Repetitive Stress Injuries and Needlework

A large amount of needlework can cause an RSI condition, and a modicum of it can aggravate a previous injury. Some [unenlightened!] medical professionals might laugh off the possibility, but that's because they aren't stitchers.

What is RSI? It stands for Repetitive Stress Injury, and this happens when the same movement is done repeatedly for a long, long time. Supermarket checkers are prime candidates, as are people assembling things in factories, computer people, musicians, and needleworkers.

The nerve that runs down the arm and into the hand passes through a "tunnel" in the wrist comprised of the wrist bones, tendons (the things that connect muscle to bone), and ligaments (the things that connect bone to bone). When the tendons (especially) are damaged - - often by repetitive motion - - and swell because of that, the tunnel narrows, thus squeezing the nerve and causing symptoms ranging from numbness to sharp pain.

You have sore hands. Do you have RSI? Or could it be a muscle strain, arthritis, or some other condition? In the April 27, 1999, edition of the "For Your Good Health" newspaper column by Paul Donohue, MD, the good doc speaks about a way to "diagnose" if you have carpal tunnel: "Hold the hands out with the palm facing the floor. Bend the hand down toward the floor. If tingling, pain, or numbness appears, that's a clue that carpal tunnel syndrome is the problem." He goes on to say that anti-inflammatory medicines, corrective splints, and rest from repetitive tasks are the first lines of defense. After that, he mentions cortisone shots and surgery as forms of treatment.

I've been plagued with RSI for several years--the result of lots of typing and piano playing. When I add too much needlework to this already-bubbling brew, I have a problem!

I'd like to share some of the things I do to keep my problem under control. I am not interested in cortisone shots or surgery if I can possibly avoid them!

1) I don't hold a frame in my hand (hoop, Q-snap, scroll frame). Many folks use a lap stand or a floor stand, but I just mount my fabric vertically in my scroll frame instead of horizontally. I rest one [small] end in my lap and lean one of the roller rods against my forearm. Thus both hands are free to stitch. I'm right- handed, so I lean the R roller rod against my R forearm and put my R hand beneath the work. My L hand goes on top of the work. I can really speed along this way. It's gotten to the point where I can now railroad with my L hand! This method works well for me. Not only does it eliminate discomfort from gripping the stretching device, but I can stitch in confined spaces without disturbing others, such as an airplane seat. (Another thing I've discovered using this method of mounting the fabric and holding the scroll frame is that when I sink the needle, I don't pull the fiber all the way through; I turn the needle and immediately send it to the top of the work. I pull the fiber through only with my L hand. I realize this puts some added fuzziness on the floss, but it's worth it to me because I can keep the frame in place on my forearm and not move it with every stitch. I compensate by stitching with shorter lengths (no more than 10") and ending the thread when it starts to fuzz the least little bit.)

Another approach is the "string scroll stand," an inexpensive and completely portable (folds up the size of a skein of floss!) support. I thank my cyberfriend, "Skyhooks", for permission to use her idea. Take some common kitchen string 3-6 feet long and knot the ends to form a single loop. Lay it on a flat surface and flip one end over so it looks like a figure 8 instead of a 0. Put the "cross-over" point at the back of your neck and let the loops hang down over your shoulders in front. Slip the knobs of your scroll frame into the two loops, thus suspending the frame. Adjust the length of the string at the knot to put the frame where it's comfortable for you. Note: This works only for work mounted horizontally, unless you modify the way you form the stitches or don't mind looking at the developing pattern 90 degrees out of phase!

Another cyberfriend, who describes herself as tall and with a "long torso," told me that having a high enough floor stand made a big difference for her. By high enough, she means one which, in use, requires that she bend her head only very, very slightly. Proper height also minimizes how much she must use her wrists at unhealthful angles in order to compensate for a too-low floor stand. "The height of the work, in relation to the spine, is critical. I 'sit tall' with good vocalists' or pianists' sort of posture. My arms are held close to my sides (almost propping on my ribs), with arms bent at elbows so my hands are at about bust level or just below shoulder height. Wrists are held straight. This alone makes it much, much easier to enjoy my work and not get tight & tired in upper torso, especially shoulders and neck." Thanks for the great tip, Lydia.

2) A practice I use to increase stitching speed also will help RSI. Put the non-dominant hand on the top of the work and the dominant hand on the bottom. This will seem a little clumsy at first, but you will get the hang of it in 10 minutes or less. This makes it easier for you to keep your wrists straight (not bent). When you pull the thread through, pull straight up and make sure you do not flex (bend) your wrist! Investigate the John James double-pointed needle (Colonial Needle Company); no need to turn the needle! Great needle! (Floss degrades more quickly, however, so use short lengths - - about 8" max.)

