The Woodshed

Guitendonitis? GuitElbow?

1

Several weeks ago I gradually - and then vividly - noticed sharp burning pain in my left elbow when playing, soon followed by localized wrist and forearm pain in response to particular common finger positions. I tried to keep playing - just play through it - but localized pain then developed in the upper arm, shoulder, and neck.

My GP (an NP) said the symptoms sounded like "tennis elbow," which maybe. It did appear first in the elbow. But the elbow doesn't get the repetitive abuse in playing guitar it gets in tennis, as we hold the instrument at a pretty steady elbow deflection. Tendons no doubt get a thorough workout in tennis with the wrist motion, up and down the forearm.

But not nearly in such intricate combinations as in playing guitar. You wanna terrify yourself sometime, watch the tendons in your wrist as you play something complex for a few minutes, and try to calculate how many reps those organic wires in your arm have done over how many years you've been playing. Got to be billions. Is any machine built for that repetitive abuse? There's surely a mean-time before failure.

It won't matter to you till it does, of course. So feel free to ignore the heads-up. I did too. While I accepted my overall corporeal mortality 6 years ago when I had the heart attack, I've been almost completely spared the indignity of arthritis. My fingers may not be as fleet as they were 30 years ago, but I think they're more accurate - and they've thankfully remained fluid and flexible enough to play anything I qualify as music.

Thus I guess I assumed I could be a blubbering wreck in a wheelchair, and I'd remain guimmortal. (That's "guitaristically immortal.")

So this left arm pain has caught me up short - followed by the almost immediate realization that of course I'm wearing out my hands. (And typing on the GDeep contributes. Not to mention the billions of keystrokes and mouse moves required by my job.)

So the question on the floor: what to do about it? I've almost completely stopped playing, taken to wearing a tennis elbow brace just below the elbow, and have been waiting for the arm to heal. (Which I can test just by making a loose fist, rotating my wrist, and flexing the elbow.) It's been weeks, and it still hurts - though some days it seems better.

I'll go to an appropriate specialist when I have time - but that will be at least a few weeks.

Has anyone experienced this? Is it permanent damage, or will it fix? Are there exercises? A better posture, different physical approach to the guitar?

While I like me ambient noise-makery, I don't want to end up as a one-note-to-the-measure pedalboard atmospherics jockey.

2

Years ago when my band was playing regularly I had guitar elbow. Mine was pretty much localized to the elbow. I don't remember doing anything special other than rest and deal with it. Probably took about a year before it went away.

3

My guitar teacher had the same thing, he swears by Glucosamine Sulfate.

He went through round after round of steroids, but after he quit that and just went with Glucosamine Sulfate, that's what "cured" him.

4

I saw an old pianist go through stuff with the wrist. He had a thing where tendons were meeting nerves, maybe what you are having. He had a physiotherapist give him massages, collagen [or was it cortizone?] injections. The last cure he had was to cut out a piece of bone or cartilage.

I have a weird bump on one wrist, I'm keeping an eye on it.

I'm really worried about tendons, especially with a newer technique I'm considering continuing developing.

Working on a keyboard can't help. I remember all the data entry operators had problems. Wresting arms on tables made it worse.

My guitar teacher said to use the minimum possible force, which I think is very good advice, also for typing.

5

Had it a couple of months ago in my left elbow.

General lack of playing time made it unlikely to be 'guitar elbow' (or the bass equivalent), and while it might have been a result of filing and hacksawing in the garage, it's not my 'leading arm' for either activity.

I put it down to bad posture at a newly-issued work laptop - elbows bent much more than with a conventional keyboard.

Some info here: https://www.nhs.uk/conditio...

And some exercises here: https://www.arthritisresear...

As in the first link, it went away of its own accord after a week or two, and thus far, hasn't come back.

H59

6

I had this and the Dr said you've got tennis elbow. Go get a padded, forearm, velcro secured, wrap thing. (That was not his technical description) I picked on up at the local Harris Teeter, wore it for a week and really, truly helped. It's something about holding those tendons in place.

I was convinced some severe arthoritus was to blame. Good luck.

7

Now that I am well past the Big Six Oh, I do notice a little pain from the back of my left hand from time to time, but so far it has not really impaired either my guitar or piano playing- at least not in the volume of each I do these days. But once upon a time...

