How To Overcome RSI For Guitar Players – Part 2
When it comes to learning how to play guitar most people are able to go an entire lifetime without any sort of guitar-related injury.
For the small percentage who do develop an injury like Carpal Tunnel, Tendonitis, Tennis Elbow or RSI, it can be completely debilitating to the point where we may even stop playing guitar altogether.
I am of the firm belief that almost all guitar-related injuries are caused by three factors, all of which can be controlled by you so that you can avoid injury and play guitar pain-free!
Having suffered on and off from chronic pain in my hands, arms, shoulders, neck and even lower back and even had surgery to fix ongoing issues, I am making it my personal mission to help guitar players either avoid developing a guitar injury entirely or quickly recover from an existing condition by educating you on great practice habits.
In this article, I will share the best guitar stretches and hand exercises that I have discovered that will lead to great posture, less tension and healthier hands so that you can play guitar pain-free once and for all!
Disclaimer – I am not a doctor and am not qualified to give medical advice. I am however a professional guitar teacher with over 15 years of experience. I have cured my own RSI and guitar-related problems and used the hand exercises and stretching routine provided later in this article to great effect with dozens of struggling guitar players who have sought me out.
I am providing advice that is general in nature. If you are suffering from any guitar-related hand or arm pain that lasts beyond three days I recommend you seek advice from a medical professional before trying any of the ideas I present here.
Last thing before we get into it. This is part 2 of a two-part series on RSI and Guitar Related Injuries. If you haven’t read my first article on how to cure RSI and Carpal Tunnel for guitar players I recommend you read it in conjunction with this one.
Common Guitar-Related Injuries
Some of the most common guitar-related injuries are:
- Carpal Tunnel Syndrome
- Cubital Tunnel Syndrome
- Trigger Finger
- Tennis Elbow
- Repetitive Strain Injury (RSI)
It is also common to have neck pain, shoulder pain and lower back pain as a chain of effect with your guitar-related injuries.
Many of these injuries have colloquial names and are manifestations of repetitive strain injuries (RSI) effective different muscles and tendons.
Let’s take a look at each injury in more detail:
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome is a condition that occurs when the median nerve in the wrist is compressed.
This nerve controls movement and sensation in the hand and wrist, and symptoms can include tingling, numbness, weakness, and pain in the hand and wrist. It is very common to wake up at night with deep throbbing and intense pins and needles.
The cause of carpal tunnel syndrome can be attributed to repetitive hand and wrist motions, such as typing or playing the guitar and is exacerbated by bad posture and excess tension.
Cubital Tunnel Syndrome
Cubital Tunnel Syndrome is a condition that occurs when the ulnar nerve in the elbow is compressed.
This nerve controls movement and sensation in the hand and forearm, and symptoms can include tingling, numbness, weakness, and pain in the hand and elbow. It is essentially the same as Carpal Tunnel Syndrome except that it affects the elbow and forearm rather than the hand and wrist.
The cause of cubital tunnel syndrome can be attributed to repetitive elbow movements, such as playing a musical instrument or playing sports. For guitar players having the edge of the guitar dig into their elbow can contribute to the compression of the nerve.
Tendonitis is a condition that occurs when a tendon becomes inflamed due to repetitive or overuse.
Symptoms can include pain, tenderness, swelling, and difficulty moving the affected joint.
The cause of tendonitis can be attributed to repetitive movements and is one of the most common injuries suffered by guitar players. Tendonitis is more common when several activities that require frequent use the hands and fingers overlap resulting in overuse.
Tenosynovitis is a condition that occurs when the sheath that surrounds a tendon becomes inflamed due to repetitive or overuse.
Symptoms can include pain, tenderness, swelling, and difficulty moving the affected joint.
The cause of tenosynovitis can be attributed to repetitive movements, such as those you perform when playing and practising your guitar.
I like to think of Tenosynovitis as being caused by excess tension where your tendons are inflamed and grinding against each other, like driving with one foot on the brake and another on the accelerator at the same time.
Trigger Finger is a condition that occurs when a tendon in the finger becomes inflamed, causing the finger to catch or lock when bending or straightening.
