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.

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 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, Helen "Skyhooks" Mardis, 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, Lydia McBride, 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 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.

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!

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) My cyberfriend Kristen Wells 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.

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 also sometimes use a commercial ice-wrap pack on my forearm. It hasn't been bad enough for this drastic measure in a while (thank goodness!), but I keep it in my freezer at the ready, anyway. Another approach is to designate a bag of frozen vegetables (we're an Irish family here, so I chose green peas). Whack them (the peas, not the Irish) on the floor to separate them and then put the veggie bag on your arm (or wherever it's hurting). I find this much better than a leaky bag of crushed ice. The veggies conform to the contours of my arm and give greater contact, and thus greater relief. I refreeze for use again. Since it's not recommended to eat these frozen- unfrozen-frozen-again-etc. peas, I mark the bag.

Here's another cold pack (which I haven't tried because I haven't had a flare-up in a while!). Pour 1 c rubbing alcohol and 2 c water in a quart-sized zipper bag. Squeeze out air and seal. Place this bag, zipper down, in another quart zipper bag, again squeezing out the air before sealing the second bag. Freeze. Mixture will be a slush (because alcohol won't freeze) and thus very "mold-able." Refreeze after use. Label! Rubbing alcohol is poisonous! (You might want to use food coloring to dye your ice pack in a non-food color, such as blue!) This recipe can be doubled; use gallon zipper bags.

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

When I type, I wear support gear. I wear a Hand-Eze 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.

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.)

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.

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, 1997). 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, but then I just put the mouse on the L side and didn't have to pursue that further.

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.

A 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) 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 oven is different, so you'll have to find out how long it takes your oven 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). The proof is left to the student! (Ha! Didn't you -hate- that in school?!)

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!

I am still trying--with not much success--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!

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 than power! This has made a big difference, too.

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.

And finally, 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.

I have recently begun treating myself to a hand and arm massage every two weeks. 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.)

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. 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: My cyberfriend, Laura Ruiz, 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.

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Last updated Nov. 15, 1997.