The Healthy Writer: How To Keep Your Keyboard, Mouse, Laptop & Writing Habits From Destroying...

Hey, welcome to today's show. If you have carpal tunnel, you're probably going to want to listen in. If you have wrist issues or neck issues or back issues, if you type on a freaking laptop, this podcast is for you. It helped me out tremendously. It's with a doctor who co wrote a book called the Healthy Writer with another gal whose podcast I listen to, Joanna Pench puts out an amazing writer's podcast. Many of you may not know, I wrote a 500 page work of fiction over the past two years and I really followed Joanna quite a bit to give me advice as I was writing that book called the Forest. Can check that out over@BenGreenfieldFitness.com the Forest. Go immerse yourself in a magical fantasy world that I created with two young protagonists inspired by my twin boys. But before we jump in, speaking of a magical fantasy world, have you been to the ONNIT website? On it, you go over there. It's BenGreenfieldFitness.com Onnit May I recommend to you, as your sommelier of Onnit, the emulsified MCT oil that is cinnamon swirl flavored. Cinnamon swirl flavored it is.

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Quite well with coffee in this episode of the Ben Greenfield Fitness Show.

Laptops are just evil, really. They just batter you. Everything is in the wrong position, your wrists are all cocked in the wrong direction. There's a little bit of a stigma around it. I think as well, people sometimes feel that it isn't being taken seriously by the medical profession. And sometimes the problem with these conditions, which are very nebulous and there's not just one thing, they're kind of present in all sorts of different ways, is that they're just lumped together.

I mean, I'll tell you, just like two one hour calls. I did.

I had 16,000 steps yesterday.

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Hey, folks, it's Ben Greenfield. And a while back, I had an author named Joanna Penn on my podcast. And Joanna had developed these chronic repetitive motion injuries in her wrist and her elbow. And we took a deep dive into ergonomic keyboards and ergonomic computer mice and how they weren't working for her. What she wound up doing instead, how she wrote a book while simultaneously training for an ultra marathon and did so using different tools and microphones and softw that allowed her to work quite well using dictation and training her computer to recognize her voice and her accent. And we even delved into, like, how to enhance productivity with ambient noise and focus apps and a whole bunch of really, really practical takeaways, especially if you spend your time on a computer. And I'm going to go ahead and put that previous podcast and all the show notes for it if you just go to BenGreenfieldFitness.com HealthyWriter because Joanna has just finished penning a brand new book that she wrote along with a British medical doctor named Dr. Ewan Lawson. And Dr. Lawson, her co author for this book, helped her delve into addressing things like her back pain and her migraines and her repetitive strain injuries.

And they sent me this book and.

I read it and it's just chock full of practical, actionable information for anybody who writes, who types, who, like me, might be hunched over a laptop. Who isn't these days, it seems. Unless you're a frickin farmer, I guess. So Dr. Lawson and I are going to dive into some of the new topics from this brand new book. Joanna may join us later on. She was having a few Skype call in issues, but we may bring her in as well. But in the meantime, Dr. Lawson, thanks so much for coming on the show, man.

Hi, Ben. Yeah, hi. Good to. Good to be here. Call me. You and I. You make me feel about 100 calling me Dr. Lawson.

Well, the reason I was calling you Dr. Lawson was your name is spelled EU A N and I wasn't quite sure how to pronounce you and I didn't want to stick my foot in my mouth during the whole podcast, so I was going to just sound all respectful, but.

Yeah, no, no, no, you absolutely. You said it at the start. You nailed it. It's you.

And yeah, okay, got it. Not Eon or Ewan.

Yeah, no, yeah, you can just pretend it's a W there and that's exactly the same. Yeah, Ewan.

Nailed it. I'd do great in England if I lived over there. Hey, so before we go all doom and gloom, Talk about a lot of the issues that can arise with writing.

Writing can be good for your health. And I'd never actually kind of thought that much about the benefits from a health standpoint of writing, but you guys delve into them in the book. Why would writing actually be good for you?

I mean, I think we were keen to make sure that there was a risk that it did come across as very doom and gloom if we just plunged into all the horrors of sitting in front of a screen and not moving all day. I guess one of the major things I think that is great for you is, I mean, if it's your passion and your thing in life writing, then actually following your passion is very hard to dispute as being the best possible thing you can be doing. But there's some medical evidence around writing as well, and particularly things like gratitude journals, which have got really astonishingly good evidence for minimal amounts of gratitude and writing it down in a journal and reflecting really helping your psychological health and then going on to help things like your sleep. And if you help your sleep well, that's then a superpower in terms of your overall health. If you get your sleep right, you live longer, you're less likely to get cancer and you can, I think you can trace all that back to writing.

Interesting. Have they actually done studies on writers and found that they, they have less anxiety or less cortisol or anything like that? Or is this more one of those deals where we know that the people who, who start off the day with, with free writing or I know some people will do like the two page exercise each morning, that they're just generally, you know, happier and healthier from, you know, like, like an observational standpoint.

Yeah, I think the studies, they're kind of extrapolating a little bit. There's no cohort of writers that they've looked at and said, oh yeah, they've kind of been able to follow them for long enough to see that they're definitely healthier. But the smaller studies looking at small groups of things like gratitude journals or free writing then have translated into benefits. And I think you can, I think it's pretty reasonable to pull them out to, you know, as you say, lower stress levels, lower cortisol and then of course that, then you support. If you hit those, if you hit those targets, then you're highly likely to be doing yourself a lot of good in the long run.