In the early 1990's when we were gigging a couple of hundred nights a year in the Celtic band, my long-time bandmate Dale developed what he called "tennis elbow" in his right elbow. His role in the band included a lot of finger-picking as well as what he terms "strong" six-string barre chords while I mostly flatpicked my 12-string (chords on the chorus, counterpoint noodles on the verse). At the time we did a mix of 2-set concerts and 4-set pub/legion gigs. Four nights in a row of four hour gigs equals a lot of finger picking, and Dale was hurting.

It crippled him up pretty good and he thought he'd have to put it down (the guitar, not his elbow, though I am certain he considered the latter for a bit), which was a worry for us because when the problem came along we had almost three dozen gigs booked up and the phone was ringing several times weekly in those years.

We abandoned practice, abandoned learning anything new and stuck to just doing the shows, but it didn't help. By the third set every night, he was into the Tylenol, so after a month or so, he sought out his family doctor, who prescribed a cortizone shot, then pulled out a very cold needle and injected what Dale described later felt like "frozen mercury" into his right elbow.

Dale said that shot hurt like hell- worse than the elbow- and for a few hours he was absolutely miserable. But the next day...

Tested cautiously- no pain. Got a little more ambitious- still no pain. Well, maybe a mild ache, but nothing debilitating by any means. With a general sigh of relief he, and "we" carried on, and the pain never returned. Even the little achy feeling went away after a couple of days. Dale was back to as normal as ever.

That shot lasted nearly a year. When the elbow eventually acted up again, another shot was ordered up and it was the last one he needed.

He still has not had a third.

To be fair, we began to scale back our schedule in the months following his second go-round as age and gradally fading demand took over. But still, we can grab our guitars and wail away for hours again and his elbow still doesn't bother him.

So cortizone works- for some. But it's one of those you-don't-know-until-you-try-it fixes, and I am acutely aware that it doesn't work for all.

Still- you might talk to your doctor about it.

8

Eliminate the cowboy chords and you'll be fine. Keep everything above the 5th fret, with your elbow tucked to your waist. If that doesn't work, then switch to accordian.

9

These are great suggestions, and right on point. Thanks to all.

My guitar teacher had the same thing, he swears by Glucosamine Sulfate.

I'll try it, by gum.

Working on a keyboard can't help. I remember all the data entry operators had problems. Wresting arms on tables made it worse.

Which I do when I type...and I type a lot, and fast. Sometimes the edge of the table cuts off circulation and puts my hands to sleep, I had electric nerve pain and weird half-numbness in my right hand a few years ago after a weekend of tens of thousands of mouse click-and-drags. Took a long time to clear up (as nerve issues do).

My guitar teacher said to use the minimum possible force, which I think is very good advice, also for typing.

An excellent reminder. I try to do that, but still have the instinct to throttle the damn thing while raking the strings with a brick.

I put it down to bad posture at a newly-issued work laptop - elbows bent much more than with a conventional keyboard.

I haven't changed my keyboard lately, but you seem to be saying straighter works better than benter - and as my eyes have deteriorated, I've been pulling the computer much closer to my face, thus bending the elbows further. Damage could be gradual and cumulative till it breaks through a threshold and is suddenly noticeable.

I'll look up the links.

Go get a padded, forearm, velcro secured, wrap thing. (That was not his technical description) I picked on up at the local Harris Teeter, wore it for a week and really, truly helped. It's something about holding those tendons in place.

Yes, that's what my NP suggested, and I picked it up at CVS on the way home. I've been wearing it most days for a few weeks, and I think it has helped - but I've all but stopped playing to avoid re-injuring while it's trying to heal, so I don't know whether it's the brace or the rest.

he sought out his family doctor, who prescribed a cortizone shot, then pulled out a very cold needle and injected what Dale described later felt like "frozen mercury" into his right elbow.

Cortizone is one-a-them steroids? My mother has had numerous such shots into various joints, which have kept them working for similar periods of time. But I understand that it really can't be done many times, because it damages tissue. Or do I have that wrong?

Eliminate the cowboy chords and you'll be fine. Keep everything above the 5th fret, with your elbow tucked to your waist.

That's crazy! I discovered on my own that elbow tucked against waist greatly reduces the pain. I hadn't thought about first-position chords, but the one that hurts worst is adding the D on the 2nd string to turn a simple one-finger A into an Asus4. So maybe you're onto something. But I LOVE all my first-position chords (not that they're the common inversions), especially in conjunction with open strings. So that can't be a final solution.

then switch to accordian.

