Tendonitis / Fatigue / Injury?

Warren

My third finger on my fretting hand is quite sore. If I make a fist and squeeze, it hurts a bit, not terribly, but enough that it makes playing uncomfortable. This is probably the finger that I bend with the most, and possibly also use the most (along with my first finger) during many solos, so not surprising that it's a bit tender.

This happened before a few months ago, I ceased play for a week and it seemed to come right. Will do the same again now, and see what happens.

Should I be worried? Is this just a bit of repetitive strain? Tendonitis? There is no inflammation, just some pain.

What signs should I look out for regarding injury? And when is it time to go to the doc?

Bob-Dubery

Warren wrote: My third finger on my fretting hand is quite sore. If I make a fist and squeeze, it hurts a bit, not terribly, but enough that it makes playing uncomfortable. This is probably the finger that I bend with the most, and possibly also use the most (along with my first finger) during many solos, so not surprising that it's a bit tender.

This happened before a few months ago, I ceased play for a week and it seemed to come right. Will do the same again now, and see what happens.

Should I be worried? Is this just a bit of repetitive strain? Tendonitis? There is no inflammation, just some pain.

What signs should I look out for regarding injury? And when is it time to go to the doc?

Tingling and numbness in fingers are not good. Pain in the elbow is not good.

There could be damage to soft tissue as well. If it's been bothering you for more than a day or two then maybe you want to get it looked at by somebody who knows their onions.

RSIs need not be caused by guitar playing. They can be down to other factors and effect guitar playing, or they can have some other cause and be aggravated by guitar playing.

I am going to PM you contact details for a physio I have dealt with who specialises in hands and arms and who I recommend (for general physio as well). She is the bees knees.

Warren

X-rated Bob wrote:
Tingling and numbness in fingers are not good. Pain in the elbow is not good.

There could be damage to soft tissue as well. If it's been bothering you for more than a day or two then maybe you want to get it looked at by somebody who knows their onions.

RSIs need not be caused by guitar playing. They can be down to other factors and effect guitar playing, or they can have some other cause and be aggravated by guitar playing.

I am going to PM you contact details for a physio I have dealt with who specialises in hands and arms and who I recommend (for general physio as well). She is the bees knees.

Thanks very much Bob!

No tingling or numbness yet thankfully, just a bit of soreness when I apply pressure. I also work on a computer all day so the constant typing is not always good for the hands.

Bob-Dubery

Warren wrote: I also work on a computer all day so the constant typing is not always good for the hands.

Indeed it isn't, The condition that used to be known as "tennis elbow" is now often called "mouse elbow".

Notebook machines are not good if you doing lots of work on computers on a regular basis. They force the wrists into an unnatural position.

I eventually had to have surgery for carpal tunnel syndrome in my left hand (worked well, pain stopped almost immediately). My right elbow continued to bother me. Then I made two changes
1) Got an ergonomic keyboard (Microsoft 4000)
2) Swapped the mouse to the other hand. I am right handed, so started using the mouse left handed.

Much better.

Also pay attention to things like seating position, position of monitor etc.

I like working in IT, but it does have it's negatives.

NB! Nothing I am saying here should be considered superior to the advice of a medical practitioner.

aja

May I suggest a trackball mouse? I have tried a few and by far my favourite is this one:

http://www.sybaritic.co.za/store/product_info.php?cPath=110_111&products_id=23314

It really helped me with tightness/pain/reduced suppleness in my right hand and wrist...

I spend pretty much the whole day on a computer doing CAD design

vic

@Warren.... have you had any other sore joints in the past (ankle, knees, toes) ? One is never too young to have elevated acid levels in the blood and this tends to affect those joints which are under stress. Re-occurring joint pains should be checked out..... BUT please don't worry about it....there's nothing that a change in diet can't cure ? Check with your doctor.

singemonkey

My 2c:

I've been getting some pain in my left ring finger from barring A-shape chords with it by the nut. I also had pain for a while from bending and vibrato as I upped my game in those departments - especially as I have a nasty tendency to use one finger to bend.