Yeah, it makes sense. I mean, like I, I start off every day penning in my gratitude journal. If I do no other writing during the day, that at least sets the standard for me to have. You know, we could talk about the woo woo stuff like, you know, better empathy towards others and a feeling of gratitude and in a better mood. But ultimately I find that I engage in deeper breathing. I have not actually tested salivary cortisol or done like a urinary cortisol evaluation on the same day that I gratitude and then repeated a day that I'm not journaling. But I definitely feel the effects. Even this morning I woke up and I opened my phone and then kicked myself because I actually, I took it out of airplane mode before I picked up my journal and it was just blowing up with all these messages because I wrote an article this morning for the blog and it went live and there were. There were issues with it that I was supposed to go fix. And my first temptation was to just jump out of bed, head downstairs to my laptop and take care of it. And I kept myself in bed partially because I knew my wife was laying there watching. And we keep each other accountable with our gratitude journaling. So that helped out a little bit. But yeah, I mean, I wrote and I felt far less stressed after I wrote and there was enough time to still go down and work on the article. But yeah, I agree, a lot of people don't realize, even if they're not authors for a living, how therapeutic writing can be. I know that when you wrote this book, Joanna Penn, your co author, she was having health issues that you guys were kind of addressing as you wrote this book. Do you want to speak to what kind of issues you were trying to deal with in her?

Well, yeah, and I think to be fair to Joanna, she tackled most of them. It has come to the realization herself, I think, around a lot of these, although I think we' both got a lot out of writing the book and reflecting again on what we're doing and what we're not doing as well. But I think particularly you mentioned at the start there, her repetitive strain injury. And she went through, and she discusses this in the book, that she went through years of, you know, really debilitating agonizing pains, and they affected her all through her body and not just her hands and wrists and neck and back. And she really, I think the one thing that really made a huge difference to her and she tried all the ergonomic stuff, was that she took a much more holistic approach. And really yoga, perhaps more than anything, and physical exercise and a regular physical habit is really what, particularly with the yoga and stretching and core strength has really just really fixed Her RSI for her. And I think it was quite a transformation in that regard.

Now when you say rsi, can you explain because you guys go into. In the book, you go into RSI1 versus RSI2. Can you kind of fill me in a little bit more in RSI for listeners who aren't familiar with that and how it manifests in riders?

Yeah. So repetitive strain injury and type one and type two, which are not the most imaginatively named that you've ever come across. Type ones tend to be very specific conditions. You've probably heard of some of these things like carpal tunnel syndrome, where you get pains and numbness around your wrist and in your fingers of your hands, and tenosynovitis, which are in particular tendons going into the wrist and in the hand, which are just an inflammation of those tendon sheaths. So type one, they tend to be very specific ones. They tend to have more often than not, they tend to be very specific treatments. Carpal tunnel syndrome, it might be using the wrist splints or you can inject the area or you can inject the tendon. If it's a tenosynovitis, the tendon sheath, I should say, if it's a tenosynovitis or there's even surgical options sometimes that can. Things like carpal tunnel syndrome that can fix it.

What would you inject with if you were going to inject something for repetitive strain injury? Are you talking about like prolotherapy or like a cortisol?

Yeah, yeah, cortisol. Corticosteroids.

Yeah. Okay.

Generally there's not always great evidence around all of those, but there's definitely. They're still regarded as fairly decent, fairly reasonable practice to try those before you. Certainly something like carpal tunnel syndrome before you launch into surgery.

Yeah. Have you ever heard of BPC157 or it's a peptide. There's another one called TB500 that they'll inject into racehorses, for example, for tendonitis.

Okay. Yeah, I haven't come across that.

I've talked to a ton of people who have found that to be incredibly efficacious. And I've even used it myself in elbow issues. I've assisted some pretty well known authors who have developed issues and hooked them up with these peptides and they just self inject like subcutaneously around the area that's painful and they always have to. I'll have them go adjust their workstation ergonomically, get the elbows at 90 degrees while typing and ensure that the computer is the correct distance from the face, et cetera. But to just get rid of, like, a chronic inflammatory issue, those. Those injectables seem to work pretty well in terms of just something you can get, like pennies on the. You know, technically it's. It's not sold for human consumption or human use, but you can order it and you can, you know, you can inject yourself if you really wanted to, but. But you've got type 1 RSI that, and you said that would be like carpal tunnel syndrome. There's inflammation, there's irritation of the tendons. And then type two, it sounds like that's a little bit more nebulous or varied.

Yeah, that's right. That's right. And type two just encompasses just about everything else where you've got pain. And, I mean, it's gone under lots of different names in the past, and there's a little bit of a stigma around it, I think, as well. People sometimes feel that it isn't been taken seriously by the medical profession, and it's been known as cumulative trauma or overuse injury. And it's sometimes the problem with these conditions, which are very nebulous and they don't. They're not. There's not just one thing, they're kind of present in all sorts of different ways, is that they are. They're just lumped together and people have aching. They might have cramped numbness, tingling, all sorts of symptoms. And it could be in their hands, wrists, elbows, as you mentioned, their shoulders, even up to the neck. And headaches can be related to it. And I think the problem with those is they. They are a source of frustration for the patient because there isn't a single. And the person who's got it, because there isn't a single answer to fixing them. There isn't one thing you can point to and go, well, we could try injecting around this area here, or we can, you know, there's this surgery here we could offer. So they tend to be much, very much harder to get a grip of and to fix. I think probably it was a type 2 RSI that Joanna really had problems with when she was having difficulties. And so she's a good example of the right kind of approach probably, to fix that, which is very much more a holistic approach where probably addressing your entire physical activity around, the activity around your daily work is a really critical thing.

Right.

So.

So with rsi too, that's just like general tightness, soreness, neck pain, headaches, stress, tension. It's not necessarily like a. Like a clinically diagnosable issue, as much as just like a cluster of issues that arise in people who are just basically hunched over a laptop.

