I can avoid developing Emacs pinky by wearing padded fingerless gloves and hitting Ctrl with the metacarpal base pad instead. Can work for the adjacent modkey as well.
I'm using a Perixx ergonomic split keyboard sitting on lap, in ergonomic chair.
Using pads works when wrist is extended. When wrist is flexed, pads don't work as well, but pinky strain is less anyway.
I can operate the two outermost mod keys with pads when wrist is extended, and one when flexed.