Symptoms can include pain, stiffness, and a popping or clicking sensation when moving the affected finger as well as the locking of the finger in a bent position looking like you’ve just pulled the trigger of a gun (hence the name)
Trigger finger is an injury unique to guitar players and can take several days to several weeks to calm down.
Tennis Elbow (or Golfer’s Elbow)
Tennis Elbow is a condition that occurs when the tendons in the forearm become inflamed, causing pain and tenderness on the outside of the elbow and the top of the forearm.
Symptoms can also include weakness and difficulty gripping objects.
The cause of tennis elbow can be attributed to repetitive arm and wrist movements, such as playing tennis, playing a musical instrument, typing on a computer or using tools. Tennis elbow is one of the most common guitar-related injuries and is a variation of tendonitis.
Repetitive Strain Injury (RSI)
Repetitive Strain Injury (RSI) is a term used to describe a range of conditions caused by repetitive or overuse of the hand, wrist, or arm.
Symptoms can include pain, tenderness, weakness, and difficulty with fine motor skills, such as typing or playing guitar.
The cause of RSI can be attributed to repetitive hand, wrist, and arm movements, such as those you repeat over and over when playing guitar.
Most of the aforementioned guitar-related injuries are variations of RSI isolated to specific areas of the arms and hands.
Understanding RSI & Carpal Tunnel Syndrome
Guitar players are prime candidates for RSI and carpal tunnel syndrome, which occur when the nerves and tendons in the hands and wrists are overused.
RSI can cause pain, weakness, and numbness in the hand and wrist, while carpal tunnel syndrome results in tingling, weakness, and numbness in the fingers.
Unfortunately, nothing that you do in life doesn’t involve the use of your hands, which makes it difficult to recover from any hand-related injuries because you can’t actually rest properly.
Instead, you must look at managing your injury over time so that you stop damaging yourself and doing things that contribute to the problem, while gradually changing your environment and your approach to practice so that you heal over time.
What Causes Guitar-Related Injuries
When it comes to guitar-related injuries I’m of the opinion that there are three main causes:
- Practising with bad posture for extended periods of time
- Practising with too much excess tension for extended periods of time
- Bad practice habits
In order to play the guitar humans have to adopt an unnatural position for extended periods of time. If you have one or more of the above-contributing factors and practice over a long enough period of time then it can lead to problems developing.
In addition, if you have two or more factors then it’s possible that you’ll have each compound and end up in pain much sooner.
Let’s dive a little deeper into each factor to take a look at each one.
Bad Posture Can Lead To Carpal Tunnel And Other Guitar Related Injuries
The ideal posture one should adopt when practising guitar is to take on the classical position and keep your shouldars in a T shape at all times.
Instead of craning your neck and hunching over you can use a footstool to keep your guitar the right height and angle. You also use your eyes to look instead of tilting the guitar too far back or holding your neck at an extreme angle.
Most of us can get away with having bad posture for short practice sessions, but if we are doing longer sessions and playing for extended periods not only will we likly develop Carpal Tunnel or RSI, we can get headaches and other strains and muscle aches.
Making minor adjustments to your posture and practice environment can make a big difference. This includes simply being aware of your posture and changing the way that you sit.
It can also include purchasing a nicer chair, a footstool and avoiding sitting on the end of your bed or other chairs that don’t suit quality practice.
Lastly, you can also practice standing up provided your guitar is adjusted to a good height as a means of avoiding sitting. This is especially popular with the rise of standing desks and new research into the dangers of sitting for extended periods of time.
Excess Tension Is the Leading Cause Of Carpal Tunnel And Other Guitar Related Pain
When you first start learning how to play guitar you have to squeeze extra hard in order for the notes to fret correctly.
If you’ve ever seen a little kid learn how to play the guitar this is very obvious as the extra squeezing that they do with the fretting hands causes them to tense up and hit the string harder than necessary with their picking hand.
The extra tension goes through their entire body and causes them to squeeze and pick harder than needed.
Most beginners grow out of this phase once their fingertips harden up, but many people retain the additional tension and it becomes a permanent part of their state whenever practising guitar or playing their instrument.