Yeah, that's exactly it. And there's probably. There's probably as many varieties of. As there are people in the world. It'll be completely individual to you what the symptoms you get and the symptoms you suff. But no mistake about it, that it can be incredibly, you know, it can be incredibly unpleasant, incredibly debilitating, and you're really a source of really unpleasant chronic pain.

Yeah. The other thing is, you know, and this is something I've noticed increasingly, is that breathing, when you're kind of in that forward posture, hunched over position, belly breathing, diaphragmatic breathing, tends to be something that suffers. And a lot of people don't realize how related that is to things like peristalsis. Right. Like movement of foodstuff through the digestive tract. I've noticed on days that are more stressful where I'm hunched over my laptop and I forget to belly breathe, I can tend to be more constipated the next morning and get digestive issues. I've noticed, like, psoas tightness that alleviates, like, pain in the psoas that relates to or refers to low back pain that disappears once I stand up straight or begin to. To belly breathe or adjust my workstation. So even breathing seems to be really important. And then the other one, and you guys delve into this one in the book, is the actual screen that you're using. Can you talk a little bit about why screens would cause problems?

I think screens you could. There's all sorts of different ways that can cause problems as well, isn't there? I mean, you can just go down the postural side of things where they, you know, the position of them. You know, you talk about being hunched over a laptop or hunched over your computer. If you get that screen position wrong, then you're already setting off in a really bad direction. I think the other thing is your eyes and headaches particularly. And we noticed that Joanna ran a huge survey and got an enormous response from her community writers, and they very generously completed.

A questionnaire on the symptoms they'd suffered from. And eye symptoms were remarkably common. It was probably. It's right up there in terms of people having difficulty. So that kind of the blurry vision, dry, scratchy sore eyes where you feel red and irritable. The screens definitely are a big factor in that.

And I actually did a podcast about this. And you guys get into it in the book as well, about this concept of blinking and how blinking is supposed to lubricate your eyeballs and tears, help deliver oxygen and nutrients to the eyes and protect against, I think in the book you call it lysozyme, that they protect infection by producing lysozyme, and that heals damage to the surface of the eye. And you're supposed to blink like 12 to 16 times per minute. And when you're staring at a screen, you blink. I think it drops to what, like five, six times per minute?

Yeah, it can be really dramatic, the difference, you know, two or three times slower. And you. And I think I wrote in the book, your eyeballs are just shriveling up while you're staring at that screen. And it's no wonder you get a few symptoms when you've spent all day even. Well, even just a few hours, a couple of hours, staring at a screen. I think actually it's really any activity. It can happen with reading as well. Actually. It's not completely just related to screens that anything where you focus on one spot, a set distance for a certain amount of time can do it. And a lot of people sit far too close to their screens. And that certainly there was some good ev. There was some good evidence for that, that you probably just. You need to be a little bit further away. People who are sitting 50 centimeters. So what that is in inches. But I guess that would be about. Oh, what would that be? A couple of feet?

2.54. Right.

So.

So less than. Less than. Less than a couple feet.

Yeah, yeah, a couple of feet. You need to be a couple of feet away from that screen. And there's no excuses for that these days. You can easily zoom things in. You increase font size, but, yeah, the tendency is as you hunch over that screen, you get closer and closer, and sometimes you feel like your nose is just a couple of inches away from your laptop.

Yeah. The other thing is, and I don't know if you've experimented with this much, and I'll link to this, if folks are listening, they go to BenGreenfieldFitness.com HealthyWriter I did a podcast interview with this Romanian computer programmer who developed a piece of software called Iris. So I have that on my laptop now. And it's kind of like that program flux, where it will decrease blue light from the screen depending on whatever time zone of the world you happen to be in at the time that you've chosen so that you don't shut down your melatonin production, and it reduces A little bit of screen glare. But Iris, you can lower your screen temperature. You can automatically change the font of any website that you visit to be like a. An easier to read, like a. Like a sans serif font, for example, versus a cursive font. You can decrease the screen flicker rate like that. It's a pretty robust program. And then I also, like, while you and I are talking right now, I'm just looking out the window. Like, I'm not actually looking at my screen. I look, I've got this big picture window in my office. So I just. Basically, as much as I can, I don't even look at. Look at the screen. I just look out the window and I guess imagine you sitting there in your pristine white lab coat. You. And so, yeah, that's.

Yeah, I always wear. I wear it everywhere.

Yeah, I. I'm everywhere.

I wouldn't. Yeah, exactly. Lab coat. Don't be without it. Yeah, that's that 20, 2020. Yeah, yeah, yeah, that's that 202020 rule, isn't it, that you can, if you look away from your screen every 20 minutes, focus on something 20ft away for 20 seconds if you do nothing else. That's a really good.

Oh, is that actually a thing 2020?

Yeah, we don't mention it in the book, actually, and I've come across it since. But it's a good way of sort of just remembering it that just. And of course, the 2020 thing with related divisions fits nicely that it's just giving yourself a bit of a chance and changing the distance that you're focusing on.

Yeah. Okay, got it. Okay, so we know that we can adjust our distance from the screen as well as the type of screen and screen software that we use. That program I was talking about, for example, is called Iris. We know that, like, Joanna and I kicked this horse to that the last time we talked. So I'm not going to delve too deeply into this on my show with you because folks who listen to it, but dictation is huge. That's been a life changer for me as far as allowing me to walk on my treadmill to switch positions frequently. I use this jabra931 headset dragon dictation software. And like Joanna and I talked about in that previous podcast, you still have to go in sometimes and edit if you're doing a serious article via dictation. But for emails, it frickin. It rocks. I mean, I can stuff a salad in my face or be doing like isometric squats. I have like a, like right now, in addition to staring at my window while I'm talking to you, I'm standing on a wobble board, right. And so I can like stand on a wobble board, dictate emails, et cetera. But we didn't really get into a few of the other things that you guys talk about in this book. Like for example, active sitting. You get into the concept of active sitting in the book, you know, things like these stability ball chairs, etc. And whether they're gimmick or a good evidence based option. Can you get into what they've actually looked at in terms of trials on these type of these active sitting options?

