I have also taken to using a rubber finger on my index finger to pull the needle through and reduce some hand strain. I've used all sorts of thimbles, this is not the best one I've used but it is the cheapest and doesn't wear out. My hoop is only a 14 inch because I have short arms
I am a self taught quilter because when I wanted to learn how to quilt in the traditional rocker method, nobody would teach me. I practically begged other quilters to teach me since there were no classes. I tell you, I would have walked on glass but no, nobody took me under their wing.
Now this sounds unusual for quilters not to share but I've come to understand why. I think they felt that the way they did it might not have been the "real way" and they didn't want to corrupt me. The answer was always, you have to learn your own way because everybody does it differently.
I got every book out from the guild library and proceeded to teach myself. I tried just using my finger underneath to feel the tip of the needle, I couldn't do that, I kept subconsciously moving my nail in the way to avoid the pain until I lost that fingernail.
I switched to a rounded thimble on the underneath finger and that was working. Of course I had read that 12 stitches to the inch, top and bottom was the goal to be a good quilter. I no longer believe that! I impose my own standards now to please myself!I have to say that the perseverance paid off, why did I persist when I could have given up? There were no long arm machine quilters, big stitch hadn't taken off, and machine quilting wasn't what I wanted to do.
I now have the pleasure that hand quilting gives me, the quiet moments of the needle moving in and out, creating the soft wrinkly texture of a quilt coming alive.
I can't beat the feel and look of a hand quilted item made by my own hands.