3) It's important to stretch before starting, whether it's needlework, typing, or piano playing. Here are a couple of stretches my physical therapist gave me. (a) Place palms together as if praying. Keeping palms together, lower hands to waist height. Hold. (b) Stretch arm out straight in front of you. With other hand, press hand back, applying pressure at the top of the palm (not fingers). Hold and repeat with other arm. (c) Beside a wall, hold arm straight out at shoulder height and move toward wall until palm touches. Hold and repeat with other arm. (c) Another cyberfriend offered an alternate stretch from her therapist, which is a great deal like my therapist's stretch (a): with hands in the same praying position, gently rotate the fingertips toward the sternum. Return fingertips to upright position and gently repeat several times. Kristen's therapist noted that this stretch is particularly good for reaching the tough-to-stretch ulnar nerve.

4) For pain, my doc recommended three Advils, 4 times a day. He said it was OK for me to continue this regimen for a week or so but to cut back for a while on what was causing the problem so the RSI could get better again and I could stop the medication. *Ask your doc about what dosage is recommended for you.* I give this information here -only- as an example of what my doc said for -me- to do. Your body and the severity of your condition is completely different!! *Please don't self-medicate!* Ask your doc. I'm not an MD!

5) I also sometimes use a commercial ice-wrap pack when my elbow really hurts. It hasn't been bad enough recently for this drastic measure (thank goodness!), but I keep it in my freezer at the ready, anyway. Before I got the fancy ice-pack (it was a gift, actually), I used some home-made cold packs.

Beyond stretching, here are some other things I have found that help.

6) When I type, I wear support gear. I wear a Hand-Eze or a Hand-Aid glove on each hand (turned inside- out so the seams don't irritate). Then I put on a Velcro-tabbed wrist support (by Pro), recommended by my doc. I look like something out of a science fiction movie, but I find this really does help.

7) As a pianist, I keep my wrists straight naturally, not "breaking" (flexing) at the wrist. Look at your position when you type and make whatever ergonomic changes you need to in your equipment or workstation. (You might find the Pro wrist wraps will help you, as they immobilize the wrist.)

8) I mouse L-handed. I had a big problem with the "clicking" finger of my R hand. All that clicking sent me over the edge in aggravating my elbow problem, since the return key is also on the R side. Putting the mouse on the other side has helped considerably. I also rotate fingers, so the same one isn't always clicking. I didn't need to reprogram the mouse buttons, by the way.

Look at your mouse. Is it too big for you? Too high off the pad? I had to hunt quite a while to find a small enough mouse so that my wrist didn't "break" while using it.

I've heard of people putting the mouse and mouse pad in their laps, too. The new Microsoft mouse (which requires no moving ball)

There's a gadget called a "Ring Mouse" (Kantec, 800-536-3212) which I haven't tried but will if things get bad again. You wear it on your index finger and take advantage of the natural opposition of the thumb because the thumb does the clicking. Another product, the Kensington Expert Mouse, which I've not even seen pictured, also uses the thumb-opposition principle. (Addendum: my friend, a computer guru/stitcher/pianist bought one of these and wasn't too impressed.)

I investigated the availability of a foot-controlled mouse, too. I couldn't find such a critter (as of this date, which is 1997). I asked several engineer friends if it would be possible to somehow merge a sewing machine pedal or a guitar pedal with a mouse's wiring. Probably possible, they said. Has anyone done it? They didn't think so. When I put the mouse on the L side of my keyboard, I didn't have to pursue that further.

I guess someday someone will actually have some decent products for folks with RSI..... Guess we'll have to wait for someone with decision-making power to get the problem!

(9) Someone on a newsgroup said that vitamins E and B6 were recommended. Whether this actually does anything, I don't know, but I throw out the information here so you can -ask your doc- whether this is an avenue worth pursuing.

10) I read that a naturopath/acupuncturist in London (Michael Van Straten, ND, DO) recommends cabbage leaves. Pull one or two of the outer, very green leaves off a head of cabbage. "Roll" them with a rolling pin to break down the fibers a bit and then soften them further by putting them in the microwave oven for a few seconds. Leaves should be warm (not hot - - careful! they get quite hot because they contain a lot of water!) and pliant. Wrap leaves around site of discomfort, followed by a towel. Wear your cabbage about 15 minutes. Be careful not to burn yourself by heating the cabbage too long. (Each microwave oven is different, so you'll have to find out how long it takes yours to render the cabbage leaves the correct limpness.) The article does not say whether the cabbage is re-useable (and I have not tried this method, so I don't know). The proof is left to the student! (Ha! Didn't you -hate- that in school?!)

