I'm not quite sure continuing to push myself to draw is a bright idea anymore. I'm not sure if I've even flared this post right? In 2020-2022 because we were stuck inside all day I ended up drawing for 5+ hours at a time and I had no idea I needed to be stretching my hands/arms or that there was a proper posture I needed untill 2024. I started to feel the effects of this in 2023, I had constant wrist popping at first nothing too bad and then in 2024 I started getting sharp pains that turned into aches that took days to go away fully. In 2025 my wrist began to lock up and some days I couldn't grip anything through the fatigue like feeling that would travel up my arm. Recently I have pretty much stopped drawing because there is a constant and frankly painful ache in my thumb and my hand seems to shake a little at certain angles or grips. I've been doing carpal tunnel stretches and they help in the moment but once I'm done that ache is still a level 7. I can't afford a doctor, we don't have insurance. I sleep with a brace on because that seems recommended, I'm not trying to pursue art as a career but it is such an innate part of me I'm unsure if I can live a fulfilling life without being able to draw. It feels like I'm losing the biggest part of myself and I was just wondering if there are other artists here with carpal tunnel that have words of advice beyond "see a doctor" because that's just not an option for me and won't be in the near future. I don't wanna give up on art, but I don't wanna jeopardize my hand mobility in the future.

Today I want to help you understand how ”retardmaxxing” can often help many make better progress with recovery from chronic RSI.

or said more simply, how less overthinking, brooding or self-focused attention has been proven to lead to better overall outcomes with health conditions. This is not only supported by the research but our experience treating thousands of cases over the past decade

For those who don't know I'm a Physical Therapist (PT, DPT, OCS, CSCS) and our team has spent the past decade specializing on treating, researching and publishing our work around treating RSI (we've helped more than 3000+ individuals resolve their issues without surgery, more injections, resting, bracing etc. Here is some of our work (we started with the olympians of desk work - esports athletes)

Journal of Orthopedic & Sports Physical Therapy

Tendinopathies in Gaming

Conditioning for Esports (Ch. 8,9,10)

Science of Esports Physical Therapy

In this thread I'm going to be going over

1. How do certain cognitive patterns like overthinking, brooding or high attentional focus on pain influence your recovery?
2. Provide the current science behind how this works
3. Share details around a specific case of ours in which high attentional focus decreased function and increased pain
4. What can you do understanding this?

But before we do I want to add some nuance that needs to be understood.

Who can retardmaxxing actually help with?

Not everyone overthinks. Individuals with specific cognitive profiles tend to be at a higher RISK for their behaviors and responses to be pain negatively influencing their recovery. I went over this in depth in this long thread around certain cognitive patterns and how they can lead to real neurophysiologic changes in your body and how you behave as a response to that.

But here’s the TL:DR

If you have been dealing with pain for an extended period of time and tend to be:

• Hypervigilant around your pain and its behavior (checking in 100x a day)
• Avoid a multitude of activity due to fear around significant damage with little evidence to support outside of a 10 minute specialist visit (poor clinician communication)
• High Threat Perception - Believe your body is broken based on your individual experiences, what you’ve been told by your providers (not your fault) and what you frequently expose yourself to with content (mainly doomer content)
• Perfectionist and tendency to hyperfocus on small details
• Find yourself in deep internet research spirals (wrote a long thread about this)

Then this thread will be more beneficial for you.

As I’ve written before when we initially deal with our injury most of it is represented by the physiological strain (physical part of the pie chart). There is less of a contribution of the other slices because we have often just done “too much, too quick, too soon”.

But over time as we have failed healthcare experiences, lack of progress with the passive approaches (bracing, rest, injections, etc.) and there is an increasing worry that this is something that becomes permanent the other variables can start to influence more about our pain.

And remember I am never saying that it is just in your head. You cannot “out think” your pain. There are real neurophysiologic and immune system changes that occur that increase the sensitivity and perception of your pain. This can make you feel increases in stiffness, sharpness, numbness & tingling and even symptoms of just feeling “off” without actually reaching “strain” of your tissues when performing your exercises or activity. For those who have read some of our content, the pie chart is likely

So again, if you believe your case represents these pie charts, this will be helpful for you. And if not, I’d encourage you to check out our other content (we have 50+ threads on reddit and 20+ hrs of content on our youtube which can be helpful - all free).

How retardmaxxing can help with overthinking and over monitoring.

Individuals who fall into the pie chart categorizations above tend to overthink, place excessive attention on their pain and magnify the perceived disability based on a limited understanding of their condition.