Yeah, so the best evidence seems to be it's a few years old now. Actually there was a good systematic review done. I think it was back in, it was 2012, I think it might have been 2015, but I think it was 2012 and which looked very much all studies they could find related to active sitting. So it's as you say, it's this kind of sitting on Swiss bowls or it's kind of stools where you've got to do all these constant spinal micro adjustments, micro movements. And the idea is that sort of helps you maintain your posture and that you'll get some kind of benefit from it and preventing or treating back pain. And they really didn't come up with very much. They couldn't come up with any convincing evidence that it made any difference. I mean, I think. So you could argue maybe gimmick, but I'd be a little bit more generous than that in that almost all the studies that when you look at interventions, particularly any physical intervention for back pain, it's plagued with really low quality evidence, you know, studies with small numbers with, you know, sources of bias. And it's obviously very, you can't do randomized controlled studies, but you can't blind someone to whether they're sitting on a Swiss bowl or not, you know, whether you're sitting on a chair or a Swiss bowl. So you can't. There's no way to easily do these studies in a very effective way. So it's a challenge with all the literature and the medical evidence related to back pain. So my general feeling is that if you think it works for you and you're getting benefit, then, you know, all power to you. But overall it's hard to, it's hard to recommend them in a wholesale way. There isn't great evidence.

Okay, now what about these chairs that you sit in? And I even interviewed a guy from Finland about this that like Split the pelvis and caused you to sit up straighter. Like, there's one called. The one I have in my office is called a Sally saddle chair. And there's another one that. That's very similar, but it's a stool. It's called the. The focal upright mogo stool, which you can even like, fold up and put in a suitcase and create a standing workstation on the go. What do you think about these kind of like, alternatives to sitting that naturally adapt to the shape of the pelvis?

Well, I think. I mean, I think it's. Again, everyone's very different, and I'm not aware of any evidence to point towards those to say to. In a. From sort of a generality to say that it'd be good for all folk. But it's one of those that if you kind of. If you're seeing a therapist or they recognize a problem in terms of, you know, that's a particular postural challenge for you, then you may well get benefit. Yeah. And I think the problem with these is they can be expensive, can't they? And it's. You don't really know until you've given them a goodwill for a long while.

The mogo stool is not super expensive. The Sally saddle chair gets a little bit. It is a little bit spendy. Yeah, absolutely. But I mean, between like having those and in a little balance mat and then one of these. One of these, like, you know, skateboard. The one I have is called a fluid stance. It's like this little wobble board type of thing. I stand on little walking treadmill. I mean, I. I don't know how you feel about this, but my philosophy is I switch positions as much as possible throughout the day and. And I have lots of options.

Yeah, that's exactly what I was going to say. For me, I suspect that's more important than anything. And I'm the same when I'm at work. I've got a homemade standing desk. I've got a Swiss bowl. I've got a normal chair. I pace around doing dictation. But it's the. It's the variation that works for me. It's the sitting still not moving, not. Not changing up it up at all. That feels horrible. And doing different things. I think. I think that for me is probably for most people is going to work well.

Now, another thing you get into in the book is this concept of being ambidextrous with a mouse.

Ambiemosterous. Yeah.

Ambidemoustress. How would that work exactly?

Well, I think it's just that the fact that I'm not. I haven't seen a shred of evidence for this, so this is entirely spectacular. I think it's just that we all use our dominant hands to operate our mouse or our trackpad. And if that's the. A lot of people in the service, particularly, we noted that if you're starting to get a bit of RSI kind of symptoms, it's often in that mouse hand that is the problem. That's where you feel it. It's that way you feel like you're kind of. You start to feel like you're getting friction just moving your tendons around in your hands. And I think it's because it's such a fixed position and just with these tiny movements, it can feel really uncomfortable after a while. So it's just a very simple measure of just using your other hand and getting used to using your other hand for something you wouldn't otherwise normally do you use it for at all? I certainly. I'm happy to say I don't really get problems with rsi, but I know that if I were to go to my MacBook just now and try to use my trackpad with my left hand, I'd be a disaster. But I think it takes a. It would only take. I also know it would only probably take an hour or two and I'd start to get very comfortable with it. You probably wouldn't notice much difference.

Well, I can tell you that I never had any biomechanical issues associated with being an author and a blogger until I began to use a laptop. And this was like six years ago that I switched from a desktop with a nice external keyboard to a laptop. And the laptop is so convenient that I haven't really given it up. And syncing from the PC to the laptop back and forth can be a little bit of a pain. It's getting easier in this day and age. But.

I'll work in the office, then I'll want to go up to the kitchen table and then quickly get to the airport with my laptop. And it's so hard to switch back and forth. But one of the things you guys get into in the book is kind of fixing part of that issue with the concept of an external keyboard. Do those really make much of a difference, do you think? And if so, what kind of external keyboard should people be looking for?

Well, I think that. I mean, they are just from the ergonomic perspective, and again, these are difficult studies to do, but from the ergonomic perspective, laptops are just evil, really. They just batter you. Everything is in the wrong position. Your wrists are all cocked in the wrong direction, you're looking down at the screen awkwardly. It's really, I think, anything you can do to sticking your notebook on a riser or even a book or whatever's handy, and then using an external keyboard just helps you maintain a slightly. And you talked about having chatted with Joanna about this in the past. It gives you a chance just to stick to some of the good principles of ergonomics. And to be honest, after that, I'm not sure it matters too much what the keyboard itself is. You can buy it the cheapest USB one out there that probably would be will do the job if it gets you in the right position. I mean, I personally have got a couple of Bluetooth keyboards. I like to use an Apple one, and I've got a very nice one on order from Kickstarter. I'm still waiting for with a retro appeal to appear. But that's just an aesthetic thing. I don't think it will make any difference from an ergonomic perspective. What makes a difference is getting it in the right position so that I can actually have my, you know, you have your arms parallel to the floor and have your wrists at a relaxed angle, a neutral sort of position and all those things. I think that's how they really help.

