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Overuse injuries


simpleman3441

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There is a difference between overuse and missuse. When you do something wrong ergonomically, you hurt yourself. If you follow proper technique, you'll not hurt yourself.

"I believe that entertainment can aspire to be art, and can become art, but if you set out to make art you're an idiot."

 

Steve Martin

 

Show business: we're all here because we're not all there.

 

 

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Like Bill says (more or less), figure out if you're doing something wrong/harmful beyond just playing a lot.

 

What specific problems are you experiencing?

 

Your posture, the way you sit or stand with the guitar, the way you position and hold the guitar, the adjustment of the strap, the positioning of either hand and their writs and fore-arms, all come into play here. You can gain a lot from looking into how Classical and Jazz guitarists do all of these things.

 

If it's just from playing a lot, lay off for a while, work on careful stretches and warm-ups for when you get back to playing, and work up to being able to handle long playing sessions gradually. In the mean time, gently, carefully stretch and alternate warm and cold water soaks for your hands, massaging 'em for loosening and circulation. Ibuprofen can help reduce inflammation.

Ask yourself- What Would Ren and Stimpy Do?

 

~ Caevan James-Michael Miller-O'Shite ~

_ ___ _ Leprechaun, Esquire _ ___ _

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I don't know if that's the case. I think it's more than that. I believe good form helps one to play faster and have cultivated that since my freshmen year. It may be possible that during last spring semester I lost track of that in my stress over having to jury twice in one year. Either way, I rested it for four months and have had physical therapy and still have not yet been able to get back to where I was. I think if you push a muscle past its point of endurance, you are far more susceptible to injury regardless of how your form is. Then again, I'm a musician not a doctor, but even they are artists more than scientists.
We cannot accelerate the growth of a tree by pulling on its branches. - Ricardo Iznaola
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Thank you for your advice, Caevan. I guess I should have written more about my issue before asking for advice. I'm trained in both classical and jazz guitar. I'm very particular about my form and am sure to keep my hand and wrist in as neutral a position as possible. I admit that my warm-ups may not have been as thorough as they should have, but one of my hobbies is yoga and stretching is very important to me. I tried most of the things that you suggested during my four month hiatus. My real hope was that I might potentially find someone out there that has experienced similar issues and would be able to share with me something I havent found yet.
We cannot accelerate the growth of a tree by pulling on its branches. - Ricardo Iznaola
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One of the main things players can do is to pause periodically while playing & stretch/relax their hands.

It can also be important how one starts any playing event.

Matt Blackett did an article once outlining some specific exercises he designed based on the physical nature of the guitar.

They're very good.

Interesting guitarist exercises, courtesy of Matt Blackett

d=halfnote
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Hi;

I'm new here but just wanted to let you know about a stress related injury that occurred to me about two years ago. After not doing anything out of the norm, I woke up one morning with terrible pain in my left wrist, thumb and forearm. No matter what I tried to do it caused pain. After about a week of it I went to my doctor, he put me immediately into physical-therapy, after about a month which included (hot/cold packs, exercising my hand and wrist as well as acupuncture) there was absolutely no change except a lower bank account.

My doctor than referred me to a orthopeadic surgeon, who specialized in hands and wrists. When I saw this surgeon he knew exactly what it was by one little test, he pushed my thumb back and asked if it hurt. My diagnosis was "De Quervain's disease" this is a repetitive stress injury, that causes pain at the base if the thumb up into the forearm. He explained the ligaments become inflamed and can't move freely through the sheaths surrounding the ligaments.

I was placed in two casts over a 6 month period that really didn't help much so they then designed a brace that totally immobilized my thumb. I wore this thing day and night and after about 3 months, my hand was almost back to normal. I started playing again just a few minutes a day until I was able to play for an hour or two. That was 2 years ago, even today if I feel anything not right about my left wrist I put the brace, take a couple of Ibuprofen back on for a few of days.

The surgeon said this problem in frequent in guitar players and if pushed too far will not heal. I'm not a doctor but if anyone is having a problem where it's painful to do bar chords, or it hurts to play even a couple of songs. Try the test by pulling your thumb back a bit, don't force it and believe me if you have De Quervain's you will know it in an instant. Also, total immobilization of the thumb is the only treatment that works, meaning a special brace made to do so. Take Care!