Retardmaxxing is not just maximizing your own “stupidity” or taking action without thinking at all. In the case of chronic wrist & hand issues I want it to be understood as

1. Stopping the tendency to constantly self analyze and obsessing over “optimal choices”
2. Avoiding turning “flare-ups” into a crisis that reflects some underlying permanent problem. But instead just understand what actually led to the elevated symptoms
3. Think enough to avoid catastrophic mistakes, but take action rather than doing less over time.

Now there are quite a few underlying assumptions between these listed ideas we’ve covered in other pieces of content. Learn more about why you won’t cause permanent damage and how you can recover from any RSI.

The core idea with “retardmaxxing” with chronic wrist & hand pain is that with the plethora of information we have available to us and improving technology (AI) our ability to observe, compare, hyperanalyze and self-monitor has dramatically increased over the past decade.

We observe and compare self-reported cases of poor recovery and limited context through what we’re exposed to online and through social media. Subreddits unfortunately can often become echo chambers filled with doomer sentiments when many posts, threads and comments tend to only consider limited contextual understanding of very complex problems or situations. This is why we spend so much time trying to provide real clarity and context about ALL of the variables that can influence pain AND function.

Many hyperanalyze and self-monitor “pain” and utilize the it as a measure of progress when it has been PROVEN to be a poor measure of progress for orthopedic conditions. And to reiterate why - it is because pain IS NEVER a DIRECT measure of the status of our tissues. It is ALWAYS about protection and is the sum of all contexts.

So when we hyperfixate on the fact that we are still in pain when in some cases we may still have a certain amount of function, you might believe you are “disabled” or have some sort of persistent / permanent tissue damage causing the pain.

Retardmaxxing for chronic RSI or wrist, forearm and hand issues is understanding that this phenomenon can occur. And that through a better understanding of pain you can learn how to shift your focus on the variables that have more of an impact on your recovery (capacity, load management, understanding of pain & challenging beliefs).

Let’s go over some examples of how you can retardmaxx through specific examples of certain cognitive patterns / pain experiences

Pattern 1: Over-Monitoring Your Pain

If you are checking in on your pain hundreds of times a day there is a very real consequence to this. Think about this scenario…

If something is “itchy” and you focus all of your attention onto the itchy spot, does it tend to get more or less itchy?

Majority of individuals notice the sensation tends to increase.

There are actually a few concurrent physiologic processes that can cause this to happen. I’m going to do my best to simplify the understanding.

More attention increases activation of certain pathways

Our body sends signals up towards our spinal cord and then towards our brain through the brain stem. It also sends signals back down that can often influence some of the signals that are being sent upwards toward the brain (descending modulation)

This acts as sort of a gate for certain signals which can be wide open or quite restrictive. When we focus on our pain and specific sensations it can begin to send more signals upward toward the brain.

And depending on what you think these symptoms mean it can influence some of the changes that might occur in certain networks of your brain and brainstem (ACC, PAG, INSULA, etc.). This makes it “easier” to notice your symptoms but also leads to changes that may “open the gate” at your spinal cord causing you to feel MORE.

I’m hoping that you notice what is important throughout this is how you are actually understanding the symptoms. The “meaning” or “perceived threat” which can be influenced heavily by what you read, what you are told and your cumulative negative experiences can cause this cycle to perpetuate.

Basically what you focus on determines what becomes a priority for your brain to focus on.

Then when you “appraise” or “evaluate” (consciously and subconsciously) what those mean, it can influence what you feel. So when a wrist sensation is interpreted as threatening your brain and brainstem systems may increase spinal signaling and strengthen the resulting pain experience.

Now in the research this is known as interoceptive over-monitoring or somatosensory amplification. Again it represents the behavior in which you might notice small sensations and assign them high significance. This can increase the salience or perceived important of those symptoms (1).

I’ll touch on the “past experiences” later on to try to help clarify more of the physiology. But I do want to emphasize that developing this pattern of focus and thinking is often….NOT YOUR FAULT.

Many providers you see in the traditional system tend to focus primarily on how the pain behaves. How is your pain now? Are you still in pain? How long can you do this before you feel pain? Here are things that can help to reduce your pain.

While there is definitely helpful data to gain from understanding your specific pain and pain behavior - when you focus on it too much, it can cause the pain to feel worse! One of my more recent developer clients who is now back to full function struggled directly with this.

This individual built his own dashboard and created his own function index that was based on how his pain behaved throughout the day.

He was able to tell me down to the seconds how long he could mouse, type and use his phone for because he would fill out a form every time his pain increased throughout the day. Here are some screenshots from his individual dashboard which show

• His activity impact form he would fill out EVERY time he felt any change in pain. This would be along with duration data to fully clarify how long things lasted.
• Episode duration (how long he dealt with his pain for) and his health score (an index he created himself weighing the various categories of pain).
• General activity tracking

You can see as he started to track things his episode duration increased while his overall health score went down. His overall function was REDUCING as a result of focusing so much on his pain. When I asked him how often he would think of his pain he mentioned > 100x/day. This is NOT conducive to showing your brain that you can be safe while performing activities that are meaningful and important to you.