11) I am still trying--with not much success because I type so fast (and not necessarily with accuracy but fast!)--to train myself to type piano instead of forte. It's hard because I get going fast and stop paying attention. Pounding hard on a computer keyboard is -very- aggravating to the condition, believe me! That's why prolonged bouts of writing are a dangerous time for me!

12) My piano repertoire has changed quite a bit, too, as a result of RSI. Gone are octave runs and thundering pieces of Rachmaninov! Now I go for finesse rather than power! This change in repertoire has made a big difference.

13) I find that using the "stab method" allows me to stitch for long periods, but when I use the "sewing method," my hands begin to ache sooner. If you "sew," you might want to try "stabbing" and see if that helps.

If you're a quilter and use the sewing method, you already have found out that it puts you in major pain. Use the stab method and/or lay aside your quilting for a while. (What the heck. What's one more UFO, anyway?!)

14) I use a well-plated needle. The tarnished ones don't slip through the fabric very easily. Platinum needles "feel good" as they pass through fabric, but I am not replacing mine when it grows tarnished because I learned that the process of platinum-plating results in all kinds of toxic waste materials.

15) I have recently begun treating myself to a manicure every two weeks, just for the hand and arm massage. It feels so good, I am thinking of changing to weekly! I chose a manicurist who is also a certified massage therapist. If you have a massage, I suggest you hire someone with training and credentials so further damage is not done. If you can't find someone on your own, ask your doc or physical therapist for a recommendation.

The short answer for RSI:

You might want to check out this web site for more information on RSI. (There's a sub-section on RSI and playing musical instruments, too, if you have the same peculiar combination of needlework/music/computing as I do.) Also see for more info. You must register first (no charge). Use the frame on the left side of the screen and scroll down until you get to "register."

Other links:

If you have RSI, contact a doctor (an orthopedist is your best bet). Do not try to cure yourself! You might do the wrong thing and make matters worse! (-That- is not something any of us wants to contemplate!) RSI is a chronic condition; it's not like a cold that eventually goes away. RSI is forever. We have to learn how to modify the tasks we do and how to control flare-ups. Please see your doc as a first step!

Update: A cyberfriend has sent information on a foot-operated mouse:

"It's called the 'No Hands Mouse' and it's by a company called Hunter Digital. If you do a search on the Web, you should find a number of references to it. The phone number I've got is: (310) 471-5852, and a URL of" Thanks, Laura! If anyone out there has used this device, please e-mail me so I can put the info here for everyone.

Update (April, 1999): Another cyberfriend, an occupational therapist, sent me some more information about the foot mouse. It really does exist now! It's called the "No Hands Mouse" and is made by Hunter Digital, Ltd., 11999 San Vicente Blvd., Suite 440, Los Angeles, CA 90049; 800-376-6873. It has two foot pedals and is 6.5" x 4.5" x 2" in dimensions; 2 1/5 pounds in weight. Cost is $230. Whew!

Update from my cyberfriend about trackballs. She writes:

"I was just re-reading [your file on RSI], and I thought I would mention that trackballs, especially those by Logitech are wonderful. They are shaped to give the hand full support, and if you feel you need it, coupled with an adaptable wrist rest, like the gel ones, give the maximum of support and flexibility.

"I have been using Logitech trackballs forever, as I have never liked the mouse concept. With the trackball, you set your worksurface or keyboard drawer at a height so that your arms are bent at a 90-degree angle, place your hand on the trackball and your thumb moves the ball. There are 3 buttons positioned below the outside 3 fingers. Mine, a Trackman Marble+ has the standard left and right buttons, but the middle and right buttons can be programmed and sensitized by the user. The middle button is also an automatic scroll wheel that lets you set the scroll rate to 1 line, 3 lines or by the page, and this alone is an incredible feature. Using all the buttons to their full potential keeps the arm at optimal position, eliminates the repetitive arm movement needed for the mouse and gives the hand a comfortable resting place. There is no hyperextension or stress. I would kill before I gave mine up.

"When I was working, I was in charge of ergonomic support. I would visit the offices and look at what people needed, from anti-glare screens, hoods, wrist-rests and arm support, better chairs, etc. The most common request was for anti glare screens. Most needed to have their monitors raised and angled, their chairs raised or lowered, and wrist rests. The bank had standardized on a 2-button mouse and would not budge. A systems engineer was using a CAD program to design the new intranet and was getting very frustrated with his mouse; he came to me for support on purchasing a digitizer. I knew they had no funds, so I told him about trackballs, and how I use mine in AutoCad and CorelDRAM!. I volunteered to lend him mine for the day, and next morning, brought my trackball and software to work. He didn't want to give it back. Soon, every computer services employee wanted one, and then health services became involved. It became a non-standard standard. In other words, if you asked for one, you got one. If you didn't ask, you didn't.

