Conference napalm::guitar

    It's so bad I couldn't even type affliction correctly...

    Be very careful; if not treated properly it can go on indefinitely. 
    See a doctor for a therapy program.  An orthopedic surgeon should be
    the best bet for advice.   Do not inflame it!  If it hurts, DON'T use
    it!!! Trust the voice of experience.
    
    FWIW
    
    Steve D.
    

I had a similar problem. I fractured my left hand index finger & now am
the proud owner of a small calcium lump on the side of the bone. I ended
up teaching myself to hold my guitar a bit differently (after taking
massive amounts of ADVIL for about 6 months). The doctor that I saw said
that he could surgically scrape the lump off, but couldn't guarentee that
it wouldn't come back (this was the result of an injury about a year
previous). I still have the lump, but no pain.

A piano player friend of mine said that he can play light synth keyboards
but can no longer play a piano because of tendonitis. I understand this
to be common to many pianists after years of playing.

							Jens

    
>    Has anyone out there had tendonitis? How long does it take to heal?
>    This is really a drag. (having tendonitis)
    
It's been discussed somewhere in this conference (as a subtopic) and also
in DREGS::MUSIC, I believe.  

Here's the short version of my experience:

I had tendonitis in my right wrist, in the extensor tendon of the thumb.
This is a common form called DeQuervain's disease.  It eventually spread
to the other wrist and to every other joint that ever experienced a trauma.
I won't go into the details of my misery, but I'll tell you some things I 
learned.

Inflammation is not well understood by medical science (-itis = inflammation),
and even the specialists (orthopedists and rheumatologists) aren't always
well versed in the methods of treatment.  I was treated by six MD's, two
chiropractors, one acupuncturist, two physical therapists and one "healer".

Individuals respond differently to different treatments.  There are lots of 
different anti-inflammatory drugs and it can take weeks to tell if one is 
working for you.  I went through eight before finding one that helped 
(Voltaren), and I had to convince a doctor to let me try it.

Ice usually works better than heat.  The ice treatment is painful in its
own way, but you get used to it and it helps.

I started to improve after about twenty months and, a year later, I'm still
recovering.  Most cases last three months or less.

Hmmm.  This is turning into a long version.  Send me mail if you want more
details about what I learned.

Bob

    I've had tendon problems in my elbows but not due to playing guitar.  
    It was due to rock climbing.  It may be similar.  Mine came from
    over-use and lack of rest.  I would climb hard several days a week and
    my elbows would get sore because of the forearm muscles staying so
    tight.  I changed my routine to never climbing hard two days in a row
    and then after the workout, stretch my forearms.  That cleared up the
    pain in a matter of a few weeks.
    
    I would think that you could get the same symptoms from playing guitar
    a lot, particularly in the left (fretting) hand.
    
    You can stretch your forearm by, for example, putting your fingers on
    the edge of a counter, say, up to the second joint of the middle
    finger, and pushing down with your forearm oriented vertically.  Let
    the muscles relax and stretch your fingers back good and hard.
    
    What the stretch will do is relieve tension on the tendon when the
    muscle is relaxed and allow the tendon to recover from hard use.
    
    I agree with checking with the doctor, because tendon injuries take a
    long time to recover and can be pushed into more serious conditions if
    not taken care of.  If nothing else, just stop playing until it quits
    hurting.
    
    Good luck,
    Will

    
 
    Re: Other Afflictions
    
    	I'm suffering from someting called "repetitive stress syndrome",
    which is a problem that can occur in anyone who does lots of 
    repetitive activity, like typing or playing the guitar.
    
    	The problem manifests itself as pain at the base of the thumbs,
    the pins & needles sensation in the pinky and sometimes the thumb.
    There are other symptoms as well, I just can't remember them all 
    at the momemt.
    
    	This problem is similar (in symptoms) to the infamous "carpal
    tunnel syndrome", which is a nerve disorder, involving a nerve that
    goes into the hand. If you suspect either of these, consult a
    neurologist about it. There is a test, called an EMG, which will
    help the neurologist determine what the problem is. I went to
    a neurologist and had the test and luckily for me, I don't have
    carpal tunnel. 
    
    	The rehab for me has consisted of A) Typing less. I'm a PC 
    user at home, so I've cut back on that hobby. Also B) I now wear
    "wrist splints" when I type. The splints force me to assume 
    a correct hand position when I type. Many times, incorrect
    typing posture or having the keyboard at too shallow can bring 
    it on. My Dr. says that he is getting more and more cases of 
    these types of problems in today's computer based workplace. 
    