In addition, some individuals are naturally tense or carry more tension in their bodies. Often they bring the stress and tension of a hard day at work to the practice room and are gripping their guitar white-knuckle tight as they play.
Without realising it, the extra tension they bring to practising is doing damage to their hands. Hobby players who don’t practice all that much may not experience a detrimental effect but it is made worst and more obvious when playing for extended periods like those who are more serious about their guitar playing and spend extended periods of time practising.
Think of excess tension as driving with one foot on the accelerator and one foot on the break. If you do it for too long the car just grinds against itself until it tears apart.
Learning how to first become aware of how much tension you are holding when you play and then taking steps to systematically reduce how much tension you use when playing will lead to much healthier hands and less pain when playing.
Bad Practice Habits Contribute To Carpal Tunnel And Ongoing Hand Pain
This is a broad category but some other contributing factors to chronic guitar pain and RSI include:
- practising for too long without a break
- practising for extended periods of time (3+ hours per day)
- practising specific techniques like bending and vibrato which are very physically demanding for extended periods of time.
- not having a good practice environment set up.
- not having practice equipment that helps with posture and tension
- Only practising technical work
- Pushing through pain and other warning signs
Many of these practice habits are made worse when you have bad posture or too much tension.
The good news is simply becoming aware of better guitar practice habits and taking some steps to create some better routines will lead to very quick reduction in the amount of pain you feel.
Guitar Stretches To Help Ease The Pain
In my previous article about the topic I mentioned that stretching was a great way to reduce the amount of tension that you’re holding in your arms, hands and shoulders.
I even gave you a simple stretch that you can do.
In the video below I outline eight essential stretches and guitar-playing exercises to get you into a relaxed state for playing your guitar.
Let’s go through each of the stretches below:
Guitar Stretch 1- Glory To The Guitar Gods
For every hour you spent leaning forward hunching over a guitar, you should spend 5 minutes stretching out the opposite way.
For this stretch, you are going to stand up straight with your shoulders back. Raise your hands above your head and lean back.
You will feel a stretch in your back and shoulders which will ease the tension all the way down to your fingers. Hold for up to 30 seconds and then lean forward to release the tension.
Guitar Stretch 2 – Forearm Extensions
If you spend a lot of time in an office job or other role where you use your hands for most of the day then this will be a great stretch for you.
Start with your arms bent at a 90-degree angle and then slowly extend your forearm while using your opposite hand to bend your wrist back.
Hold the stretch for 5 seconds and then relax your arm. Do this up to three times before swapping hands.
When it comes to stretching the muscles and tendons in our hands and arms the key is to do short, sharp exercises. You don’t want to hold these stretches for minutes at a time and overstretch them.
Guitar Stretch 3 – Elbow Rolls
This stretch works the top of your forearm and will be great if you suffer from tendonitis or Tennis Elbow.
To perform it you start by raising your hand in front of you. Then hold your wrist with your opposite hand bending your hand down to stretch the forearm. Complete the stretch by rolling your elbow towards the roof as if it were attached to a string being pulled up.
Hold the stretch for 5 seconds and do three repeats before swapping hands.
Guitar Stretch 4 – Shoulder Swirls
This is my favourite exercise and one of the most helpful I had in my own recovery and injury management.
To perform this exercise raise one hand above your head so that it is past your ear. Then rotate it 5 times in a clockwise direction, and 5 times in a counter-clockwise direction.
You’ll probably hear lots of popping and clicking as your shoulder grinds itself out but will feel so much better after it.
Swap sides when you are ready.
Guitar Stretch 5 – Shoulder Rolls
This is a really basic exercise that will free up the tension in your shoulders which you probably learned in primary school.
Referred Pain is a term used for pain that you might feel in one part of your body but is actually caused by a problem somewhere else.
A great example of this is when you may have a leg injury that causes you to walk differently, which in turn leads to you developing lower back pain.
No matter how much you try and treat your lower back until you solve the issue with your leg you won’t solve the underlying problem.
Guitar Stretch 6 – Wrist Rolls
This is a great finger exercise that will free up your wrists of excess tension and keep them supple.
To perform this finger exercise just lock your hands together and rotate them in a figure-8 pattern.
It is more of an exercise than a stretch but will hopefully leave your fingers feeling freer and full of energy.
