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Been playing guitar for 8 years now, focusing on jazz two, and the last few months I've been practicing for hours every day. Lately I've started feeling a terrible pain in my left hand wrist, a pain that intensifies slightly when I play guitar. Am I doing something wrong, or could there be another reason besides guitar playing for my pain?
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11-12-2014 02:10 PM
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Assuming left hand is fretting hand?
Are you warming up before playing? Are you a "neck strangler?"
Careful with long hours of practice. I'm hoping JakeAcci will drop in, he had some serious issues due to overworking his hands...and he's come back from it.
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Left hand could be angle of the guitar, get the neck up more so wrist isn't bent as much. Has you playing position changed much in last couple months? Also how your gripping the guitar if been working on a lot big chords or big stretches you weren't in the past. Plus guitar itself gone to heavier strings. A lot of things to look at to self diagnose where problem could be coming from.
You doing things other than music that could be contributing? I work out a lot and on back day I will sometimes have pain in hands or fingers afterwards. Back exercises require a lot of grip strength.
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Most likely you are bending your left wrist rather than maintaining a straight wrist. I had to give up guitar for a year when I had wrist problems, but now I can put in 3, 4, 5 (this is rare) hours a day without any issues. On longer days I will do some pro-active icing though and use shorter practice sessions once past the 3 hour mark.
When I was in recovery mode, I used a "neck up" device to keep the neck high and my wrist straight if I was playing a solid body.
Another thing people almost always overlook: typing can hurt your wrists. Invest in an ergonomic keyboard if you type much. I suggest the Kinesis Advantage.
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Do you have a history of injury to that hand? Does your occupation involve possible repetitive motion injury potential or particular stresses that are job related? Any current relevant medical conditions? Paresthesias, numbness? Muscle weakness? Where is the pain - the palm is the ventral side, the other side is dorsal? Discomfort in select fingers? As a physician I am not allowed to dispense other than generic advice to someone who is not my patient and whom I have not examined, so any comments are general and advisory in nature.
One suggestion is to use proper positioning of the fretting hand. Generally, the left thumb should be floating around the mid-portion of the back of the guitar neck, with a good arch to the left hand fingers addressing the front of the fret board. In other words, definitely NOT the Pat Metheny style approach with that left thumb nearly hovering over the sixth string.
Jay
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Thank you all for your great answers(and questions), I'll try to give some further information in response to your... responses:
I only work part time(every weekend) as a church sexton/verger. I don't typically warm up, and I think I have a Metheny thing going on with my left hand, as suggested by targuit. Docbop: I have been using heavier strings, playing much faster, and playing more spread chords and such, like I haven't before. I shouldn't have anything 'wrong' with my arms, all that's 'in the family' is quite a lot of rheumatism and coeliac disease on my mother's side, and prolapse from my father's side(from whom I carry the most of my features).
The pain occurs when, if for instance I hold my left arm out straight, with my palm facing 'inwards' and move my wrist/hand down. The pain is concentrated to the 'corner' between my hand and my forearm (dorsal?)
edit: scratch the Metheny technique, but I have an arched thumb that I squeeze the neck with when I playLast edited by mr quick; 11-12-2014 at 06:00 PM.
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Marwin - From your answer there is nothing that would immediately suggest a clear cut cause for your pain, although if I have understood its location from your description it could be in regard to hand position. One possible approach is to cut back temporarily on the playing time daily for a week or two to see if the discomfort improves. But a visit to your physician is likely the best suggestion, especially if the pain does not improve with rest or worsens.
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BE CAREFUL
I got pains in my wrists and years later its still a problem. I even had to give up playing for a year during Jazz college.
Mine was several reasons. One I was trying to play licks to fast without the technique. This makes you tense up and muscle tension is not what you want a lot of when playing.
Also the guitar i had was rubbish. It wasn't very loud (gypsy jazz) and was hard to play. The louder I tried to play the more my wrists locked up to the point were I coulnt even hit a string or note. Turns out the pain got so bad, I couldn't even drive.
Check your guitar action is too high, or its not comfortable to play. Go to a shop, try some different necks. Wider bigger ones can cause more rotation ion the wrist which is not good.
make sure you r not trying to force speed or licks your not yet comfortable with.
Try and remember, the looser you are, the better. Get rid of any unnecessary muscle tension in your hands whilst playing.
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I had some pretty hefty tendonitis issues right before my senior recital that almost developed into carpal tunnel stuff. If there isn't a pretty obvious cause for it then it's probably just over-exertion. There are a few easy things you can do to make it better that I got from my teachers and a physical therapist I saw....