    	Now, how does this affect my bass playing? Generally, it
    manifests itself, guitar-wise, by fatigue in the palm of then
    hand which makes it hard to keep pressure on the neck. I guess
    a lack of plaing stamina would best describe it. I know if I
    lay off typing (as much as I can) the playing gets better. Also
    adjusting my basses for extra-low action helps as well. 
    
    	I've been meaning to write this note for a long time. I hope
    my experience is helpful to someone.

    >	I've been meaning to write this note for a long time.
    
    ...but couldn't because he has to cut down on the typing.
    
    8^)
    
    Sorry, Tom, I don't mean to make light of your condition.  It's just
    that your last statement after the rest of the note seemed to beg it. 
    I hope you take this in the spirit I intend, I would never want to make
    fun of someone's physical difficulties (goodness, I have plenty of my
    own).
    
    Greg

I agree that stretching is important.  There's been some research on it and 
the recommendation is to stretch before, during and after a workout - whether
you're an athlete or a guitar player.  Once you've had a bout with tendonitis, 
it's especially important to follow this advice.  

One of the chiropractors I went to showed me how to stretch all the muscles 
I use in playing guitar or fiddle.  It makes a tremendous difference.

BTW, if conventional medical treatment doesn't help, don't be afraid to try
less orthodox approaches.  Some chiropractors are very effective and 
acupuncture works for a lot of people (and dogs and cats, so it's not just
a placebo effect).  

Bob

    Acupuncturist puts dog on table :---
    
    Dog: Woof Woof!
    
    Acupuncturist: I'm just going to stick these needles in to you,
                   now repeat after me... 
                   You will speak English.
    
    Dog: Hi there.
    
    Acupuncturist: I will not urinate on the carpet.
    
    Dog: I should xxxxxx hope not!
    

    Whoever said this is a drag wasn't kidding!
    
    It appears that I've developed tendonitis in my fretting hand index
    finger. It doesn't hurt much when I'm playing chords where the fingers
    are bridged (arched), but hurts loads when I play things that require
    me to bend the finger backward a little, like a first position A chord
    where you press down two strings together with just the index finger.
    
    It has become aggravating enough so I want to do something about it.
    Playing is fast becoming more of an ordeal than fun! So before I go for
    professional help, is there anyone out there that has had tendonitis of
    the finger(s) and that can give me sound advice on how to get over
    this?
    
    I hope the only answer isn't to stop playing entirely for some extended
    period of time!!!
    
    
    Rob

    I had what seems to have been tendonitis in my left index finger for
    a while.  Playing barre chords hurt, and reaching back for notes on
    my fretless bass was excrutiating.
    
    I finally went to a physical therapist when it got to the point that I
    couldn't even unscrew a lid or open a box of cereal without it hurting.
    
    The physical therapist said that my overuse wasn't the result of any-
    thing in particular that I was doing, but rather that I was putting
    stress on the finger by not using other muscles as much as I should
    (besides which, the finger itself was abnormally weak).  He gave me
    excercises for my finger and for the muscles in the ball of my thumb
    (which were the slackers), and that cleared it up surprizingly quickly.
    The thing that surprized me the most was that almost right away, I
    could play a barre chord, experience pain, deliberately make the ball
    of my thumb take more of the load, and while I was still holding the
    same chord, the pain in my finger would go away.  The PT had dealt with
    musicians quite a bit; he carefully explained that he wasn't suggesting
    that I mash the back of the neck harder, but that the work my thumb
    needed to do was of an internal, isometric sort.
    
    Hope this helps...
    
    Paul

	_The Bottom Line_ dedicated an entire issue to music-related 
	injuries, and while there was no specific advice dealing with
	tendonitis of the fingers, the consensus seemed to be that
	seeing a doctor early on is key.  However, you'll probably need
	to see someone who specializes in sports medicine, or someone
	who deals with 'repetitive motion' injuries.  Most agreed that
	not playing should be a last resort - modifying your technique
	is generally the way to go.

	If anyone would like this issue mailed to them, let me know
	and I'll send you an on-line copy.

	Sandy

    Well I am not sure if this will help or not but when I play an A in the
    first position, I use three fingers, one on each string and none of my
    fingers are bent backwards at all.  It may not be the proper way but it
    works well for me.
    
