I had severe tendonitis in my right wrist, needed surgery and was unable to lay my arm flat for months. As I work in an IT call center this was a big problem. I ended up getting a trackball and tripping over this pad while trying to figure out a way to prop it up at an angle that wouldn't hurt. The lip keeps it from sliding down without significantly affecting my use (one button is partially blocked but I can still use it), the angle is acceptable, and the "shelf" cushions my wrist and arm , so they don't rest directly on my desk. My physical therapist was so impressed with this setup that he now offers it to all of his clients who struggle with wrist rotation. I know it's not for its intended purpose, but it was a lifesaver!
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