Guitar and RSI (A Personal Experience)

[Michael. A]

I thought this was important for all musicians. Its something that can happen to any one of you and having RSI myself I thought you might want to know how it has been for me on a personel level.

RSI is a term which is used to describe any kind of Repetetive Strain Injury where as mine is muscular there are nervous problems like Carpal Tunnel Syndrome which develops in your wrist which is a fairly common form of RSI (and 10 times more likely to happen to women) and other conditions affecting tendons as well.

If you have it full on you'll definately know and its bes to go see a doctor straight away. I have to say though that some of them are pretty dumb so never just trust your local GP, they don't know everything. If you are worried if they are gonna help ask them if they have experience with RSI if they don't then find someone else. Some doctors don't actually believe it exists. No joking!

So my story no one big or anything just like most of you I guess. I had been playing for 3 years 4 months. My technique had been adjusted 5 months earlier to a proper floating picking hand and left hand position as well as knowing the proper voicings and ways of playing.

On looking back at myself before I had full on RSI I noticed that my picking arm would ache when standing up and playing. I just thought it was me doing it wrong and also I noticed my arm would ache holding things up as well and my arm would shake as well if I were to try hold it steady. I also noticed after a lot of typing my left hand ring finger would kinda tense up.

So my RSI kicked in and it started as a tension in my nuckles and spread. The areas I got it most in both hands were...





Below where the little finger meets the hand
Along my index finger mainly close to the nuckle
Base of my thumb, the bit that sticks out where the thumb meets the wrist.
Inbetween my thumb and index finger that kinda bit of flesh thats there when you make a L shape it V with index finger and thumb.
In my the rest of my body where got affected later I got it...


In my wrists and forearm (this controls your hand a lot you wouldn't beleive)
Around my elbow
top of my arm
In my shoulders and neck
Where the neck meets the head

[Michael. A]

So on to the treatments I tried...


Well first my doctors perscription. A 4 week course of anti-inflamatories/painkillers (ibuprofen) which I don't think helped me at all really. I was also instructed to not use my hands. I had to though as I had a tone of coursework and my coursework deadlines for school and you don't get added time if it happens towards the end because you're supposed to have done it all by then but everyone knows that most work is done in the last few weeks ;).

I did actually get my guitars, put them in their cases and lock them in the attic with another case over them and a mirror on top so I had to look at myself in the mirror and tell me if I should really play them when I go back. I lasted a week and a half of hell!!! Afterwards I just cut down on playing cause I was worried my hands hurt.

Ok so next, I started taking fish oil tablets everyday. Don't know if they helped but didn't hurt. Supposed to be good for joints in lining the fluid between the joints. Like oiling a rusty hinge.

I got a powerball (http://www.powerballs.com/) and used that maybe too much which did more harm then good I think its very cool though and would probably help you if you used it correctly.

Ok next (I meditate anyway) I concentrated on my pain areas and relaxing them through meditation. This helped alot and after doing this often I started healing. The turning point was when I went to India in the Himalayas and started doing it properly. Thats when I noticed it helped.

Next is making sure you have the proper supports for your wrist support typing. Makes a huge difference I really can't emphasis this. Also one for your mouse and a proper posture and chair (still working on posture.)

Ok next and I did this all the time anyway I looked at my guitar and consciously looked at what hurt me and what didn't. Chords hurt a lot, lead less so unless bending notes. I noticed my strap was too tight and learned to play with it lower so it put less preasure on my shoulders (having a comfortable strap is important.) And finger picking, make sure you do it the right way or it screws your hand up, like with a classical guitar, the proper classical posture really helps you can feel it reduces the strain a lot. I changed my electric strings to 8s :) nice and light which helped reduce strain some more.

In general notice when you are tense and relax whenever possible as fully as possible. Thing with RSI is that you feel the muscle ache so you know what tense is and you can feel if you are relaxed more then others as you feel pain when you aren't relaxed. If you've read that excellent article on Stage Fright under the articles section and get stage fright then picture that kind of tenseness except you can't make it go away. I had a try out for a music course in this condition...