Guitar Stretch 7 – Back Swivels
This is one of the best exercises for those of you who have lower back pain.
When I used to have V-shaped guitars I would have to sit at a funny angle to make it easier to hold them. This resulted in me having lots of lower back pain.
While the stretch helped in the end it was just better to get rid of the V guitars and buy something that was more ergonomic. My back pain went away overnight.
Guitar Stretch 8 – Shoulder Extension Into Cobra Pose
Our final guitar stretching exercise combines two yoga poses together into one of the best shoulder and lower back stretches you can do.
Both of these stretches will be performed on the floor so make sure you have a suitable space to work with.
Part 1 involves stretching your arms ahead of you and then kneeling back onto your feet so that your shoulders get stretched out.
Part 2 involved leaning forward onto your stomach and then pushing yourself up into a cobra-like pose which releases your lower back. You can even tilt your head back for an added neck stretch.
Creating A Guitar Stretch Routine
now that you know which stretches and guitar finger exercises you need to relax your shoulders and ease excess tension you can create your own routine.
My recommendation is to go through each of the exercises for up to three times each ahead of your practice session each day.
Doing so will ensure you are loose and free of tension ahead of time which will also make it more likely for you to notice any tension that does build up in your body once you start practising.
Pay attention to how your body feels as you do each exercise. Those that feel very tense are indicating that you are either inflexible or carry a lot of tension and should be repeated to build up flexibility and ease tension over time,
Those exercises that don’t really do anything for you can be ignored as some stretches work better for specific injuries.
Regardless, doing all of the exercises will lead to you feeling much better and may even eliminate some of the referred pain caused by weaknesses in other areas of your body.
Avoid Overstretching Before You Practice Guitar
Most of the exercises and stretches we learned targeted small muscles and tendons, not the larger ones you would be using in sports.
For this reason, it is important that you only stretch for short periods of time. Don’t hold stretches for more than 30 seconds and don’t do 20 repetitions of your arm extensions.
Do each exercise three times and change sides if necessary. You can definitely overdo it when it comes to stretching and that can lead to other injuries down the track.
How Many Times Can I Do These Exercises Every Day?
If you are a hobby player you can spend 5 minutes stretching ahead of your guitar practice routine.
If you are a more serious player then you can do these routines up to 3 times per day.
Personally, I like to do the stretches first thing in the morning ahead of my first practice session to make sure I feel great and full of energy for the day.
Then I do a second stretching session ahead of my guitar teaching shifts and often a final session at the end of the day to help me unwind.
I also throw in a number of leg and lower back stretches too but these are more for sport and flexibility than any sort of rehabilitation for guitar injuries.
What To Do If You Have A Guitar-Related Injury?
The first thing you should do is stop playing guitar.
If you’ve hurt yourself or feel any short, sharp stabbing pains in your hands or forearm – STOP!
They are warning signs that something is wrong so listen to your body.
Take a break for a few hours, if you still want to practice it, come back to it later.
If you come back to playing and the pain returns, stop once again and take a full day off.
If you take a full day off and you still feel pain, stop immediately and then go and see a doctor.
Unlike sports injuries where you notice a pop or crunch and immediately feel pain, guitar injuries and overuse injuries are usually be triggered by going over a threshold of activity which brings on pain.
It’s common to do a big practice session on one day, feel tiredness and fatigue in your hands and then wake up the next day in pain or unable to move your fingers. Don’t try to play or push through pain, go and see a doctor.
Recovering From Carpal Tunnel and Other Guitar Related Injuries
Unfortunately, there is no quick fix when it comes to carpal tunnel syndrome and other similar guitar-related injuries.
This is usually because Carpal Tunnel Syndrome is the result of long-term bad habits leading to damage to your tendons or compression of your nerves.
What takes a long time to cause, can take a long to time to heal. This is made even more difficult by the fact that nothing you do in life doesn’t require the use of your hands making ‘resting’ virtually impossible.
Instead, you have to manage your symptoms over time. This might mean taking a short break of 3 days to up to a month to let your existing symptoms settle down.
Once your carpal tunnel or tendonitis has calmed down you should then implement steps to reduce or eliminate the causes so that you can avoid future flare-ups.