    It funny you mention this because for the past few weeks I have had
    pain in my index finger.  I think that  mine is nerve nerve damage but
    it is still not back enough to make me stop.
    
    Bruce
    

    Well,. I don't know if it was tendonitis but when Buck got me ripping
    up the fretboard,.. a problem surfaced. The problem: index finger
    on retting hand into pain mode.
    
    What Buck finally noticed (thank God!) was that I had a very bad habit
    of "planting" my first finger. What I mean is I would get my hand into
    position and once there,.. I would leave my index finger planted,..
    permanently barring the first two/three/four strings. I could play
    great licks because the notes there being barred were always available
    without "thinking" about it,.. or having to actually move my fingers
    to that position,.. I could just pick those strings and the notes were
    there,.. so this bad habit was actually pretty neat sounding,.. but in
    the end analysis it sucked because by planting the index finger like
    that it kind of gets frozen there,... and then the licks youy wnat to
    play where you have to move it really sound,.. um,.. well,... they
    were definitelt out of time because of the delay indecued from the
    "frozen" finger...
    
    Then the next problem surfaced which was when I lifted the index
    finger,. suddenly all my playing became way sloppy :-(,.. and that
    was becasue it was also my "anchor" for position playing. I now
    use the thumb as the anchor (kind of sounds similar to what the
    Physical Therapist recommended to .-?) and the thumb is placed
    against the middle of the back of the neck,.. not draped over the
    top Hendrix/SRV style (can you tell who my heros are? :-)
    
    	Anyway,.. general advice:
    
    	Anchor the thumb and let the index finger (and all the other
    fingers) fly..
    
    ]								/Bill
    

    
    	i've somehow aquired a real throbbing ache from the inside at the
    elbow. I'm beginning to think i hurt it while starting the chain saw
    a month or two back. Others think it's due to my recent cello
    adventures, but it tends not to hurt while playing, only after. What
    does hurt alot while playing is on the guitar - the tighter angled 
    bend makes it real tough.
    
    	I've never experienced "tennis elbow", but perhaps someone who
    has could share where the pain comes from. Last night just sitting
    at a local school committee meeting the pain became quite severe!
    
    puzzled..bob

    A few months ago, I had a big problem with some sort of
    "tendonitis-like" ailment concerning my left wrist.  It seem to exhibit
    the problem most when I'd put pressure on my hand with the palm down
    (pressing the hand backward).  It give me intermittant pain for many
    months.  
    
    I saw a doctor, who took x-rays and told me he couldn't see anything
    wrong.  I'd already found that ibuprofen helped it, so he recommended
    that I continue using that when I experienced pain, and to take
    slightly larger doses (3 Advil tablets) four times a day for a couple
    of days *after* the pain went away (I'd always just stopped when the
    pain subsided).  I did this and in the 3-4 months since I saw him, I've
    only had to take the ibuprofen one time.  The doctor I saw said that
    often times pain in complex joints like the wrist and shoulder will
    just kind of suddenly show up, and go away just as suddenly. 
    
    It never bothered me much as far as my playing went, except when
    lifting my guitar the wrong way, or carrying equipment around.  In
    fact, a lot of times, it seemed that it felt better after I'd played
    guitar for an hour or two.
    
    Got my fingers crossed that it doens't recur...
    
    Greg

>    It never bothered me much as far as my playing went, except when
>    lifting my guitar the wrong way, or carrying equipment around. 
    
    May you could get a prescription for a roadie!  :-)
    
    Dave

	A few years ago I had some pain in my left hand fingers and even some 
cramping and tightness in my wrist/palm. I never went to a specialist but I 
observed some common sense approaches to playing. I always played the 
instrument high enough to insure that the angle of my left hand wrist joint
was a large angle. Even when sitting down I used a strap to position
a "smaller instrument"(ie a Les Paul,Strat,Tellie style). Left hand 
technique as far as string pressure and fretting was carefully observed
to insure I was not constantly applying pressure when it wasn't neccessary.
	I made small changes in the instrument's setup and functionality
to decrease finger pressure. For example I stopped using a locking whammy
systems,I made sure the frets were setup/height and leveled properly as was the 
nut. 	Whenever I play,I warm up and stretch finger muscles,I know if
I don't I can strain a muscle or a ligment. I avoid playing very fast
long passages and breathe to "phrase" those passages. And I used less 
string bends in my solo's.
	When I was in "pain" I found it took approximately 3-4 weeks to 
totally recover. No muscle relaxant's or pain killers were/are compatible with
my metabolism. And I found they became a real "albatross" to my playing 
ability. I found this to even be true with Advil etc... After loosing
that nagging painful feeling I could work at my playing accuracy and speed.
	Even during those 3 to 4 weeks I still played,but less aggresively
on a daily basis or a day on and day off.
	Just this year some pain returned when I was trying to play a solo
transcription to speed and some other work I was doing possibly strained
some fingers. It took about 2 weeks to recoup.
	I know people who are much worse off than I,so I really look at
my experiance to be quite minor.

