Eight (8) Ways to Avoid RSI

The threat of guitar related Repetitive Strain Injury (RSI) should scare any guitarist. In fact, many musicians suffer from symptoms related to the cumulative stresses brought on by their devotion to their music and their guitars. Unfortunately, many don’t realize the potential consequences. While largely treatable and avoidable, RSI can lead to actual disability. Constant pain, limited mobility and even focal dystonia are among the consequences.

For those unfamiliar with focal dystonia, this is possibly the worst case scenario for a musician. This article by Henrike Blumenfeld describes this terrible condition:

Focal dystonia of the hand is a condition characterized by a loss in motor control of one or more fingers. A single muscle or group of muscles is involved: muscles in the hand and forearm tense and tighten, with the result of making the hand (or part of it) curl. Musicians who have intensively practiced their instruments over a number of years are a group most affected by this condition.

Pause for a moment and imagine being stripped of the ability to make music…

Fortunately, RSI doesn’t have to end up as a worst case scenario. And, while information on RSI is still growing, there are some notable steps the guitar player can take to deal with or even avoid RSI. Consider the following:

1. Keep moving! – A recent Canadian study shows that physical activity is very important. The body hates to be static for prolonged periods of time. Movement is essential for maintaining circulation, flushing away metabolic wastes away from tissues and preventing muscles from growing tense.

2. Keep it in neutral – The human body is most efficient when it is in a “neutral” position. While sitting this means a straight back, head balanced over the spine, arms close to the body, feet flat on the ground. Think about all the ways a poorly designed guitar forces you out of this position. Many guitars put us in a hunched position that throw the muscles of the neck and back out of alignment. Acoustic guitars tend to force our picking hand elbows out and away from the body which lends itself to stress on the shoulder joint. The result is unnecessary stress and tension.

3. Ice it – Inflammation is one of the body’s reaction to RSI and icing 20-30 minutes will reduce inflammation and reduce potential damage. It’s a good idea to do this after any prolonged effort. I particularly like using the Elasto-Gel Wrist Wrap for this purpose.

Note – If you have circulatory problems, icing may be contraindicated.

4. Learn about RSI – RSI comes in many forms. Everyone has heard of Carpal Tunnel Syndrome (CTS) which unfortunately has become the catch all for these types of injuries. In fact, it is just one of a number of syndromes that fall into this category. If you’re looking for a good place to start, I can think of no better resource than It’s Not Carpal Tunnel Syndrome. This book is invaluable. Written in layman’s terms, it takes the reader through the basic anatomy of these conditions, covers predisposing factors, provides invaluable resources for additional research and contains a wide array of exercises and stretches that specifically target the muscles, tendons and nerves impacted by RSI.

5. Stretch – From the Body Mind Resources, site, these yoga-like stretches are a wonderful way of developing and maintaining general flexibility and reducing stress and tension in the body.

6. Rest – Once stricken, there is no substitute for rest. The body needs time to recuperate and heal and the only way to do it is to refrain from the activities that caused the issue. This also means getting enough sleep since this is when much of the body’s healing actually takes place.

7. Review contributing activities – Remember RSI is a cumulative stress injury. The likelihood is that you engage in a number of activities that contribute to the problem. Here are a handful of activities to consider:

  • I spend many hours in front of a computer.
  • I’m a rock star on Guitar Hero.
  • I love texting people on my Blackberry.
  • I spend hours on video games.
  • I spend a great deal of time behind the wheel of a car.
  • I work almost exclusively on a laptop computer.
  • I love gardening.
  • I do a lot of sewing.
  • I hold a child for long periods at a time.

8. Use an ergonomic guitar – Surprised? You shouldn’t be. While knowledge of ergonomics and RSI is important, there is no substitute for using the right tools – in our case ergonomic guitars. In Ergonomics is all about equipment, the author points to a study indicating that the best possible results in addressing ergonomic issues come from using the right tools. While knowledge may be power, it’s of little value when you are under pressure to perform a task and forced to work with tools that only serve to injure you. The right tools make it possible to apply ergonomic principles while allowing you to focus on your task.

For guitar players, this means taking a serious look at how our guitars contribute to our problems. Guitars that balance poorly, are excessively heavy, and place us in awkward non-neutral positions only make things worse. It may be that an ergonomic guitar strap is sufficient. Maybe neck-up devices that help place conventional guitars in more ergonomic positions would benefit you. Or, maybe the answer is a radical break from convention and serious consideration of ergonomic electric guitar and acoustic guitar designs. Ultimately, the goal is to allow our bodies to operate in an efficient (and thus less injurious) manner while keeping our focus on playing the guitar.