Oh, I like a well-played accordian too much to start torturing one at my age. I have tons of synth and other keyboard apps I can drive from a regular keyboard, though, so there's always a way to make noise.

Maybe BAGPIPE, though, for WindsorDave.


Any more ideas, keep'em coming. This will really help. Knew I could count on y'all.

10

Based on my past experiences with tendonitis, I suggest including an anti-inflammatory (Ibuprofen is my preference) in your healing regimen.

Along with the brace that you've already purchased, and changing your computer-keyboard position.

11

Yessir. I can’t get my durn cardiologist to get specific about what dosage of which such med is advisable, how often, with the heart meds I take.

12

Maybe more clever inversions.

The bottom strings clash with all the other instruments, you don't need them.

13

Using an accordion will make your back hurt. Far heavier than a J Bass.

I had a carpal tunnel issue. Between the cortisone shot and avoiding one particular hand movement it hasn't been an issue since. Unfortunately, being blessed with arthritis isn't fun. It's getting worse and there's little to be done on that front. At least when my hands hurt too much for guitar, I can still bang away on piano---totally different finger movements. Thankfully. To be honest, if I didn't hurt in the morning, I'd really start to worry.

I wish you the best, Tim. Hopefully the medics can get you squared away.

14

"Cortizone is one-a-them steroids? My mother has had numerous such shots into various joints, which have kept them working for similar periods of time. But I understand that it really can't be done many times, because it damages tissue. Or do I have that wrong?"

A Cortisone shot just might help Tim, but don't have too many. If you have more than 3 per year, it can cause problems. It's a helpful drug, but if over used can damage the cartilage in the joint, and cause systemic problems like thinning of the skin and connective tissues in other parts of the body.

I have two blown shoulders, I've had rotator cuff surgery twice on each shoulder. I get cortisone injections, in each shoulder, about 3 times a year. It's helping me to put off shoulder replacements, which only last 10 - 12 years. The longer I can put off replacement surgery, the better. I have enough hardware in my body as is.

This "getting older" thing isn't for faint of heart. I lived a very active lifestyle in my youth, and carry some wounds. I feel your pain brother, I hope you are able to get it addressed properly. For something like you're describing, a good orthopedics doctor could help a lot. I wish you good luck with your elbow, please try to find the time to get it looked at.

15

I've been through this, got cured, but am going through it again now in the other arm. If you are interested Proteus, send me an email or give me a call. Just ask and I'll send my phone number.

16

I have problems with a Strat that I think relate to the scale and reach. But Teles don't seem to bother me. Shorter scale guitars tho' seem better for me so lately I have spent more time with my Gretsches and Guilds. What does bother me tho' is when I am playing and my hand freezes up. It literally locks and with a little massage I can get it to unlock and move again. Does anyone else have that problem?

17

I can’t get my durn cardiologist to get specific about what dosage of which such med is advisable, how often, with the heart meds I take.

Try the exercises in the second link in my previous post.

H59

18

First, Don, get to your doctor. Trigger finger, or a whole hand of them, can be indicative of things that need prompt treatment.

Tim, you know all the hand, wrist, shoulder, and arm issues I've dealt with. (Thanks. Again, KCEd, for the Takamine.) My rheumatologist seems to see it all as pretty standard for someone with my level of arthritis.

I've had my last cortisone/steroid injection after a whole body rather dramatic reaction to an injected shoulder.

I'm on all sorts of prescription meds. For what you are describing, first see if your doc will add to the anti-inflammatories a prescription topical Voltaren gel (diclofenac sodium topical gel 1%.) It works wonders. I'll bring it & a Young Living magic potion called Deep Relief which Gavin Pring first gave me. He said without it, he couldn't continue performing. The combo works for me, most of the time.

19

There is lots of solid information that turmeric (which has been used for centuries in Ayurvedic medicine) is an effective natural anti-inflammatory and has been used as a treatment for both osteo and rheumatoid arthritis. You can take it in capsules, as a tea, or cook with it (it's a major ingredient in both Indian and Thai curries). It's also readily available and inenxpensive. Also tasty.

Here's one article about its benefits. The interwebs have many others too.

