Mouse Ergonomics for Gaming: Carpal Tunnel Mouse, Weight, Height, Shape & More

Is there such a thing as an ergonomic mouse? A carpal tunnel mouse? Does the weight or shape of the mouse matter? These are a few of the many questions we have received about the mouse and ergonomics relating to it. This is the one-stop guide for all of your ergonomic questions relating to the mouse and how it can potentially be a cause for wrist pain.

In this article you are going to learn about some of the following information – this is also a quick reference point for you in case you want to skip over some sections

  1. Carpal Tunnel, Ergonomics and the Mouse
  3. Height & Shape of the Mouse – What we forget about most
  4. Weight of the Mouse – does it matter?
  5. DPI, Scripts and their influence on mouse movement

Carpal Tunnel, Ergonomic Mouse – Do these really exist for gaming wrist pain?

Let’s get this one answered first – There is no mouse out there that can specifically address carpal tunnel syndrome. This is because carpal tunnel syndrome is complicated in its nature and is often caused by a VARIETY OF FACTORS. For one person it may be their ergonomics (how they are holding their mouse), for another it might be their conditioning (poor endurance of the wrist), and for someone else it could be their schedule (using their wrist for 10 hours a day without a break). A mouse cannot possibly address all of these issues so when you see any mouse marketing their mouse as a “carpal tunnel mouse” – SORRY BUD, it’s just a bait.

Well what about an ergonomic mouse? I believe it is both Yes & No. Yes because there is a length that our muscles work most optimally meaning there is a height & shape of the mouse which can help us achieve this. Everyone is different though however – which means there is not just ONE mouse that should work for everyone. A 5 year old’s hand isn’t the same as a 25 y/o bodybuilder’s hand. So this is the No part, there is not a ONE ergonomic mouse for everyone.

No also because I believe preference matters with gaming and computer use and the often recommended vertical mice redistribute the stress of lifting the mouse to different muscles. The additional stress on our muscles/tendons when using a mouse of our preference in my opinion is a MINIMAL factor to consider when considering our wrist health. Of course a mouse that is ridiculously heavy or causes an insane amount of wrist extension will not be healthy, but most mice aren’t like this.

Wrist angle – The most important consideration with gaming wrist pain

Before we get into all of the characteristics of the mouse let us consider the #1 consideration we must take into account when using our mouse – HOW WE HOLD IT. I have gone over this quite a few times in some of my other content (Rez Case Study, Posture etc.) and it was the primary reason why Rez the CS:GO player from NIP had developed wrist pain.

The most important thing we have to understand about wrist angle is ensuring our STARTING POSITION for when we hold the mouse is NEUTRAL. This means that the wrist is not bent when we hold our mouse as shown. Some individuals tend to start with their wrist tilted either towards their pinky or thumb which shortens muscles at our forearm and often cause them to fatigue more quickly – thus leading to tendon irritation earlier in our gaming session. Again, Rez was the primary example of this.

Neutral Position (Left), Tilted Position Ulnar Example (Right)

Of course we expect movement into these ranges of motion during aiming, macro control, flicking, etc. however we must always return to this initial neutral position in order to avoid extra stress on your forearm.

Height & Shape of the Mouse – Can these cause wrist pain?

Height and shape all influence one important thing for our wrists – the position (angle). And as I have written and said many times, our wrist position can influence how well our muscles work and how quickly they fatigue. Both shape and height can be a potential cause for pain at the wrist. Let’s start with the height.

Height of the Mouse & Wrist Pain

A mouse that is “tall” just over the palmar arch (distal transverse arch for ya anatomy nerds) can cause the wrist to be in too much extension (show picture). This causes the muscles at the top of your forearm to fatigue more quickly and can often lead to overuse/wrist pain. How much extension is too much? Current research says that >30 degrees can already begin to increase pressure at the carpal tunnel by 7% while anything >45 causes both significant increases in carpal tunnel pressure and increased risk for musculoskeletal symptoms.

The bottom line is that you want to stay away from mice that put your wrist into too much extension. Of course there is the discussion about preference – Yes if you prefer a taller mouse that can potentially work for you but you may have to work more on the condition of your wrist through exercises with the expected increase of stress on your muscles/tendons. In the end, I would always suggest selecting a mouse that does not place you in the extremes of extension because preferences can always be changed.