1. You're basically an athlete. Stretch a little before you play. Goes a long way.
2. Warm-up always. Not like - play scales before you shred but rather very slow deliberate warming up. Play scales in whole notes and don't press down the strings all the way but rather touch them like you might for a harmonic. Do that for a warmup for a week or so and you'd be surprised how often you accidently fret the note. Lesson to be learned? It requires very little pressure to fret notes and we almost always apply too much. Do the same sort of jelly hands thing with your picking hand too. It's all a system and when you play really hard with right hand your left is more likely to follow suit.
3. Use a little ice during the day. Get raw ice (not an ice pack and not in a bag) and rub it on your wrist over the sink. Then run warm water over your wrists. Then back to the ice. Alternate like that every twenty or thirty seconds until the ice cube melts.
4. If the pain changes or worsens while you're playing then take a break. Get a little ice or stretch. Go for a walk. Do some ear training. Whatever. Sometimes ibuprofen is good for getting yourself through the acute stages but it has to be a lot and frequently so it's not really a long term fix because you have to take it with food and it can still be bad for your stomach. No good.
5. ********** if it's really a problem then go see a physical therapist. Not a general practice doctor (except for the referral). A general practice doctor will tell you to take ibuprofen and stop playing. That's not really an option for most of us. Also practicing hard after long periods of rest is a really good way to hurt yourself worse so it's better to cut back and work on staying super relaxed and retraining yourself to play loose. A physical therapist on the other hand will help you work out strategies for preventing the problem in the future given the routine of your life and career. Meaning ... they'll help you figure out how to play guitar without the pain as opposed to stopping playing until it goes away.
I don't really know the science behind all of this but I do know that I had to cut my practice time in a quarter and was worried I wouldn't be able to play my recital for several months before I finished and it wouldn't get better. I went to a physical therapist three times and she gave me the icing trick and a handful of stretches and it was like magic. Haven't had trouble since. Comes back from time to time but it's never particularly bad and it always goes away with the stretching or icing and stays away.
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Find some hand exercises to do before playing, classical guitar ones are very good they strengthen your fingers wrists and forearms and make your fingers more flexible. Jim Hall always warmed his hands up in warm water before playing.
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I recommend this DVD very highly.
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heyyyyy so I basically have devoted a lot of my life to working with my pain and tingling issues, and not a lot of specific info has been given in the thread, so I could write a novel, so I'll try to do a brief summary of anything i think has been helpful both in terms of diagnostic and actually making the pain go away
Originally Posted by mr. beaumont
1. technique technique technique technique, learn as much as you can and put in as much effort as possible into having as little tension as possible, especially in your neck
1a. consider technique not just of your instrument, but what you're doing with your body in all activities.
2. see doctors and get different opinions. it is likely that you won't get anything definitive from different people but get started on getting a medical perspective. PT and OT can at minimum give you a lot of things to consider
3. keep practice material varied, do not repeat the same things over and over again
4. never play for more than 25 minutes at once - play 25, break 5 and let your arms and hands truly rest, then play again.
5. mindful of what material is more likely to cause pain...like stretching and fast playing. mix up your practice routine so that you don't have consistent focus on the things that are causing physical pain
6. If you can afford it, study the alexander technique. It's a lot of work, and it's expensive, but i've found it very fascinating and has helped me a lot in managing my pain.
7. self massage/rolling techniques are quite nice - painful but in the process (if you're doing it right) but do loosen you up.
but I think technique is #1. Most non-classical guitarists have no idea what they are doing when it comes to positioning, posture, etc.
I think there's big potential for injury in jazz guitar because so many jazz guitarists start out playing 'easier' music like rock and folk, music that you can play pretty well with 'bad' technique and sloppy posture, but then taking that same physical approach towards music with stretches, more awkward left hand fingerings, etc, seems to me to be a recipe for disaster. That was my experience at least, sloppy rock guitarist and didn't have any problems when I was playing simpler music...
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I'm finding that spinal posture is the source of a lot of other ailments. The body is all connected and bad posture can manifest everywhere. The worst is the combination of flexion (slouching or bending forward) and rotation. In physical therapy it's very common that the root cause of a pain is somewhere other than where you feel it. I've found that focusing on my posture clears up aches in my extremities.
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Couldn't agree more, and this is the basis of Alexander Technique except that it takes the concept of posture to a new level. Originally Posted by teok
Anybody into Alexander Technique?