Final Thoughts

Realize that RSI is not a new condition. In a time before modern conveniences, wash women developed what was then called “wash woman’s thumb”. Now, it’s identified as Dequervain’s Tenosynovitis. The problem we face today is that we are at greater risk of RSI than at any other time in history. The advent of computers, PDA’s and video games and the increased sedentary nature of our culture exposes us like never before. If you doubt this or think that you’re safe because you’re young, consider that even children now suffer from RSI.

The bottom line is that RSI is a serious condition that requires serious attention. While far from exhaustive and certainly no substitute for professional advice, these steps illustrates that you can take an active role in prevention and your own healing process. Stop suffering for your art…

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51 Responses to “Eight (8) Ways to Avoid RSI”

  1. Good thoughts on RSI!
    Very good and laid out pedagogically. I would add a thing that I have been discovering all through these years, especially when viewing other players, and on top of this, intonating guitars for other players. It’s about left (fretting hand) hand pressure.

    I have yet to find out, say, the benefits of alternate intonation systems such as Buzz Feiten, True Temperament necks, and alternate tuning methods. I basically think all these are made for people that presses too hard with their fretting fingers.

    I have started to wonder if not HIGH FRETS are beneficial to ergonomic playing and will hold back RSI a bit. I think, guitar teacher guru Mick Goodrick stated in one of his formidable books, that your fretting finger is like a camera, there is just one tiny range when the lens are in focus. Either you press too hard or too light. There’s a perfect honing in a sweet spot between those two extreme points that needs to be practiced at. People have been raised on playing on a beginners lever on shitty guitars with action and frets that where out of this world, and slowly starting to develop a pressure they can’t get rid of. And sooner our later, they develop unnecessary strains.

    High profile frets, won’t let your finger pads touch the wood of the fingerboard, and thus if you do, will get you out of tune, and play the notes sharp. I’ve found out when playing higher frets, you don’t have to you use excess pressure to get a decent tone.

    I think “fretless wonders” and low profile frets guitars are – by and large – unergonomic and will speed up RSI or Tendonitis or increase the risks. The downside of high frets guitars is that it will probably take a while to get the intonation going on again. If you’re not already used to it. Recently, a hype has been made about stainless steel frets, making bends “easy as butter” and so on. That must be beneficial to ergonomics.

    I will not tire you out by going into fingerpad calluses
    that develop over time, but you can figure it out yourself.

    But, the question is, to you all, do you think that low frets are unergonomic?

    /Mats

    1. I just wanted to comment in response to the “fretless wonder” reference… I agree! I owned a 1980 Gibson ES-347 with the lowest, widest frets ever. It was an odd phenomenon, but I found myself pressing *harder* to play that guitar. I never quite understood why, but it had to do with tactile cues, and the feeling that I was not really coaxing enough tone out of the fretted notes. The guitar had a beautiful neck too… it resides with someone else now.

      One concern I have with the Klein I’m about to own is the small size of the neck in relation to jazz guitars that I own (and my Forshage). I am not a big person, but I find chunky necks to be much less tiring to play on than small ones. With a small neck, your finger muscles do more work since the neck does not fill up your hand. It’s like the hand forms a letter “U” with the top part closing in on itself (the fingers). Contrast that with a larger neck, where the convex area of your cupped hand is supported by the neck outline.

      Or at least, that’s what I think is happening… :-)

      Roger

      1. With my thinking about building a neck and your comments regarding profiles, do you or any other folks have any comments about asymmetrical profiles?

    2. Mats – How do you do it? :-) A very thoughtful post and it has me thinking quite a bit. I haven’t given compensation methods enough thought to speak to them but you certainly make a strong argument for tall frets as a means to reduce potential RSI – a lighter touch results in lower stress.

      And, this discussion between you and Greg couldn’t come at a more opportune time for me since I’ve been giving some thought to building a neck. My first guitar project focused on the body itself with the neck coming from a Musicyo Steinberger. I had originally been thinking low frets (lower equaling less distance to press) but now I’m rethinking that approach. Thank you both for the contribution and don’t let me stop you from discussing it further!

      1. Well, Robert. Like all ergonomics it’s all up to the individual. That’s why tall people with large hands plays basses instead of tiny guitars!

        :-)

        But if your playing consists of large bends and a lot of vibratos I’ll suggest TALL frets and – if you have the patience – stainless steel frets. I happen to think that as low action and as low distance as possible that you have to “fret”, the better. But it depends on how peoples hands, fingers are formed. Compare to the one who wanted large chubby neck profiles. That’s very true. I agree completely. If you’re used to – or brought up with – classical fretboard and classical fingering, your preference for what is ergonomical may be different to you. You wont do as much blues vibartos and bends if your used to “thumb always behind the neck” style.

