But we are not talking about freak accidents here, but rather sneaky injuries that will build up over time and show up when you least expect them.
I’ll take you through some of the most common guitar injuries, how they develop and how to best avoid them. And also my own journey through one of these injuries and how I eventually was able to get back to playing guitar.
Let’s go!
Common Injuries
Apart from the sore fingertips and blisters or just freak accidents like falling off the stage or dropping the guitar on your foot, there are actually a number of serious injuries you need to be mindful about.
The strain on our hands, wrists and arms from intense practice routines and jam sessions can actually result in some pretty serious damage. Especially if we don’t pay attention to early signs of pain and discomfort. Even bad posture and loud volume contribute every year with countless injuries to guitarists worldwide.
Below are the most common ones to be aware of. They are known as Repetitive Strain Injuries, or simply RSI’s, which is an umbrella term for a bunch of injuries caused by overuse involving repetitive movements.
These types of injuries are often long term and take months to heal. Sometimes even years. About 80 % make full recovery without the need for surgery.
Tendonitis
Tendons are cords that connect muscles to bones, and when a tendon gets inflamed we call that Tendonitis. It could be any tendon in your body, but for us guitarists it’s typically in elbows, forearms, wrists and fingers.
When a tendon is inflamed it swells and causes pain and discomfort. The cause for tendonitis could be many things, but for guitarists it’s almost always strain and overuse.
Tenosynovitis
This is linked to tendonitis, but is the inflammation of the sheath around the tendon. The cause and symptoms are pretty much the same. And even though Tenosynovitis refers to the sheath around the tendon, and not the actual tendon, both can be inflamed at the same time.
Trigger Finger (type of Tenosynovitis)
If the tendon sheath in a finger or thumb becomes inflamed and thickened, it might result in difficulties extending that finger. It might even cause the finger to suddenly lock in “trigger position”.
Tennis Elbow
This form of tendonitis has of course a fancier medical name, Lateral Epicondylitis, but since that doesn’t exactly roll off the tongue we’re just gonna stick with Tennis Elbow.
It causes pain in the backside of the elbow and forearm, and it is mostly felt when you lift or bend your arm. Also when you try to grip an object.
Carpal Tunnel Syndrome
This is a very common injury among guitarists. It’s mostly caused by too much, or prolonged pressure on the wrist (or medial nerve to be exact). It manifests as tingling, throbbing pain, numbness or discomfort in the wrist, index and middle fingers and thumb.
Cubital Tunnel Syndrome
This is a sibling to Carpal Tunnel Syndrome. Instead of pressure on the medial nerve it involves excess pressure on the ulnar nerve. It results in pain and tingling from the elbow down the arm to the fingers. The pain is said to be severe at times, with stories about sufferers from this condition waking up in the middle of the night with intense sensation of pins and needles.
If you want to learn even more about tendonitis, please read this.
(Dis)Honorable Mentions
Focal Dystonia
First off, this is not a common injury. It affects only 3 in 10 000, but it’s still worth mentioning as it is a condition that sometimes affects musicians.
It is a neurological disorder that causes involuntary muscle spasms in one part of your body. For guitarists this would primarily be hands and wrists, causing sudden contractions of fingers. Experts can’t point to one distinct factor that causes it, but it is believed that for musicians it is linked to practicing and performing more than usual.
Back & Neck Pain
This one is so common it needs no further introduction. We’ve all felt it and experienced it, and we’re all very annoyed by it.
Back pain is often related to practice posture. It usually comes from practicing sitting down on a chair or sofa that was never intended for these purposes. We tend to sit down on whatever piece of furniture we have at our disposal, even the amp itself, and curl up in weird and unnatural positions for our necks and backs while trying to balance the guitar in our lap.
Needless to say, this will cause great discomfort in the end, and could possibly lead to more serious conditions over time if not corrected. Practicing standing up, or at least using a strap will help a lot. Finding a comfortable chair, while also being mindful about your posture is not too shabby either. For more tips watch this great video.
Tinnitus and Hearing Loss
As far as classic injuries go, Tinnitus is definitely one of the big ones. It affects countless musicians every year.
