StarkyWorking with RSI: setting up a Mac you can use without your hands
If typing has started to hurt, the useful thing to know is that a complete hands-free setup is achievable in an afternoon, costs nothing, and is far better than it was even three years ago.
The short version
- A complete hands-free Mac is achievable, free, and better than most people expect.
- Set it up before you need it. Learning this while in pain and behind on work is the thing people most regret.
- Voice, not dictation. Dictation leaves you reaching for the mouse, which is usually half the problem.
- Voice is one part of a kit, alongside rest, hardware and medical advice. It is not a treatment.
This is not medical advice and we are not qualified to give any. If your hands hurt, see somebody who is. What follows is the practical computing half: how to arrange a Mac so that it does not require your hands, written for somebody who has recently realised they might need that.
You are not in an unusual situation
It is worth saying plainly, because the experience is isolating. Musculoskeletal disorders account for roughly 30 percent of US private-sector workplace cases involving days away from work, on Bureau of Labor Statistics figures, and carpal tunnel syndrome alone makes up about a third of workplace repetitive-motion injuries. Surveys of office workers consistently find wrist and hand symptoms in double-digit percentages.
Behind those numbers is a very large number of people who still have jobs that require a computer all day, and who mostly worked out their own arrangements without much help. The tools are better now than the ones they had.
What to do in the first week
In order, because the order matters.
1. Reduce load before you replace it
Before any software: the cheapest wins are usually physical. Keyboard shortcuts instead of mousing. Tap-to-click instead of pressing. A different pointing device. Taking your hands off the machine entirely at intervals. None of this is glamorous and all of it buys you time to set up properly.
2. Turn on what you already have
macOS ships with a full voice control system, in System Settings under Accessibility, in the Motor section. It costs nothing and it works in about two minutes. Do this today rather than researching alternatives for a week.
Spend twenty minutes with it. Scroll a page. Dictate a message. Click something using the numbered grid. You are not committing to anything, you are finding out whether this is viable for you, and it almost certainly is.
3. Get a real microphone
This is the highest-return purchase in the whole exercise, and it is not expensive. A wired headset microphone that sits near your mouth dramatically outperforms a laptop microphone across a room, and recognition accuracy determines whether the whole experience feels magical or infuriating.
If you try voice control and find it frustratingly inaccurate, change this before you change anything else.
4. Learn six commands, not sixty
Sleep and wake, scroll up and down, undo, and the escape hatch that types a word instead of obeying it. That is a working system. Our cheat sheet has them in a table you can keep open.
5. Then decide about the serious option
If you are going to work this way regularly, you will eventually outgrow the built-in system, usually at the point where you want a command it does not have. That is when Talon becomes worth the setup, and it is what most full-time hands-free users run.
The mistake almost everyone makes
Waiting.
The common pattern is: hands start to hurt, person pushes through, hands get worse, person is now trying to learn an entirely new way of using a computer while in pain, behind on work, and unable to type the configuration files that the setup asks them to type. It is a genuinely miserable place to start, and it is avoidable.
Set this up on a good day. The version of you who needs it will not be in a position to.
Even light use, an hour a week, builds the habits that matter. The commands become familiar while the stakes are low. And the setup, which is the part that requires hands, is done while you still have the choice.
What a working setup actually covers
People are often surprised by how complete this gets. A full voice setup handles:
- Reading: scrolling, jumping to the top or bottom, following links, moving between tabs.
- Writing: dictation with spoken punctuation, and corrections by voice afterwards.
- Editing: selecting words, lines and paragraphs, deleting, copying, pasting, undoing.
- Clicking: labelled hints on web pages, and a numbered grid for everything else.
- Windows and apps: switching, launching, moving windows around the screen.
- Code, if you write it: spoken alphabets, symbols and editor commands. This corner is unusually well developed precisely because so many early users were programmers in your situation.
What it does not do well is anything requiring fine continuous pointer movement: drawing, detailed image editing, some games. Plan around that rather than fighting it.
Talking all day
A real consideration that rarely gets mentioned: your voice is also a body part, and it can also be overused. People who move to voice control full time sometimes trade a hand problem for a throat one.
Things that help: drink more water than you think you need, use short commands rather than long sentences, do not raise your voice at the recogniser when it mishears (a better microphone fixes what shouting does not), and keep using your hands for the things that do not hurt. A mixed setup is usually healthier than a pure one.
On asking for what you need at work
Voice control setups are a common and generally uncontroversial workplace accommodation, and the software here is free or inexpensive, which removes the usual objection. A headset microphone is a trivial expense against the cost of losing a person's productivity for months.
If you need a quieter space to work in, that is a reasonable thing to ask for and worth asking early rather than after struggling in an open-plan room.
Common questions
Can you really use a computer entirely without your hands?
Yes, completely. Navigation, dictation, editing, clicking, window management and application switching are all covered. A number of software developers have worked full time this way for years, which is a reasonable proof of the ceiling.
Will voice control help my hands recover?
We are not qualified to answer that and nobody selling software should pretend otherwise. What it does is remove the requirement to type and mouse, which is a different claim. Talk to a clinician about the recovery part.
Is it slower than typing?
At first, considerably. After a few weeks, comparable for most work, faster for some things and slower for others. Speed is usually not the deciding factor for people in this situation anyway.
What if I share an office?
Command systems listen for defined phrases rather than transcribing everything, so background conversation causes less trouble than people expect. A headset microphone and knowing the sleep command handle most of the rest. A quieter space is still worth asking for.
Does any of this send my voice to a company server?
Apple's Voice Control and Talon both recognise speech on your own machine, so no audio leaves it. Some cloud dictation services do send audio away. It is worth checking for anything you install, particularly if you handle confidential work.
