Sunday Mailbag- RSI Trouble?

February 1st, 2015 | Posted in Mailbag

Sunday Mailbag!

Q: A few months ago I finally got my first serious contract as a freelance illustrator, but unfortunately, almost at the same time I started feeling slight twinges in my wrist, that initially just came and went, but now they’re starting to last longer and increase in intensity as well.

I have been considering getting a Cintiq (now I’m using a tiny Bamboo, that I think because of its relatively small surface being mapped onto a bigger screen kind of forces me to concentrate too much on getting my lines right and thus grip the pen too tightly). Do you think that could be a solution or is it just a bad habit that I’d still have, independent of the size of the workspace and the direct eye-hand connection? The other thing is, most articles I read say that one’s forearms should be in a horizontal position while the screen should be at eye level, which might not be the case with a Cintiq, so from that aspect e.g. an Intuos might seem like a better choice. What do you think about that? I’d also appreciate any other thoughts you have on ergonomics and ways to prevent RSI.

A: Sorry all for the long question, but there were some specifics here that I thought belonged part of the discussion.

First off, like I say when I answer question on copyright and right of publicity and say I am not a lawyer, I am not a doctor. If you are having problems with repetitive stress injury to your drawing hand/wrist, seek real medical advice.

That said, I have only had problems with RSI once, and that was a bout of¬¨‚ĆDe Quervain’s Tendonitis in my wrist. It was not caused by drawing, but by an injury from punching a heavy bag. The problem was that drawing exacerbated the injury, and would both not let it heal and caused a lot of pain making drawing harder to impossible. I went to the doctor and this ensued:

Doc: “You have De Quervain’s tendonitis, where the tendons in the outer area of your wrist swell and rub against the band of tissue that holds them in place, causing pain and further swelling.”

Me: “Amputation?”

Doc: “Funny. No, you have to cease all activities that irritate the issue for as long as it takes to go away. Once the swelling is gone and your tendons are normal sized again, you’ll be fine unless you re-injure it doing the same activity that caused it in the first place. What did you do?”

Me: “I was punching a heavy bag.”

Doc: “I thought you said you were a cartoonist?”

Me: “I’m a cartoonist who occasionally hits things really hard.”

Doc: “So, you make a living drawing with your right hand, and you put that hand in a padded glove and throw it with all your strength against a large heavy object? And you consider that a good idea?”

Me: “….”

I sold the heavy bag.

It took over a year for the tendonitis to completely clear up. In the meantime I had to give up doing live caricatures because I pressed too hard with the pencil and that pressure was what was causing the irritation to the injury. Regular drawing and working was not a problem with that particular injury, so just the live stuff had to go, or I needed to switch to a marker that didn’t require the pressure.

Anyway, on to your question.

First, ignore the advice about horizontal forearms and vertical screen… that’s for typists. While I am sure using such a small surface area for drawing and painting like a small Intuos or a Bamboo is part of the problem, likely the way you hold your pen and how hard you are pressing for pressure is the real culprit. I’ve seen rookie caricaturists hold their pencils in the oddest and most awkward ways. Good ergonomics is the most important aspect to avoiding having a problem with RSI. The second most import aspect would be avoiding doing the same, exact motions over and over again… that’s what it’s called repetitive stress injury.

The reason I never had any RSI problems even after doing live caricatures full time for 20 summers was, surprisingly, because I did live caricatures full time for 20 summers. Yes, I pressed hard when I drew live to get big. bold lines, but I also learned to draw not with wrist and finger movements, but with my arm and shoulder. I’d pivot my forearm at the elbow and rotate my arm at the shoulder to get big, sweeping lines, with my hand went along for the ride. Sure, for the fine stuff I’d use my wrist, but by involving my whole arm I switched between different muscles, tendons and ligaments throughout a drawing, meaning the repetition on any one tendon group was minimal. Rethinking how you actually draw is not easy to do but just experimenting a bit might loosen you up.

How you hold the pen/pencil is also important. Grab the pen and take a good look at how you are holding it. Where do you apply the pressure from? I’ve found that artists that have trouble with RSI tend to apply pressure from one finger somewhere on the pen, usually the one placed at the top of the pen opposite the drawing surface. A better way is to hold the end of the pen in a three-digit grip, Thumb-index finger-middle finger. all surrounding the pen in a triangle shape. Then apply your pressure with all three equally like you are trying to extend them all at the same time. Better yet, learn to use the weight of your arm to apply the pressure. That takes the stress off the little tendons in your hand.

I would say that getting a Cintiq, or a larger Intuos, would help because with the greater surface area you’ll be able to use your arm and shoulder more for drawing, but I know plenty of digital artists who use small tablets and have no problems with RSI. You know you can adjust the pressure sensitivity of your tablet, right? Try making it more sensitive so you don’t have to press so hard, and develop a lighter touch with the pen. You won’t like it at first as you are so used to using a certain level of pressure, but keep at it and you will quickly get the same results with a lighter touch. That will make a huge difference on the stress you are putting on your tendons.

Once you have RSI problems it is hard to get rid of them because the act of drawing, even when done more ergonomically, will keep that RSI from healing. A brace or wrapping your hand in an ACE bandage for a while while working on fixing the issues that caused it in the first place will hopefully keep you drawing.

Thanks to¬¨‚ĆLorant Sarkozi for the question. If you have a question you want answered for the mailbag about cartooning, illustration, MAD Magazine, caricature or similar, e-mail me and I’ll try and answer it here!


  1. anon says:

    Have you considered making a patreon account eg. pay 10$ per month to get one critique on your caricature, pay 1$ per month to see “sketch of the week”.

    Some artists make a few thousand a month from that.

  2. I had a bad bout of RSI about 7 years ago. In the short term I had prolotherapy (glucose injections), which sorted it out. In the long term, I’ve avoided recurrences by installing software on my computer which forces me to take breaks and stretch my fingers, hands, arms and shoulders. I really notice the tension when I ignore the breaks and work through.

    I’ve used Workpace and Breakz. Both good.


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