							Rick

    Thanks to all those who have replied! I have decided that the best
    course of action right now is to just stop playing for a while and see
    if the pain goes away. I hate the thought of not playing everyday, but
    I really can't see any other solution right now. I'm going to give it a
    week or so, and if things aren't alot better by then I'm going to call
    my doctor and get some advice or a referral to a specialist.
    
    What a drag this is!!!
    
    Any other experiences out there? Suggestions for treatment?
    
    
    -Rob

    If it is bad enough, you may have to give the guitar a break.
    This problem has a tendency to migrate up the arm and into the
    back and neck (headaches are common). I went to an orthopedic
    surgeon and his examination yielded a steriod shot, (right where
    it hurts most), a fugly brace, and a very large bill! Of course,
    none of this was effective, and his suggestion was surgery. I was
    gigging 4 to 6 nights a week so...cutting was out of the question.
    It was, however, another justification for the numbing effects of
    various substances. (I needed another justification about as much
    as a moose needs a hatrack...ya know what I mean?)
    
    Anyway... Here a re a few things that help:
    
    1) A trip to a *good* chiropractor - well worth the investment, and
       way cheaper than the orthopedic surgeon.
    
    2) Retire your LP (or heavy axe) and get a Strat (or similar weight
       axe).
    
    3) A wide strap
    
    4) Change your posture/stance/guitar height - immediately 
    
    5) Switch to lighter gauge strings, and use the bracing/fingering
       techniques suggested in the last few replies.
    
    I hope these help. Ultimately I had to quit playing for periods
    longer than 15 minutes. Goodbye music biz, hello DEC.
    
    Scotty
    

    
    I have had (and probably will continue to have) tendonitis in my
    right shoulder.  I told the doctor I felt like having it in a sling.
    It just seemed like the right thing to do to immobilize it.  More
    than one doctor and a couple of physical therapists have said the
    same thing - to stop moving it would result in stiffness in the
    joint, and putting it in a sling would be BAD.
    
    I'm not sure if all other joints work the same way....but maybe this
    is a case for continued use - as long as you're careful and stop the
    moment you experience pain.
    
    guy
    
    

re:.20

Are you sure that your problem is guitar related and not  related to
some other cause, like computer keyboard typing?

I have lots of problems playing bass and guitar, that come not from
playing but from the fact that I have a repetitive motion injury that
comes from *typing*. 

As a long time sufferer of RSI, and regardless of what you may think
about your ability to handle it by yourself, go see a doctor. 

The sooner you get treatment, the easier your recovery will be. The longer
you wait, the longer the rehabilitation will be. 

BTW, I agree that changes in an instruments setup help, but there is
a limit to how much. I mean I already have *very* low action for a bass
(5/32 to 6/32 at the 12th fret) and it's still hard for me to play. 

Anyone who would like to talk about it, feel free to call me.

-T
DTN:381-1864

re: .23

One last point. 


The point of that note is to make sure that people realize:

1. RSI (tendonities, carpal tunnel, et. al.) is quickly becoming
   a common problem among computer professionals and that your
   problem may not be directly caused by guitar playing. 


2. Don't mess around with it, get medical attention.


-T

    How about Bersitus(sp.) of the shoulder. Doc said first restriction was
    playing.. I was in Boston in December and had trouble picking up a
    soldering pencil...went to an arthopedic doc and found out I had
    Bersitus. Cortizone shot. Repeatitive medication ...switched sides of
    the bed with the wife....
    