        —-

        Think of the actual finger pads. My fretting hand could not play partial barre chords until I got the Klein. They were too fluffy and the pad touching neighboring strings. If you have to press, your finger pad is like a cushion or soft pillow that will “swollen out” until you actually stop the string at the fret and produce a firm grip on the string. Now, it takes a lot of years to hone in calluses that are so hard that the skin, or the pad doesn’t give in at all or go “swollen out”.

        —–

        Peculiar nonsense trivia, when doing blood tests at the hospital, they usually pin-prick the left hand fingers. The only one they can pin-prick on me, is my right hand pinky. That’s the only finger, that they really can pin-prick through to get any blood out from! The others are way too thick! They sure have tried! It’s the only one I allow them to do it on, by the way, because all the other ones I use for playing, and if they COULD pin-prick it, I would not be able to play for a week at least.

        —-

        Now here’s a minor nitpicking on frets. When going for tall high frets, I personally think that you could go for fat, wide frets as well. Because if they are just balancing on a very fine point of say a very rounded and thin fret, the intonation will waver much more, and will be harder to master.
        It will be more exact though.

        If the string resides on a slightly larger fret surface, it won’t be as prone to wavering from fingering idiosyncrasies. The intonation is only measured from where the string actually leaves the fret. You will definitely get more sustain. Of course, the most immediate, and important thing is the tone/timbre of high/fat frets vs low/thin.

        I think you should try different guitars with high frets out, and see where your finger pads fall.
        It’s totally individual, and there’s absolutely NO “one size fits all” when it comes to frets.

        Think like this: If you’re an avid jazzer and uses thick gauge strings, chances are that you can get away with lower frets, since those strings are so thick that they will “reach” the fretboard or fret before any of you fingers do (compare with bass strings).

        As fast as you play rocknroll and want to bend and vibrate as hell… well, go figure.

        You should also not only consider soloing, but also when doing chords. Especially what happens to the barre finger. Just play a barre chord anywhere. Just with the index finger. No extra fingers. Just like open strings. Like a capo. Test if you get the same results when doing that barre on the first fret (sort of open F) and then do the same on 7th fret. Especially, strum soft and hard with the pick. Chances are that if you strum soft, you will hear all the strings, but when you strum hard, one or two strings will die out sooner because, they will rattle just behind the fret because they are not pressed with enough force with the barre finger. Now, think ahead, what will people normally do to try to remedy this? Press harder with their index fingers of course, which has to be done with the thumb behind the neck, because there are no muscles left in the index finger to use for this purpose. And in the long run…Tendonitis, Carpal Tunnel Syndrome, RSI!

        This is especially true at the first fret, and VERY ESPECIALLY TRUE ON Classical guitars, because the large difference in thickness between the fourth and third string. All of a sudden the D string (4th) are spun and much thinner than the unwound G string which are plain nylon. Chances are that one of the strings happen to fall into the slot or groove that separates your index finger joints.

        Unless you can grow BICEPS on them or calluses that protrude over the rest of the finger…:-) I think having a fret large enough to cover for all these finger anatomies/anomalies is the better – or at least most practical – solution to this!

        Or Botox them…:-)

        /Mats

        PS. Yes, I’m on vacation, and it’s been raining all the time…:-)

  2. I have to disagree with the assessment of compensating at the nut being due to pressing too hard. Each of our strings is operating under a different amount of tension in order to achieve their respective notes. So even if the “sweet spot” of pressure is achieved, each is being pulled sharp by differing amounts. THIS is what nut compensation is really helping to counteract.

    If it was all about fretting pressure, we wouldn’t need to compensate at the bridge, either. 😉

    However, I do believe you are correct that the “sweet spot” of pressure will help minimize the need for compensation at the nut (after all, you’re pulling the whole string LESS sharp than heavy fretters), and I do think you’re right that finding the sweet spot should be helpful for reducing stress.

    As for low frets, I’m not at all sure, either way. Let me play “Devil’s Advocate” for a moment– what if being able to touch the fretboard wood is exactly the physical cue you need to stop pressing TOO hard? Perhaps the answer to finding the sweet spot lies in having this tip-off?