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Does it bug you needing to carry an extra external keyboard around? I mean, have you found any like portable fold up type of solution that works well as an external keyboard?

Yeah, no, nothing particularly. I mean, the Apple Bluetooth ones are pretty lightweight anyway, but no, there's nothing particularly. I haven't come up with it. Yeah, you've just got to carry it around. To be fair, I'm not, I don't do that much traveling these days. So it's generally just humping it into work and pumping it back again. So it isn't that big a deal. But yeah, yeah, yeah, you're right. It's an extra bit of kit to carry around, but I think if you're starting to get pain, it's definitely well worth the, well worth the effort.

What about the little pads that you can put on top of the actual laptop, like on either side of the trackpad? Have you used those at all?

I haven't tried them myself. As I say I've not been. I've not played. I've not been particularly plagued with problems myself.

So, yeah, again, I think it's one of those. There's lots of little ergonomic bits and pieces, isn't there? You could try, I think, if you find they help. The key thing for me with RSI is that you have to change what you're doing. And sometimes that's a very. A message that gets translated badly when a doctor, someone goes to a doctor with type 2 RSI and they say you have to stop writing or you have to stop playing tennis because you've got, you know, almost. You could argue that tennis elbows are kind of type 1 RSI, whatever it is you kind of.

But the message is really you have to change what you're doing somehow. You don't have to stop, but you've got to change it up a little and you have to take the pressure off the way that you're moving. And so you don't have to do things, you'd have to stop doing things, you don't have to stop writing, you don't have to stop using a computer, but you've got to alter something because you don't want to get into that really deep chronic where it's a really deep seated problem and trying to shift it then is a real. It becomes a bit of a nightmare. So, yeah, if those things do that, I think then they're incredibly. They're all useful, but you've just got to try and see what works for you. But if it changes it up, then I think it's. Then it's doing its job.

Okay, got it. Now, one of the other things that you talk about in the book is the Alexander technique for fixing some of these issues. What is the Alexander technique technique?

Now? The Alexander technique, it's been around for a very long time and it. We didn't cover this in the book, but I looked into it in some detail that it stems back into the 19th century and it was. It was an Australian chap called Frederick Alexander and he was an actor who had he noticed that he went on stage and he had problems with his voice and if somebody couldn't project, he couldn't, he couldn't, he couldn't get his voice out there. And he was looking at himself in the mirror and he noticed all this tension in his neck associated with him, with his efforts to speak and when he was going to try to do his orations. And so. And he also notes that when he even thought about it, he Started to get the same tension. And the whole idea of the Alexander technique is it's this kind of self awareness to do with posture and balance and mobility. And he started, he sort of taught himself these exercises. And then in 1904 he came over to London and started rolling out to the people in London who are getting any kind of pain and back pain in particular. And he trained up a whole cohort of teachers. And I think he died in the 1950s in the end. But the Alexander technique has just kept on going. And I've heard it described as not even being a therapy really. It's almost like a self awareness, I think one way to describe it, it's almost like a practical physical application of mindfulness. So it's a really interesting technique and I think it has been shown to be really quite effective. There was a good study in the BMJ, the British Medical Journal back in 2008, which showed it was effective for back pain. I mean, the studies since then haven't been wholeheartedly.

Haven'T been able to wholeheartedly endorse it. But I think again, that stems back to some of the problems I was saying about, you know, this in studies into physical treatments for back pain.

I don't understand, I don't understand how exactly does it work? You're just being more aware of a certain muscle. Like there's no actual therapy or systematization in terms of its application.

No, no, I mean it's. I. It's an area which is. You're right, I'm not sure I know either. And it's very much a one to one thing where you get taught how to move and how to. I think breathing is a big part of it. So it may be a lot of that sort of, you know, getting that diaphragmatic and abdominal breathing right is a huge part of it. But they also, they teach you to think. You to recognize when you're holding yourself in tension and when you're holding yourself in what in effect are kind of damaging postures and positions and to build that awareness and that recognition of what you're doing. So that as soon as you feel them coming on or you react, even if you react to a stressful life situation or you're stuck in traffic or having an argument with somebody, that you recognize you're doing this and you can control your body and you see quotes from people saying, you know, they just. It's that recognition that you can do what you want with your body, you are in control of it and actually building that Self awareness. Interestingly, I've seen very little of it around, but the medical practice I work in had an Alexander Technique practitioner. That was about five or 10 years ago and we don't have it anymore. And it was phenomenally popular with the patients and pretty good evidence for the back pain side of things. But yeah, you're right, it doesn't have a. It's much more this almost this self awareness aspect to it. I said I'm not an Alexander Technique practitioner and it may well be something worth exploring with one. But really intriguing, interesting option for people with back pain or who just want to explore that whole posture, balance, mobility thing a bit further.

I want to learn a little bit more about it. I was able to find a podcast on it that I didn't actually download yet, but what I'll do is I'll link to it in the show Notes. It's from like 2010, but it's an audio introduction to the Alexander technique and how it actually works. So if you guys are listening in and you go to BenGreenfieldFitness.com HealthyWriter you can learn more about the Alexander technique. To me it sounds like a little like at first glance when you tell me about it, it sounds kind of gimmicky. It's just like better body awareness. Then it' kind of like, you know, I like Wim Hof but Wim Hof breathing is just, you know, just fire breathing. Right. So it sounds like this Alexander technique is almost just like being aware of your body, but interesting. I'll have to look into it a little bit more. It sounds fascinating. Now you also, or. Well, technically it's Joanna that talks about this in the book and I know she's unable to join us today due to some tech issues, but you guys do delve into diet and she tells a pretty compelling story about this whole the whole idea of eliminating FODMAPs, these fermentable carbohydrates from I believe it was, it was her husband's life and the profound changes that they saw when they removed fodmaps from his diet. Was that something you were involved with or have you looked into this much, this, this low fodmap diet for writers?