Ok while in India I met a herbalist and got a concotion for me. She said my blood was too acidic so my muscles would ware down quicker in use. The medicine I take is horrible but again after taking it I am actually improving.

I also did a treatment a guy who I stayed at in india told me to do which also helped. He gave me some eucalyptous oil. You get two bowls of water one hot one cold and put salt and the oil in both. Only a little eucalyptus as its strong stuff maybe a half a tee spoon of it should do nicely. Put one hand in hot and one in cold. Wait a while then swap over. The change of temperature improves circulation and the oil which has a burning sensation does the same too. The salt, he said, makes the saline solution draw out bad molecules in your blood but don't know about that.

I used to sit with an icepack on both hands as this is supposed to reduce inflamation which is what the pain is supposed to come from. No idea if it helped overall but does numb the pain.

I also take Vitamin B6 and B12 supliments to help cause I heard they help in muscle regrowth.

I heard caffeine is really bad for muscles as it dries them out but I havne't been able to remedy that one yet.

Something that also helped was massaging. Get someone to massage you with oil, its good for you anyway but its such a release cause you get so tense.

I got myself a magnetic bracelet I still wear. The theory is it improves circulation which is what massaging does too btw and so increases your bodies natural healing rate.

I am coming to healing enough to play a lot, I don't practice scales anymore until I improve. I can still write songs as much as before and my playing hasn't suffered though when your arms ache you can't play really which sucks. They are involved more then you would think.

I heard that some of the problem is caused from the shoulders and 2 professional musicians I know went to an oestiopath which sorted them out almost completely with similar problems to mine. I'm yet to try this though I will sometime. Conventional science really doesn't have all the answers yet, try everything that has helped other people with similar conditions. If you can afford it, its worth a try.

I took up singing and other instruments too and listened to a load of new music. Didn't stop me getting so depressed and I crying myself to sleep at night. It affects your whole life, not just guitar, I type a lot and might rely on I.T as a carrier and suddenly that goes down the drain. You can't relax properly and your muscles ache so much you can't sleep sometimes or ever get comfortable and people have it much worse then me.

The worst thing to do is over use your muscles in this condition particularly when you are cold. Playing with cold hands is the worst thing for it I think that you'd do in normal life. Also when you are warming up, don't move your hands as quickly as you can until you start hitting the notes. Stretch your hands and arms fully. I've heard doing regular exercise will help too, like running and weights. It makes sense it might be caused by lack of this for me as I spent all my time in my room playing :).

Enjoy your playing and let it be for the rest of your lives.

[Kuckelimuck]

I feel your pain bro!
For the 2 last months i`ve had pain in my left ringfinger right below the knuckle and at the middle part of the finger. I haven`t been able to practise at all this time. It`s really depressing. This comes from many houres of practicing everday with bad warming up. The pain has gone away a little but it seems that it won`t give in completely. What can i do?? If i go to the doctor they probaly just give some **** medicine that won`t do me any good.

[Michael. A]

Yeah I've got it there too. RSI supposedly does heal eventually. There are 3 stages or something like that. Stage one and two are completely reversible aparantly. But healing can take from between 2weeks to a year sometimes. Its not a set thing if its got better at all you can be optimisitc it'll heal fully if you rest it. Oh and possible look at it coming from your shoulder and upper arms. Its all connected and some people with that problem had it sorted by having an oesteopath work on them that I know.

[hairballxavier]

RSI's are no joke and if you ignore it it can be dehabilitating. I've never had it from playing guitar but I have had "tennis elbow" and "shin splints", 2 of the most common types of RSI's. I'm in the conctrete construction business and these injuries just creep up on many in this field of work. It's from pushing yourself too hard for too long with too little recovery time between periods of abusing your body over the long term.

I think the only thing that really helps is a recovery period which can be very lengthy if you ignore the symptoms for too long. Drugs may hide the symptoms temporarily but your body still needs time to heal the injury.