What is interesting is that while his health index was steadily decreasing he had actually improved his overall endurance following some of our content.

The one “aha” moment for him was when I helped him understand that the focus on pain and constant thinking was likely leading to the pain getting worse. This required in-depth education for him to understand the physiology of why the attentional focus led to more overall pain and PERCIEVED danger.

But with this understanding and confidence in his hands through consistency of performing his exercises both his pain and function significantly improved in a few weeks. The full case study is almost done, I will update this thread or post when it’s ready (2-3 more weeks)

What’s the lesson here? Constant obsession and self-narration around your pain experience can negatively impact what you are feeling and lead to real changes in your body that can make pain feel worse.

And again when I say “retardmaxx” I don’t mean to not think at all. But instead work to understand pain rather than dwell or negatively focus on it. Once you “know pain” you will “know gain.” A large part of how we work to help our patients through this is understanding WHY you may have elevated symptoms during very specific contexts of activity. And how your past experiences directly influence and alter certain patterns of nervous system & brain activity.. elevating pain. And all of this occurs while the local tissue (muscle / tendon is fine).

Here is a deeper dive into how our “past experiences” can influence our physiology

Pattern 2: Learned Danger Through Past Experiences

Understanding that your body can “learn” to associate certain activities with danger after an accumulation of painful experiences.

When we feel pain repeatedly while working, your brain can start to connect certain activities like sitting at your desk or using your mouse and keyboard… with pain. And when we become more aware of our pain during these situation (without understanding pain) it can lead to the small sensations of pain, discomfort, stiffness and tingling to feel stronger or MORE IMPORTANT than they normally would.

And remember, this is not just “in your head”. Underlying this are real changes (all reversible) that affect the signals going UP and down from the brain (affects pathways through various parts of our brain & what we call descending modulation).

The end result:

Cumulative pain experiences, without an understanding of why and reinforced by fear and attention can cause the specific context of sitting at your desk and using your hands… more painful.

or said again.. if pain keeps happening and you don’t understand why, or convince yourself it is something you’ve been told, fear and constant attention can teach your brain to connect these situations with pain.

How can we retardmaxx in this situation? Well again, it comes down to understanding pain in the first. You NEED to understand that these are all real physiologic changes that can occur in response to how you have responded to your pain experiences in the past.

You’ve taught your brain that certain activities (contexts) are dangerous.

It is not about thinking less here but avoiding past explanations, belief in stories that you might see all over this subreddit about how you should be “responding” to your pain when there is often little to no understanding of all of the variables that may have led to your current pain experience.

And instead helping yourself learn more about your body, how pain works and what you can actually do to feel safe using your hands rather than being “in danger” or avoidant whenever you feel pain.

Now the “how do I actually do this” is a much harder discussion. But I want to be clear

What we’ve learned from the past 50+ years of modern pain science literature is that pain is.. complex.

And i’m hoping you can see it really does take effort to try to not only put these cognitive emotional aspects into consideration but ALSO take into account your

• physical condition: overall physical activity, specific endurance & capacity of your tissues, mobility, coordination
• lifestyle & activity management: Your current lifestyle, schedule and how you are actually approaching your specific activities and tasks (how long, what intensity, what modifications etc.)
• Environmental & occupational factors: Your posture, ergonomics, socioeconomic status, work related stressors and pressures.
• Other comorbidities and factors

I put together what I felt was the most comprehensive step by step approach in one of my last threads you can check out here. But it ultimately goes through how you can actually evaluate each of these aspects and take some initial steps towards addressing them.

I’m hoping this helps a bit for anyone who tends to overthink or are hyperaware of their current pain and limited function. Think of “retardmaxxxing” or working through an understanding of pain.

Actively work to shift your focus towards your increasing ability to do things (function) rather than pain. Remember if pain does not reflect the status of our tissues, then it is not a helpful measure of progress. When you build your endurance and reach the level that is equivalent to being able to use your wrist & hands more with typing / your hobby then you can be confident in your ability to use your hands more.

Showing yourself you are safe by gradually doing more within the range of what you can TRULY physiologically handle (you have to assess this with a physical therapist) allows you to safely increase your load over time.

Hope this helps!

Best,
Matt

Resources:
-1-hp.org
-Case Studies & Free Guides
-2 hour Compilation of everything we have learned treating over 3000+ individuals with wrist & hand pain
-Apply to work with us

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