It’s the sound of ringing in the ears. It may also be described as roaring, buzzing, hissing, or clicking inside the head. The sounds may come and go, or worse, be constant and ongoing. The sound may occur in one or both ears, and vary in pitch.
There are many reasons why people develop Tinnitus, but one of the most common ones is exposure to loud noises. Of course, there is a broader spectrum of people in the risk zone, such as construction workers, concert goers or those being too close to the speakers in a nightclub. But for us musicians this is a real hazard to be aware of. Especially if you’re in a band and do a lot of gigging and rehearsing.
Getting Tinnitus truly affects the quality of your life. It is often a permanent condition, and there is no known cure for it. So, always make sure your ears are well protected when you play, whether on stage, in a studio or in your rehearsal room. Also always be mindful about the volume when using headphones.
My Battle With RSI
As already mentioned, I’ve had tremendous problems with RSI myself. In short, my fretting hand will never be the same. Ever since my recovery I’ve had to be careful about overuse. It has become something that I have to always be weary of and adapt to in my playing. And even though it never stopped me from playing the instrument I love, nowadays I do so with a lot more precaution and focus on comfort.
Not listening to my body
Once I reached that stage where I wanted to learn how to shred and play lead guitar, I was pretty much unstoppable. My wife didn’t see much of me, which is almost an understatement.
I often played 2-3 hours straight every day, sometimes more, and very often after such a session my fretting hand would be fatigued and sore. Playing posture was not something I thought about to any greater extent, and I would often sit hunched over my guitar on my sofa.
After a few months I started noticing a tingling sensation in my forearm, and an ever increasing pain in my wrist and hand. I still didn’t care all that much, thinking it would all go away by itself soon enough. Wrong!
Surgery
When the pain got real bad I realized that something was off, and I stopped playing altogether. But the pain lingered, and wouldn’t go away. After resting as much as I could for the following 4-5 weeks, it was time to see a doctor to find out once and for all what the hell was going on.
It was a bad case of Tenosynovitis, and my doc was completely bewildered why I hadn’t sought help sooner. So was I to be honest. Dumbest thing ever, but sometimes common sense isn’t on your side.
Months went by without any real improvement. And with a swollen tendon putting pressure on the nerve underneath it quickly became a matter of surgery. This to avoid permanent nerve damage. Yeah, a whole bag of fun!
The 3 Things That Helped Me Overcome My RSI Problems
Recovering from surgery did not take as long as I had feared, and it was a joy to be pain free again. However, getting back to playing guitar proved to be a little trickier than expected. My hand would tense up quicker, and I could only play for very short periods at a time.
Something had to be done.
Stretching
This is of course something I should have started doing a long time ago, but it’s never too late to start good habits. Nowadays I warm up a bit before playing, and I make sure my hands are stretched and good to go. This allows me to play longer sessions, pain free.
Good Posture
I started paying much more attention to my posture while playing, and realized it was absolute shit. It had to change, so I started using my strap all the time, even when sitting down. A straight back and comfortable chair became my new best friends, paired with looser shoulders and more relaxed hands and arms.
I will often play standing up, and even keep my guitar slung higher than I normally would, and it’s sooo comfortable. I know, it’s hard to look cool with your guitar on your chest, but what the hell. I’m too old to care!
Awareness of Excess Tension
Nowadays I pay close attention to any tension in my arms and hands. I will stop playing immediately if any discomfort comes creeping up. I also keep my practice sessions a lot shorter.
Also check out the story from guitarist Josh Middleton below.
Avoiding Injuries
While guitar injuries aren’t inevitable, they do happen more often than we care to admit. Most of my axe-wielding rock-o-holic friends have had similar experiences as me, with varying pain and severity. Some have been more lucky and are still going strong.
Regardless of whether you’ve only started playing or been at it for a while, one thing is for certain. The longer you play the more likely you are to experience pain or discomfort. That’s a fact. Best thing is, most of these problems can be avoided altogether.
Needless to say, I’m not a medical expert. My opinions are from my own experiences, and the many conversations I’ve had with my doctor. Some of it also comes from friends in similar situations.
Let’s take a closer look.
