Expert shows how pens should be held

Co-contraction of agonist and antagonist muscles (a necessary
occurence for any episode of fine motor control as well Dr Mann knows) can
only explain the tightness of a grip and not the position. Anecdotally,
many sufferers of writers cramp are helped by improvement of writing
position, but a neurophysiologist is perhaps exposed only to those who are
not.

Irritatingly, among three left-handed SSI Fellows there is no agreed
hand position, although all hold the pen in the way illustrated in the
drawings, that is on or above what my wife would probably call the first
metatarso-phalangeal joint and what I would say was Not in the Crutch of
the Hand. The options for left-handers appear to be limited only by their
inventiveness in dreaming up some new way to disport either themselves or
their piece of paper such that the left arm doesn't smear ink all over
what has previously been written, although in some circumstances this can
be a blessing.

To date the left-hander has four well-established options:

1. To write with the right hand. My brother, a left-hander taught ab
initio by a lost generation of Australian schoolmarms does this. His
writing is dreadful. I, a right-hander, use the fingers of the left hand
for the fingering of my violin. My playing is dreadful. Whether this
speaks against using the non-dominant hand or whether it merely informs
the gathered readership of the BMJ of my talentless family, I cannot say.

2. To position the paper twelve inches to the left of the left
shoulder. The left hand then adopts a position relative to the writing
line not unlike that of a right-hander.

3. To position the paper at ninety degrees such that the line of
writing (left-to-right) descends towards the writer's belly as he writes:
the top of the paper is at the three o'clock position, as opposed to its
normal twelve o'clock position.

4. To hook the hand above the line of writing, and make all the
penstrokes in the reverse order; so where a right-hander makes the top-
left bit of a letter first, the left-hander makes the bottom-left of the
letter first. I am told by its most distinguished practitioner, Tony
Curtis FSSI, that one must wait for a line of writing to dry before going
on to the next line.

It may, however, prove useful not to address which is a 'correct'
position (the captions, though accurately placed, were alas not my idea
but were added by some kindly member of the BMJ editorial staff) but
rather to consider why one pen hold leads to cramp and another doesn't.
This relates to cursive handwriting, which has a natural and gentle up-and
-down rhythm to it, although ironically a good Italic hand owes its beauty
to its regularity, and too much regularity detracts from legibility.

Any handwriting seeks a point of equilibrium among distinct pulls in
three mutually exclusive directions:

first, all the letters should appear distinctly similar, to give good
related form;

second, all the letters should appear distinctly different so we can
distinguish between them;

third, all the letters should be made easily by the least and easiest
movement of the pen.

It is to this third demand that we bow when avoiding writer's cramp.
I can only encourage experimentation, but among left-handers it may be
helpful to rest the right fingertips on the bared left forearm when
experimenting: one gets rapid feedback as to when lots of muscles are
being used to make small pen movements.

Failing that, computers aren't too bad these days.

Richard Middleton

Chairman

The Society of Scribes and Illuminators,
6 Queen Square,
London
WC1N 3AR