[Although it’s a stationary profession,  making art can still cause injuries: backs, wrists, arms and more. Kriota Wilberg is a cartoonist and massage tehrapist whose upcoming book Draw Stronger, (coming in April) gives a ton of advice on how to avoid repetitive stress injuries and recover once they strike. As a supplement to the book, Kriota proposed this column, Get a Grip! to talk to injured artist, discuss their recovery and give other tips for safely making art. There’s a lot of solid advice here (charts!) but remember: if you’re in pain, seek medical attention!]    

Nate Piekos, the founder of, has created some of the comics industry’s most popular fonts, lettering comic books for Marvel Comics, DC Comics, Dark Horse Comics, Image Comics, as well as for independent publishers. Nate’s work extends to video games, television, and feature films. At the end of the summer of 2016, Nate started experiencing pain in his hand, shoulder, and neck. The pain became so constant he had to completely re-adjust his relationship to his job and his life in order to deal with his new reality. I learned of his injuries through his Tweets about them last August. I interviewed Nate vie Skype on September 13, 2017 and the interview was edited and updated with Nate in November, 2017. I find his experience with injury nightmarish but hopeful and a must-read for everyone working in comics.

Nate Piekos

In Part 1 of this interview Nate describes the early stages of his injury, his experiences with treatment, his changes in equipment, and the process of “healing by millimeters.” Everyone’s experience recovering from injury is unique. This article is not meant to offer medical advice.

KW: When did you first start to notice your symptoms?

NP: August of 2016. My wrist started to get sore. I didn’t think anything of it. At the time I was working out five days a week doing cardio and light weight training. I thought I must have tweaked something.


It didn’t go away. Then my thumb started hurting and I thought, “Oh, that’s odd.” But deadlines were looming. I was in the middle of this cycle where I worked a lot every day and I trusted that my wrist would just fix itself and I could get through it. That was completely wrong! I wish… I really wish that I had stopped at that point because I could have saved myself over a year of pain, probably. But I pushed it and pushed it and then eventually the shoulder started. Then I started having to ice my arm every day, and I’m like, “Oh no, this is bad.”

KW: That’s a very quick progression, from August to November (of 2016).

NP: Yeah, I guess so. Before the injury, I was completely normal. I could abuse my right arm. I could work a 12-hour day with my arm up in the air, working on a Cintiq or drawing at my drafting board. No symptoms at all! And then all of a sudden it just went like a chain reaction all the way up my arm.

KW: When did you go to the doctor?

NP: Early on I went to my regular doctor before it got really bad and knew it was a big problem. He said that it was probably just a sprain or a strain or something. It turned out that was wrong, so I went back to him when things got bad and he wrote me a prescription for physical therapy. I spent four months at that first physical therapy place, then I switched. I’ve been in the new one for about a month.

KW: Your diagnosis was wrist tendinitis, is that right?

NP: It started out as wrist tendinitis in my right hand. Originally it was a biceps impingement in my shoulder with the rotator cuff involved. There’s also some thumb and neck stuff going on.

Logo by Nate Piekos for Uncanny X-Men ™ Marvel Entertainment.

KW How long have you been lettering?

NP: Professionally since about 2002.

KW: What kind of equipment do you prefer to work with?

NP: For years I used a Wacom Cintiq and now I don’t.

Now I’m using a Wacom tablet. I’ve changed my work area drastically at least three times since my injury. I just got a sit/stand desk. I’ve bought this stupidly expensive chair I’m sitting in. Beyond my workspace I’ve done everything from a new mattress, new pillows, to every type of brace you can think of. At this point if you told me magic would help, I’d try it.

The wrong way! Illustration by Kriota Wilberg

KW: Sure! Even though you’ve made all these changes you’re still looking for more to help you move forwards. Of all the changes you‘ve made so far, which ones do you think were the right way to go?

NP: The only thing I can think of besides physical therapy is not using the Cintiq any more. For 8-10 hours a day my arm was supported by my shoulder. It was loading, and now my arm position is more ergonomic, at a 90-degree angle, and flush with my torso. As far as I know, that’s probably why my shoulder is better. The only measurable thing that’s improved with me is my shoulder.

KW: That’s interesting! In terms of drawing, general wisdom says, “Use your shoulder! Make big motions!” But injury becomes a matter of what joint you use and how much you use it. And that joint is vulnerable to injury.

A better way! Illustration by Kriota Willberg


NP: I’ve been in physical therapy for five months. I feel like I’m getting better. I tend to be a “glass is half empty” kind of person. My wife is the one who’s cheerleading me. She’s saying, “Look! You are better! You’ve got these small improvements!” So yes, I call it healing by millimeters. It’s hard to see where I’m getting better, but I’m not getting through my workday by having a bucket of ice by my desk and putting my hand in it, anymore. That’s important!