From prior sports experience, I know that when you don't quite have a technique right, it can cause pain. Once it's being done properly, no more pain. So I wouldn't worry too much if it's related to playing and then goes away gradually when you're not.

But the key thing, as I'm sure you already know, don't continue to play when playing causes you pain. It may take a while to develop the technique to the point where it ceases to do so, but in the mean-time, if what you're doing causes pain, stop doing it.

Bearing in mind that this may not be the problem in your case.

Warren

Good suggestions guys. 8)

@vic
Luckily, I don't have any general joint issues just yet. I will give Bob's contact a shout though, to be sure.

@SM
Exactly my problem, I think. Barres, bending and vibrato are heavy on that finger and since the new Strat is strung with heavier strings than I'm accustomed to, it's taking a bit of a toll. Hopefully as I grow accustomed to the guitar my technique will adapt a bit. I will also check with my guitar teacher that I'm not doing something stupid (like trying to play Texas Flood, for example) ?

Jack-Flash-Jr

Similar... pain from shoulder into thumb. Physio didn't work but acupuncture paying off!

Reinhard

You may wanna try stretching your long wrist flexors en extensors, may even try some neural mobilization.
Also check your posture when you are behind the PC and while you are playing guitar.
Strengthen your grip (what gauge strings do you use?)
Also triggerpoints can give referred pain into shoulder, elbow, hand, pins and needles etc. I shudder to think how many people have gotten elbow injections or operations for tennis elbow, while it was caused by referred pain from a triggerpoint.
Another idea, check the position of your wrist while you play, guitar slung low with wrist really flexed?

Sorry if I repeated anything mentioned before.

evolucian

quick suggestion? never use yr finger to bend. Its the wrist that needs to come into play...

another quick suggestion? Get Dave Kilminster's dvd "Playing with feel". It will help u on identifying little things in yr playing you can correct and use to play better ... thank me after you have it ?

http://www.licklibrary.com/store/dave-kilminster/15587/ultimate-guitar-playing-with-feel

lapdawg

Carpal tunnel syndrome is quite common nowdays & has appernetly increased a lot with the modern lifestyle of all day on moused & keyboards. I am not saying that this is what you've got, but you want to at least rule it out. Wiki it, ask the right type of doctor etc. If I recall correctly its got to do with nerve pinch in palm / wrist & is alleviated by a simple & minor op.
You might also try some over the counter anti inflamatories i.e. iboprufen (sp?) - can't hurt.

BTW - Wikipedia says:
"Carpal tunnel syndrome produces a series of symptoms from mild to extreme. These symptoms worsen over time and patients that have been diagnosed with CTS experience numbness, tingling, or burning sensations in the thumb and fingers, particularly the index and middle fingers, which are affected by the median nerve. Individuals also experience pain in the hands or wrists and some report to have lost gripping strength...."

Check it out. Let me know. I'm curious.
Good luck.

Bob-Dubery

Reinhard wrote: You may wanna try stretching your long wrist flexors en extensors, may even try some neural mobilization.
Also check your posture when you are behind the PC and while you are playing guitar.

All good advice, and from a pro.

One of the things that I had to do to try and eliminate surgery for CTS was to change the position I slept in. I have a habit of sticking one hand under my head, palm up, when I sleep - even though there are pillows as well. Result? I would spend hours asleep, when circulation is slowed down, with my wrist and elbow bent into a position of tension. Not good.

We (phsyio, surgeon and I) worked on all these sort of things because the surgeon is a professionally conservative guy who believes in cutting only as a last resort.

I have stretches to do as well (both during my working day and after guitar playing). They help.

Bob-Dubery

lapdawg wrote: Carpal tunnel syndrome is quite common nowdays & has appernetly increased a lot with the modern lifestyle of all day on moused & keyboards. I am not saying that this is what you've got, but you want to at least rule it out. Wiki it, ask the right type of doctor etc. If I recall correctly its got to do with nerve pinch in palm / wrist & is alleviated by a simple & minor op.