    Or perhaps it’s somewhere in-between. I personally believe that you are correct, and that it takes a lighter touch than many people are accustomed to. I use medium frets, and I don’t make any significant contact with the fretboard. But if I DO happen to touch the fretboard, that might be at least a warning that I’m pressing too hard. :)

    Thanks for the article, Robert! Those are 8 great points, some of which make me suddenly glad that I stopped enjoying action video games a few years ago. I’ve been meaning to begin stretching on a daily basis (not just my hands, but my whole body) and this reinforces that line of thinking. :)

    Greg

    1. Greg – I really enjoyed the response and thanks for playing devil’s advocate. Between the two of you, I’m starting to think taller is better and I’m sure that will be a factor when I go to build a neck.

  3. Valid comment!

    The thing I’ve noticed with most other players are that they are transferring acoustic/thicker gauge string pressure to the electric, or at least, pressing the same amount on thinner strings as on heavier bottom strings. These can yield intonation problems, as well as the notion that they don’t really need to use that much force.

    The thing is, that the strings are more taught and tense near the nut, thus demanding greater force. I’ve witnessed numerous instances – especially when debunking Buzz Feiten advocates – when they play a G sharp on the third string only, with any of the fingers. We measure it in a chromatic tuner. It is spot on, but as fast as they add the other fingers to fret a common E chord, all of a sudden the G# goes way sharp in the tuner, and adding these minor idiosyncrasies within a chord. Thus, some extra – UNNECESSARY – force is brought on to the G# finger for some strange reason.

    Of course, on electric, when you play a lot of blues bends and wide vibratos, you have to use much more force, and it’s a whole different kind of muscles you use, than when “just” fretting any note right on, with no vibrato at all.

    I’ve encountered guitar students that have switched to higher frets, and reconsidering and re-honing in their fretting technique, they’re more relaxed, and they can play for days on end without getting fatigued.

    There is a certain “loss of timbre” connected to this thing with high frets, or scalloped fretboard as well, if you like. Different sources has told me that the strings natural sustain and timbre becomes thinner behind the fret – how that is possible – since there’s no wood connecting with the string, it’s only skin and fret wire. I personally find this stance very peculiar.

    On the other hand, players such as Yngwie Malmsteen, Steve Vai, John McLaughlin, etc uses scalloped fretboards now and then, because they will get a “better grip” on each string. Scalloped is almost the same result as very high frets. One things for sure, you wont get as dirty and gritty strings, if they don’t touch the fretboard. The finger pad is like a cushion or pillow, when it reaches the string, and needs to have calluses built up, before it starts to “hit” or get hold of the string in a firm grip.

    Of course, violin players (and cellos and the likes) have been playing without a fretboard for ages, but we rarely hear some full chords from them. BTW I can’t think of an more unergonomic instrument than a violin, but let’s go back to guitars because that’s what it’s all about around here. :_)

  4. Another thing GregP
    Good point you made with “what if being able to touch the fretboard wood is exactly the physical cue you need to stop pressing TOO hard?”

    I think it’s just like that. People may need to revert their opinion, so that the fret wire will be the physical cue to stop pressing too hard, instead.

    Actually, when doing vibratos and blues bends I want to feel as little fretboard as possible under my fingers. It brakes and stops the movement. On abalone inlayed fretboards it’s terrible, you can even hear some squeaking when the finger pads rubs the abalon…thank good the Klein is plain…all over.

  5. Excellent article! I would also add that a good massage therapist could be of assistance with chronic cases of RSI.

    1. Without a doubt, massage therapy is a very valuable way to address RSI issues. For this particular article, I thought I’d focus on self-help type activities. I’m sure I’ll cover specific therapies in future related posts. And, thanks for stopping by. 😉

  6. On the other hand (pardon the pun). Think fretless bass for a while. Fretless bass players… do they ever touch the wood? No, because, the strings are – by and large – to thick gauge, so the finger pad will however get a firm grip on the string before it touches wood…

    One guitar player in Sweden I’ve seen (not known) used to play on top of the frets just to get a muted sound. Just like palm muting at the bridge. He cold swap instantly between playing on top of the frets (I mean FRET with you fingers ON TOP of the fret wire) and the normal way. It sounded the same as muting though.

  7. Hi, great article, Robert!!!
    I think there should be 9 items, and the 9th should be “reviewing your technique, muscular tone, and hand AND BODY position”. By technique I don’t mean that you can’t play certain things or that you don’t have speed, I mean that maybe (or most likely) the way an injured person moves his hands and body, and positions them in the first place, isn’t the easiest/effortless for his body. This causes a lot of extra tension and increases muscular tone unnecessarily. Anyway, those are just my thoughts.
    On another issue, I have an Ibanez RG 350. I want to cut off it’s lower wing for better high fret access, but I’m afraid it will look very bad. Does anyone have any idea on how to do this and make it look good? or even better, has anyone ever done anything like this?

