The best and easiest way for me is having a large enough table or tables so that the quilt is supported as much as possible. I think I use a combination of rolling the quilt and scrunching it up when quilting. I have a wall behind my sewing table, so that keeps the quilt from taking a run for it, and keeps it supported so there is less stress and strain on the quilt and you. If possible a large table or ironing board along the side of your sewing table should help as well. Just keep experimenting to find what works best for you with the quilting and with your neck,back and shoulders. You'll find a rhythm that works.