posted by mahler82
According to several studies done by the First Department of Orthopaedics,at Athens (Greece) University Medical School, the Department of Upper Limb and Hand Surgery and Microsurgery at KAT Hospital, and the Institute de la Main, Clinique Jouvenet, Paris, France, guitarists number among the musicians most likely to develop injuries. Their paper, “Disorders of the Musicians’ Hand,” published in Volume 59 of the Hellenic Association of Orthopaedic and Trauma Surgery in 2008, points out some of the more common injuries musicians can incur.
Tendinitis from overuse, of course, is a major culprit. Physicians in Greece rightly distinguish tendinitis caused by overuse, which they label “overuse syndromes,” since tendinitis is limited to the tendon and its sheath, while in overuse syndromes, “the whole musculotendinous unit is affected.” (p. 177) Overuse syndromes and tendinitis can be comorbid (co-existing) conditions, or either condition can occur by itself.
Other common conditions encountered by musicians who use their hands to play their instrument, such as guitarists, violinists, and pianists, include focal dystonia, carpal tunnel syndrome, ulnar tunnel syndrome, and arthritis. If you have one of these conditions, do not despair. You are not alone. Several well-known musicians, including composer Robert Schumann, have also dealt with these issues. (pp. 176-177)
Focal dystonia is generally painless, but no less debilitating. It causes spasms in the musician’s hand. In guitarists, focal dystonia most often involves “involuntary flexion of the 3rd and 4th finger . . .(sometimes combined with 5th finger abduction).” (p. 177). Treatment for focal dystonia can involve medication, rest, night splints, physical (occupational) therapy, and a strengthening program. Several well-known guitarists have suffered with this condition, most notably David Leisner, who taught LA Guitar Academy faculty member Emre Sabuncuoglu at the New England Conservatory. He details his struggle and victory over this condition in his article “Focal Dystonia,” available on Leisner’s website.
Carpal tunnel syndrome and ulnar tunnel syndrome, both grouped in the general category of “nerve compression syndromes,” are painful, but can often resolve with night splints and improved posture. (p. 177) Again, with these issues, prevention is, as the old saying goes, “the best medicine.” Guitarists, therefore, must not neglect this most fundamental ingredient of good technique.
Arthritis is an inflammation of a joint that causes stiffness, swelling, instability, and pain. It breaks down the cartilage in the affected joints, causing friction as the joint moves. Arthritis can arise from a number of causes, including broken bones, overuse, autoimmune disease, and infection, according to the U.S. National Library of Medicine, in their online article, “Arthritis.” Physical therapy, anti-inflammatory medications, cold and warm compresses, rest, splints, and a strengthening program that avoids ballistic exercises can ease the pain and help increase mobility. Dietary changes, such as eating more fish, fruits, and vegetables, as well as staying well-hydrated can also help greatly in dealing with this condition. (U.S. National Library). In musicians, the authors of “Disorders of the Musicians’ Hand” point out, arthritis usually appears between the musician’s thumb and index finger, and is most common in wind instrument players. (p. 177)
Though many frustrated musicians suffering from these issues may want to revert to surgery, we would strongly advise caution. As this paper, written by some of the most distinguished hand specialists in Europe, points out, “surgeons should be aware that hand and upper extremity disorders of the musicians should not be treated surgically.” (p. 179) Rather, these renowned physicians advocate prevention measures, including warm-up exercises and cool-down exercises, proper posture and technique while playing, and taking frequent breaks. If these measures do not work, a musician must stop playing altogether until the inflammation subsides. (p. 179)
It would, therefore, make good sense for guitarists to take steps to prevent these injuries from occurring, if possible. The faculty members at Los Angeles Guitar Academy have written several articles, which explain many of these preventative measures these doctors mention–as they apply to guitarists.
The LAGA guitar faculty also have a video, available in their free online guitar lesson series, of warm-up exercises for guitarists. Guitarists may also want to use these exercises as part of their cool-down routine as well, adding some deep breathing exercises to clear the mind and relax the body before packing their guitar away after practice or lessons.
In the worst-case scenario, taking a break from playing need not mean taking a break from music. We would advise that students use this time to continue their study, whether in ear training, music theory, songwriting, or composition. If you are a private guitar student, speak to your teacher about converting your lessons to instruction in one or more of these areas until you are ready to return to playing. If you are an online guitar student, use the time to develop your ear for good technique by listening to fine guitarists, as well as reading some books on music theory. This need not be expensive. Libraries generally have both CDs of great musicians and good books on music theory. YouTube also provides a treasure trove of fine guitarists whose work is posted on the site.
We would be the first to acknowledge that hand and upper-extremity issues are one of the most frustrating parts of life as a musician. As David Leisner discovered, however, they need not end one’s enthusiasm for playing the guitar. Rather, guitarists should find the best physician to treat their condition, heed their advice, and use any down time to study the structure and beauty of the music they play.
