I use both, an ergonomic (programmable) keyboard and an ergonomic, customized layout (German Neo2 https://neo-layout.org/). The effect on my hands and arms was really perceptible, I do not want to change back.
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The color-coded layout on that page is exactly what I'm talking about! Those XUÜ \ VIÖ \ LAÄ finger lines that are completely perpendicular to the curling movement of your fingers... ouch!
This looks interesting. Is there an English version. Sorry if it's obvious, I'm tired after a long day on my feet.
For English, you probably want to check out Colemak. It does well on a very wide variety of measures of ergonomics (there is actually not a lot of agreement on what makes a layout good, so take with a grain of salt), while also not being too different from QWERTY, and keeping the XCV keys in the same place.
Neo is optimized for letter frequency of German language. You might check out Dvorak. I assume there are even more alternatives.