KW: I think “healing by millimeters” is very descriptive of injured artists’ experiences. Of all the changes you’ve made, is there anything you think has been a waste of time? Something you regret doing?

NP: I wouldn’t call anything a waste of time in that I had to try it to rule it out. The biggest draw back of that has been the money spent and time wasted. I’ve literally dumped thousands of dollars to change my workspace over and over again, trying anything. But you don’t know until you try it, which is the hard part.

In our living room we have a basket of rehab gadgets – rollers, and rubber bands, and foam rollers. We call it the basket of pain. I’ve got all these toys. It’s like, this week I’m going to roll out my wrist twice a day and see if that changes anything, and then this week I’m going to do all this back strengthening stuff and see if that works.

I’m on my second physical therapy place because the first one basically gave up on me and told me to go live in pain. They were like, “Well, maybe you should just get used to this.” It was time to go at that point.


KW: Wow! That’s hideous. But your new physical therapists are working out?

NP: My new physical therapy place is fantastic. But I’m sort of a conundrum to them because this is injury from art! They’re used to sports injuries or older clients. I had to introduce them into the world of comics to show them why I’m like this. They were all kind of scratching their heads. But they’re really good and encouraging and helpful.

KW: And I bet they’re really interested in you, too!

NP: It’s been a little weird. I had to take pictures of how I’m sitting. My posture is terrible from 20 years of working alone in my home studio with nobody saying “Jeez Nate! Will you sit up?!?” People have told me throughout my life, “Hey, you’re a little stooped over there, buddy!” but I never gave it much thought because I was fine. I’ve always been fairly athletic. When I was in my 20’s I lost 75 pounds. So I thought, “I know health. I know how to eat. I know how to exercise. I must be doing all the right things…” Not so much!

KW: Don’t you think that if you hadn’t been healthy already, this probably would have happened a lot sooner?

NP: Yes. I’m doing my best now to sit up straight and be constantly aware of my eyesight with monitors. The neck thing only happened when I was in physical therapy doing all the stretches.

Lettering by Nate Piekos for Shaolin Cowboy © Geof Darrow

KW: Oh, interesting! So once your posture started to change, then you noticed the neck stress?

NP: Yes! From trying to change the curvature of my spine that happened over 20 years, only in a few months.

KW: Yes, that kind of radical change can be hard on everything. You also draw and play the guitar. How are those activities affected by your injuries?

NP: They’re down to zero. I have to save every good moment with my wrist for the paying jobs and that kills me because, I don’t know if you can see it, behind me – that’s a wall of guitars! I’ve been playing guitar since I was seventeen and that’s my number one way to chill out. It’s my way to step away from comics and reset my brain. I haven’t been able to do it for eight months and it’s killing me!

I usually have one or two of them out on stands so that I can just walk by and plug them in and play them for a couple minutes. I had to put them all away because just looking at them in the room… I can’t… when I want to pick it up, I can’t. So… Sorry I’m such a bummer!

KW: You’re a “bummer” but you’re a very sympathetic bummer!

[Continued in Part Two]

Kriota Willberg uses her experiences as an artist, massage therapist, and health science educator to create comics and teach artists about self-care. But even she will tell you not to use her work as a substitute for medical care (go see a doctor). Her injury prevention book, Draw Stronger, will be out April 2018 from Uncivilized Books. Willberg is the inaugural Artist In Residence at the New York Academy of Medicine Library. For more:




  1. Thank you Kriota Wilbergfor such an interesting and helpful article. As a beginner in comics designing, this really helped me. I will make sure to avoid such injuries. Thank you to Nate Piekos for being open with his painful experience, speedy recovery to him.
    I cannot wait to get “Draw Stronger” , i hope it will be available in South Africa too.

  2. I’m recovering from a set of neuropathy symptoms from overwork as a freelance digital illustrator. This article is a near mirror reflection of what I’ve been experiencing. Healing in millimeters has been hard, and I’m still working on a better work space and sleeping situation to help with that. My physical therapist was somewhat baffled by me as well, I mostly got exercises for carpal tunnel and cubital tunnel syndrome, but still experience problems with my neck, back, and hand which haven’t been addressed. It’s an ongoing battle. I’m looking forward to this book very much, I’m going to recommend it to all my peers and friends in the art world so we can better help our fellows avoid art related injury!

  3. Well, now I’m freaked out about getting a Cintiq. Will a future installment offer tips on best posture for using a Cintiq? Or is it more about taking breaks and not overworking?

  4. Please don’t freak out about Cintiqs (Kate Willaert and everyone else)! I use a Cintiq and love it. Different work stations work better for different artists. There will, over time, be future installments, galore – with tips on posture, breaks (always a great idea no matter what your workstation set up is), and more!

    And thank you, Katie, for sharing your injury status. It’s important for artists to understand that injury (and healing) can happen to any of us. Self care is very important.

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