Luke Winter – Page 12 – Midlife Guitar

I am part of a forum for beginner guitarists and one of them recently asked if anyone else had carpal tunnel syndrome and if they had found any ways of coping and dealing with it whilst playing guitar. So I wondered if there was much of a resource available for those that have to deal with this. From my research it seems that is a very common occurrence for guitar players. However a lot of the advice is scattered so I took some time to collect this information so hopefully it can help him and others. It should go without saying but any action taken you take upon the information provided here is at your own risk. Can I Play Guitar With Carpal Tunnel Syndrome? It is likley to be yes if you have mild to moderate symptoms. Discomfort can be alleviated with physical changes in the way we play and the type of guitar that we use. Developed symptoms will require consultation with a medical practitioner. Carpal Tunnel Syndrome (CTS) can develop quickly when playing the guitar if we don't seek to negate some of the situations that can increase its likelihood. The repetitive nature of guitar playing mean that it is very common so it is worth taking the time to read below understand what options you have to keep on playing guitar before the issue develops further and you might need surgery. Playing Guitar With Carpal Tunnel Syndrome According to Orthopedic Center Of Arlington more than eight million people are affected by carpal tunnel syndrome each year. Surgery for carpal tunnel syndrome is the second most common type of musculoskeletal surgery, (back surgery is #1) with well over 230,000 procedures performed annually. Given that the majority of us sit at a computer or use our hands, wrists and fingers in very repetitive situations it is no surprise that many of us suffer from Carpal Tunnel Syndrome. The success rate of clinical surgery which reduces symptoms is 75 - 90% which is great and should be explored first by seeing your doctor. However it the issue is just starting and you want to control the onset or you have it after surgery then there are methods to help alleviate and prevent it from affecting your playing. These can be separated into two areas: Physical ChangesGuitar Changes Physical Changes Warm Up Before Playing According to WebMD these are some great ways to deal with mild to moderate carpal tunnel : Below is a shortlist of exercises you can do. Senior Physiotherapist Jeff Caulfield has written an illustrated guide on preventative and treatment exercises for Carpal Tunnel, Cubital Tunnel, Tennis elbow, Trigger Finger and provides a general practice routine for all guitarists here Best Stretching Exercises For Guitar Players – Illustrated Guide (Back, Neck, Hand, Elbow, Fingers) Before you do the exercises below, run your hand under really warm water for a few minutes and massage it with the other one as you do it as this will get the blood flowing, then: 1. Shake It Out This exercise is super easy. It's especially useful at night, when your symptoms can be worse. If you wake up with pain or numbness, just shake your hands out to get some relief 2. Fist to Stop Sign Make a fist.Slide your fingers up until they point toward the ceiling, like you're telling someone to stop.Repeat 5-10 times. 3. Fist to Fan Make a fist.Fan your fingers, outstretch them as far as you can.Repeat 5-10 times. 4. Thumb Touches One at a time, touch the tip of each finger to the tip of your thumb so they make an O-shape.Repeat a few times. 5. Basic Wrist Stretches Sit down at a table.Rest your elbow and arm on the table and let your wrist hang over the side, palm of your hand facing up.Start with your hand in a straight, neutral position.Bend your hand toward you so your fingers point up toward the ceiling.Hold for 5 seconds.Return to a straight, neutral position.Bend your hand away from you so your fingers point down toward the floor.Hold for 5 seconds.Return to a straight, neutral position.Repeat 10 times.Do this up to three times a day. Wrist Position & Technique Try to keep your wrist straight as possible. With carpal tunnel the issue is that when you bend your wrist and then do fine movements with your fingers the flexed muscles in your forearm will bear down upon the channel your nerves flow through before reaching your hand. This channel is the "carpal tunnel". So by avoiding putting your arm and wrist into compromising position, you can control the issue if not eliminate it whilst playing. The most important thing to do is work on your hand/ wrist position because once carpal tunnel starts it can get worse quickly. Try wearing your guitar up higher as this naturally reduces the angle of your wrist with little effort. It doesn't look as cool but it might allow you to play