I have just finished a wall hanging--my first hand quilted project. Hand quilting takes practice--lots of it. The more do it the better you get. You have to hold your needle the way it suits you. I use my thumb and index finger to guide my needle.
When I started this project, i was getting about 3 stitches to the inch. Upon finishing, I could stack 8 stitches on my needle and filled up an inch length. I enjoyed hand quilting so much I can hardly wait to start another project.
Oh yes, I quilted it without a hoop or frame because it was basted very well.
So take heart, keep practicing and maneuver your needle and thread the way it works best for you!!
Chris