It's not something I was involved with directly with Joanna and Jonathan, I think it was. But I'm certainly aware of it as a kind of, you know, job in Dr. And we see people obviously it's used for irritable bowel syndrome. So irritable bowel syndrome is. Can present in a whole host of ways and with a whole host of symptoms. But, you know, the severe end of the spectrum can be really debilitating and really unpleasant. And clearly Joanna's husband had some really horrendous symptoms and wrote, you know, it's a really nice section of the book actually, explaining just what, you know, the difficulties they were having and just how much impact it was having on their lives. And then the remarkable, remarkable story of the FODMAP diet that really did change their. Change their lives together in terms of just the improvement. And I know that there's the FODMAP diets. Only recently, just the last few years, it's come into kind of the mainstream. And I think it's been shown to be. Some of the studies have shown it's effective for about 70%, 77 oh percent of people with syndrome. There's some good evidence around it. In no shape or form is this on the fringes. I think it's very much in the mainstream. I think the major challenge is just the difficulty with executing it. Well.

There's a lot of foods. It is one of those diets where there's a laundry list of foods you got to stay away from, from apples to wheat and beyond. But she goes into how her husband would just like, lay on the couch exhausted at the end of the day from all the bloating and the gas and just have a. Having to fight it. And I read through some of those sections. If there's one area, like I mentioned, how I found that deep belly breathing helps me a ton with my gut function. And I didn't realize how tied deep diaphragmatic and deep belly breathing was to the comfort of my gut function. But actually, after reading about Joanna's experience and her husband Jonathan's experience with the FODMAP diet, two of the biggest, biggest culprits, if you're just going to go with the 8020 approach and the lowest.

Hanging fruit.

Pun intended, in something like the FODMAP diet, it is onions and garlic. And I actually, that was like the, that was what pushed me over the edge to actually be really careful with onions and garlic and almost completely eliminate onions and garlic. Unless I'm using like a garlic oil or garlic powder or an onion flavoring versus the actual onion or garlic itself. Huge difference in gas and bloating just by, like, I used to go to Whole Foods and I'd load up my whole food salad with like, some of that. They have like a really nice, like, like these, these garlic cloves that I put sea Salt on. And a lot of their salads that are pre made, like the kale salads and the spinach salads, they all have like onions added to them. So I start to avoid those night and day difference in like bloating, gas, constipation, amazing difference. So. So yeah, it's interesting how even these dietary adjustments can make a huge difference, you know, especially for, for riders who already are susceptible to more gas and bloating.

Yeah, I think that's right. And the section on Jonathan's when, when he excluded onions, garlic, there was a near miraculous result for them. And as you say, we've taken the old Pareto principle, 80, 20, that actually there would be at a. There's a couple of quick wins there potentially for a lot of people.

Yeah, yeah. Now the other thing that you go into that I guess is kind of diet related is this concept of, of psychotropics. You know, things like.

You know, psilocybin and LSD and where those fit into a writer's life. I didn't really realize that it was such a, such a prevalent, such a prevalent habit among writers to use a lot of these psychotropics, but it sounds like it really is. And I don't know what the status of all that is over in the uk, but fill me in on what you guys discovered about cognitive enhancement and nootropics, what writers are doing and what your take on that is.

Yeah, nootropics. There's certainly been a lot of interest in the nootropics. It's difficult. Again, in terms of the writers. We didn't get a lot of comments in the survey about this. I mean, if you were going to go for any cognitive enhancer, then we're all using. Mostly everyone's using coffee.

Right.

So caffeine. So nobody, nobody's exempt from this in that regard. Obviously it's a relatively smaller number who are going on and using the other kind of stimulants and amphetamine like substances. But most of the research around this is in students, actually, probably unsurprisingly. But then that's not, that's often the case just because they're handy for researchers, I think more than anything else. But again, the statistics in the USA are of anything between 5% and 35% have lifetime use of trying serious stimulants like Adderall or Modafinil. And so like amphetamine, like salts or Modafinil. And the numbers are quite big in terms of people that have tried them at any point in their Life. And.

I mean, my, my. I've worked in addiction quite a lot as well, actually, with people that have had addictions to things like heroin and cocaine and other kind of substances. So I'm very. My general view as a doctor as well, that there's. There's almost no such thing as a free lunch when it comes to medication. Almost everything has a. There's an upside.

And, but there, there is a. There's a little bit of evidence for Modafinil as a cognitive enhancer.

Yeah, I've certainly seen a lot of evidence for modafinil. The only issue with Modafinil I've found is it's so efficacious. It can keep you up for long periods of time. It can make you a little bit too hyperactive. It's difficult to sleep after a day of using something like Modafinil, in my opinion, versus. I mean, I'll shoot straight with you. I've microdosed with psilocybin and I've microdosed with lsd and I've used some of these nootropics. Like, there's one called qualia that I really like, A, because it's legal and B, because It's got like 42 different brain nutrients in it and seems to work pretty well. I actually, I've written an article about it and I've called it the God pill in articles. But yeah, I think that dependency is an issue. Like, that's the one thing is I never like to, as a writer, wake up and feel like the only way I'm going to put together a quality article or a quality chapter of a book is whether or not I have access to my nootropic. When in fact, things like breath work and meditation and fresh air and large amounts of natural light exposure, et cetera, can help out quite a bit. But yeah, it is very interesting the number of authors now who are actually relying upon nootropics. I mean, that fantastic fiction book that someone listening in might be reading right now may have been entirely written under the influence.

