If you’re an Emacs user who works primarily on some sort of Mac, you may be interested in a post by Nick Drozd in which he suggests a keyboard layout for avoiding pinky fatigue and all that goes with it. The TD;DR is that he switches the ⌘ Cmd and Ctrl keys in Emacs and then maps Caps Lock to Ctrl at the system level. That gives you a Ctrl and Meta key on both sides of the keyboard and they can both be reached with a thumb rather than a pinky finger. Drozd gives you the Emacs settings for switching Ctrl and ⌘ Cmd and, of course, you can map Caps Lock to Ctrl by clicking on the Modifier Keys button on the Keyboard pane of System Preferences→Keyboard. Drozd’s settings also map the fn key to Hyper. I’ve used that to give me a Hyper key for many years and really like it. It doesn’t interfere with the system function keys so you have the best of both worlds.
I haven’t tried this yet because I’m worried that it will mess up my muscle memory for the ⌘ Cmd key. It’s probably not a big deal so I’m still considering it. If you’re not worried about such things, give Drozd’s system a try. It’s easy to set up and easy to back out if you decide you don’t like it.