october 2010

If you have not had a guitar-related injury of some sort, you probably know someone who has. Your wrist? My shoulder! Oh, my aching back. Ice it. Put some heat on it. Rest it. Use it. Stretch it. Ah, the athleticism of being a guitarist. Around final exam time in the Guitar Department at Berklee, those volar wrist splints start to look like a fashion trend. The power of observation and awareness of your technique can save you from injury, as can careful and deliberate warm-ups, stretches, and rest.

Most of the muscle strain I’ve experienced in my hand came from my early days of practicing bebop heads, searching for the melodies and memorizing patterns that my left hand had never been asked to do before. Finding new and interesting chord voicings added to that tugging and pulling on the pinky side of my hand. When it got so I could aggravate my hand simply by a slight turn of a steering wheel or by pulling up a blanket at night, I knew I had to get some rest—and advice. I visited my friend, guitarist, and teacher, Rich Falco, of Worcester, Massachusetts. He gave me some great stretches to try, and admonished me to use my right hand to carry my amp if my left hand was hurting, for heaven’s sake.

First stretching lesson: Open your hand wide, making space between each finger very slowly, then hold it. Close your hand into a gentle fist and hold that. Do that several times, as often as you think of it throughout the day. It’s a convenient stretch—no guitar necessary. I do it on my way to gigs in the car, while walking, and any time I have a moment to sit and relax.

After many years of playing my full-sized jazz box on gigs, I recently decided to try using my 3/4-sized jazz guitar, which I had only been using for teaching to that point. Since I had been having some shoulder trouble for the past two years, I thought downsizing might be worth a try. Throughout the set, I noticed the funny little way my left shoulder would shoot up and out and around, as if it were trying to help my arm reach around some giant structure to allow my fingers to land on the strings. Once I adjusted, I began to wonder if I had been unnecessarily flailing about on my larger guitar for years and never bothered to notice. I preach economy of movement to my students—had I not practiced it in my own playing?

I turned to Katherine Riggert, D.O., a sports-medicine specialist at UMass Memorial in central Massachusetts (who, by the way, lives with her guitar-playing husband and all of his guitars). We shared a few dos and don’ts, confirming the validity of the stretches I’ve been doing for myself—and teaching my students— since my meeting with Rich Falco.

“I consider musicians a type of athlete,” says Dr. Riggert. “You have to develop good habits. If you want to play guitar for a long time, you have to develop good form, or you’ll develop overuse injuries.” She encourages us to consider the whole body rather than just the fingers when assessing our guitar playing habits. What affects the elbow, affects the wrist, affects the hand. We fall into the position of doing whatever it takes to get the sound out sometimes. “If you’re not paying attention to your posture, that can lead you to rely on how you hold your wrist.” Standing with a strap that is adjusted too low, for example, can lead to over-flexion—or bending too much inward—in the wrist. Posture problems and the weight of the guitar can lead to “degenerative joint disease in the neck, which itself can cause problems in the hand.”

Dr. Riggert cautions: “Before stretching, get some circulation going in your hand. You shouldn’t stretch a cold muscle.” She recommends an assisted stretch with your other hand helping. Very gently and slowly bend each finger back and hold for a few seconds. Then hold all four fingers back together. You can also use a table to facilitate the stretch— try it palm up and palm down with your fingers on the edge of the table. Dr. Riggert also recommends shoulder shrugs and a gentle neck roll before performances.

I get all of my students to join me in a meditative warm-up using the guitar (note: not a tennis ball, or any other sort of hard-to-squeeze device). Start with your first finger on the fifth fret of the high E string. Hold it for four long beats, then add your second finger to the sixth fret. Hold each finger down this way until all four fingers are down, separated at each fret, pointing in a parallel direction to the frets. Repeat on each string and take your time—feel the gentle pull.

If it’s too late for prevention and you’re dealing with discomfort or injury, but you can’t cancel an upcoming performance, you may have to find ways to recover while still playing. “There’s rest and then there’s relative rest,” Dr. Riggert points out. “Relative rest is something you can do early on when you sense an injury coming, so you cut back your practice time and take lots of breaks.”

Complete rest, however, may be what’s necessary until symptoms resolve. “It’s easier to treat overuse injuries early on in the process. Tendonitis can take years to resolve. Chronic tendonitis, or tendonosis, is a disorganization of the tendons rather than an inflammation, and that is much harder to treat.”

To make a safe return to playing, Dr. Riggert recommends a gradual approach, with rest breaks and rest days. Use the time to “figure out what happened in the first place. It’s gradual. That’s how it has to be. That’s the frustrating part.”