Avoiding injuries from kneading

Speaking as someone who does a lot of kneading*, not only of dough but of clay as well (where it's called "wedging"), ideally you want your kneading counter a few inches lower than your general culinary work counter.

Here's how to measure: stand upright, straight-backed with your shoulders back in front of some arbitrary counter. Extend your arms without moving your shoulders. The ideal wedging counter should be the height where your hands meet it just before your arms are fully extended (so elbows bent at about 15°). This encourages you to keep standing upright and deters back injury.

However, if you are getting pain in your wrists, it is unlikely to be because of counter height. Instead, it's likely because you are either bending your hands too far backwards, or twisting them and then applying pressure Try kneading the bread very slowly, and look at your wrist positions while you do so. First, your hands should never bend back more than 45° from your forearms. Second, if you are applying pressure to the dough, your wrists should be straight and not twisted.

Beyond that … you should maybe ask a medical professional. If this is a chronic issue, you'll find that 20min with a physical therapist will do you more good than several hours on the internet.

* i.e. I am not a doctor, physical therapist, or ergonomic expert. The above is based on my personal experience, due to grappling with back and joint issues from computer work combined with cooking and clay work, with some personal advice from a physical therapist.

I see two questions here that are connected.

1. The right height of a kneading surface.

As a rule of thumb, the surface for kneading should be about 10 cm / 4 inches lower than for chopping. You want to be able to ever so slightly lean on your dough, using your body weight to support your hands and arms. Too high means you will inadvertently pull up your shoulders and are more likely to put pressure on your hands and wrists at a bad angle.
I, being on the shorter side, have occasionally used a small step, especially when working with heavier or lots of dough.

2. Good technique to protect your joints.

If you knead with the part of your hands where the fingers meet the palm, you are putting a lot of pressure on a piece of your anatomy that is designed for finer tasks. Plus you are likely splaying out and bending your fingers more or less backwards, which you will also feel in your wrist.

Imagine yourself leaning on a table, for example during a conversation with a coworker who is just telling a captivating story. You will almost certainly use the base of your palm, near the wrist. And that's roughly what you should use for kneading as well.

Apart from that, don't bend your wrists to far backwards. Even with a lower surface, I aim for 45 degrees (give and take) between my forearms and the counter and I keep my hands on the same axis as my forearms, never turning them in- or outwards. If I need to adjust, I will work nearer to my body or keep the dough a bit farther away to compensate for the height.

Keep your back mostly straight and your shoulders down - most of us sometimes go "hunchback-style" after a while, so check yourself. (You don't want to have an aching back instead next time!)

I've made bread for close to 50 years and still do but no longer as big a batch at a time. I've also got shoulder injuries from when I was a kid and in my 20s, had a wooden window sash drop down on my wrist. I learned by trying out ideas on what was best for me in kneading dough. You may not wish to do the same but perhaps. It made a huge difference for me.

Ever seen photos of women in different native cultures from around the world kneeling on the floor or ground, bum lowered on their heels as they ground grain or kneaded dough? It's not due to lack of a table or raised platform but for how easy it becomes to grind grain or knead dough. They can put the weight of their upper body into doing so. I didn't sit completely on my heels though but would rock back and forth a little throwing more weight into it.

I decided to give it a try and couldn't believe how easy it was! I git a large plastic round dish pan just for that purpose. A pan with a diameter of 40-50 cm (16-20 inches) is ideal. I used a mixer to initially beat the batter and finished kneading it in the pan. The floor had to be swept/vacuumed thoroughly first and clean even if the dough never touched the floor. Otherwise, it didn't feel hygienic to me. I put a wrung out wet cloth under the pan so it didn't slide around.

I enjoyed kneading dough like this as it contained any mess. It was simple to work in all the flour and simple to add more as needed. I left the dough to rise in the pan too. That looked after the problem with my shoulders but I had to work out what to do for my bad wrist.

I've always seen dough being kneaded by folding it towards you and then pushing the folded part away with the heels of your hands. (Hope you can visualize what I mean.) But the angle of my wrist like that really hurt and I could only do a small amount for a couple of minutes. The whole purpose of kneading is to stretch the dough to develop gluten. It doesn't matter what method is done as long as the gluten is well developed.

Rather than kneading the typical way, I used fists instead, using the flat of my knuckles to push the dough both down and away. Thus way, I could keep my hands in line with my lower arm with no wrist strain. I got the idea from seeing pushup hand grips and figured keeping my wrists straight would work since that's the idea behind them.

So that's what worked for me but my legs are still very flexible and I have no trouble kneeling and getting up either. Not sure if it would work for you.

I make a fair bit of bread, but I don't knead for 5 or 10 minutes at a time ever. I have fairly severe joint problems.

Mix the dough, then set it aside for 20-30 minutes. The dough will look like a shaggy mess, and that's fine. Setting it aside for 20-30 minutes allows the flour to absorb the liquid and to allow the gluten to start developing. This is called autolyse.

Knead the dough for ten strokes, then let sit for 15-20 minutes. Repeat for a total of 4 kneading sessions. Each time you knead the dough, the dough looks smoother and smoother like you're used to seeing. Then let the dough sit for another 15-20 minutes, then shape the dough as you normally would.

The gluten still develops as it would had you spent the 5 or 10 minutes kneading.

You've likely read about no-knead bread dough recipes. They work the same way.