Right.

But I guess that's. That's the way that a lot of artists actually create great art.

I think.

Yeah, that's right. But I. Well, I mean, yeah, be careful about that stereotype because that's something we tried not to get too much. We tried to look into in the book a little bit with that sort of creative stereotype that you can only produce great art by drinking heavily. You know, if you're an alcoholic or you're fatally flawed in some way or you have to use substances. And actually most people, I think are out there creating very happily by doing all that. The other cognitive hands and things you mentioned there, like getting some fresh air and getting regular breaks and exercise and eating a balanced diet and getting enough sleep. And that's also the thing I think about these amphetamine substances like Adderall or Modafinil or whatever it is. Actually you're always trading off against sleep more often than not with these. And that's their kind of. One of their core actions is to, is to keep you alert and you'd be hard pressed not to have your sleep affected in kind of slightly damaging way. So there's certainly a long term trade off there, you know, and I can understand why people and why students use them in very, you know, in limited times when they're under particular stress. But as a long term option for maintaining your creative life, I'd be a bit, I would have some anxieties about that.

Yeah, yeah, yeah. It's one of those things where I think it's all in moderation, something I might use like one or two times a week, for example. Now, there are a few little things that I had highlighted in the book that I want to check in with you on and get some practical takeaways for people.

Screen height.

People are confused about the actual screen height and what it should be at when you're looking at your screen to maintain normal biomechanics and whether it varies depending on whether it you're typing versus whether you're reading. Because I interviewed one guy who will adjust his desk up and down whether he's typing or whether he's reading. I'm curious what your take is on that and if there's any rules about how high the actual screen should be that you're looking at relative to your head to maintain proper cervical neck posture, for example.

Yeah, the thing about everyone's necks is they're all a little bit different though, aren't they, in terms of where your neutral position is. So I would be really careful about offering any kind of general sweeping generalization about the right position. My understanding is always just that the neutral position will usually result in you looking just slightly down towards your screen if you're in a natural position.

But that's so vague. I don't think you can offer in terms of how many inches that would be or for any given distance. And everybody, people do have different, different curvatures in their cervical spine in terms of what's going to be right for them. And if you age, that can change considerably. If you've got a bit of osteoarthritis in your neck then the advice is going to be completely different if you've had, obviously if you've had previous neck injuries. So I would be very. I think you've got to go with what feels reasonably comfortable, I think. But bearing in mind that it's probably. If you look straight ahead then slight down, that's roughly where the neutral position for the neck is.

That's what I try to do. I look at it, I try to make my eyes level to about the top of the screen. Close to it.

Yeah, yeah, yeah, absolutely. I've certainly seen that. Just that, that top. Yeah. The top of your monitor, the top of your. Whatever it is that's just like your eyes across there. I think actually Joanna put up a video for the healthy writer with and including my stand up desk set up and she said I saw it the weekend and someone said that they'd picked up that I. Mine didn't look very comfortable and I was looking, I was in the wrong position. I was looking too far down but maybe a wee bit. But I certainly don't get any neck problems and I think that's more or less what I base mine on as that position. Going back to your point about the. I do think the stand up desk thing and the treadmill desk is an amazing option rather than even some of the dynamic sitting bits and pieces in terms of the positioning of, you know, in terms of your posture and getting in the right position. Actually sometimes just being stood up and, and the treadmill is an incredible. Some great evidence for treadmill desks in terms of improving hard numbers like your blood glucose and your cholesterol and other things like that. Your actual blood work improving and studies have shown improvement in blood work in people using treadmill desks. They're right up there. My number one recommendation, if you can manage to make it work in your work.

And home setup, whatever that is.

Yeah, I use a manual treadmill because I don't like all the beeping and all the wires and all the electricity from the engine based treadmills. But yeah, I have a manual treadmill called a true form treadmill and that's what I walk on. And what I like about it is it also allows me to sprint. It's one of those treadmills that you can actually run on. A lot of crossfitters use this thing because it forces you into a proper biomechanical position while you're running. It's Like a curved treadmill. It's spendy but it works like gangbusters.

Yeah. So let me ask you, do you have one of the. Certainly the studies I was reading there was a little bit of a kind of a cognitive issue with using treadmill desks where it was harder to concentrate or doing the same level of work because you were kind of, you know, it's a bit of thinking in chewing gum.

Yeah.

Going yeah, if I'm going to be doing deep work, deep writing, I'm not on the treadmill. But for a lot of my phone calls, consults, meetings. Yeah. Dictating emails, like a little bit more surface level work works amazingly. It also works well when I need to, you know, somebody will shoot me a video, you know, like let's say like that Alexander technique we were talking about. Right. I'll probably find a YouTube video later on and watch that. And when I'm doing something like that I'll just, you know, put the video on whatever 1 1/2 speed so I can get through to a decent rate and then I'll just hop on the treadmill and I'll walk at a pretty brisk rate while I, while I check out the video. You know, it's a way to kill two birds with one stone. And, and honestly like I've gone through entire courses, you know, I've done, I've done like udemy courses on my treadmill and just, just walk two hours while going through a course or while reviewing a technique.

Yeah. I was at a conference at the weekend with some writers and one, one I was having a chat to one young lady and she said that she's. Once she gets in the zone and she's writing, she like sometimes, you know, 200 steps in a day, just complete disaster in terms of any movement. And so my view is that you know, kind of modern life you've just got to grasp every opportunity to get moving because it's it trying to stop us moving and trying to make us eat too much. As a general rule, the world we live in.

Oh yeah.