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Immobilization also works for carpal tunnel.

 

For me, the problem started with over use (playing bass six nights a week, 52 weeks a year, for seven years). I also used to wake up with numb hands.

 

The doc did some tests and told me I had Carpal Tunnel Syndrome and also Ulnar Myopathy.

 

You can tell because Ulnar Myopathy is acquired by leaning on your elbows a lot (I work at a computer now). This causes the Ulnar nerve to become pinched and causes numbness in the pinky, part of the ring finger and down that side of the palm. Carpal Tunnel causes the other half of the ring finger, the rest of the fingers and up your wrist and fore arms to become sore and numb.

 

I cut down on my playing and my computer use a bit and started wearing good quality wrist splints (the ones with the thumb hole and the two sheets of metal that totally immobilize your wrists) and after three month, they are feeling much better.

 

As eube said, anytime I feel my wrists starting to hurt or my hands starting to go numb, I wear my splint for a few nights. I'm am also VERY aware of keeping my wrists straight.

 

Bill@WelcomeHome has had stress injuries as well and may be able to offer further insight.

 

Good luck.

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I think if you push a muscle past its point of endurance, you are far more susceptible to injury regardless of how your form is.

 

Generally these sorts of soft tissue injuries involve inflammation of tendons and/or their surrounding sheaths, not muscles. Muscles heal much more rapidly. Among a large number of players I know who have had debilitating soft tissue injuries (meaning they must cease playing altogether for some period,) the majority have been women of slight build. A small musculature seems to be a common trait among sufferers. I'm pretty skinny & have had a lot of tendon issues. When I was undergoing physical therapy for tendonitis in my forearms I was told that increasing muscle tone, but only after the inflammation had subsided, would help prevent recurrence of the tendon injury. Having a good strong set of muscles around those tendons does seem to help keep the tendons from over-extension & I find that working out every day has helped stave off reinjury. Obviously stretching exercises are part of any guitar warmup procedure, but a bit of daily work with some small 5 or 10 pound dumb bells can help the muscles keep the tendons in line.

 

Scott Fraser

Scott Fraser
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I cut down on my playing and my computer use a bit...

 

Many of us that play and also use computers and hang on the internet and/or play games on 'em, etc. could take a bit of a break from the keys and mouse now and then, and also take a good look at how ergonomically we use 'em.

 

As eube said, anytime I feel my wrists starting to hurt or my hands starting to go numb, I wear my splint for a few nights. I'm am also VERY aware of keeping my wrists straight.

 

Years ago I found that while I was sleeping, I was curling my fingers and even balling my fists up; I found that my fingers and hands loosened up quite a bit after I conditioned myself to relax my hands and keep them more or less flat, often under the pillow, as I slept.

Ask yourself- What Would Ren and Stimpy Do?

 

~ Caevan James-Michael Miller-O'Shite ~

_ ___ _ Leprechaun, Esquire _ ___ _

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My left index finger would snap shut and stop me from playing toward the end of a gig about 5 years ago...I started forcing myself to take a break after every 10 songs, take vitamins and minerals that relieve joint pain and the problem went away...I also limit my practice time to no more than one or two hours...
Take care, Larryz
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I haven't played video games for close to a year. This has caused stress in my relationship, since she's a bit of a gamer and gets mad that I'll never play with her. :/ I've considered my sleeping positions as well and am always conscious of what position my hand/wrist is in. Especially with the little bit of typing I do in the forum from time to time.

 

I was able to see a family friend that is a neurologist, but I don't know that I agree with his diagnosis. He thinks I have focal dystonia. This is a neurological disorder where signals get crossed and I think maybe he was biased towards this since he is a neurologist. According to the Dystonia Foundation website, musicians with focal dystonia don't experience pain (my main symptom) and experience a decrease in ability with familiar passages (I never experienced this). I have a thumb splint that was made for me to wear while playing which definitely has helped to avoid serious pain. I do therapy nightly for the intrinsic muscles in my hand which also helps. I still experience strange sensations in my forearm that keep me reluctant to put in any serious practice. I'm interested in trying many of the suggestions here, so keep em coming guys!