    1. The approach to the instrument has to be a huge factor – I definitely agree with that. As I noted, it wasn’t an exhaustive list but I think it still covers good ground.

      As far as your Ibanez, are you trying to reshape the cutaway by deepening it?

      1. Sorry, as far as my english goes, I can’t understand what you’re asking me. The idea would be to cut the “horn” or “wing” that is below the fretboard to be able to access higher frets with less effort. The problem is that I’m afraid it would look like crap. Still looking forward to hearing suggestions about this.
        Gabriel

      2. I’d start by coming up with a template of the shape you’re trying to achieve. MDF is a good material for the template. It’s easy to work with but PLEASE use a mask. The dust created is incredibly fine. You can take a look at my article Making The Klein Electric Guitar Template for ideas on the general approach. It sounds like you’re trying to achieve something like the Washburn Extended Cutaway so you might want to take a look at that.

        Once you’re happy with that, its time to start cutting. A jigsaw will give you the basic shape but you’ll want to complete the task with a router and your template. You’ll use the router to complete the flush cut and radius the edges. Here again you can refer to my guitar project articles for thoughts about the approach.

        As far as what this will do to the finishing, I can’t give you much advice in this area as my own focus has been on the guitar itself – not the paint job. I used a very simple Danish Oil finish on mine. Reranch.com and its related forum is a great resource for this sort of thing. You may want to look at my article Making Guitars – Ten Resources for the Guitar Builder for other resources to consult.

        Hope this helps!

  8. Here’s a secret tip to you all.

    When watching ANY guitarist, you can sure tell he/she will eventually get RSI or similar only from by watching his mouth.

    If he does a grimace or wry face, or looking as he is chews a chewing gum (while not actually chewing on one) he sure is too tensed, and high strung. Embouchure (sp?) I think it’s called. “The thing that musicians do with their mouth while playing”.

    I have to confess, when trying to do too much of fast things or technically demanding things, if I watch myself in a mirror I laugh…it looks weird. Then I calm down and really watch my behaviour. Why am I doing faces? I tense myself, just like if I would lift a ton of bricks. I e trying to do something that’s WAY OVER may abilities TOO MUCH and TOO SOON. I try do do it and concentrate what I am doing with my mouth… Why am I not doing this when playing all other things and simpler things? Time for REVIEW as Gabriel said. Agree completely! I have never played something so hard, that I got lactic acid in any of my fingers. I do not simply force myself to go there, because it just feels very unnatural. If I get faster, or better at whatever it is, so be it. I can’t help it.

    I try to hone anything in, though, WITHOUT moving even my tounge inside my mouth. That is a signal – if any – that I press to hard, or doing something slightly wrong. The only thing I allow myself to do is to put on a BIG SMILE when I’ve mastered something, while I am playing…

    Some people I’ve heard, doesn’t even BREATHE! Scary thing! They hold their breaths when trying to impress…
    faints eventually, and has to hyperventilate.

  9. Sorry for being a blabman, but if you’ve read my earlier post about fixing a guitar to a stand so it wont move at all when playing, renders the following:

    You barely have to use your thumb behind the neck at all, or with very very light pressure because the neck wont move at all from fretting with the fingers on the other side.

    You use your thumb so the neck wont move towards you by the pressure of the fingers on the other side. If you wear a guitar or sit down with it, that is. The counterweight the thumb makes and how much force you have to use there is a “sore thumb” in ergonomics… (Apologies for the bad pun, I just couldn’t help myself)

    I’ve heard that the thumb should just be used as a guide anyway, and with no pressure at all, it should be used to STOP the movement from the fingers on the other side. One shouldn’t use any force on the thumbs muscles to press the neck towards the fingers on the other side.

    Try this for yourself, and see how mych relieve it gets!

    This is not an idea of my own. It is fairly common knowledge among classical guitarists, and if you’ve read or heard about Robert Fripps Guitar Craft classes, he’s an advocate for this as well, and a whole bunch of other things! :-)

    1. Finally someone who says that about the thumb!!! Even so, the idea is not to press with your other fingers, but to position your guitar in a way that allows you to focus all of your arm’s weitght in each finger without pressing at all. (this concept is very basic for piano players, but we guitarists spend years without anyone ever telling us that!!!)

  10. My guitar teacher told me that early on. Perhaps I were lucky to get on a good one in the first place. I’ve heard others saying this too, so it’s not that uncommon.

