Drawing Basics: When It Hurts to Draw

24 Feb 2014

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.

Colored pencil drawing by Leslie Arwin of the median nerve.
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--colored pencil drawing by Leslie Arwin
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--colored pencil drawing by Leslie Arwin
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.


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+ Add a comment


andrew wrote
on 26 Nov 2008 11:16 PM
Hello, Great article. I've been drawing all my life but only on a daily basis for just over a year now. I've always drawn holding the pencil the same way I write. But heard the best way to hold the pencil was underhand and using a masonite board at roughly a 90 degree angle. So this way your arm is not supported by anything. I switched to this way of drawing in January and started experiencing pain in the summer and it's been somewhat chronic ever since. At times the pain comes almost immediatley. I've never experienced pain in my wrist until I switched to this method. And when I was drawing before I was never a casual drawer, 4 hours or more a day everyday. I've talked to my doctor about this and he prescribed advil and to wear a splint while drawing. Which I don't really think will help my problem. I guess why I haven't gone back to my old way of drawing yet is that I'm a little confused as to why it's affecting me like this if that's even the problem. I've seen many art classes and they all draw this way especially when drawing a nude model. And I've heard references made about the masters such as Leonardo and Michelangelo stating this is the way they drew. I read your article and it was the first I've found for artists and was wondering if you could give me some feedback? Thanks so much.
MollyR@5 wrote
on 17 Mar 2012 12:26 PM

I have carpal tunnel and arthritis in both hands.  I wear braces at night and they do help. Totally agree that it is not a good idea to wear them while working. I find that if I do my hands become weaker and more painful.  My doctor is recommending surgery for both hands but I am hesitant as I do not want to lose time away from my art and can't be certain that the surgery will allow me to retain the mobility needed to draw. But the pain is worse everyday so that may be the only option. Great article!

tomottoe wrote
on 1 Mar 2014 12:34 PM

I strongly recommend a book called "Overcoming Repetitive Motion Injuries the Rossiter Way" by Richard Rossiter. I am in no way affiliated with Mr. Rossiter--my rolfer introduced me about 15 years ago to the stretch regimen he created. Even just occasional maintenance with these stretches, which require the help of a friend, can do wonders to alleviate the pain and restriction of RSI, and often eliminate the need for surgery.


MLP Rusty wrote
on 1 Mar 2014 3:12 PM

Thanks so much for the great advice.  A suggestion for another topic: artists with essential tremor, how they cope, how they continue to be creative.

guayfra wrote
on 1 Mar 2014 4:08 PM

I used to have a carpian tunnel problem in my left hand. I would wake at night with my hand numb, every night. My right had started to be like that also. Sometimes i would feel pain in my left hand if i had carried something during the day. Splints only moved the problem from my wrist to my elbow. Therapists told me to not lie on my belly at night. Still it went on. I had seen a woman with both wrists in a plaster and i didn't want any surgery,

A few years ago my osteopath sent me to see a Pilates therapist. She worked on my lower back, on my upper back, on my shoulders, hardly ever on the wrist per se. I started doing Pilates every week and then twice a week, at the YMCA + Gyrokinesis. First i found a way of letting go of my shoulder, lying on my belly (yes) to relieve the numbness at night. And then it subsided; now i feel it maybe once every two weeks and it doesn't last.

Bluebird18 wrote
on 2 Mar 2014 11:14 AM

A very comprehensive article full of great tips. As an artist, I can certainly appreciate the problems we experience. Oh how easy it is to sit for hours at a time when you are on your game! As an Occupational Therapist, specializing in treatment of hand and upper extremity injuries and disorders, I see many patients with RSI and several things become very clear. We are all made very differently from one another, both physically and emotionally. So we all, individually, have to adapt our environments to fit us, not the other way around. For carpal tunnel sufferers, I would suggest you start with the wrist. You want to keep it straight if you can, or slightly cocked back, but not bent forwards or flexed. The reason for this is to reduce the pressure in the tunnel which may be exerting pressure on the median nerve, causing pain and/or numbness or tingling. So, set up your workstation with that in mind, whether working at a keyboard, table or easel. This will also determine the height of your work surface, the height of your chair and if you need foot support to maintain good posture. Also avoid the 'death grip' on whatever you are working with....pencil, brush, pastel, etc. Great suggestions in the article, but you may also want to try an alternative grip. It feels weird to begin with.....like wearing new shoes, but may help. Hold the implement between the index and middle fingers and thumb tip. This causes much less pressure in the carpal tunnel and less pressure on the joint at the base of the thumb, a frequent source of pain in older thumbs. Also remember, the arm bone is connected to the backbone, the backbone is connected to the hip bone, etc, etc. There may be more than one problem, or one problem is cascading into several. I love the get up and move/stretch when the CD stops, but if the CD is more than an hour's duration, it's time to stretch. Use the oven timer???  And perhaps talk to your local friendly Hand Therapist for further help.  You can find a directory at the American Society of Hand Therapists or at ASHT.org.

on 21 Jul 2014 7:39 PM

Great article, excellent tips and advice.  I experienced carpal tunnel syndrome many years ago after teaching a portfolio preparation course at an Art's Academy for gifted Middle and High School students.  After helping to mat college protfolio work and final student show work, with NO mat cutter and only box cutters for a week straight, I could not even open my hands.  Excruciating pain, lasted weeks, doctors wanted to do surgery.  Long story short, a friend recommended accupuncture!!  I thought it was crazy but the pain motivated me to try it.  It was miraculous.  Sixteen sessions with a Chinese trained doctor/accupuncturist, and I was drawing, painting and even playing tennis, again.  Now, if I ever feel any stiffness, aches or pains, I go for a couple of treatments and I'm good to go.

on 21 Jul 2014 7:39 PM

Great article, excellent tips and advice.  I experienced carpal tunnel syndrome many years ago after teaching a portfolio preparation course at an Art's Academy for gifted Middle and High School students.  After helping to mat college protfolio work and final student show work, with NO mat cutter and only box cutters for a week straight, I could not even open my hands.  Excruciating pain, lasted weeks, doctors wanted to do surgery.  Long story short, a friend recommended accupuncture!!  I thought it was crazy but the pain motivated me to try it.  It was miraculous.  Sixteen sessions with a Chinese trained doctor/accupuncturist, and I was drawing, painting and even playing tennis, again.  Now, if I ever feel any stiffness, aches or pains, I go for a couple of treatments and I'm good to go.