The DISABLED UI

[Shurrikhan]

Swap your Caps Lock to (Right) Alt, then make use of Caps, Shift, and Ctrl/Alt (with the edge of your hand), if you want to keep turning, then rebind those to Q and E, and then turn A,S,D, and maybe F into your less frequent binds, and use Tab, 1,2,3,4,R, and maybe ~ and T. Also, use a mouse with at least a few extra buttons. Just off those, you'll have 33-42 binds available, not counting Tab uses, sufficient for everything in XIV, without having to move your hand from a rest position whereby the edge of your hand rests against Ctrl, and at most the fingers bend from 1-2-3-4 to A-S-D infrequently, with little to no necessary lateral stretching of fingers (unless also taking ~, T, F). The only major mover will by your pinky, from Tab to Shift.

You can also use C, V, and maybe X and B with your Thumb, which will require less actual hand movement than R, F, T, or ~. If the Windows near Ctrl ends up an issue, rebind it to a second Ctrl, and either natural Alt to Windows instead. And, if you plan only on playing BLM, since you won't typically need to move and cast at the same time, you can get another 6-9 binds out of Q, E, and maybe W.

Since you're down to 7-10 buttons per mod row, layer your hotbars accordingly, with your weaponskills/spammable spells with no-mod at bottom, then, say, Caps, Shift, and Ctrl moving up, away from 1-2-3-4, as tracking priority increases and frequency of use decreases; this should keep it intuitive and thereby easy to remember what's what, while also letting your screen remain minimally cluttered.

The main thing will be retraining yourself to use your hand's edge for Ctrl and rest your pinky between Caps and Shift. Once you've got the hang of that, though, this ends up having huge button-mobility with very little lateral flexion or stress of the hand itself (though the pinky still gets a mild workout).

And if you go ahead and combine the hand edge with the pinky, you can do pretty much everything on just 1-2-3-4...

If macros were viable in this game, I'd provide some of those to help you out, but XIV has decided they'd rather enforce manual play by destroying alternatives (macros) rather than by providing significant reason in the skills themselves not to macro them together...

So, what this might look like, without even using the mouse or half those binds:

1 Fire III
2 Fire IV
3 Fire I
4 Fire II
R Flare
C Between the Lines
V Scathe
Tab <Tab Target>

A1 Blizzard III
A2 Blizzard IV
A3 Blizzard
A4 Blizzard II
AR Freeze
A-Tab <Previous Target>
AQ <Target Focus>
AE <Set Focus>
AC Aetherial Manipulation
AV Aetherial Manipulation (to focus target; target of focus target)

S1 Thunder I/III
S2 Thunder II/IV
S3 Swiftcast
S4 Surecast
SQ <Assist Target>
SE [Sprint]
SR Foul
SC [Mount]
SV [Cycle Companion Stance]

C1 Enochian
C2 Ley Lines
C3 Triplecast
C4 Sharpcast
CR Lucid Dreaming

CA1 Convert
CA2 Diversion
CA3 [Pot]
CA4 Mana Shift

CS1 Waymark A
CS2 Waymark B
CS3 Waymark C
CSQ Waymark 1
CSE Waymark 2

CAC Mark [1]
CAV Mark [2]
CSC Mark [Ignore1]
CSV Mark [Ignore2]
ASC Mark [Bind1]
ASV Mark [Bind2]

Opening rotation (assuming no Thundercloud luck): Pinky Caps + 1, Edge Ctrl + 1, Drop pinky to Shift + 1, drop modifiers + 1 [Fire III]; Again edge Ctrl + 2, then +3, 2, Ctrl and Caps both + 2, 2, Ctrl +4, 2, 3 [Fire]; 2, 2, 2, 2, 1; Ctrl+Caps + 1, 2, 2, Caps + 1, Shift + 1, Caps +2, 1, 2, 2, 2.... [Feels like a gentle wiggle of the hand at most, at least at my hand size]

There you go, barely 4 keys lateral, and only slight pinky movement (Caps to Shift) and hand edge, to to do damn near everything.