I've had that op. Whilst the procedure is quick and simple and very successful (if diagnosis is correct), recovery time is non-trivial and would pose problems for a professional musician. You will be out of action, as a guitar player, for about 10 days and will have to rebuild strength and flexibility afterwards.

So don't all go rushing off to the surgeon ? The guy who cut me takes the view that the procedure, whilst safe, quick and usually successful, should be performed only when all alternatives have been eliminated and sent me off for a course of the sort of treatments that Reinhard mentioned. He said that in many cases the symptoms can be alleviated without surgery.

Not that I'm saying that Warren has CTS. I'm no healthcare professional and I am not offering any kind of diagnosis here, just relating some of my experiences with this problem.

Best course of action, for all of you reading this, is to be aware of the problem, and start working on preventative measures now. A bit of stretching, a bit of attention to posture and playing position, can significantly reduce the potential of you having such problems. Don't invent your own stretches or do what just happens to feel good for you - consult a professional.

singemonkey

evolucian wrote: quick suggestion? never use yr finger to bend. Its the wrist that needs to come into play...

+1 to Evolucian. It doesn't have to be using the finger per se, just extending it slightly during the bend with the wrist as a part of the bend will put on a lot of strain.

Warren

Wow, great info, thanks everyone.

@Evo + SM
I do try to not use my fingers to do the bends, and my technique has improved a lot in that regard by using the wrist over the course of this year. Still, I think I'm still putting too much pressure on this one finger, even while holding chords or during regular playing etc. so I'll definitely check out that DVD. I really like LickLibrary stuff, I think their instructional vids are great.

@Reinhard + Bob
My posture on the PC has always been very good, being acutely aware of the ergonomic issues since I was little. Guitar posture is OK too, I think. I sling my guitar probably halfway between Jimmy Page and John Scofield ? Somewhere in the middle, where my wrist is not bent uncomfortably. So hopefully that part is ok. I will try remember to do some basic stretching and stuff though, that's one area I definitely neglect.

Hopefully not CTS, as it doesn't feel like nerve-type stuff (which I've had before in my leg). No numbness or tingling or burning, just some pain when pressure is applied.

Definitely going to consult the contact Bob has given me too.

Bob-Dubery

Any more news on this Warren? I mean, I hope the pain is going away, but I am more than theoretically interested right now because I have a little pain in my pinky and ring fingers. The joint nearest the finger tip. I can't help but think it's something to do with playing the electric, but maybe that's just coincidental. I am doing more runs lately - with the electric and on acoustics. Not a lot of bending, but a lot more vibrato than I am used to.

Bob-Dubery

I now suspect that in my case it's an issue of posture. I am Olympic class when it comes to slouching on a couch. You look at your hands and the guitar neck and figure that everything is more or less at the same angle, but they're not really. One big issue is that your left hand is working a lot harder to support the instrument. Another is that the series of angles and stresses from neck to shoulder to elbow etc is different.

Keira-WitherKay

Bob also look at the chair you sit on when you play ............ it's wierd but the wrong chair for me makes my back sore and means by end of a gig i'm not sitting so upright anymore........... and in turn tires my arms that they feel heavy ...... but if i do same gig with correct chair i'm fine and the pain is n9ot in the butt as one would expect but in neck arms and back .. getting old sucks

Warren

@Bob
I've started employing a little stretching / warm-up routine very religiously before I play. I also perform a flicking motion with each finger for a few minutes as a warm up, followed by a few more light stretches. I then employ a simple scale run in G all the way up the fret-board a couple of times, followed by a few light pentatonic licks with some mild blues-curl bends etc. Finally, I run through the chords of the C and G scales using barre shapes all the way up the fretboard.

This all only takes a few minutes before I get down to playing anything.

Result: the pain is now almost entirely gone, and I have a lot less stiffness during the initial hour or so of play. Even as I type, the residual pain I had in my fingers is completely absent now.