Damage Control

Hey Jazz Guy,

I’ve been experiencing pain when I play and don’t know what to do. How can I handle this without having to stop playing? –Hurting in Houston

Dear Hurting,

First of all I commend you for seeking help on what can be a very sensitive subject. Let me start by saying that I am in no way a medical professional, but I have had significant experience with this situation. Although there are always a myriad of things that can go wrong with the human body, repetitive strain injuries (RSI) are extremely common in athletes, dancers, musicians and performers of all types. In addition, people who’s careers require frequent motions such as lifting objects or typing are at always risk for RSIs.

The most important thing to do when you begin to experience some type of discomfort and pain is to STOP PLAYING. Let me repeat that – STOP PLAYING! Do not think you can play through the pain and be fine the next day. Ask any athlete and they will tell you that if you try to man up and play through it you will cause even greater damage and you might be out of action for a long time. I have known talented folks who did critical damage to themselves and had to “sit on the bench” for years! So be careful. You need to stop, assess, and begin some type of treatment.

The first thing you must do after you stop playing is adjust your mindset. You may have played for 2 years or 20 but either way your body has reached its natural limitations. You are not just a musician, you are an athlete. You are a performer that relies on their body to do certain tasks in a very precise manner. Just like any athlete, you need to adopt certain habits that protect the fact that your body must be kept in great shape at all times. Stretching and warming up properly are the most important things. No you can’t just pick up your axe and wail through “Eruption”. You have to do some slow chords and scales first, to get the blood flowing and the muscles warm and relaxed. Keep the rest of your body in shape! You may think you only use your hands, but the entire body is involved in playing an instrument. You do not need to work out until you look like The Hulk, but building core strength and upper body strength in the back and shoulders is crucial. Remember, the large muscles support the small ones!

That said, let’s dive in to specifics. There are three really common things that tend to go wrong with guitar players – Muscles, tendons and nerves.

Muscle Injuries, such as a strain or general fatigue tend to be an easy fix. Taking a few days off, applying heat frequently and light stretching should do wonders. If you rest it for two or three days and there is no change, you probably have something more serious, like a tendon injury.

Tendon Injuries such as tendinitis are extremely common and are basically an inflammation of the lining of the tendons. This is an inflammation injury, and the usual techniques of ice, heat, anti-inflammatory drugs like IB Pro-fen are very helpful. Physical therapy and specific strengthening exercises are the most effective ways to combat tendinitis and keep it from coming back many times. If you must play while suffering a tendon injury, ice down afterwards and try to play for only short periods.

Nerve Injuries such as carpal tunnel can be crippling and greatly affect your non guitar life. So if you feel numbness and weakness then stop immediately and start treatment. Only rest and changes in technique can fix a nerve injury in the long run. These can take many months to heal so don’t be impatient and try to play again too soon, because you could quickly end up right back where you started.

Drastic Measures: Advanced physical therapy treatments such as ultrasound and electrically charged medicines, coupled with ice, heat and rest can be a very effective way to deal with tendon injuries. The recovery time can be 4-6 months and you must stick with the treatment and exercises. If that does not help, there are surgical options, but you must weigh them carefully as the recovery time could be years and you may never return to your former abilities.

Returning to the guitar: After laying off for a few days or weeks or months, returning to the instrument can be daunting. Technique changes are one of the most crucial things to adopt when you come back, and to make sure you avoid the injuries that found you the first time. Playing in front of a mirror and watching your posture, as well as looking for unnatural angles can be very helpful. Make sure when you come back you start slow. I mean really slow, 5-10 minutes at a time. Build your strength back up so after a couple weeks you can play for an hour. Take frequent breaks in your practicing and stay well hydrated. Play different things each day so you don’t work a week straight on one type of motion. Continue with any therapy and exercises you’ve adopted…never stop those, they are very important to your long term playing health. At the end of it all, I hope you will have acquired a new appreciation for just how precious the gift of playing music can be, how much it adds to your life. Perhaps the natural limitations of your body can become musical strengths in end. It’s up to you to figure out how. Jazz Hard! (But not too hard!)

My Story

Between the ages of 15 and 21 I struggled with multiple bouts of tendinitis and ulnar tunnel syndrome. At one point It was so bad that I was referred to a hand surgeon who told me “I can fix that, but you’ll never play again, you weren’t meant for the guitar, find something else to do.” I refused to give up however, and after working through many routines of physical therapy and a great many treatment regimens, the injuries subsided and I was able to resume a normal playing life.

Looking back, I believe the injuries led me in musical directions I would not have found otherwise. Great athletes never fret about time they spent on the bench last season, they just know its part of the game and they focus on the present. That is my philosophy, and it sure makes me appreciate every day I get to pick up this piece of wood with wires attached and make a little noise.

Further Reading: Repetitive Strain Injury