    However, rock guitarists with their thumb around the neck, and low slung rock guitar posing, may have completely forgotten about this.

    Well, as for arms weight, that may be true on piano, but on guitar where you can play a lot of legatos, and some fingers hold a chords while others are busy fiddling around legato lines I think the “arms weight” is out of question in that instance. Legato playing on piano is fixed via the pedal…:-)

    BTW the thumb ought to point straight up as well, with no bend in the joint either way. I’ve seen horrible instances where they try to make the grip thicker (compare to those who wants a large broom neck shape, and thin neck as discussed earlier) with actually using the tip of their thumb to produce a larger gap distance. Bending it “inwards” so to speak. Weird. I get RSI just by watching someone else do that… :-)

    1. Arm weight is always there, and never “out of the question”. After having RSI myself, I’ve studied with a teacher who specialices in this technique (which she built by herself) that allows you to always do that, and she is known for helping a lot of guitarists recover from RSI. Right now I’m with a lot of projects, but probably next year I’ll post several videos in Youtube explaining this technique.
      Gabriel

  11. Great posting. I’ve suffered from RSI from a combination of too much typing and playing scales too much in a short period of time while seated in a compact office chair. I’ve eased off, adjusted my office desk setup for typing and now try to play standing up. This was very helpful.

    –Zack
    http://www.guitarvibe.com

    1. Thanks! I’m glad you found it helpful. RSI is a serious issue although its far too often taken lightly. I’m just glad to bring some light to the problem.

  12. This is a very good article on RSI. The writing is good and the content is both informative and accurate.

    Rusty
    Editor

    1. Thanks Rusty. As an RSI sufferer, I have a special interest in the subject and I’m glad that readers find the tips valuable.

  13. Hi again. One thing I’ve noticed with other people when playing my guitar, the Klein one, even then Klein replica one, I asked them to play notes on the first few frets. When run through a Strobe tuner, their notes are always SHARP, but when I play, the same notes are even a few cents flat. Of course, open strings are dead on.

    So, it’s all within fingering margins, that’s why I am not an advocate for Buzz Feiten, Earvana or other nut compensating things. Headless guitars have zero frets, and I have always thought they have better intonation on the first few frets. I think you could duplicate this on any guitar fitted with a Capo. The first few frets after the Capo are NOT slightly sharp. Go figure. The Zero frets and the stop, and angle of the string behind the zero fret aren’t as sharp as on acoustic guitars. It’s the angle of the nut towards the first fret that is somewhat too high, making it go sharp.

    This is related to ergonomics. Put a Capo on the first fret, tune down, and play. You feel it’s much more easier to press/chord near the Capo. Because it acts as a zero fret. And there’s no angle behind that fret and the capo.

  14. I was wondering if anyone on here may have experienced similiar conditions to what i have had on and off for quite some time now.. I get sharp pains in my elbows and achiness in the muscles around them, and when I play the guitar sometimes I will get a tingling feeling in my hand occasionally; I have also had soreness in my hand and fingers.. I have tried playing in the classical style as suggested by Jamie Andreas’ movie which seemed to help some but that aggravated my back. Any advice or thoughts would be greatly appreciated.

    1. You’re not alone, Matt. I’ve also had the occasional sharp pain in the elbows as have others.

      Aside from the guitar and the recommendations above, think about how you might otherwise be stressing your joints. There’s computer use and gaming as I mention above but also look at how you sleep.

      For example, do you tuck your hands up under your head? That bend can put a fair amount of strain on elbow joints especially ones that are already stressed in some other way.

      Do you work out with very heavy weights or do a lot of repetitions?

      You mentioned playing in classical position and that it aggravates your back. What part of your back? Using a footstool can contribute to problems with the lower back as it pulls the lower back out of alignment.

      It’s one of the things that ergonomic shapes like the Klein, Forshage and Toone Orchid address. They can typically be played in a very neutral position without the need to raise the instrument into position.

      You may also want to look at specific devices that help position a conventional guitar in a more ergonomic fashion. Check out the following article:

      Guitar Accessories for Ergonomics

      While you’re at it, take a look through the Guitar Accessories section for other ideas.

  15. I am an ‘almost’ cured case thankfully which is surprising considering i had RSI, Focal Dystonia, Carpel Tunnel Syndrome and Tendonitis and Tennis Elbow!

    No im not a hypochondriac i have never been to a doctor for anything apart from that in my life. The principle causes were

    Classical Guitar/Electric guitar playing with high action thick strings and trying to shred, while not warming up properly, taking breaks and having too aggressive technique

    Drumming with a heavy style. Drums were tuned high and cymbals heavy and thick which coupled with a terrible grip technique and playing far too hard caused focal dystonia and tendenitis as well as tennis elbow from the heavy impact.