more. You can also try working on playing in a classical style hand position. Fingers spread apart, arm and wrist nearly straight. Keep the guitar between your legs instead of over your right leg (if right handed, left left for left handed), like this, https://www.youtube.com/watch?v=bVmq2C5kLoM The next step would be to figure out the least amount of pressure you need to fret the string. Try different finger and thumb positions in order to find out which require the least work. If you strumming / picking hand is the issue then you may need to relearn how to strum or pick. The issue is usually the result of excess tension. You will want to work out the least possible number of muscle groups it will take to bring your picking / strumming hand into position. Do this by letting your arm go limp from the shoulder down and then slowly moving it into position from different angles. Whenever you feel tension in the wrist, even the slightest amount, then immediately let you arm go limp and do the exercise above before trying to strum or pick again. Unless the symptoms are unbearable you should be able to make some simple adjustments and avoid further harm. Style & Type Of Guitar It can be also time to explore a different style like slide guitar where your fingers aren't expected to dance around the fretboard as much. It doesn't have to be permanent, you could alternate, but if it helps alleviate any pain then it could be worthwhile. You could also look at playing a Ukulele or a Classical guitar with nylon / gut strings that are lighter. Rest If your problem is CTS, then you have swollen tissue that compresses nerves in a tunnel in your wrist. The swelling is from overuse and it can be hard to give your hands a few days off. Anti inflammatory drugs can reduce the swelling and restore function, but they can also allow you to injure it further without knowing or realising it. Take small breaks when you are in everyday life when you are using your hands, use ergonomic chairs and keyboards if your job is behind a desk for example. For under $20 you can buy a wrist brace like this one at Amazon that provides support to the wrist. These are worth trying as they are cheap and many people play whilst wearing them, like Johnny Greenwood in the early years with Radiohead. The key overall is to be continuously conscious of what you're doing with your hands and whether or not it's going to aggravate the condition. Guitar Changes Low Action & String Type Get a guitar with a low action (action is the distance of the strings from the fretboard) or ask your guitar shop or luthier to alter the action on your existing guitar. This way you don't have to press as far with each finger in order to create the note or chord. Changing to a lighter softer string and one that is not high tension is also a good choice. This will change the tone but it will also alleviate some of the pressure that you place on your fingers, particularly evident if you play acoustic guitar. Guitar Neck Profile Having to work your wrist and fingers a great deal around a guitar neck can increase the onset of Carpal Tunnel. Barre chords can be particularly difficult so it is important to find a guitar with a neck that can help you. Many people find that by choosing a guitar with a ‘fatter’ neck it alleviates a lot of the discomfort. Better suited are those that have a “V” or “U” shaped neck as they help to open up the hand. It is isn't just the back of the neck that needs to be considered but also the fretboard itself, the smaller the radius the better. A smaller radius means a more curved fretboard which suits the geometry of the hands better than a flatter larger radius. This cross-section of a guitar neck below, from Warmoth Custom Guitars, provides a good visual understanding of this. The exact thickness and radius is specific to you as each of us has different hand geometry. A company like Warmouth Custom Guitar & Bass Parts offers replacement necks which can suit your needs and whatever guitar you have. Guitar Weight For some, the weight of the guitar can cause issues. Changing the position in which you play to a more classical style can help alleviate stress on your fretting hand. Whilst there shouldn't be really any weight on your fretting hand if your technique is fixed, there are light guitars you can try. This carbon fiber guitar from Journey Instruments, although not cheap, weighs only 4.1lbs (1.9kg), very light when the average acoustic guitar weights between 6.6lbs - 11lbs (3 - 5kg). Related Questions How Can I Tell If I Have Carpal Tunnel Syndrome? Firstly you should visit a medical practitioner in person but Dr Alan Mandell an experienced Chiropractor provides a guide here that you may wish to use. https://www.youtube.com/watch?v=SSbcdh4SVpE