I have been doing it for so long that I don't even think about it. I made my first quilt when I was 16 or so. I will be 62 next month. Keeping the fabric loose in the hoop does make it easier. When I was younger I used a very short needle and the thinner the better. With age I have had to use a little bit bigger needle just because my hands are aging. Practice is the real answer. It bothers me when everyone automatically assumes that you will machine quilt or long arm all quilts. I can handquilt a bed size quilt in less than six weeks and watch TV, visit with friends or family and not have to hide myself away with my machine. For many years I quilted one stitch at a time. Rocking the needle is a little faster but either way gets the job done.
A lot depends on the tightness of the weave of the fabric and the thickness of the batting. Make yourself up some samples using different fabrics and battings. That is the only way to find out what works best for you.
I love the look of batiks but hate handquilting them. The weave is usually tighter and the extra dyes make it difficult to puncture with a hand needle.