscular therapist in San Francisco, advises mobile typists to strengthen their hand and arm muscles by doing tai chi, yoga or pilates.

Sarah DeLorenzo, a certified pilates instructor at Myofascial Therapy Center in Los Gatos, Calif., said the exercise can also improve the posture and alleviate the pangs of pain troubling handheld typists, who tend to be "wearing their shoulders for earrings."

"You want to make sure that there is space between your shoulders and your ears," she said. "We talk about having your shoulder blades slide down your back toward your back pocket."

Dr. Steven Mark Davis, a chiropractor and certified sports physician at Davis Health Services in Los Gatos, favors underwater tae bo. Pushing warm water out of the way while throwing biceps punches and backhand blocks helps soothe and tone muscles simultaneously, he said.

Davis also advises patients to practice typing underwater, an easy exercise they can do at home.

"Whether theyíre in the bathtub or in the Jacuzzi," he said, "theyíre developing all those muscles and massaging those muscles at the same time."

The best way to prevent BlackBerry Thumb is by learning how to properly use handheld typing devices.

Aaron Parnell, a posture therapist at the Vitality Center in San Mateo, said it would help if manufacturers included an exercise card showing hand and wrist stretches.

And Fleischer, the corporate ergonomics consultant, said training in techniques that seem like common sense is needed, too. She was on her way to conduct a class six months ago when the man walking beside her discovered an e-mail had arrived on his BlackBerry, which hung from his waist.

"He never took it off his belt. He bent his head sideways to look at it and started answering," Fleischer said.

She was horrified, she said: "Heís the companyís health and safety guy."