How to Type After Surgery: One Hand, a Sling, or No Hands

After hand, wrist, arm or shoulder surgery, the easiest way to keep writing is to stop typing most of it: dictate the sentences, and use one hand (or your voice) for the few clicks and shortcuts left. On a Mac, that means a dictation app with a trigger your good hand can reach, a couple of built-in accessibility settings, and, ideally, ten minutes of setup before the operation rather than after.

#How long you might be typing differently

It depends entirely on the operation and on you. As a reference point for one common procedure, the NHS says it can take a month after carpal tunnel surgery to get back to normal activities, and Cleveland Clinic says recovery usually takes a month or two. Shoulder and other hand operations can mean longer in a sling or splint. Plan for weeks, not days.

If everyday tasks, at home or at work, are hard during recovery, the NHS says occupational therapy can help people recovering from an operation find other ways to do them. Ask your care team about a referral.

#Before the operation: a ten-minute setup

Doing this with two hands is much easier than doing it with one.

1. Install Sayburst and grant permissions. Allow Microphone and Accessibility when it asks. Both are one-time clicks.
2. Download the speech model at home. After that, recognition runs on your Mac with no internet, so hospital or hotel Wi-Fi doesn't matter. See offline dictation on Mac.
3. Move the talk key to your good side. The default is fn, which sits bottom-left on a MacBook. If your left hand is the one out of action, switch to right ⌥ or right ⌘. If your right hand is out, fn or a left-side key works. A mouse's middle or side button also works as the talk button.
4. Add the words you'll need. Colleagues' names, your manager, client names, project names. Add replacements for things you'd normally type from memory, like your address or phone number.
5. Set modes for your main apps. Email for Mail or Outlook, Message for Slack or Teams, so each app gets the right tone without editing.
6. Practise for a day. Write a few real emails by voice while you can still fix things easily by hand.

#Make the keyboard one-handed

For the keystrokes you can't avoid, macOS has settings under System Settings › Accessibility › Keyboard. Apple's keyboard accessibility guide describes them:

• Sticky Keys lets you press modifier keys one at a time in sequence instead of all at once, so ⌘C becomes Command, then C. You can set it to turn on by pressing Shift five times.
• Slow Keys adds a delay between pressing a key and it registering, which helps if your typing hand is unsteady or you're using a non-dominant hand.
• Accessibility Keyboard is an on-screen keyboard you click with the pointer, and Apple's guide notes it shows suggested words as you type.

#Write by voice

With the setup done, writing goes like this: put the cursor where the text should go, start dictating, talk, finish. If holding a key is awkward with your available hand, tap fn (or your chosen key) once to start hands-free, talk as long as you like, and tap again to insert. Pauses don't stop the recording.

Here's the email most people send in week one, said out loud:

"Hi everyone, quick note, um, I'm back online but I'm typing with one hand for the next, uh, four weeks or so, so my replies will be short. If anything's urgent, call me rather than, rather than emailing. Thanks, Jordan."

What Sayburst puts in Mail with the Email mode:

Hi everyone,

Quick note: I'm back online, but I'm typing with one hand for the next four weeks or so, so my replies will be short. If anything's urgent, call me rather than emailing.

Thanks, Jordan

The greeting and sign-off land on their own lines when Sayburst Writer, the optional AI model that runs on your Mac, is installed. Without it, you still get the filler and repeat removal, punctuation and capitals. Dictating in Gmail and Outlook work the same way.

#When you can't use either hand

Some operations, or some days, mean no hands at all. Apple's Voice Control (System Settings › Accessibility › Voice Control) lets you say "open Mail," "click Reply" or "scroll down," and "show numbers" puts a label on everything clickable. It has its own dictation mode as well. Sayburst doesn't control the Mac; it's for writing, with cleanup and your vocabulary. Voice Control vs Dictation explains how the two divide up the work if you use both.

#Small things that help

• Prop the laptop up. If you're working from a sofa or bed, a raised screen and a microphone close to you help more than you'd expect. A headset is the most reliable option; see microphones for dictation.
• Edit by selection, not by typing. Select a paragraph with your good hand, hold Sayburst's rewrite shortcut and say "make this shorter" or "more formal." The selection is replaced.
• Don't lose a half-written message. If a notification pulls you into another app mid-sentence, Sayburst keeps the text, and ⌃⌥⌘V pastes your last dictation.
• Keep messages short for now. People expect it after surgery.
• Talk to work early. If you'll need different deadlines or fewer written tasks for a while, ask your manager or HR before the operation.

#Limits worth knowing

You need somewhere you can talk, which a shared ward or open office may not be. Spreadsheets, forms and passwords are still keyboard tasks; Sayburst can't type into password fields and keeps the text for you instead. It inserts text when you finish speaking, not word by word, and it runs only on Apple silicon Macs with macOS 14 or later; on Windows or a phone, use the built-in voice typing. And go by your surgeon's or therapist's advice about when to use the hand again, not by how much typing you have to catch up on.

Questions people ask

How can I type with one hand after surgery?

Turn on Sticky Keys in System Settings > Accessibility > Keyboard so shortcuts can be pressed one key at a time, and move longer writing to dictation. In Sayburst, put the talk key on the side of your good hand, like right Option, right Command, or a mouse button.

When can I start typing again after hand or wrist surgery?

Your surgeon or hand therapist decides that, so ask them. For carpal tunnel surgery, the NHS says it can take a month to get back to normal activities, and Cleveland Clinic says recovery usually takes a month or two.

Can I write emails and documents without using my hands at all?

Mostly. Dictation handles the writing, and Apple's Voice Control lets you click, scroll and open apps by voice. Setting both up before your operation saves fiddling with one hand afterwards.

Does voice typing work on hospital or hotel Wi-Fi?

Sayburst's speech recognition runs on your Mac and works with no internet once its model is downloaded, so a weak connection doesn't affect dictation. Download the model at home before you go.