    Bass Guitar-heavy strings-shredding on a bass isnt good at the best of times!

    Heavy Computer Use

    I tried all sorts of cures (powerballs, anti imflammatorys, vitimans and other general health, ) but the one thing that sorted it out was playing 9 gauge strings, low action and using superstrats when possible as well as reducing classical guitar use..trying to practise on electric instead. Drumming 7a sticks and thin cymbals with lower tuned drums and moeller technique.

    1. Thanks for sharing your experiences, Andy!

      They point out the need to take your entire life into consideration when looking at problems related to RSI and other musculoskeletal disorders.

      For me its my work – I’m in Information Technology and spend most of my day at a computer. Then add two hours of commuting time a day where I’m largely in a static position.

      I’m glad to see you willing to address the music side of the equation as well. I understand it impacts sound but far too many guitarists latch onto the idea that they can’t sound the way they want without heavy strings, high action, etc. Better to make an adjustment than to end up unable to play at all. Afterall, what good does a musical vision serve then?

  16. Hello,

    Thank you for all the above valuable information. It’s been really helpful and interesting to read.

    I’ve had intense pain (and loss of strength) in my strumming hand for 3 weeks now (which started after a long band practice playing electric guitar). I’ve only just accepted that there’s a possibility it might be RSI and be linked with my guiatr playing. I’ve recently started playing with a pick and wonder if it’s affected the position my wrist is in when I play.

    I was wondering if any of you wise musicians could suggest what I should do!

    On another note (and I know I’m asking a lot-apologies), I work for a music project with about 100 young guitarists (I am only 20 myself so quite new to it all!) and wondered if anyone could summarise all the key points to avoid guitar related RSI which I could pass on, and hopefully protect a big group of future rock n rollers!

    Many thanks for any advice offered. And thank you for providing a resourse for people like me to read.

    Laura

    1. Welcome to BTEG, Laura!

      First, I’m sorry to hear of your problems with RSI. The fortunate thing is that with some effort it can be managed and the list above can do a lot in that regard.

      You’ll also want to take a look at the topic Repetitive Strain Injury for other articles on RSI.

      As you have probably noticed, it can be tough to come by information on RSI specific to guitarists but its out there.

      Part of the goal of this site is to become an information hub and as the site expands, you’ll see more and more.

      Aside from considering whether your instrument design is impacting you (one of the focal topics of the site), there’s technique.

      I’ve read a bit about this from various authors and the one thing that comes up over and over is the need to eliminate tension in the body. This relates not only to the act of playing but to reducing the potential for RSI with more to follow on this in future articles.

      For now, I suggest the following:

      * Read through existing articles in the RSI topic

      * For those not playing ergonomic instruments, review some of the devices we’ve covered that can help Guitar Accessories – guitar straps that distribute weight more effectively and neck up devices that help with instrument position can be helpful.

      And if you haven’t already, please refer your group of 100 young guitarists to the site! :) This is a family friendly site and open to everyone regardless of age or experience level.

      On this last point, readers can subscribe to email updates or the RSS feed – see the Subscribe to Updates section in the sidebar. That way readers are alerted of new content as its added.

      Also, the article footer contains an “Email a Friend” link where you can let up to five friends at a time know about an article of potential interest.

      Hope this helps you get started!

      And if you would, please drop me a note through the site’s contact form. I’d enjoy hearing more about your 100 person music project.

  17. Hey great article!

    Its great to hear someone not just saying
    “go to a doctor” or “stop playing”
    Stating the obvious gets a little old for me

    Anyway
    Ive had RSI for 6 months now
    It started in september while i had my
    guitar across my lap and i was tapping out arpeggios
    got that burning pain in my wrist

    the pain has reduced significantly the last few weeks although it still lingers a little bit.

    now i started picking up the guitar again the last few weeks and playing a few scales, a few riffs and trying to keep my sweep picking relatively tight.

    Do you think playing is a good idea?

    thanks in advance!
    Kieran

    1. @Kieran – I’m glad you enjoyed the article! Speaking from personal experience, I would suggest waiting a bit longer.

      Inflammation is one of the major problems with these injuries and getting this under control is critical.

      When I went through the worst of my own issues with tendinitis, I stopped almost all activities that might involve my hands for almost two months – it was that bad and that painful. Rest along with icing several times a day brought the inflammation and pain under control.

      So I suggest patience. Take care of yourself now and avoid longer term ill effects from trying to push through the pain.