This can include:
- Implementing a stretching routine into your daily practices to avoid excess tension
- adopting the classical position and being aware of your posture
- Getting lessons from a professional guitar teacher who can help you reduce the amount of tension you are using when playing the guitar and develop good techniques.
- Having a healthy practice routine that incorporates regular breaks
- Setting up a healthy practice environment with a quality chair, music stand and footstool.
Having said all of this, I know guitar players who have had terrible pain when playing and upon having a session with me and changing something as simple as getting a good chair instead of sitting on the end of the bed leading to a full recovery in less than a week.
It might seem simple, but if you solve the cause then you solve the problem.
It’s also worth mentioning that more experienced guitar teachers will have had their own guitar injuries from time to time and usually take steps to avoid them in their own playing and practice. If your regular teacher is quite young it may pay to have several sessions with a more experienced teacher who can set you up with the right posture and position and help you identify and avoid excess tension.
The Golden Rule Of Guitar Related Injuries
The golden rule is that playing guitar should never hurt.
If you’re experiencing pain when you play guitar it is an indication that something is wrong.
This doesn’t include slight finger pain when you’re a total beginner or you haven’t played in a while which is perfectly normal. This is sharp pains, pins and needles, numbness, tingling or really deep throbbing pain similar to sports injuries but in your hands and arms.
If you’re playing guitar and are constantly in pain, it’s time to get help so that you can start playing guitar pain-free.
How I Cured My Ongoing RSI Issues And Finally Started Playing Guitar Pain-Free
Even after I had surgery on my left elbow to decompress the ulnar nerve which was causing cubital tunnel syndrome I still had ongoing issues with RSI and excess tension.
After my grandfather had hip surgery and was back to walking in three days, I couldn’t believe how I was having 2 years of constant hand pain.
So in frustration, I googled “How To Cure RSI”
The result was this (now archived) website called Rachel’s RSI Homage To Dr John Sarno.
I read a few of the testimonials on the page and it sounded like many people had a lot of the same problems that I did, which led me to hope that I would be able to overcome RSI once and for all.
I would read every word on the page which is archived and now available here
More importantly, it led me to discover the works of Dr John Sarno who explored the manifestation of psychosomatic pain in the form of RSI and other repetitive injuries.
These books were able to help me when all other options had failed and I believe I had a unique case where I had conditioned myself to feel pain whenever playing guitar. It’s a bit of a woo-woo topic which I am happy to tell you about but perhaps a topic for article #3 on chronic guitar pain.
If (like me) you have seen countless doctors and medical practitioners all whom say nothing is wrong with you and can’t figure out why you’re in pain, reading the books above will hopefully hold the answer and the cure to your pain.
If you think you have any sort of guitar-related injury and you are getting the painful early warning signs then the best thing you can do is stop, rest, and see a doctor if your pain persists.
If you’ve been battling with ongoing pain when playing the guitar, using these exercises outlined here under the guidance of a medical professional will hopefully bring you some much-needed relief.
If you’ve been struggling with constant pain or on-and-off flare-ups of pain over a period of months or even years, I implore you to look into better practice habits, becoming aware of tension and how much you’re using, along with the posture you adopt when playing the guitar.
Fixing just one of these factors will have a big impact on how you feel. Fixing multiple might be life-changing!
If you ever need help I would be more than happy to should you reach out to me,
About The Author
Michael Gumley is a guitar teacher in Melbourne, Australia who has a passion for music and a wealth of knowledge about playing the guitar.
In addition to being an expert in his field, Michael also has a personal connection to the topic of repetitive strain injuries (RSI), carpal tunnel syndrome, and cubital tunnel syndrome. After battling with these conditions himself and being unable to play the guitar for nearly three years, Michael gained valuable insights into managing the injury and overcoming guitar-related pain. This experience has equipped him with the expertise to help others overcome similar obstacles and continue pursuing their love of music.
If you’re having issues with your own guitar-related injuries then Michael would love nothing more than to help you overcome your injury and start playing guitar pain-free (especially if doctors have told you to give up guitar and find a new hobby).
Get in touch and book a guitar injury management session today.