Drawing can cause a repetitive strain injury (RSI), but with a few precautions and the right equipment, this risk can be minimized.

by Edith Zimmerman

Drawing is not usually thought of as a high-risk occupation. Calluses, dirty fingernails, stained clothes, and the occasional paper cut are usually the worst that can happen. But for many artists, particularly those who have been drawing for years, the simple act of making a pencil line drawing can yield painful and devastating results over time.

Median Nerve by Leslie Arwin, 2006, colored pencil, 10 x 8. Collection the artist.

Blame it on devotion, but many artists—chiefly those for whom pencils are the instruments of choice—experience a repetitive strain injury (RSI) at some point in their careers. Repetitive strain injuries, as the name suggests, come from repeated stressing and flexing of certain muscles and joints. For most, pain associated with RSI is located in the hand, wrist, elbow, shoulders, neck, or even the lower back. The bad news: for many, the pain is chronic and often interferes severely with their passion for drawing. The good news: everyone can benefit easily from learning how to draw with a few preventative and restorative measures. We consider working this way one of the drawing basics.

Tennis Elbow & Ergonomics 
Tennis elbow—or, as Allison Fagan, a signature member of the Colored Pencil Society of America (CPSA), calls it, “pencil elbow”—is a common complaint among those who spend long hours drawing. Says colored pencil artist Helen Passey, “My tennis elbow is definitely a direct result of colored pencil work on a show deadline.” Leslie Arwin, a doctor who practices occupational medicine and a member of the CPSA, says her struggle with both tennis and golfer’s elbow (lateral and medial epicondylitis, respectively) has been frustrating and has also forced her to re-evaluate the way she draws. “It is important to have an ergonomic evaluation of your work space,” says Arwin. “For artists, that isn’t always easy.” If you don’t have an ergonomic evaluator at your disposal, here are some basic improvements you can make on your own.

Wrist Flexors With  Extension Stretch by Leslie Arwin, 2006, colored pencil 8 x 10. Collection the artist.

Setting Up Your Workspace 
Make sure your chair is giving you the best support possible. Deborah Quilter, the author of The Repetitive Strain Injury Recovery Book (Walker & Company, New York, New York) and creator of an RSI website (www.rsihelp.com), recommends that artists “adjust the height of the chair so that your feet are resting flat on the floor. If your feet don’t reach the floor, use a footrest.” Moreover, “You need a chair with pelvic tilt. That means it allows you to have your hips higher than your knees,” she advises. “That’s really important, because otherwise you lose the natural curve in the spine, which leads to back pain and other problems.” Several such chairs are on the market, including the Martin Universal Vesuvio Series drafting stool, which is available through vendors such as Blick Art Materials. But Quilter asserts, “You can get a wonderful chair, but you should really spend as little time as possible sitting in it.”

Make sure there is ample support for your drawing arm. “Setting up your work space so that your forearm is supported is the most important thing,” Arwin explains. Linda Wesner, a signature member of the CPSA, agrees. “If my forearm is supported by the desktop while I’m drawing it really helps,” she says. “Whenever I let my elbow hang over the edge of the desk for extended periods of time, I feel pain.” Quilter concurs, “You don’t want the arm to be pressing into the hard edge of the table. You don’t want to lean on your elbow—both these things can give you nerve damage. Make sure you have an elevated, slanted surface so you’re not craning your neck to see your work and so your arm can move freely without being pinched by the edge of your desk.”

Wrist Extensor With  Flexion Stretch by Leslie Arwin, 2006, colored pencil, 8 x 10. Collection the artist.

Changing the angle of the drawing board can also make a workstation more ergonomically sound. “I had an ergonomic assessment of my work space shortly after the problem arose,” says Fagan, “and as a result changed the angle of my drafting table so that it is almost perpendicular to the floor.” CPSA member Linda Koffenberger adds, “I don’t have any discomfort when drawing because I use a drafting board set at a 20- to 30-degree angle.” Fagan also recommends using “a small footrest so that my legs are bent at a 90-degree angle, and I’m not tempted to lean forward when I draw.”

Stretching, Posture, Breaks 
Some of the simplest solutions to the pain associated with repetitive stress are based on common sense—stretch, take breaks, and maintain good posture. “Sit up straight, stretch frequently, and pace yourself,” says Quilter. Explains Fagan, “Most important to maintaining a healthy status is stretching for five to 10 minutes before I work. I extend my wrist up and down with my arm bent and my elbow straight.” Koffenberger also suggests a particular stretch that works for her: “Sit up straight in a chair next to a low table (the surface of the table flush with the seat of the chair). Place your hand, palm down, on the table. With your arm straight over your hand (your wrist forms a 90-degree angle with your palm), lean into your hand. Hold for 20 to 30 seconds and then relax. Do this five times. It helps to loosen up the tendon in your wrist and relieve pressure on the median nerve. Or at least it works for me!” Colored pencil artist Laurene Puls says that for every muscular action, she makes an equal and opposite muscular reaction to keep pain at bay. “In other words, if I’m going to make a clockwise circle a dozen times, I need to go counterclockwise a dozen times.”

Another factor that contributes to the development of an RSI is poor posture. “No ergonomics will solve poor posture,” says Quilter. Good posture—holding the spine erect, standing tall—is important to maintain not only while standing but also while sitting. “You want to sit up straight when you’re drawing,” advises Quilter, “because when you slouch, you’re compressing your diaphragm, your spine isn’t supported, and you’ll get back pain.” Working for prolonged periods in a seated position can cause people to slump, to assume the position of their chair, and to hang their heads. “I try to keep my ears aligned over my shoulders when I work, so I am not leaning forward,” says Fagan. Extending the arms for long periods of time—as one often does while drawing—can exacerbate the problems caused by poor posture. Says Quilter, “Proper posture is crucial to preventing myriad ailments, including repetitive strain injury and back pain. No state-of-the-art workstation compensates for the risks introduced by slouching.”

