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I must be doing something wrong because I am developing acute elbow pain/soreness in my left elbow (I'm right-handed) as a result of practicing/playing guitar. The pain is always there but subsides if I don't play for several days at a time and would probably go away if I didn't play for 2-3 weeks. But I'm not about to stop playing or practicing.
My physical therapist says it's called "Golfer's Elbow" (probably because more P/T's play golf than guitar) and has to do with the movement of the fingers on the fretboard, which tendons end at the inside bump of the elbow. He advised me to practice in shorter periods and to ice it regularly.
But it seems that not everybody has this problem, so I must be using poor positioning when practicing (sitting, with a strap) or gigging (standing, with strap).
I'm sure some of you have dealt with this. How do you treat it and how do you avoid it from recurring?
Thanks.
J.
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12-18-2013 12:35 PM
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I am in a very similar boat--I have started getting a sore/stiff right elbow (picking hand) when I play now. I was at first blaming my jumbo-sized guitar for exacerbating an existing injury, but playing an electric really didn't stop it.
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Ten years ago I developed "Tennis elbow" which is a lay term for lateral epichodylitis.
The MDs call it a repetitive stres injury (RSI). It comes from overuse. My case became chronic because I kept playing and took anti-inflammatories to deal with it instead of seeing a doctor immediately. By the time I saw a doctor, it had become so bad that I couldn't play. I was out of the game for 18 months by which I mean I could not play. AT ALL!
I ended up seeing an MD, two massage therapists and a chiropractor before finding the doctor who was able to help me with a permanent cure. Needless to say, it was expensive, I lost 18 months of playing/gigging/practice and it could have been permanent.
If stopping for two weeks will give it time to heal, DO IT. This is serious
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Monk, thanks for sharing your experience. What was this "permanent cure" to which you refer?
I should point out that I asked my P/T whether this was the same as "Tennis Elbow" and he said "no", that tennis elbow affects the lateral epicondyle (as you mentioned, Monk), while what I have is affecting the medial epicondyle (in other words, on the inside of the arm, which distinguishes it as "Golf" elbow instead of "Tennis" elbow). So, I'm not sure if the "permanent cure" for TE is also good for GE, but I'd still like to know about it, please.
Thanks,
J.
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I'm convinced that keeping a straight wrist with the fretting hand is the key to avoiding tendonitis injuries.
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@ Guy: One would think that; it's a reasonable assumption. But I had been playing with a straight wrist for decades when I was stricken. At the time, I was playing with three bands several days a week, practicing every day and teaching four days a week for four or five hours daily. For me, it was overuse with insufficient rest. That's why it's called RSI.
Originally Posted by GuyBoden
@jasaco:The first MD gave me a cortisone injection and prescribed Celebrex. Neither helped. The first massage therapist I saw referred me to a great chiropractor who helped enormously. I switched to a second massage therapist who specialized in sports injuries and deep tissue work. Between her and the chiropractor, I improved greatly but not completely. After reading two articles in music magazines about Prolotherapy and RSI in musicians, I sought out an MD in Nashville who used that protocol. It took four round trips from Knoxville to Nashville over a three month period after which I recovered 100%. It took me 18 months from onset to cure because I didn't know about prolotherapy until 15 months into the ordeal. You can web search Prolotherapy to find a doctor near you.
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Monk, do you now have to do anything different in terms of posture, or routine exercises, etc. to prevent it from recurring? Or was this really a "permanent" cure and you can do whatever you like now?
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Someone else posted this here so I can't take credit for finding it, but maybe some of these exercises might help? I also have a DVD called 'Healthy Hands, Wrists, and Forearms' which I can't recommend highly enough.
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I exercise routinely as part of my lifestyle but other than maintaining good technique and posture when I play, nothing special. I'm cured. Originally Posted by jasaco
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Monk, sorry to keep belaboring the point but what I want to know is: what constitutes
your "good technique and posture" now and is it different than what you did before? Specifically, how do you now sit, hold your guitar, hold your arms, hold your wrist to avoid the recurrence of this problem?
Thanks.
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I'm sorry to hear about your problem. I had the same thing, and it hurt! Took a few months to get better.
It will not get better if you keep using it, improved technique or not. Give it a rest for a few weeks so you don't end up prolonging the tendonitis.
There are injuries where you can work through the pain and get better, but this is not one of them.
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I believe a video of you playing would help in correcting any posture problems. Hard to convey your posture with words. Also what may seem a good posture to you would negate you from describing that particular area of posture.
As they say a picture is worth a thousand words.
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OK, here's a video of me practicing. Thanks in advance for any helpful observations on posture, etc. (and always happy to receive constructive criticism on the playing too...) [BTW, I already know I need to clean up my room! LOL]
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Real nice playing!
It's hard to tell from the angle but it looks almost like you're tucking your left elbow too close to your torso and dropping your left shoulder. I'd first suggest removing that left armrest from your chair because, if you're anything like me, you're making subconscious contortions of your body to avoid your elbow hitting the armrest, and you won't know one way or another until you remove it or get a different chair.
But like I said, it might just be the camera angle.
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jasaco, Originally Posted by jasaco
The main thing here was learning that my problem arose from playing too much without rest periods. When I was at GIT in the early 80s we we encouraged to practice 50 minutes then rest for 10 minutes. Like many of us, I tend to lose track of time when practicing and overdo it. My timer that I used to use for practice sessions broke and I didn't replace it and soon slipped back into my old habits of playing for hours on end.