    All helped....but it has taken 6 months to LEARN how to take care of
    the shoulder. Right after the shot,...I built a shed behind the garage,
    which trashed the shot.   With Bersitus, the Bersa sacks secrete a
    fluid that is similar to WD40, to lub the joints. If ones level of work
    exceeds the amout of fluid, then the sacks try to work harder which
    indeed inflames them...making them useless. The more the work..the more
    the inflamation....and a Catch 22 starts.   Even typing keeps them
    inflamed. The cortizone reduces the inflamation and allows the Bersa
    sacks to once again begin filling up. The steroids keep the inflamation
    down. My problem is that I do too much woodwork/hobby stuff + guitar to
    slow down...and consequently, the problem has not gone away.  I am
    about 80% recovered now and have learned when to quit.  I played for
    close to 2 hours Sunday with some folks... with no pain.  
    
    The problem came from hanging sheetrock in my model train room and  
    the associated floating that followed. I got so tired with the entire 
    project(I wanted to get back to the hobby), that I just held my breath
    ...and dug in till I finished.  The old phrase...Do it till it hurts..
    stinks. I had a quote for the job of $175. The doc bill was in the $400
    range.  I guess I learned a lesson.
    
    The solution requires a complete lifestyle change ....something that 
    did not come easy for me. Something I have not yet fully learned.
    
    Beeeeeeeeeeeee careful
    
    Pc
    

    	I had a strange thing start occuring about a year ago when we
    started playing a lot again. I started having problems gripping  my
    pick. It would get worse the longer we played. As well I noticed the
    general grip stength of my right hand was less that my left and I'm
    right handed. Went to see the Doc who sent me to a Neurologist who in
    turn did some nerve tests on that arm and compared the to the other
    one. Turns out I had a problem with the right Ulnar nerve (funny bone)
    where it went across the elbow, the nerve was compressed. He had me try
    some things like not leaning on my elbow, not bending int when I sleep
    (Impossible..) etc. These things helps but playing would bring it back
    again. Finally had surgury to fix it and they found a bunch of scar
    tissue around the nerve. Oh yeah now I remeber... Yeah skiing through
    the gates, only 5 more to go...OH SHIT!!!!..Yeah, I landed on that
    elbow.  The doctor said that this is common among musicians who play
    with their elbow bent. The surgury was successful and now am almost
    back to full strength (nerves take a long time to regenerate).
    	

    
    	I've not picked up the cello since weds past and have not had
    residual pain since friday evening.  It hurts like hell when i play
    guitar, but no residual, so i'm guessing there's something seriously
    amiss in how i grip the bow.
    
    	I've also been avoid certain motions with the right arm - such as
    starting the mower and carrying the brief case. I'm trying to develop
    left hand habits. My big sister is a tennis-elbow victim and also
    recommends Advil.  Meanwhile, i guess i'm finally gonna have to fork
    over some bucks for a bowing lesson.
    
    _lefty_

I've been dealing with wrist problems for five years.  For nearly two years, I 
couldn't play the guitar and it was another year before I could play more than
twenty minutes a day.  I have to agree with tomg that the best thing to do is
get to a good physician early.  Ask around, get references and go to a 
specialist - not just an orthopedist but someone who specializes in hands,
sports injuries, musician's injuries, etc.  If you don't improve, change 
doctors. I went through several doctors, therapists and chiropractors.

Some people get better without medical help, some get worse.  Even if you get 
better on your own, you may just be postponing more problems.  Out of 
ignorance, I misinterpreted some warning signs for a couple of years.  Now I 
seem to have some permanent damage to my wrists.  Don't risk it.

Bob

	I just saw my doctor the other day, and he confirmed that I have
	tendonitis (tennis elbow).  He told me to use ice on it rather than
	heat, and I've got a 'script for 600mg Ibuprofen tabs.  I can feel
	the difference already.  He thinks that it will probably clear up
	as long as I rest it - didn't tell me to stop playing, just to take
	it easy for a while.  He's agreed to refer me to a person who does
	sports medicine if the condition doesn't clear up in a reasonable
	amount of time, or if it becomes chronic.

>            <<< Note 1685.29 by SANDY::FRASER "Err on a G String" >>>


Good for you, and good luck with it.

My first Dr. prescribed heat.  I think that cost me significant recovery time.
Heat relaxes muscles and helps a little with the pain.  Sometimes that's 
enough to get you moving toward recovery, but one of my later doctors said
it can sometimes make things worse. 

Ice actually reduces inflammation (itis = inflammation) and pain.  Learning 
to use ice (or an Ace Cold Compress) was one of the most helpful things for 
my recovery.

Bob

    Cold therepy also helped me with my wrist problems.
    
    Greg