Today I’m going to talk about something that’s a little bit off the beaten path of what I normally write about.
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I want to talk about stress. I tweeted this last night:
This is what stress can do — I cannot lift laundry detergent “normally” with my right arm.
In fact, it turns out that your trapezius muscle allows you to do many things such as
- Reach for things in a cabinet
- Adjust the rear-view mirror or radio knob in a car
- Wash dishes
- To a certain extent, use a fork to eat food.
Without this muscle, many things are challenging.
One of my founders even texted me right after I posted this video if I was stressed out about his latest investor report! Hah!
This video isn’t about stress from fundraising (we’re not raising right now anyway) or from having portfolio companies who are doing well or not well. In fact, the reason I decided to write about this so publicly is not to garner sympathy (but thank you for all the well wishes!) but to show to everyone what can happen because of stress — and that this can happen to anyone.
In fact, all of this started when I was 23 — not just recently. At 23, I ended up in a hospital in Tokyo after having terrible neck pain, where I was living and working at the time. I was fortunate to have excellent care, but the bad news was that I had a pinched nerve and I would likely live with this pain and weird issues forever — though it could be managed with proper diet, exercise, and low stress.
The likely combined cause? Years of
- Poor posture (sitting and standing)
- Poor ergonomics using computers
- Using computers too much (by age 23!)
- Slinging too many backpacks filled with heavy books during high school
- Combined with stress
In other words, there wasn’t any particular trauma or incident. But guess what? 80% of people I know have some permutation of the above.

Over the years, I’ve been able to manage this chronic issue pretty well. I started taking up swimming, even though I was never a swimmer in school (YouTube can teach you so many things!). And, I have bought so many ergonomic keyboards over the years, that I’m sure single-handedly propping the Amazon share price up.
But every once in a while, stress creeps up and sends me back into health issues. In 2009, when I was starting my company, my arms and hands were tingling and it hurt to type. In 2011, when I was fundraising, I felt like someone was constantly poking me with pins all over. Some of the best physicians who were specialists in this area could not find anything additional wrong — miraculously when I stopped fundraising, the prickly feeling left! And fast forward to today, the combination of shelter-in-place/little kids/handling of the COVID-19 situation/police brutality/racism/and even the murder hornets are all fairly stressful! (I’m sure I’m not the only one here who thinks this)
As it would turn out over half of my friends who are tech entrepreneurs or recovering tech entrepreneurs have stress-induced issues. Repetitive strain issues, tingling feelings, shingles, IBS or other chronic stress-related problems, etc. It’s seemingly quite common, and while mental health is starting to be discussed, the physical ramifications of stress are rarely discussed publicly.
And once you have one of these issues, with proper care, you’ll be able to manage through it, but you’ll get flare ups from time to time as stress comes and goes. You’ll never be quite the same.
If I had to rewind the clock, what would I tell myself?
Never use a computer or iPad in an un-ergonomic way
- No laptop usage on the couch
- Buy an ergonomic mouse & keyboard that fits your hands (the built-in ones on the Macbook Air are way too hard)
- Buy an external monitor and set it to eye-level
- Set up proper typing and mousing heights
- Use a tablet pen with an iPad
Do a stress-relieving exercise everyday – even for 5 min. Once we leave school and become adults — there’s no PE or fun sports forced upon you to keep you accountable. And, for some (such as myself), forcing exercise becomes challenging. But even just a few jumping jacks a day can do wonders. In fact, jumping jacks are near impossible for me to do now.

Always lift things in an ergonomic way – not just weights but everything. In school, I used to sling a lot of books over my shoulder. (Maybe I should have studied less? My HS schoolmates who had those wheelie backpacks got it right.)
Sprint when you need to but jog when you don’t – in building a startup, sometimes you need to sprint — it’s inevitable. But understanding when you need to sprint and when you can jog is the key. As Mac Conwell discusses here, most people try to sprint all the time, and that’s just not sustainable.
Jog mode doesn’t mean do nothing, but jog mode means reducing really extraneous things. Standing or sitting in front of a computer for hours on end isn’t what humans were meant to do. Reducing extraneous Zoom mtgs & calls, extraneous emails, etc and really focusing on health (exercise + mindfulness + stress reduction + good diet) during these times is what jog mode means. Prioritizing and only focusing on just 1 work thing for a “normal” working day is what jog mode means.
A lot of people wonder why not that many builders go back and build again. My hunch is that it’s this: they have some sort of chronic ailment that prevents them from being in “go-go-go mode” all the time and don’t think they can build a fast-growth company if they are not in “go-go-go mode” all the time. I think if we didn’t have “go-go-go mode” all the time as the norm expectation, we would see more multi-repeat builders. There’s this sense that if you’re not in “go-go-go mode” all the time, you’re not ambitious, but I think the right analogy is akin to marathon runners. Most people can’t run marathons everyday. You need to slow on some days and rest too. But when it counts, you need to be all out there running your race. Understanding what day is your race and what days are your training are critical, but often we don’t understand that. And if you get injured, you’ll never be the same. We have so many former athletes who are now injured who don’t want to run races again because they think they won’t win.
For me, with my ailments, I literally cannot type as much as I used to — I need days of typing rest. That used to frustrate me to no end. But over time, I’ve come to learn what is important to type, what emails to hold off on, and more recently, I’ve started building homegrown tools to allow me to do more with less typing.
As a parent, I actually care way less about screen time and more about ergonomics. When my 3 year old said his back hurt from looking down at the screen, I was/am really hoping he was exaggerating (hard to tell), and it would not surprise me if this upcoming generation who will grow up on more portable devices that easily allow for poor posture and ergonomics will have even more chronic problems. I think ergonomics and posture should be taught in schools as part of PE or health.
In conclusion – take care of your stress and health — you only have one shot, and once your health is gone, it’s hard to be the same again.