Nancy L. Haydon

Repetitive strain injury (RSI) is thought to be caused by work tasks which are performed repeatedly, thereby causing muscular strain and eventually injury. RSI can be defined as inflammation of the tendons round a joint resulting from regular, repeated movements of that joint. And yes, you've guessed, poor posture, stress and overwork also contribute to the symptoms.

Repetitive movements, such as creating cross stitches, can often be responsible for this condition in some people. However, an awareness of the factors that cause the condition can be helpful in avoiding the pain and frustration that RSI can bring. RSI is not inevitable after cross stitching for long periods of time, so by bearing in mind a few simple precautions, you can spare yourself the experience of RSI altogether.

The repetitive movements used in cross stitching involve the change of the needle-holding hand from the front to the back of the fabric, and also that particular movement made in reverse, to bring the needle back through the fabric.

This can be made worse for you if you hold your work in your hand, or on a hand-held frame or hoop. The larger the hoop, the larger the movement made which may even involve shoulder and elbow joints as well as wrists and fingers.

The medical remedy for RSI is rest, meaning complete abstinence of the movement causing discomfort. But if the problem is not resolved in a few days it may be worth seeking medical advice. Anti-inflammatory drugs, physiotherapy or heat treatment may be the answer.

When the pain eases, it is essential to try to have analysed the precise cause of the problem and plan to avoid the movement that is the root of the problem. This will prevent the recurrence of the pain. Also, there is little point in resting for a few days, only to return to the same habits of repetitive movement. Ideally, you should be thinking about taking a preventative approach to dealing with the problem.

To adapt the movements of your needle-holding hand, you can use a frame to secure your work, either from the floor or one your lap. This means that one of your hands is free to work on top of the fabric, and the other can work from below it. Many of the repetitive movements of creating stitches will be removed.

If you tense your muscles and tendons when you stitch, this can be a contributory factor in RSI. Relaxing those muscles is therefore essential. You may be bringing your work close to your eyes to get a better view (in which case, try using a magnifier or having your eyesight checked). Make sure you are sitting in a comfortable position with your back supported and your neck bent forwards as little as possible.

Using a high-count fabric can make you tense up your hand, as it is trickier to get the needle into the right place. If you use a lower count of fabric it will be easier to see the holes. Many people find relief from the wearing a wrist support helpful.

If you use long threads when you are stitching, then it is possible that your arm may need to move upwards in a repetitive way, gradually straining the muscles without you even being aware of the situation. Shorter lengths of thread can eliminate that difficulty. Some people find that if they keep their elbows from pointing outwards or rest them on the arm of the chair may help to cut down on movements.

It is worthwhile to consider how you habitually stitch in order to prevent any tension building up. Try to stop every now and again to see if you can detect any tension in your arms or shoulders, and release that tension. Warm-up exercises before you begin, stretching the arm, finger and shoulder muscles gently, can be beneficial. Taking a short break every few minutes can also break the repetitive cycle of movements.

Perhaps the single most effective habit to include in your daily life is that of relaxation, performed systemically as part of a conscious health promoting regime. Relaxation can be a great way to prevent RSI -- and other medical conditions too. Remember that you do not need to curtail your stitching activities -- just adapt the way you stitch.