Now I try to keep my practice periods short and focused with rest between segments. I use an office chair with no arms some times swapping it for a straightbacked chair, I sit on the front edge of the chair with my back straight but not rigid and my feet on the floor, I use a strap to keep the guitar in the same place as it is when I stand, I try to keep my shoulders even and relaxed, my left arm close to my body, my wrist straight and my thumb in back of the neck. It's important to stay as relaxed as possible and be aware of tension in the body if it crops up.
Practice is more than just learning which finger goes where and what arpeggio to play. Your entire body is involved in playing and the more you focus on your whole body rather than just your hands and fingers, the easier it becomes to deal with unwanted tension. You want to practice relaxed so that you can play relaxed.
I hope this is helpful,
Jerome
P.S.
My practice room looks worse than yours. Books, CDs, tapes, records, DVDs, magazines and guitars stacked everywhere. Bookcases and file cabinets full.
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My observations are these: Originally Posted by jasaco
1.) You are slouched backwards in the chair, you need to sit up straight, with your body relaxed and balanced.
2.) Your fingerboard is tilted backwards this causes the fingers and arm to bend more to reach the frets causing stress on the tendons. Try to keep the fingerboard at a right angle to the floor.
3.) Your fretting hand wrist is not straight at the lower frets, this will cause stress on the tendons.
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Monk and Guy, thank you both for your observations and suggestions. I will indeed try them.
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A lot of the time tendonitis is caused simply from RSI (repetitive strain injury). It is very common among musicians. tendonitis essentially is inflammation of the tendons. The best way to address that is with cool compression therapy. Another great treatment is Blood Flow Stimulation Therapy. There are great wraps for both cold and blood flow. It is an easy at home treatment and actually FDA registered medical device so may be covered by your insurance plan. It is worth a look into at least. They make the wraps for the wrist, elbow and shoulders as well. The blood flow wraps are great to use before playing as it acts like a warm up and helps against re-aggravation.
http://www.kingbrand.com/Tendinitis-...hp?REF=34PV114
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A lot of factors can lead to pain while playing:
too much tension (too much stress in one’s life…)
poor posture or positioning (neck position, shoulder position, wrist position, finger movement, etc)
too much repetitive practicing
strain from non-musical activities
genetics -> bad luck
Jasaco, from my view the video looks all right, though you are definitely slouching and shoulders often are not even. It’s hard to see if your left shoulder is in a good position or not.
I would recommend not looking at the fretboard and keeping your head back and look straight ahead rather than extending your neck forward and to the side. I currently have a lot of problems with my right shoulder (well, and left hand/elbow) and my PT thinks that having my neck forward and bent may be a large factor.
Similarly, seems like you have the neck tilted towards you so you can see the fretboard better, that puts more of a strain on your hand causing you to have to reach around further than if the fretboard was more perpendicular to the floor.
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OP, How are you making out? Did you find something that works?
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I got it bad from practicing while slouching. Had it for over a year now and only starting to recede. I didn't stop practicing, just exerted less energy (played very lightly) for a year. And yes, the stretching exercises help. It's slow to heal, but not the end of the world. You can keep practicing - lightly, or give it a rest for a few months. (My guess is you'll choose the former option
)
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I've had this lately too.
I had it once before, back in the summer of 2001. I was in Omaha for the summer and playing a lot but don't recall doing anything new or unusual. But I had this tingly feeling in my left forearm (-I'm right handed, so that's my fretting arm). I went to a drugstore and a pharmacist said it sounded like tennis elbow. I bought a flimsy looking thing that seemed like it would do nothing but as soon as I put it on, the arm felt better. In a couple days I was fine and hadn't thought about it since.
Until last week. This time, I'm sure it's overuse. And the same goes for my thumb. I bought a thumb-support at the drug store (-it's a bit awkward to play guitar with it on but doable) and a band for tennis elbow / golfer's elbow and it has helped a lot. The arm doesn't hurt anymore and the thumb doesn't either. They're not 100 % but they're better day by day rather than worse. So I'm taking it easy and avoiding things that would strain the thumb. (Jim, that means the Jimmy Bruno five fingerings down near the nut, the warm-up exercise, and various thirds exercises down near the nut. I'm pretty sure that's how I strained my thumb in the first place.)
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Yeah, I'm pretty sure I was over-doing practice in the 1st position (close to nut)- trying to get those pesky stretchy drop 2's to feel "normal"... That and some stretchy bop enclosures down there, all while I was slunk back into a couch. I noticed it almost suddenly one morning, the pain was pretty bad, I couldn't really lift anything with the arm. Trying to raise the middle, ring and pinky from a flattened hand was excruciating, all the way to the outside point of the elbow.
My Physio showed me the stretch exercises and explained the tendons near the elbow don't house any blood (unlike muscles), and therefor heal way slower... She wasn't wrong!
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With regard to "Tennis elbow". I've been suffering from this for several months now and its exacerbated by the fact that I play mostly fingerstyle and my right hand gets a workout. Now I own a fair amount of property which keeps me on a tractor, lawnmower, weedwhacker etc a fair amount of time so the real problem is not necessarily from my guitar playing but all the other stuff I do i.e. I am right handed and I use my right hand to grip the steering wheel on my truck, tractor etc. . I visited my GP a couple of weeks ago and he recommended this brace over the sleeve type and it has been in my case effective. The brand that I use is shown below in my link. The key is located the sore point and placing the brace pressure point just below the sore point.
http://www.amazon.com/SIMIEN-SPORTS-...5%3A2470955011
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I used to get lots of little aches and pains in wrist, elbow and fingers. The things that helped were posture, physical therapy style exercises (get the amazingly effective Healthy Hands DVD) and using much lighter strings for at least part of my practice time. If you're having tendonitis pain try putting some super light strings on a spare practice guitar for a while.
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