20

I feel your pain,literally. Been dealing with inflammatory arthritis for over 30 years. These last two months I've had horrible pain in my hands and wrists. My rheumatologist says I have ortheoarthristis in both hands and back. Yet something more seems to be going on. The usual NSAIDs haven't done much , in fact I stopped taking diclofenac after a recent study showed a 50% increase in heart attack risks,something apparently common to most nsaids medicines,including ibuprofen. Oral prednisone helps, the injections have never helped. I can't play at all except on rare days,and then I pay for it the next day.As a player,I'm my own worst enemy, as I'm sure rest and recuperation are the best things right now. Best of luck to you.

21

I had a similar problem about six years ago. I had just started a reggae band and was practcing bass like crazy to learn the songs and build up my stamina, not having played bass regularly for a few years. I got a bad case of tennis elbow and didn't like hearing that I should just stop playing for at least six weeks. Instead, I got a Theraband rubber bar and did exercises with it for about four days, and all of my symptoms were gone.

I've had trigger finger (left index finger) as well. It went away on its own, but resurfaces occasionally. I manipulate the finger a bit and then ignore it, and it stops in a few minutes.

I also had a nasty painful lump on the inside of my wrist when I first learned Dick Dale-style trem picking. I analyzed what I was doing, realized that the problem was that I was abruptly reversing direction on the downstroke, and started making elliptical motions instead. It went away in couple of days. That was almost twenty years ago, and it's been fine ever since.

Maybe I'm just lucky. Changing how I perform frequent and repetitious tasks has worked for me on multiple occasions. I know it doesn't always work: when I had a nine-month bout of sciatica about eight years ago (almost certainly caused by sitting in the wrong chair for too many hours during one epically productive December), I had no such luck. Stretches, exercises, and massage did almost nothing. I lived with excruciating pain until it gradually receded.

The Therabar may be just the ticket in this case, however. It's certainly worth a try.

22

My problem, several years ago, was with my left wrist. At the time I was trying to learn, Cascade, which requires quite a stretch to get the first chord. My pain was constant, bad enough that it kept me awake at night, and kept me from doing anything with my left hand, including guitar. I kept trying, and the pain kept coming back. I finally gave up on Cascade, and went back to easier ways to get a lot of stretches. My docs were of no help at all, but I don’t experience the pain anymore, thank God.

23

The key is in not letting the tension get to the point where you have symptoms.
Massage and Chiropractor can be a life changer. There are things that can be done to release the overworked muscles.
The problem comes from an inbanlace of flexor vs extensor muscles over time. These unbalanced stresses play havoc on joints which need “balance” in muscle tone to be healthy.
Good luck, but find someone who can help you.
I’m most cases the pain can be elevated with one visit but it is important to stay on it to keep it from reoccurring and progressing.

24

Had a bad problem with my left wrist 20+ years ago and tried everything. Stopped playing guitar for a year -- even sold my only guitar at the time, a '61 ES-125TC (major regret)-- and finally tried acupuncture. It worked. It'll take 5-6 treatments.

25

If it's your elbow I'd suspect there's possibly also something else going on that playing guitar is aggravating.

I have tendonitis in my left wrist and thumb. It's a repetitive motion injury caused by my job (hairstylist) and playing guitar all the time. Very similar repetitive motions with the left hand. At one point I was taking 4-6 Alleve (naproxen sodium) a day to keep it bearable. That is not a good long term solution; that stuff is bad for your innards.

I took glucosamine for a quite a while, it might be a good long-term help, but it wasn't helpful to me for the acute "Damn that hurts" situations.

If you know a massage therapist who does this sort of specialty treatment -often ones who do "sports massage" or specific healing modalities for injuries- that can be extremely helpful, but a word of warning; this isn't a feel good sort of massage. It's spectacularly painful while it's being done, and often still sore/achy for 24 hours BUT having that done gives me a couple weeks of ~90% improvement.

My chiropractor said the solution was quit my job and quit playing guitar and everything would be fine. Probably would be except for the no food/no housing/deep depression thing...

The other thing that works very well for me is CBD ointments. Used topically several times a day rubbed into the offending areas works as well for me as the high-dose NSAID's but without the possibility of intestinal bleeding, etc. Not sure if they are available in your state, out here in Californy dispensaries are everywhere (there's one 100 ft. from my work) but it still takes some trial and error to find the products that work best. Also, no other 'effects' from CBD creams other than pain relief and the anti-inflammatory action.

Good luck Tim!


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