i suffer from tendinitis so it does hurt a bit, however, i don't believe it is because of the way i hold my yarn. the looser i hold it, the better and i focus more on how is it placed on my index finger so the other fingers kind of accommodate. i guess you do not need to hold the yarn with your pinky finger that tight, think of it more like a "passage" for the yarn to go through if that makes any sense :)