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Something I do is use an interval timer I got from "GymBoss" intented for HIIT (High Intensity interval training) and set it to 10 mins for playing, 2 mins rest, 10 mins play, 2 rest etc. On the 2 mins I strictly don't play.
You can practise for 1 hour straight pretty much non-stop and hurt yourself, or with short breaks like that for 2 hours and not hurt, providing you are strict to not play in the 2 min breaks.
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Warm up and treat with cold after. The pain is likely inflammation of the tendons. When it gets bad, try to rest. You dont want it turning into a chronic issue. Here is some information on carpal tunnel/tendonitis and wraps to try out.
Carpal Tunnel Treatment by King Brand
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Stay free from all tensions. Always do warm up. You will get relief from chronic issue.
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The main thing is avoiding bend in the left wrist.
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[QUOTE=JakeAcci;479094
6. If you can afford it, study the alexander technique. It's a lot of work, and it's expensive, but i've found it very fascinating and has helped me a lot in managing my pain.[/QUOTE]
Julian Lage has trained in the Alexander Technique- check out his videos and just observe his posture and how he addresses the guitar. Guitarists often look tight and hunched over their instrument and that's bound to be bad for us in the long run. Going with your guitar to an AT person who has training in musicians might be a worthwhile consult (also, going with your guitar to an occupational therapist, hand therapist and/or physical therapist might be helpful). There are doctors who specialize in care of musicians; if you live in a metro area where there is an orchestra, there will be one or more of these.
Marwin, one of the first things I would recommend doing is having your guitar setup checked if you haven't done that already. Is the nut cut too high? Is the action too high? Is there too much neck relief? All of those things can make the instrument harder to play. If the instrument is hard to play, that makes it hard to fix other possible contributors to the pain.
Are you a "death grip" player? I had trouble with that for decades and have gradually learned to lighten up with my left hand. I developed my death grip by learning to play on a poorly set up flattop with a nut that was cut too high, so I really had to squeeze to get the strings solidly planted on the frets. When I got better guitars, my brain still thought it had to over squeeze. I still have this when I am playing fast, I tend to squeeze harder (which is really the opposite of what you want to do when playing fast). I also find that the death grip communicates with the rest of my body- my shoulders get tense, I hunch over the guitar, my picking hand starts driving the strings harder- and my sound deteriorates and I start making more mistakes (which increases the tension in a vicious circle). When I am playing well I am also relaxed.
Warming up before playing- flexing your fingers, rolling your wrists in a circle, some gentle stretching, warm water soak, etc., may be helpful. I find rubbing my hands together to warm them up is helpful in loosening them up. We musicians are "small muscle athletes" and need to take care of ourselves to prevent injury much the same as large muscle athletes do.
For managing existing pain: rest, ice, compression, elevation (RICE) is a time-honored set of recommendations. Rest = play less or not at all for a while and let things heal. Anti-inflammatories (NSAIDS) like ibuprofen or naprosyn may be helpful. Icing was mentioned above. Compression may or may not be helpful and elevation is to reduce swelling which you may not have. "RI" might be all you nee in the short term, maybe with some NSAIDS.
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Dumb question...do you play with a strap, and have it set consistently on all your guitars, so that you have a consistent relaxed position?
Do you bend your fretting fingers 90 degrees to the fretboard?! I had an old teacher tell me to do this, once ...probably bad advice. I saw a clip by Reg here on the forum, where he talked about a more relaxed bend to the fingers...sounds right to me.
How lightly can you play?!...meaning in a tension free state....turn out the lights and play...you might be surprised how the tension disappears, and how little effort is needed to still get a good tone....I'm not saying you can't "dig in" some of the time for special effect, dynamics....but for most of your playing/practicing you might be working too hard at it.
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Considering taping your wrist as well. Worth a try, can't hurt. May prevent some over straining.
KB Support Tape
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Ensure there is no bend in your left hand wrist. Your wrist should be straight whatever technique you use. The carpal tunnel, the passage the tendons pass through to make your fingers work (there are no muscles in the hand itself) must be open, or the tendons will rub on the inside of the tunnel and potentially cause inflammation etc. Originally Posted by Marwin Moody
Adjust your posture and left hand technique as necessary to make sure that your wrist is straight.
I had the problem you described. I went to a GP who had NO IDEA (wanted to refer me to a physio) and then a happened upon the anatomical reason for my pain in a classical guitar manual. The problem was I had been trying to play heavy stretches without an appropriate posture (specifically Bach, but any demanding left hand work could be an issue.)
I adjusted my technique and the problem went away never to return.
Also, make sure you are not 'overfretting' - that is holding down the strings too heavily.
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