We cannot accelerate the growth of a tree by pulling on its branches. - Ricardo Iznaola
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The neurologist did an EMG. He says it's definitely not carpal tunnel. He said the results of the test were faster than average and was seemingly impressed, if you don't mind me bragging. :D Said that was probably due to neuro-motor skills I developed as a musician or something like that. There is unfortunately no test for dystonia. They still don't know a whole lot about it.
We cannot accelerate the growth of a tree by pulling on its branches. - Ricardo Iznaola
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Do you use the same muscles typing on a computer and playing guitar? I don't see where one benefits the other.

The same for guitar and piano - I have pretty good chops on guitar and mando, but on piano my physical strength and coordination is the same as any other beginner.

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I doubt it's really your strength that is the problem with your piano chops. It doesn't take a whole lot of strength to punch a key. I'm guessin what you haven't developed are the neuro-muscular responses to allow you to play them quickly. That's a different beast than actual muscles. I think development of concise movements through focused repetition builds chops, but repetition is also what tears down muscles. Strength shouldn't be a factor in playing. It's control that needs developed. Unless maybe I'm completely off my rocker. Anyhow, my point was that I don't think that your observation about your piano chops shows that a different set of muscles are used.
We cannot accelerate the growth of a tree by pulling on its branches. - Ricardo Iznaola
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There are quite a few good suggestions to exercise range of motion. As far as building strength, I would make use of something that specifically works for hands, rather than just working out more. One way is to keep a wad of gum eraser nearby-preferably in a container so it doesn`t pick up dust and other crap from surfaces. This is the soft type you can buy at art stores, get maybe five or so and ball them up together. It`s also a good alternative to choking the s**t out of people who cut you off in traffic.

Another is the Chinese Baoding balls, they are the steel bearing type things with another ball in the center. The good ones make a faint ringing when you roll them around. They look easy but in fact take a bit of skill, you should be able to roll them around in your hand without banging them together.

Same old surprises, brand new cliches-

 

Skipsounds on Soundclick:

www.soundclick.com/bands/pagemusic.cfm?bandid=602491

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The therapists gave me theraputty and rubber-bands with varying resistances and a list of exercises that take me 20-30 min every damn night. 'Less I'm at my girl's and don't have 'em with me... :cool:
We cannot accelerate the growth of a tree by pulling on its branches. - Ricardo Iznaola
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Any advice on my unrelated left hand problems would be appreciated:

I think they may be related to back/posture:

 

Details here:

 

http://philwbass.wordpress.com/2010/01/13/my-left-hand/

 

 

See the doc and get tests done.

 

In the mean time, the Ulnar nerve is the one responsible for the feeling in half of the middle finger, the ring finger and the pinky finger. It mainly get's pinched when pressure is put on the elbows. I'm told it's a common problem with folks who work on computers and rest their elbows on the desk. However, that is just one of many possibilities...

 

With anything like this, you want to get it checked out and take the steps to fix it ASAP. Don't wait until it get's worse, to do something about it.

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Don't rest it for four months before seeing someone either. If you're not haveing the symptoms than it's hard to diagnose. I really wish I had seen a sports therapist. Or maybe even a hand specialist. Someone that specializes in this sort of thing is really important in a good diagnosis.
We cannot accelerate the growth of a tree by pulling on its branches. - Ricardo Iznaola
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Yeah, man. It's a terrible feeling having to put it down. I did for four months. There's this fear that you'll never play again and a feeling that your dreams are crushed. Let us know what you find. I still don't know what causes my pains. Hope you find out soon!
We cannot accelerate the growth of a tree by pulling on its branches. - Ricardo Iznaola
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Ouch man, four months - that's tough!

 

I broke the same hand a few years back - it was tough then too.

There's a lot to be grateful for though. Saturday's gig I cancelled is really low paid and I have a stand in already. I don't rely on music to make a living to feed my family. And I'm hoping it's not going to be a permanent problem...so yeah, things could be worse!

 

It must be tough not knowing the cause. My doctor said that most of the time with these things the cause stays unknown.

 

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I didn't read this whole thread but if it wasn't stated earlier you need to check into something called Active Release Technique. A good practitioner can also show you some stretches that can help minimize the problem.

 

I have suffered with soft tissue issues my whole life. This stuff works.

Failure is the path of least persistence.
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