I have trouble with my hands and wrist and a friend of mine cannot stand for long. So, we trade work. I have a long arm, so I quilt her quilts for her and she does all my binding. We are both very happy with this arrangement. I also have an ergonomic rotary cutter and a cutting table set high. I wear a wrist/hand brace when cutting or doing any type of hand work. I also stop and do hand and wrist exercises so my hands don't cramp up. When working on the long arm, I wear good shoes with good support to protect my spine/back. I am considering getting anti-fatigue mats as well even though the machine is on carpet on the second floor (so no cement). When working on the long arm I don't grab the handles tight, just guide them lightly - otherwise my hands cramp and hurt. After each pass I stop and stretch and my fingers and wrist. This helps a lot. It is amazing what we remedies we can find to be able to continue our beloved quilting!