I had two one hour calls on my treadmill yesterday. I track all my steps using this ring. It's called an oura ring. I'm pulling up my data right now on this ring and I'll tell you, just like two one hour calls I did, let's see, I had 16,000 steps yesterday. Right. And most of that was, was just those couple of calls. So it's pretty easy, you know, if you think about, if you're just walking for a couple hours to hit that step count.

Oh, yeah, that's just. Yeah, yeah. I mean that's just. For most people, I think that that kind of, that getting their step count up, using that kind of option is just, that's just gonna, that's gonna. Just gonna blow you away in terms of your fitness. That's gonna make massive inroads into anybody's well being.

Yeah. One other thing I wanted to ask you as well was this idea, like you co authored this book, so.

This book, you co wrote it with Joanna. In terms of co writing, did you come up with anything interesting? Like any tips for co writing for people who may want to write a book with an expert or something like that? This isn't really a health related question as much as a logistical related question. Like what's it like to co write a book?

It was good. I think the major. I would recommend it. I think collaboration and co writing is the way that very much. Certainly the indie author community is currently looking just now as an incredibly good option. And I think it'll work for any entrepreneur or anybody thinking about it. One of the things it did more than anything was keep me honest to my deadlines. So there was, I couldn't. You know, if you're writing for yourself, there's always that possibility, you can slip. So when you're beholden to someone else, it was absolutely. There was no escape from that. So. And I think that was the one thing we were very careful about was that we did have. We very. There was. I mean, we went through a whole process of getting to know each other in terms of at least each other's writing so that we knew that we were compatible and could get on. So there was an initial process that we went through where we communicated and sent a sample piece of writing backwards and forwards and then we then had a meeting after that, which we very much set out our table of contents and we knew exactly what we were heading for. Now that changed a lot as we went through the project, but we were fairly fixed in length of book, length of chapters, what was going to be in the book. From a very early stage. There was timelines set for that and deadlines, but there were breakpoints as well. We both had times where life just got in the way a little bit. And so we moved things back and were flexible. But having all those things in place was really effective in terms of getting us there.

Yeah. Did you use any. Do you use like Google Docs or Scrivener? What kind of like co writing software platform did you use?

Yeah, so we basically did. We used Scrivener but we used Google Docs to meetings and this, the kind of the agreements about timelines and other notes. So that was just shared in Google Docs. And then we use Scrivener and we both write in Scrivener notes. Both write in Scrivener ourselves anyway. But we very much had periods where we handed over the baton to each other and then had a couple of weeks where I would have it and a couple of weeks where Joanna would have it. And then we passed it, we zipped it up and emailed it to each other so we didn't attempt to share it via Dropbox and have us both, or you know, whatever cloud service you're using and have us both going in. I know that Scrivener is quite good in that it will warn you if someone else is in there and so you can avoid the disaster of corrupt files. But we didn't go there. We just completely separated our individual and we both have plenty of other things going on. And so that was part of the organization process, was blocking in when I would have it and when Joanna would have it and then emailing the Scrivener file backwards and forwards.

I absolutely love Scrivener for writing and for keeping track of manuscripts, chapters, research, etc. But the one thing that I don't like is it's not very good for co authoring or for co writing. I really haven't found anything other than Google Docs that works well for that. If, if people are listening in and they've got good co writing, co authoring solutions, I'm all ears. Because a lot of times when I'm writing a book, there are people jumping in on the project. Like I'll have a scientific editor who I'm bringing in to look up some research for me or I've got somebody doing like a beta edit or a developmental edit and it's constantly a process of like, like me exporting from Scrivener into some kind of a document, sharing it with them, them editing me importing it back into Scrivener. So yeah, I'm sure there's a better solution out there, but I do really like Scrivener for just the writing process itself. There's some kind of a cognitive switch that happens writing in that versus say Google Docs or Microsoft Word.

Yeah, we love Scrivener, you know, British, British software company. So we're super, super fans of them. But it is the one thing that it would just, it would be the killer. It would be the killer app to end all apps if they if you could collaborate with it. A Scrivener collaboration version would just be absolutely. Because there's nothing else out there that can come close at the moment. Not that I know either. So I'll be listening in if anyone comes up with anything.

Absolutely. Leave a comment if you have any ideas for collaboration software that's similar to Scrivener. If you do, let me know. I'll go talk to Tim Ferriss and a few other folks who I also know. Use Scrivener and we'll dump some money into the project. Make it happen.

Well Dr. Lawson, this is really fascinating. This book is called the healthy reduce your pain, improve your health and build a writing career for the long term. Like I mentioned, Joanna talked with me last time quite a bit about dictation. So go listen to that other podcast episode if you want to know like how to train your computer and how to dictate efficiently and effectively. And then also grab this book because it not only goes into the dictation, but a lot more. And I'll also put articles and resources in the shownotes over@BenGreenfieldFitness.com HealthyWriter for everything else that Ian and I talked about. Sorry, Ewan and I talked about including like, you know, articles I've done on these peptide injections, the iris for creating a healthy screen. My podcast with a guy from Finland who designs these saddle chairs, the wobble board. I use the Scrivener program. I'll put a link to some more information on this Alexander technique as well. So so everything you need will be over at BenGreenfieldFitness.com HealthyRider and in the meantime.

Ewan, thanks for coming on the show and sharing all this stuff with us, man. It's fascinating and hopefully will help a few people develop healthier writing habits.

I hope so. It's been my pleasure.

All right folks, I'm Ben Greenfield along with Dr. Ewan Lawson who co wrote this book along with author Joanna Penn, the healthy writer. Signing out from BenGreenfieldFitness.com have an amazing week.

You've been listening to the Bengreenfield Fitness podcast.

Go to BenGreenfieldFitness.com for even more cutting edge fitness and performance advice.

Sam.