The creedo "no pain no gain" is true only to a certain extent. Pain is natural when your muscles break down and rebuild stronger. Sometimes pain=progress. You just have to learn to recognise the difference between the satisfying pain of muscle building and the sharp pain of connective tissue damage to know when you are pushing yourself too far.

Muscles repair quickly, bone, cartlidge, or tendons don't.

[Michael. A]

Kuckelimuck I just remembered. If its in an isolated spot they can give you a steroid injection for it. Steroids obviously aren't good for you but if its bad then it might be worth it.

[Kuckelimuck]

Ok, thanks i`ll keep that in mind but for now i will wait somemore time.

[hairballxavier]

BTW, steroid injections are not a do it yourself project. Steroids can damage connective tissue and cause many other medical problems.

[daviej]

Thanks for your comments everyone. This is an important issue that is too often ignored until damage happens. I have battled with tenosinivitis (pretty much the same as tendonitis but it's the tendon sheath that gets inflamed).

The things that worked for me were an anti-inflammatory diet, flax seed oil tablets, a more balanced lifestyle (getting outside relaxing walking etc) and meditation. I also re-evaluating my left hand technique to make it is completely relaxed, kept a classical position without stretching or pushing down (squeezing) the strings too hard. I also made sure my hands were warm before playing and stretching them gently and massaging them whilst warming up.

I would also recommend seeing a specialist. I saw one and he removed a ganglion from my wrist.

Since all these things happened, I have only had a few small issues with tenosynivitis. These have only happened when I have started to stray from the cures I mentioned.

Also, it's improtant to take regular breaks when practicing repetitively. This can be working on right hand exercises for a bit whilst your left hand relaxes.

[MattW]

The things that worked for me were an anti-inflammatory diet...

What specificially did you eat that had anti-inflammatory effects?

[Mandz]

what worked for me was not touching the guitar or computer keyboard for 3 weeks. i had to quit my job as a temp. then i did regular gentle unassisted stretches everyday for like a month. i got my wrists back to where i could play simple scales slowly. then i reduced my string gauge to the wimpy nines, lowered my actions to the point where frettin was effortless and cut out unneccessary tension form my hands/wrists/forearms. now i can play much better. still can't play my acoutic for very long though. need to get it set up lower with lighter strings. still, better than having an operation. my diet is still piss poor though. i never did anything else to treat it at all.

quitting my job now would be unworkable, as i suspect it would be for most people. still, you can cut down on unneccessary stuff anyway. hardest is not playing guitar when you've done it everyday for years already. depressing too. still, worth it in the end.

i still do gentle stretches everyday.

[Michael. A]

Yeah I think a change in lifestyle definately has to happen. I play now pretty much as much as I ever did which I'm so happy about and I have a new acoustic! It can work out fine.

[daviej]

The anti-inflammatory diet involved cutting back on red meat (I'm now vegetarian), and on stuff like yoghurt, cheese, chocolate - etc. Apparently it can clog your arteries up. Also having lots of fresh fruit and vegetables. Also, wholegrain bread was recommended over white bread, as was fish, though I don't eat it anymore.

[hairballxavier]

I would also recommend seeing a specialist. I saw one and he removed a ganglion from my wrist.



My brother had one of those cysts, got it removed, and then a new one came back and he had that cut out too.



But he is a drummer, so I don't think it really affected him the way it would a guitarist.



He couldn't do those whacked out snare rollls for a while but I think that was just because of the percodan clouding his head. He recovered very quickly though.

His "recovery diet' was JD, Rib eye steaks, cocaine and rock and roll.

But I don't think a drummers wrists take as much strain as a guitarists.

How much did your ganglion effect you ability to play?

[daviej]

Basically, the ganglion was getting in the way of a tendon. It was pushing it to a side, causing friction. The specialist said it might come back, but that was a few years ago and it's not back so far...