The importance of taking breaks can’t be overemphasized. “I take a break from drawing every 30 minutes,” Koffenberger says. “Just a short, one-minute break is enough. It keeps my mind more creative and my work more fluid.” Quilter agrees. As she states in her book, “Frequent, regular breaks are critical to preventing reinjury. Do not allow yourself to work to the point of pain. Take a break as often as you need to, but certainly well before you feel any symptoms of strain, such as fatigue, soreness, tingling, or even hyperawareness of your hands. If you wait—or work in pain—you will be causing damage to the soft tissue.” Unfortunately, as many artists know, remembering to take breaks can be challenging. “When lost in the process, our brains override pain,” Puls explains. To correct this, she developed a creative reminder: “I work for one CD’s worth of music then stop for a break to assess how my arm is feeling.”

Modifying Art Supplies/Developing Creative Solutions
Changing or modifying art supplies may also be necessary. “Making tools fatter is a key element,” says Arwin. “Wrap the pencils in foam and tape to reduce the pinch motion of the grip.” For another inexpensive fix, Quilter recommends putting hair rollers around pencils. Specially designed rubber grips—not unlike the ones popular in first grade—accomplish this as well. They make pencils easier to grip and require less clenching force. For paper, Wesner recommends a type with less tooth. “Artists should use a paper surface that has just enough tooth to accept the pencil’s wax pigment; too much texture means many more strokes are required to ‘fill in’ with pigment. Also, a softer touch, with not so much burnishing, helps.” Triangular pencils, such as those made by Staedtler or Faber-Castell, and especially the large pencils manufactured by Koh-I-Noor, are easier to grip and more ergonomically sound than their round, traditional counterparts.

Solutions can often be found by simply changing technique. If something hurts, find another way to do it. “Consider adapting your technique to your physical abilities,” recommends Passey. “There’s usually more than one way to do this, and some are easier on the body than others.” Says Arwin, “I am trying to draw more with line, less with shade, and smaller to protect my elbows and wrists.” For those whose computer work exacerbates the problem, Arwin recommends a less obvious measure to alleviate the pain: “I use Dragon voice-recognition software to reduce the amount of typing that I do at work,” she says. Quilter also recommends Dragon, as it reduces work-time muscle and joint stress.

Many artists weave RSI-preventative/protective measures into their creative routines in clever and unusual ways. “Because I am sharpening my pencils all day long,” says Fagan, “I have placed my electric sharpener behind my working chair on a box on the floor so that I am forced to stretch my arm down to reach it.” Suggests Quilter, “Put the phone across the room so you have to get up when it rings.”

Splints, Bands…and Surgery 
For many sufferers of RSI, devices such as wrist braces and elbow bands are invaluable. It is important, however, to remember that splints are serious medical implements that may be harmful if used incorrectly. Quilter warns that using a splint while working can actually be counterproductive: “People can get addicted to splints,” she cautions. “By not moving, they’re not causing themselves pain. But if a resting splint is worn during activity, further injury may be produced in the injured or adjacent tissue, such as disuse atrophy or contracture of immobilized tissues.” It’s not so much that splints should be avoided, she says, as it is that splints should be worn only at the right time. Most splints are intended to stabilize the body and facilitate healing during a time of rest—not of work. The problem is, she says, that many artists do wear their splints while working, and this can potentially impede the healing process. “It feels good short-term,” she says, “like slouching feels good short-term. But long term it’s injurious.”

On the other hand, “If you have Carpal Tunnel Syndrome, wrist braces are the best investments you can make,” says Koffenberger. “It makes a big difference to put them on and rest your wrists when you finish drawing, even if you don’t think you’re having any symptoms,” says Passey. The bottom line: When considering a splint, use discretion. Wear a splint only if recommended by a doctor. Carefully follow your doctor’s instructions to ensure that wearing it yields the most beneficial results.

Braces can also be effective when worn at night. Intriguingly, sleep may be partially to blame for the pain associated with RSI. Many people flex their wrists intensely and repeatedly during sleep, and this can become a serious problem. Sleep-flexing, coupled with daytime pressure, could very well cause and exacerbate many of these disorders. People who suspect this might be a factor should consult a doctor about wearing a brace at night. Says Koffenberger, “The best thing I have found to prevent or overcome Carpal Tunnel Syndrome is to wear a wrist brace at night. The metal plate keeps me from bending my wrist while sleeping.”

For severe Carpal Tunnel Syndrome and other forms of RSI, many doctors prescribe steroids, nonsteroidal anti-inflammatory medication, or advise corrective surgery. Many chronic pain sufferers, however, are wary of these measures: “Just because steroid treatments or anti-inflammatory medications mask the pain doesn’t mean they are helping the problem. It is only through rest and appropriate exercises that the source of the pain heals,” says Puls. Surgery, steroids, and anti-inflammatory medication are options that should be carefully considered and evaluated by a trusted doctor.

Although the last thing we want to do is discourage anyone from drawing, we hope this serves as a reminder for all artists to continue paying close attention to the signs their bodies are giving them. It is far easier to prevent than to cure a repetitive strain injury, so it’s essential for artists to take care of their most vital tools: their bodies. So sit up straight, stretch out, support your arms, and keep drawing.

Edith Zimmerman is the editorial assistant for Drawing.