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    How to avoid RSI, carpal tunnel syndrome, wrist pain etc. when playing guitar extensively (part 1)

    Posted in: Guitar in general,Misc by Ingo on September 27, 2008


    RSI – the nightmare of musicians, even a Mark Knopfler got RSI problems on a tour a few years ago.

    RSI is a relatively new expression for a relatively new kind of health problem. RSI stands for ‘repetetive strain injury’, which means “any of a loose group of conditions resulting from overuse of a tool, such as a computer keyboard or musical instrument or other activity that requires repeated movements. It is a syndrome that affects muscles, tendons and nerves in the hands, arms and upper back.” (from Wikipedia)

    Repeated movements are nothing really new, I guess a smith did repeated movements quite a lot when hammering on a piece of steel, even hundreds of years ago. I think the reason why a smith can do so without big trouble is that these movements require a lot of strength which comes from groups of rather big muscles. Muscles can be trained, and in a way they like it to work because this is what they were made for.

    What however seems new to me are repeated movements that don’t require much force but a rather subtle control of small muscles. A good example might be clicking your computer mouse. Have you ever asked yourself how many clicks you might do when working or playing on the computer for some hours? Clicking once in a few seconds seems realistic to me, so let’s say there are maybe 6 clicks a minute, which means 360 per hour, or maybe about 1,500 when you spend some hours on a late night computer session (and we haven’t even talked about double-clicks yet).

    And here exactly is the problem, going 1,500 steps is probably no problem for man, but our body is not designed to move one single finger a few thousand times within a short time.

    What exactly happens to our body when overusing single muscles? Since muscles can only do one particular action, which is to contract (they cannot ‘push’, for these opposite movements we have a coresponding  antagonist muscle), overuse results in a contracted muscle state, in other words, the muscle does not relax to its full length after the job but remains slightly contracted – or cramped, a bit shorter than it was before. This contraction disturbs the balance of different muscles, and as our body is an ultra-complex system which means everything works together in some way, other parts of the body can become effected as a consequence, e.g. a contracted muscle causes a higher tension on the tendons, and this leads to a higher friction which results in a possible inflammation, and so on.

    Nevertheless, there are people who work on the PC or play guitar all day without getting these problems, while others do.

    And this is my message: there is hope – it is not an unavoidable problem, even if you decide to do nothing  but playing guitar all day long. I am convinced that the real problem is not the repetetive movement itself, but the way we use our body and our mind ( !! ) while doing these movements. More details and what this means exactly will be covered in one (or more) of the next article(s), also what to do for prevention or as a therapy to recover. Stay tuned.

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    8 Comments »

    1. Interesting article! I noticed something else as well, I often have problems with those parts I don’t use at all for guitar playing but still need. For example, when I play with a belt my back sometimes hurts or my arm (the fretting one) starts to hurt because it’s always bent in the same angle and not moving. So every half an hour or so I have to shake my arm a little bit so that it doesn’t get to stiff.

      So muscles not only can hurt because they are overused but also because they are in stiff in the same position as well…
      Have you also made this experience?

      Comment by Philipp — 2. October 2008 @ 20:36

    2. You are right, Philipp, moving is important, too.

      Comment by Ingo — 2. October 2008 @ 22:30

    3. therapy to recover from RSI, my 20 year old son who has been paying since he was 8,he goes to music school and has students he teaches has come to a stand still emotional hault..nothing seems to work and he is getting very depressed…..help…i can’t find treatment on your site,just prevention…….i sent you a beer,and slow train is one of mt favorite…thanks for ant help……we live in lagunitas marin county CA…..STEVE

      Comment by steve — 9. November 2008 @ 18:26

    4. [...] How to avoid RSI, carpal tunnel syndrome, wrist pain etc. when playing guitar extensively (part 1) (3) [...]

      Pingback by How to avoid RSI for guitar players - part 2 | Mark Knopfler Guitar / More Knowledge about the guitar — 12. November 2008 @ 16:14

    5. Ingo,
      I just discovered your blog by coincidence- I am devoted to Knopflers plaing and have been , as yourself , since Sultans in 78 – I play a decent guitar in various bands in Sweden – I have been going thru your blog and I love it – I have a lot of comments which will follow later but the one thing I want to touch on now is the RSI article – I don´t know if this is the same but I have been diagnosed with focal dystonia – As you probably know , this is hell on earth – the complete inability to move and control your fingers in familiar ways – I read what I find on the internet but there seems to be slow progress on the medical side. Anyone knows something I don´t ?

      br Jonas

      Comment by Jonas Hallberg — 29. July 2009 @ 17:36

    6. I am not a medical doctor and don’t even know what focal dystonia means. However, I found that things are often different than doctors tell you, some things are rather simple: you do something wrong and get problems, so it only makes sense to search for the reason of a problem, then the symptoms will disappear automatically.

      best to you

      Comment by Ingo — 14. August 2009 @ 08:37

    7. I’m a flamenco guitarist having a hell of a time with RSI. I was doing weights along with guitar to strengthen my bad back. This is something I do NOT recommend and I should have known better.

      Now I’m paying the price. For 10 months I’ve been having horrible chronic pain. Started with the shoulders and hit hard as “golf/tennis elbow”, meaning pain on both sides of the elbow on both arms. At first it was so bad that I had trouble writing at all, since then it has gotten better, but is still at a pain level that would cause worry with any musician. Now the weakness in my elbows is causing an overstress in the wrists leading to carpal tunnel-like symptoms. Trying to straighten my wrists while playing causes shoulder pain from bad posture. It’s pretty much all over my upper body now.

      It hasn’t effected my playing yet, my only worry is that it will continually get worse – I’m 35 and this is my only way to earn money.

      Any treatment suggestions would be great. Shock therapy hasn’t really helped, any physiotherapy just makes the pain worse…

      Comment by John Opheim — 16. January 2012 @ 15:15

    8. Pain seems often come from overuse, and overuse causes cramped and hardened muscles. Anything that helps to losen and relax the muscles is good, ideally all muscles of the whole arm, also of the shoulder.

      Don’t build up strength if the muscles already hurt!! I found Tai Chi to be very effective here, also rolling qi balls in your hand. Generally, moving a lot but without any force (!) is the key. Hope you’ll get better soon !

      Comment by Ingo — 16. January 2012 @ 15:27

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