I think some people are more susceptible to tendonitis than others. I played cello for seven years without a problem, and then started guitar. After a couple of years of guitar the problem began to emerge. I think it also had to do with technique, and I fixed that up. But I noticed that at around the same age both my siblings started to complain of sore wrists. My father gets it too. It's probably genetic. I still think that anyone can get it if they don't use decent technique, but that some people are more prone to it than others

[daviej]

By the way, I have found sleep and stress to be significant factors also.

[Michael. A]

Went to the doctor for other reasons and brought it up again. He said its regarded as not existing as its seen as a self inflicted injury and if you stop everything it'll go away but may take a very long time to go away.

[Michael. A]

I'm acutally giving my guitars to friends now. So they play em as they need em and I'll ask for them back when I'm better. Total rest is the best.

[daviej]

If I'm concerned about my wrist I might work on playing slide or on compositions or something like that, that doesn't involve stressing my wrist. Aural exercises are another thing to look at.

[Kuckelimuck]

Ok guys how is your RSI and other problems going? Improving, worse?
Mine is neither better or worse

[daviej]

Check this out: http://www.scotttarulli.com/tarulli/thoughts.aspx (http://www.scotttarulli.com/tarulli/thoughts.aspx ) - seems a bit extreme, but worth reading.

[joeyd929]

Ok guys how is your RSI and other problems going? Improving, worse?
Mine is neither better or worse

Having a bad week...both hands hurt...spent lots of time learning wide chords that require stretching...it has taken a toll..I just take a little break or even play slide as daviej said......

I spend more time working on horizontal movement when my hands hurt...It really only requires a little elbow movement. Like I will just play on one string and use fingers 1 and 2 on frets 1 and 2. Then slid up to fret 3 and 4 and use fingers one and 2,,then up to the next group, frets 5 and 6..

There is always something to work on outside of physical aspects of guitar.

One really good thing to spend time on if your hands hurt is to write out all the notes of the guitar and spend time memorizing the notes and locations...

Always something to work on....

[Ryan2005]

You all said very well:cool:

[CaptainCaveman]

I think it is very important to play with others when you try to avoid injuries. When you are just playing, and enjoying it, jamming, playing songs etc. If you sit all day in your room with your metronome practicing scales and stuff, you obviously put more stress on your hands.

I can often solo for half an hour with my band, sometimes on a crappy guitar with fat, year-old, greasy strings, and not feel anything. But when I sit at home practicing I often tense up and start feeling pain several places.

(Please note, that I am not saying you shouldn't practice scales at home with a metronome... Just be more careful)

[MJK]

For me technique seems to be the biggest factor. Within the last year I developed my first signs of RSI. My pain is the base of my thumb by the wrist joint. Perhaps it started due to mountain biking, or maybe from the metal band I joined where my playing posture changed. In all the years I've been playing my technique hasn't changed much.

I sit to practice and to alleviate my RSI inflammation, I had to change the way I hold the guitar. For 15 years, I've been resting the body groove on my leg as probably most do. The pain kept getting worse. I hit the point where I needed to wear a wrist splint periodically. After watching some vids of a few hardcore shredders like Rusty Cooley, I noticed that a lot of these guys hold their electrics like classicals, wedging the round part of the body between your legs.

I started doing this also and even a few days after intense pain, I was able to play without any discomfort. My wrist wasn't bent in that awkward "L" shape to play the massive legato stretches I was trying to pull off.

As always, technique proves again to be key. Playing should feel near effortless. Relax those muscles and play with the lightest touch possible. Watch out for anything that feels uncomfortable because that's usually where trouble begins.

[Spanky]

I got tendonitis in the meaty part of my hand below my pinky in my first year of playing. I went to a doctor and he said it was a result of my "double joints" (i.e. I can bend my fingers to touch the back of my hand), he said the way to cure it was to build up muscle in my hand. After this I started to slowly increase the guage of strings and I currently use .13 strings and am free of tendonitis. I also found that eating fresh fruit helped.

Please don't take this as any sort of medical advice, this is just my experience.

