Knitting Health: Repetitive Stress and You

I've knit more in the last 12 months than I have in my entire life. I did a quick inventory just now... In the last year, I've finished 46 projects. Is that right? Yup, just counted them again. Mostly sweaters, mostly for adults. That doesn't include little things like swatches, washcloths, bookmarks, hats. And it doesn't include the things I've 3/4 finished and frogged. I don't know how many miles of yarn that accounts for, but it does explain why my hands and wrists are a little gnarled, and a little sore.

So let's talk about some hard truths: knitting is repetitive and may lead to strain on the wrists and hands. Here's a little info on knitting injury prevention, treatment, and knitting technique.

(Okay, before we start, read the fine print).

Repetitive Motion Injury

Also called Repetitive Motion Disorder (RMD's), Repetitive Stress Injury (RSI's). From the National Institutes of Health:

Repetitive motion disorders (RMDs) are a family of muscular conditions that result from repeated motions performed in the course of normal work or daily activities. RMDs include carpal tunnel syndrome, bursitis, tendonitis, epicondylitis, ganglion cyst, tenosynovitis, and trigger finger. RMDs are caused by too many uninterrupted repetitions of an activity or motion, unnatural or awkward motions such as twisting the arm or wrist, overexertion, incorrect posture, or muscle fatigue. RMDs occur most commonly in the hands, wrists, elbows, and shoulders, but can also happen in the neck, back, hips, knees, feet, legs, and ankles. The disorders are characterized by pain, tingling, numbness, visible swelling or redness of the affected area, and the loss of flexibility and strength.

Well, that doesn't sound like much fun does it? If knitting is anything, it's repetitive. The hands and wrists are complicated pieces of machinery, with many moving and interlocking components. And like machinery, they need to be maintained and treated with respect. Hands: Strict Limit 2 per customer.

Carpal Tunnel Syndrome

Although this belongs to the above category of Repetitive Motion Injuries, it deserves a paragraph to itself. The median nerve is a big ol' nerve that goes from the shoulder to the hand, and is key to movement and feeling in your thumb, hand and wrist. The median nerve reaches your hand through the carpal tunnel at the base of the wrist. Any swelling in the carpal tunnel area puts pressure on the median nerve, causing things like tingling, pain, and weakness. Carpal tunnel syndrome can occur from making small repeated movements, and, like other RMDs, you might not realize that it's happening until you're already injured. Carpal Tunnel Syndrome, left untreated, may require surgery.

RMD Prevention

(Warning: I'm going to use a lot of exclamation marks).

Rest your hands! Take frequent, regular breaks. Don't wait until your thumb is tingling and your veins are popping.

Move your body! Knitting means sitting in the same position for long periods. Get up and walk around, do something else. Also good for preventing Knitter's Butt.

Listen to your body! Yes, I know, you just need to finish one more row. But if you feel a twinge or tingling, or any kind of malaise in your body, don't ignore it.

Rest your hands! Yes, again, because I don't believe you did it the first time.

Stretch! Shoulders, arms, wrists, fingers, neck, back.

RMD Home treatment

This is what helps me. Did you read the fine print?

Use R.I.C.E. for inflammation and strains. Do all these together, for about 10 minutes per hand:

Rest! Yes, that's also how to prevent injury. How convenient!

Ice! A cold pack. Don't be silly, don't put it directly on your skin.

Compression! A little pressure, but don't get crazy with it. I put my ice pack in a pillow case and wrap it snugly.

Elevation! Rest your hands on a pillow.

It also helps to sit on a couch and demand that family members fetch you tea and cookies.

Try Ibuprofen. (Really, read the fine print). This relieves pain and inflammation.



We usually use this term in the workplace. It means adapting your workplace to your body (rather than the other way around) for comfort and injury-prevention. Although we associate ergonomics with the height of our office chairs, or the distance of the monitor, it applies to knitting as well.

Things to keep in mind for knitting ergonomics

Where and how you sit. Sit with your feet on the floor, in a chair, and try not to hunch. When adjusting your posture, try to engage your abdomen. Yes, it sounds boring. I like to knit with my legs curled under me, on the bed, watching a movie on my iPad with one eye and my knitting with the other. Don't do this.

The position of your arms. Try this as a test: sit comfortably at a table, put your arms out on the table in a relaxed and comfortable position. Take note of the angles at your elbow, wrist, thumb. When you knit, try to get to that comfortable, natural position. Don't knit like Gollum protecting his precious ring. Gollum is wicked and does not follow Good Ergonomics.

The tools you use. Treat yourself to smooth, lightweight needles. Use circular needles for large projects.

The yarn you're using. The thicker the yarn, the more your hands have to work.

Variety. Do other thing besides knit! Gasp! This keeps your body happy.

How you knit

Ah, here's the meat of the issue. It can get controversial when you start talking about Continental vs. English. (Continental means holding the yarn in you left hand, and fishing the yarn through; English means holding the yarn in your right hand and wrapping it around the needle. Also known respectively as "picking" and "throwing"). I learned to knit right-handed, but now I knit both left and right-handed. I find that both styles have their advantages.

Here's what I've concluded, from personal experience. It's not so much which style you use (picking or throwing). It's how you move, and how much.

The basics to follow (in knitting, but this applies to typing, sewing, driving)

Avoid tension. Listen to your body, not just the big muscles, but the tiny ones too. You might easily notice that your neck and shoulders are tense, those are big muscles screaming at you in loud voices. But also listen to the tiny voices from Whoville in your fingers and thumbs. For example, I notice that my left thumb, regardless of whether I'm knitting left or right handed, tends to pinch the needle, putting a little extra pressure on the base of the thumb. This creates a tiny knot of tension in the muscles of the thumb. That tiny knot is easy to ignore, but turns into an injury after a few thousand stitches.

Make small, efficient movements. This is the biggest change I've made recently. Slow down your knitting, stay relaxed, and see how small you can make your movements. Keep the working yarn close to the tip of the needles. You're not conducting an orchestra. Or calling a cab. Or hitching a ride. So many analogies. Do you jog? You know how in running, you should watch the horizon and keep it as level as you can? You want to use as much energy as you can to move forward, not up and down (or backwards, as it sometimes feels when I jog). It's the same thing with knitting.

Don't break the wrist. You'll see this in office ergonomic posters. This means keeping the wrist in a natural position, without twisting or bending it. I'd take it one step farther and say Don't break the hand. Think of your hand, wrist, fingers as a single unit. Avoid splaying out your fingers too much, or relying too much on one area of your hand to do the work. If you move a finger, make sure the hand goes with it. (I can hear you saying, That's crazy, move my whole hand? That's more work, not less. Ah, see my previous point about making small movements). This is a common problem at the keyboard too: we flick out the pinky or the thumb because it's quicker, but it's better to move the whole hand. Just imagine you are the Queen. Look at her excellent waving ergonomics: no splaying, twisting or bending.

The fine print

This article contains research from various health sites as well as anecdotal information from my own experience. Don't use any of the information on this page to substitute for the advice of a health professional. Correct diagnosis and treatment for injuries shoudn't come from a knitting blog. Durh.
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