I an an ED nurse of 8 years...My technique goes like this: after picking my spot and preparing the area, I say, "Okay...on the count of three"...(I position the syringe over the site)..."One"...(then I insert the needle before they tense up)..."two"... (as I withdraw the plumger)..."three" (as I inject the contents). I am convinced that I experience less movement and pulling away this way. After all, most of the pain associated with shots comes from the volume and nature of the contents.