[Revenant]

My condolescence to everyone who are unable to play.
I once read a letter in a music magazine, I think it was "Sound on Sound". This bassist had totally destroyed his joints and was unable to play at all. So he started making music on a computer instead.
Now, for those who have lighter symptoms of tendonitis or RSI, this could be a fine way to rest your hands but still hone yout muse and ear. I had a similar, although lighter experience with pain in hands this summer. It was a result of heavy practise for 6-8 hours a day(almost exclusively technical exercises, go figure...). So at last, I figured I needed a break to make my hands heal. So I fired up my favourite program, Guitar Pro and wrote a few new songs that I could start rehearsing as soon as I had recovered.
For musicians feeling that they have to do music all the time(I have Asperger Syndrome so I'm totally obsessed with music), Computer music can be a fine way to keep things flowing if you are temporary, or permanently unable to play music physically.

My best wishes to those with injuries. Hope you all recover soon!

[Kuckelimuck]

I went to the doctor today. He said it was an inflamation in the joints and gave me anti-anflamatory(is that really a word) medicine. He said it would be fine after about 10 days. I´m really doubtfull that i can play guitar in 10 days with no pain.

[MJK]

No, but anti-inflammatory is. If your symptoms are acute, it will probably help, but you still need to target the source of the problem otherwise it will come back. Find out what part of your playing is causing the discomfort and try to change your technique to avoid this. As I mentioned before, playing should not feel strenuous. If anything is uncomfortable or if any back/shoulder/arm/hand muscles are tense when you play, this might be the source of the problem.

[hairballxavier]

I went to the doctor today. He said it was an inflamation in the joints and gave me anti-anflamatory(is that really a word) medicine. He said it would be fine after about 10 days. I´m really doubtfull that i can play guitar in 10 days with no pain.That just treats the symptoms, not the underlying problem that caused symptoms.

[Kuckelimuck]

ok, still in pain. Quite depressing. I`m thinking about some alternative medicine treatment. What`s your opinion about that guys?
Where should i go, chiropraktor,acupuncture,herb doctor,voodo?.
How does tobaco affekt this problem? I`m using snus as we call it in sweden, you know you put in under the lip.

[Spino]

Are any of you guys Ganja smokers ?!... Ahh ! I'm serious!

[CaptainCaveman]

How does tobaco affekt this problem? I`m using snus as we call it in sweden, you know you put in under the lip.

I'm not exactly sure about tobacco, but generally, the less you care about your health, the bigger the chance of hurting yourself. One of the best ways to avoid injury, even from playing music, is simply staying in shape. At least it will make healing faster.

I don't have any pain right now but I have had about six months ago, and I found that the best cure for a sore wrist was running, swimming etc.

[Revenant]

Tobacco and marijuana are especially bad if you have problems with inflammation. Tobacco(snus included) decrease blood flow and thus heightens the risk for injury.

Drugs + RSI = problems.

Besides, mairjuana is bad for everything as it depletes neurotransmitters, shuts down the liver function and causes cognitive disorders. It might be good for creativity while you're high, but when you come down you won't be able to do jack if you've pushed it far enough to experience the symptoms i mentioned.

So its best to stay away from both.

[dbudde]

Tobacco and marijuana are especially bad if you have problems with inflammation.

Actually, according to this recent study, marijuana has strong anti-inflammatory effects:

http://www.sciencedaily.com/releases/2006/10/061018151055.htm

[Michael. A]

Hi there, been a while.

So... It turns out that my problem could be linked to a back problem i've had for a while. I've just stayed with these Austrian physiotherapists and a Massage therapist for a week, whom I met in Italy and went to Austria with. They said it probably a mixture of many problems however my back needs more support from my front lower abdomen so I'm building that up. The massage therapist said i need regular endorphin massage every week for a while. So its... stretches, message, and strength building it seems.

I notice a lot of its from my shoulders and upper neck into my head. Its perfectly possible this all started because of my back problems which affected my posture and put strain on different part of my body. X-Ray and MRI scan showed nothing though. Doctor says its either biochemical or genetic problem with muscles. I'm looking into seeing how my diet affects me as I've read in various places that your stomach can be damaged by intolerances to certain foods like wheat and so stop absorbing certain needed nutrients into your muscles. I might get a test for allergies to try this out. I've heard the only reliable ones are hospital tests though. Companies like Boots do them but they have been proven to be unreliable.

