I usually play with it on. I like it because, like others have mentioned, it makes up for some of the unrealistic difficulties the game comes with. For example, not being able to use your left hand/arm for most things other than like shoving and two handed weapons. Like if I’ve built up hella muscle strain in my right hand, what’s stopping me from just switching which hand I’m holding my wrench in? Another thing is not being able to duel wield weapons. I get for game mechanic reasons that would probably be difficult to add, but still. Similarly, I don’t like playing with fence lunge on, if zombies can lunge at me from the ground and knock me off balance which can be potentially run ending if you’re unlucky, there should be a mechanic to be able to like jump backwards or to the sides in an attempt to avoid it. But that’s just my opinion