[Jenniferlove]

...
And my method has always been to noogle for like 10-20 seconds, release, massage then repeat.  I was not holding it for long periods of time.

So, you did a lot of pumping with your hand. Did you always use the same hand? Did you pump very hard? Was is mostly on one breast?

What other way is there to pump besides with our hand?

I would say I was most likely using the same hand.  I pumped my left breast 95% of the time and all issues on my body are on the left side.  I probably pumped harder than you should I would say.