I've also been told your frame of mind is very important. Not to identify with the pain and being able to relax in general. I'm seeing a muscular skeletal doctor in a week or so. They are supposed to be the leading doctor in their field so I'll tell you all what happens. Mind you I've realised that doctors know very little in some ways. They can't learn every field and so can only give you a narrow or too general a view like GPs of your situation unless you fit into a checklist typical illness of some kind. There are good and bad doctors too of course.

[Michael. A]

I have to add the emotional side of its the worse thing. I've suffered from pretty horrible depression which has led to panic attacks and a little paranoia from this whole thing. I've using the computer and playing an instrument is a large part of your creative and social life its a real blow to you. Many people suffer emotionally from it too.

[forgottenking2]

I feel your pain. I've dealt with tennis elbow for a couple of years now. I pretty much have it under control but it still flares up if I am not careful. What's interesting is that the tennis elbow was actually a by-product of having trigger finger on my left hand ring finger, that healed but the tennis elbow stayed. I stopped playing for a good 4-6 months before I saw any improvement. I do believe sleep diet and overall lifestyle play a pretty big role in RSI. I had played guitar for 6 years without problems but then I started music school, my student load (and my income) declined (which led to a lot of stress), I was driving an average of 3-4 hours a day and sleeping very little (5 or 6 hours on weekdays) In addition I was hauling a lot of weight in books and equipment all the time because I didn't think I had the money for a locker. In hindsight, it could've saved me the money I spent on the specialist without insurance (ouch!).

The NSAI (non-steroid anti-inflamatories) help control pain and prevent the damage from getting worse but in the end you still have to rest. Then the next key thing is not to come back to playing hard on but take it very easily at first (I began playing only 5 minutes a day) and slowly work your way up. I was stuck being able to play only 45 minutes a day for a LONG time. In all it's taking about 2 years to where I can play pretty normally. Strenght and flexibility come back relatively quickly but stamina takes a lot longer.

Be patient and you'll avoid relapses. Get plenty of sleep and begin working out (don't use the injured areas in your work out). In the beginning you may not want to use your arms at all, but running or other type of aerobic exercise increases your heart rate and contributes to your overall health. (if nothing else, it'll keep you busy and prevent you from getting depressed)

Good luck.

-Jorge

[Michael. A]

Well I've finally healed from RSI. It turned out it might've actually been a post-viral infection which weakened my muscles and probably triggered depression which has also cleared up pretty much :). Time to get back to this board I guess ;).

At one point I just started exercising slowly and rebuilt my muscles. Slowly overcame the "pain = more damage to muscles" pychology and it gradually got better and my stamina increased slowly. I can pretty much play everyday though a long jam session or too much shredding will knacker me. I play a lot more acoustic guitar!!!

[Teletubby]

for some reason...I tend to love guitars with thin necks...for a few years I have played strats and guitars with a thicker neck...


but recently...



I got out an old jackson and wow...that neck I could play for hours, and my wrist doesn't get a bit sore. Loving it...the neck is seriously thin though lol

Thin neck = Good
Thick neck = Bad

[Teletubby]

lets just hope the FBI doesn't get sight of this thread with all of the weed in it hahaha!

[Michael. A]

The killer is actually holding bar chords. That takes tones of strength... more so then lead unless you'lre going crazy and wearing out your hands.

[daviej]

Good to hear, my friend. Awesome news. I'm coming out of similar troubles again myself. So I can appreciate how it feels :)

[Michael. A]

An odd treatment for you people trying to strengthen your arms up...

Try painting walls and stuff. Its light weight exercise but if you're having to go high up then down it is a good workout for weakened muscles.

I'm doing some weights now and my arms are quite strong but i notice that the rsi problem is more like a tension in the core of the muscles then muscle bulk. I do lots of stretches to keep it flexible in core areas.