Shape of the mouse & Wrist Pain

LOL – What a shape..

Ok what about the shape? There are plenty of unique shapes of mice out there as you can see with just one quick google search. Hand & mouse size are important when we are thinking about shape of the mouse. Despite whether the mouse is more flat or more round in nature – if your hand does not fit the mouse – you will have to use more muscles than necessary for movement. For example…

If you have a large hand with a regular sized mouse – every time you pick up your mouse you will have to recruit more of your thumb/pinky muscles compared to a mouse fit to the size of your hand. Vice versa if you have a smaller hand and use a mouse that is too large you will have to use more overall grip strength to pick up the mouse with each movement.

Another important point to consider with the shape of the mouse is again what position it places your wrist. We want to always stick with what I mentioned above – avoiding extremes of range of motion (too much flexion or extension).

So the bottom line here is again, avoid putting your wrist into any extreme range of motion (too much flexion/extension) but also finding a mouse that fits your hand.

Before we move on I just want to touch a little bit about vertical mice here. There was a small trend which pushed towards creating vertical mice for better ergonomics. There is really no research to support the benefit for vertical > horizontal mouse and if we think about the biomechanics – the stress is redistributed to another muscle group when you are moving the vertical mouse around. The muscles which involve actually lifting the muscle up for a horizontal mouse do not actually change in length when placed in neutral (only the pronators are brought back into a neutral length).

So again, if you prefer vertical mice – go for it. There is not major benefit to getting one

Weight of the mouse – does it matter?

Alright alright alright…finally we can talk about the weight of the mouse. Can this influence or be a contributing factor for wrist pain? Yes – absolutely. The heavier the mouse is, the more your muscles have to work each time you are moving it. This is especially true if your style of mouse movement involves picking up the mouse more often. This physical demand is often game-dependent as well. Of course I have to keep saying that this is still just one potential reason of why pain may develop in the wrist (in this region specifically) – posture, schedule, etc. etc.

But even though I say this we often change mice for performance reasons and if pain develops after you change your mouse – consider the weight! (or shape). Here are some weights of the common mice that professionals tend to use.

Steelseries Rival 700 – 135 g

G502 – 121 g

Deathadder Elite – 105 g

Zowie ZA12 – 85 g

Finalmouse Ultralight Pro – 67 g

G305 – 99 g

DPI, Special Binds

What about DPI and special binds within the game? DPI 100% can influence how much you are using or moving your wrist within a game and as a result can also influence how much you are using your muscles! This means that with lower DPI you are often having to move more. Those with high DPI do not have as much wrist movement however often grip with more force for the increased fine motor control – so there is a tradeoff. But generally, the lower DPI often leads to increased movement but it is not usually associated with more wrist pain despite this expected increase of movement.

I have also seen some special binds be used within games to change sensitivity depending on the type of movement you’d like to achieve in game. This is seen more in CS:GO or FPS games for those who bind a change in sensitivity for “looking around” vs. “aiming” movement. The theory is with looking around you do not have to move your wrist as much (because of the expected lower DPI with a FPS game) while still being able to maintain the low sensitivity during aiming. This does change the overall stress on the wrist slightly and has been beneficial for some. I do think this is another preference type of setting and can take getting used to.


The bottom line with the mouse and ergonomics is that…. There are quite a few things you may have to consider when selecting your mouse for gaming. The weight, height, shape and even DPI can all affect how much you use the muscles of your forearm and as a result can be a contributing factor for your wrist pain. These are all things you can consider when you do have wrist pain, especially if you have made a recent change in your mouse.

But again, the most important things to consider first are…

  2. LIFESTYLE: are you playing without breaks? Do you stretch between games?
  3. General wrist conditioning: Are you making sure your forearms can handle the prolonged gaming sessions? The grind to get better at a game can be six months to a year – make sure you are conditioned to manage your professional endeavors

Hope you guys learned alot from this article, thank you guys for reading! Please let me know if there is anything I can improve on for you or if you want me to write about anything in particular! Until next time…



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