I use a broadhead arrow holder. For me, The middle thumb joint gives me trouble at times. Years of loading large printing presses with enameled paper, required lots of hand strength. My middle and end thumb joints are bad, not as bad as locked up, but still painful at times. The arrow holder allows me to palm the whole affair and take the use of the thumb out of the game of keeping the arrow stable. I use it mostly when I file sharpen, but by extending the head out it still stabilizes things with just four fingers and the palm. I think it would also help when using the Ken Onion model without the blade guides in place.