Improper posture when playing guitar
A proper posture when playing turned out to be a lot more important then I first gave it credit for. This is something that can be fixed with little or no effort, and it will raise your chances of pain-free playing by a lot.
Shoulders – Keep your shoulders in a relaxed natural position, and don’t raise them while playing.
Back – If you slouch when you play (like I often did) you will soon enough experience neck or back pain. Keep your back straight. If you play sitting down, use an adjustable chair set at a comfortable height. Use a foot stool if you have one, so that you are not straining to hold your guitar in the correct position.
Arms/Elbows – Some people play with their arms/elbows raised up a bit. This creates a lot of tension, and can cause pain in your forearms or elbows.
Your fretting hand elbow should stay close to your body, but not directly up against it. Your picking arm should rest on the front of the guitar and find a natural and relaxed position.
Wrists – Try to stay relaxed in your wrists, your fretting wrist should only bend moderately as you curve your fingers to reach for strings. If you have to, raise the height of the guitar.
More on posture in the video below.
Not warming up properly
This is something I overlooked for a very long time. I failed to see the benefits and therefore didn’t deem it necessary. Oh man was I wrong.
Think of it like this; you are just like an athlete training your muscles to make specific and complex movements. Also, if your hands aren’t warmed up and stretched you are more likely to develop micro tears that lead to injuries.
Check out this video from Michael at The Art Of The Guitar, many great tips on warm up excercises and stretching for your hands and fingers..
Applying too much pressure with your hands
Use just enough pressure to push the strings against the fretboard, and no more. Do your best to relax the fingers that are not playing notes. Most of us press down way too hard on the strings, creating a lot of excess tension throughout the body.
Pace yourself and take breaks
Here we have another concept I used to put in the “not so important” category. The truth of the matter is you should avoid practicing for hours on end, as it’s a very easy way to develop pain and aches in your hands and wrists.
Take a 15-minute break for every 45-50 minutes of guitar practice to give your body a chance to rest. Simple as that!
Lifestyle factors
Well, I’m not gonna go into a rant about healthy lifestyle choices (not my thing), but it’s noteworthy and interesting how certain things affect us and link to injuries. RSI’s are no exception.
Sleep deprivation is one thing for example. When you sleep your body rests, and repairs the wear and tear it has sustained during your daily activity. So prolonged lack of sleep will likely make these injuries easier to develop and harder to heal.
But also lifestyle factors such as sports participation and the type of work you do plays a role. For instance, if you work a lot with computers you’re probably going to strain the same muscles, tendons and ligaments. Please take note that if you feel any symptoms from overuse from work or any other life situation, this condition will only be aggravated by playing guitar. It’s therefore wise to be extra careful.
So the basic principle is this, and it cannot be overstated in my opinion: Don’t play through pain. If you feel pain when playing, stop immediately. The situation may even require you to take a few days, or even weeks, off from playing. If this is the case, so be it. Better to heal properly than risk getting injured. You’ll thank yourself later.
If You Get Injured
So what happens if you do get injured, what do you do? First off, don’t panic. It is not very likely that guitar related RSI’s will result in disability or permanent damage. Especially if you pay attention to them at an early stage.
That said, it’s definitely something you should take seriously. Ignoring them can have pretty serious consequences, and sadly I’m the living proof of that.
In other words; If you suspect an injury, reduce your playing time by a lot, or take a break altogether. If there is no improvement within a week or two (or if you deem it necessary from the start) seek medical help without delay. Preferably medical help from someone who specializes in these types of injuries.
In this situation it is also a good thing to look over your practicing habits, and improve on the things discussed above.
And one final thing. Only doctors can treat injuries. I know that friends and other guitar players are full of friendly advice. However, if you need to get to the bottom of what’s causing you pain and discomfort, if you need a proper diagnosis, then there is only one way to go about that.
In Conclusion
Guitar injuries are real, and there are plenty of things that can go wrong if you don’t pay attention. They tend to sneak up on you when you least expect it, and are more common than you would think.
Considering how long it takes to recover, I’d say the main takeaway from all this is the importance of taking a look at your practice habits. Check your posture and the way you play, and how often you play. This way you will create longevity in your career as a guitarist, and you’ll hopefully be pain and problem free for the rest of your playing days.