"I have degenerative disk disease at C4-6, which affects my neck, shoulders and arms. I never have a problem unless I am hunkering down over my Animal Nutrition lessons!"

Gale goes on to offer this tip sheet she developed. "When I was working, I was in charge of Ergonomic Support. Here are a few tips."

Your body:

Your eyes:

Update (September, 1999): A cyberfriend e-mailed and says she takes 100 mg B6 daily (or 50 mg if she uses a multi-vitamin that already has 50 mg in it). She says any brand is ok, even generics, but "it has to be Pyridoxine Hydrochloride and no more than 100 mg per day. There's a warning on the box saying B6 can't be used for extended periods or in large amounts, but all the doctors I've talked to haven't ever heard of a B6 overdose." Julie's not an MD, either, so please talk to your doc before you start taking extra B6.

Update (August, 2000): Cyberfriend e-mailed to offer her tip on making herself take a break from stitching because sometimes we just don't want to stop for anything so unimportant than our health! "I use a kitchen timer to make sure I take regular breaks. I set it for 30 minutes at a time and make sure I put it where I can hear it and a little out of reach (to make sure I actually get up). Then I make a cup of tea or refill my ice water, check on the kids, empty/fill the dishwasher, something to get me moving for a little bit and then resume my stitching. It does wonders for me to walk around even for five minutes."

Update (November, 2000): Another cyberfriend wrote to me about using magnets.

"Like a lot of stitchers and computer users, I suffer from pain in my wrists and shoulders. This is what has worked for me, and the results have been nothing short of remarkable.

"I use magnet therapy. There's a wealth of information on the internet now regarding magnet therapy and the various types of magnets available. Wal-Mart carries a line of magnets by Homedics. A box of 20 stick-on magnets and 30 additional stickies is less than $10. The stick-on magnets are a little smaller than a pencil eraser, and they can be stuck anywhere it hurts. About the only caution I've seen against using them is for people who wear transderm patches, pace makers and insulin pumps, or any other type of electrical medical device.

"I also recently found some magnetic gloves which combine magnets and acupressure to specific points on the palm of the hand and the wrist. Combined with a couple of magnets on my shoulders and the results were incredible. The material of the gloves is similar to the Hand-Eze gloves, the magnets and acupressure nodes are sewn in. They're $29.95 for a pair, and I've found them well worth the price.

"Another source for magnets is the Feel Good website. They carry all types and sizes of magnets for whatever hurts. You can request a free catalog from their website, they ship fast, they're friendly, and they send out frequent dollars-off coupons. I even bought a magnet pad for my cats and they love it!

"I hope you'll give the magnets a try. I've convinced several people at work to try them and so far, everyone has had positive results. If you have any question, I'll do my best to answer them.

"The stick-on magnets can be stuck anywhere it hurts. I use them on my wrists, shoulders, inside forearms, hips (those hurt too), base of my skull (good spot for tension headaches), wherever I think I need them. If you have a good massage therapist, they can show you where the acupressure points are for carpal tunnel and you can place magnets on those points for added benefit.

"My husband golfs and receives several golf catalogs. Most of the catalogs carry magnets and they're recommended by several of the golfers. One of the brands carried in the golf catalogs is Bioflex. The website has a wealth of information on it about magnets, where to place them, and possible side effects (there are a few).

"I've been using the magnets for about a year. The reduction of pain in my wrists and shoulders is really amazing. My medical doctor just rolls his eyes at me, but I've had good results. And it's non-invasive and non-toxic. My massage therapist and chiropractor have also been helpful in showing me where to place them for maximum benefit.

"Get on the 'net and do a search on "magnet therapy" or "magnetic therapy". There's a lot of stuff out there."

Update (September, 2003): A cyberfriend and cybercolleague e-mailed me:

"Like most people who type/stitch/write a lot, as do I, and I wanted to let you know what has helped me more than anything. The pain in my left hand was so severe that I was contemplating surgery, even though the people I know who have had carpal tunnel surgery seem to be equally divided between those it didn't help, those it did help, and those it made worse. Then I read a letter from a reader of "Mother Earth News," who stated that Papaya Extract tablets (also marketed as Bromelain extract) were helpful in relieving the pain. I figured what the heck and bought a bottle. I started taking one a day, and after about two weeks my right hand no longer had any pain, and the pain in my left hand was significantly reduced, to the point that a little massage every now and then is all I need. I no longer have to take any pain medication. It doesn't have any bad side effects and it beats the heck out of surgery!"

I can't vouch for the safety of this product or lack of side effects, so please consult your doc or other appropriate health professional before you start self-medicating!

Update (June, 2005): A cyberfriend wrote to say that Pilates mat work cured her "overnight - - literally!" This might be something you might want to investigate.

copyright 1996-2005, Martha Beth Lewis
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Last updated September 30, 2003