If Knitting Is Causing You Pain, Read This

I've been a knitter since my teens, but not until I finished my second novel, "The Immortalists," did my sporadic hobby become a full-blown obsession. Mentally exhausted and in search of a more relaxing creative outlet, I picked up the needles that sat in a cotton basket and planned a project more ambitious than the scarves of years past: my first sweater. An open cardigan with a shawl collar, this pattern was my gateway drug. The catch? Making sweaters took time. Lots of it. I told myself that knitting was meditative, but it was also addicting: I could knit for hours without stopping as episodes of my favorite television shows played back-to-back onscreen. Even when my back began to hurt or I felt a headache building, I couldn't stop.

I knew that squinting at my needles wasn't helping my chronic migraines, and that huddling over a project contributed to the muscle tension in my shoulders. But I didn't think about the toll knitting was taking elsewhere until I began to experience a burning sensation in my forearms. Before long, I was waking up at night with one hand entirely numb. Worse, there was an ongoing ache in my wrists and hands, particularly around my thumb. I stopped being able to unload the dishwasher, open jars and even drive a car. I was only 28. How could I be suffering from symptoms that typically afflicted people two or three times my age? I didn't want to admit that something I loved so much could be hurting me.

I avoided seeking professional help. Instead, I tried to self-diagnose. I found a homeopathic tendon cream and applied it throughout the day. I bought a wrist brace and wore it nightly. I searched for knitting-specific stretches on YouTube. When nothing helped, I made an appointment with Karen Blaschke, an occupational therapist and certified hand therapist at the UW Health Hand and Upper Extremity Rehabilitation Clinic in Madison, Wisconsin. "I'll try anything," I told her. "Just don't make me stop knitting."

Blaschke probed my muscles and joints. She asked me to make certain shapes with my hands and tell her which ones hurt. She observed the flexibility of my wrists and elbows. After my online research, I'd concluded that I had carpal tunnel or perhaps a type of tendinitis specific to the thumb called De Quervain's syndrome, but I was wrong. "Hypermobility," Blaschke said. "Your joints are unusually flexible-especially this one." She pointed to the joint at the base of my thumb, the one that hurt when I clutched a steering wheel or held my knitting needles. "That means there's a greater risk of sprains, dislocations, and other injuries. And while I don't want to scare you, it's possible for joint hypermobility to lead to arthritis."

The diagnosis was sobering. Joint hypermobility isn't an injury, though it can lead to injury; rather, it's a condition I was likely born with, caused by things like bone shape and abnormal collagen. Blaschke showed me a brace that supported the thumb joint; because the wrist braces I'd bought on my own left the thumb free, and had likely exacerbated the problem. She instructed me to rest my hand completely. At the same time, she was sensitive to my desire to keep knitting. After a week of total rest and use of my new braces, she said I could add knitting back in for five or ten minutes at a time. She showed me a series of exercises that would strengthen the muscles around my thumb joint, such as one in which I made a "C" with my thumb and index finger. She even referred me to another therapist in my network who was a knitter herself, and who helped me to find knitting postures that supported the muscles in my forearms and hands. I began to knit with a pillow under each elbow and another, flatter one under the project itself; that way, I didn't have the weight of two needles and a heavy sweater hanging from my thumb and index finger alone.

I was humbled by how wrong I had been about my own body. As my hands continued to heal, I committed myself to learning more. My research brought me to Carson Demers, a physical therapist who develops and manages the award-winning ergonomics program at Kaiser Permanente Medical Center in San Francisco. Demers is also a passionate knitter who teaches classes across the country on ergonomic knitting, and he had just published "Knitting Comfortably: The Ergonomics of Handknitting." I ordered it immediately. The beautiful, coffee table-sized tome changed the way I thought about my hobby. Carson pointed out that when knitters focus on the fabric they're creating, they often neglect the fabric of their own bodies: the muscles, tendons and ligaments, the nerves and joints. In order to knit sustainably, we must care for ourselves as much as we do our projects-and that requires us to pay attention to the all of the ways we put strain on our bodies.

"Like many of the tasks that we do in the electronic age, such as computing, using tablets and smart phones, and driving, knitting is often done seated and for long duration," Carson wrote by email. "Knitting also uses the same upper extremity muscle groups-and even movements-that these tasks do, which can lead to overuse. Since it's done seated, which it needn't be, core muscle groups are under-utilized, making you susceptible to deconditioning and other musculoskeletal problems.

Carson's book reminded me to drink water while I knit, confirming my secret belief that knitting is an athletic event and should clearly be inducted into the Olympics. I experimented with different kinds of needles and yarn weights, discovering that bulky yarns and metal needles are hardest on my hands. Most critically, I stopped knitting for multihour marathons. I began to take breaks, and I stretched my hands and forearms after each knitting session.

I asked Carson to recommend three easy modifications that any knitter can benefit from. Number one? Add some movement to your knitting: Carson suggests standing for part of the time. Next, pay attention to how you pair needles with yarn. "Stickier" yarns-those that are rougher, with more friction-are best paired with smooth metal needles. Smoother, even slippery fibers, on the other hand, such as silk or merino wool, can be matched with a material that offer more grip, such as wood or bamboo, reducing the work that your hands have to do to keep stitches on your needles. Third, Carson says, "if you do sit while you knit, think of your chair as a tool. You wouldn't run a marathon in dress shoes, so make sure the chair is appropriate, supportive, and well fitted."

Reading Carson's book also reminded me that there is no one-size-fits-all recovery: only a professional can create a treatment plan that helps instead of exacerbates specific issues. In addition to conditions such as carpal tunnel, tendonitis and arthritis, knitters are at risk of repetitive stress injuries. "RSI is a poorly understood symptom complex that usually involves pain associated with use of the hand," said Michael Hausman, M.D., Chief of Hand and Elbow Surgery for the Mount Sinai Health System. "The cause remains unknown, and it is sometimes confused with other relatively common conditions such as tendonitis and carpal tunnel syndrome. However, it does not respond to treatment for these conditions." You guessed it: Yhe most common treatment involves minimizing the activities that caused the pain. "While there is no scientifically validated treatment," he said, "the good news is that eventually, most symptoms seem to improve [in] months or even years."

My recovery was incremental: Two months after my pain began, I could knit for five or ten minutes at a time. After four months, though, I had regained much of my strength with the help of regular exercises, breaks and reduced knitting time overall. Now, seven months after my pain became acute, I can knit daily for an hour or two without discomfort. Ultimately, my injury forced me to slow down and remember why I love knitting in the first place. I had become so focused on productivity that I had forgotten I knit for relaxation, for the simple pleasure of each stitch. Now I marvel at the slow transformation of yarn into knitted object. What's the rush? After all, my knitted pieces, like my body, should be well cared-for-and built to last a lifetime.