      Good luck, good health and let me know how you make out!

  18. Does inflammation of the muscles occur too?
    Ive been told by my physiotherapist that my problem is
    muscular.
    i dont know does that change anything but ill throw it out there

    I know what you mean
    I stopped all activity with my fretting hand for about 4 months i reckon
    I only use it sparsely

    I have no choice but to continue using my right hand unfortunately

    also would you know anything about the ergonomics of an Ibanez SA260fm?
    Or a fernandes revolver?

    this ergonomics business is completely new to me

    Thanks again
    Kieran

  19. @Kieran – Muscle inflammation is a definite concern.

    As far as those two particular models, they’re pretty standard fair in that they’re Strat based. As you may have noticed, we look at instruments that are serious departures from these.

    Now that’s not to say that these can’t work for you but it depends on what you’re looking to accomplish. I’ve focused on instruments that are ergonomic while sitting because for most of us, that’s the way we spend most of our time. Even those who are gigging spend a great deal of time playing while sitting so optimizing for this position is important.

    Back to the health aspect. I’m working on another article related to guitar health which I think you’ll find interesting. Coming soon…

  20. strats aren’t the worst then?

    Im going to guess that BCrich guitars or les pauls are probably not so good…

    Do any major brands mass produce good, affordable ergonomic models? I know Ibanez have the ergodyne series, although im not sure if theyre still in production…

    Do you still have problems with your rsi?

    sorry about all the questions, but this is the first real in depth glance at the subject ive seen!

    and i look forward to this aticle!

    thanks again!
    Kieran

  21. FAO Kieran, Strats or traditional shaped guitars in general require more force to do certain things. I would say especially if you are ‘shredding’ it is a fair concern. Even if you use alexander technique etc it is still more or a strain. I would recommend the Ibanez s series they are just the most comfortable things for me at all. With that its important to use 9 gauge strings mostly..i noticed Steve Morse, Yngwie and Blackmore have RSI and they all use 10s (and strats or whatever).

    I find the only time i get significant pain is playing barre chords for over 1 hour at a time at gigs. Even with the Ibanez. If you can play as many open chords as possible this may also help.

  22. Kieran! It’s just the same if you walk a lot in a town, on vacation, or just walk too much. You get periostitis. No cure, just rest rest rest, and walk as little as possible for a while. It heals and builds up. If it hurts when you play, stop. Simple as that. I’ve always wondered if Jeff Healey had ANY problems playing the way he did, with the guitar flat on his lap.

    Now, I’ve to bring something NEW to this can, if it’s ergonomiv related or not I don’t know but it makes me think of future playing. I’ve been recently diagnosed with NICKEL ALLERGY and have to modify and be careful about my guitars as much as possible. I have to resort to using stainless steel strings, and changin out all fretwire to stainless steel. Will cost me a fortune. It dawned on me around new years that my fingerpads started to have a rash and skin shedding, large bits being peeled of while playing and startin to get stuck in the strings.

    The Nickel Allergy CAN be the cause of too much playing on nickel strings. And it sure was. Stopping for a month after new years eve caused the peeling to go away. Coins, keys and all that stuff too. So I don’t really know what to do with my Klein, I hate to refret it. Strings, there’s no problem. There’s stainless and coated strings now everywhere. But the rest? Knobs, whammy bars, bridges and so on. There’s no cure, and these prescription “ointments” that keeps the fingers from peeling skin is just temporary and you can’t play anything with that fat sticky ointment on. Enough of my self pitying! :-) Now the next topic brings us back to tall frets again…. :-)

    1. I started looking into nickel allergies and dug up some interesting articles which you’ll find in the guitar forum thread – Nickel Allergy and Guitarists.

  23. Just a final word on frets, since I’ve been recently struck with a guitar of a friend of mine that had almost no frets. He was an advocate of low frets, and all the thin strings (plain) kept RATTLING all over the neck, no matter how hard one pressed. He asked me to fix it.

    Now, think the following analogy:

    1. There should always be a CERTAIN angle of the strings BEHIND the nut. Nes pas?

    2. It can’t be too much, the string will break, it can’t be too straight because then the strings WILL RATTLE in the nut slots.

    Now, theres NO DIFFERENCE between the angle of one strings angle BEHIND ANY FRET and the strings angle behind the nut. If the strings angle is too shallow, it will rattle at the frets as well, giving, quite simply a fret buzz on its own fret, not the other other ones following it as they ususually does when neck relief are set inproperly and uneven frets. Your fingers will NEVER be that strong to press it down so that there will be an angle created because the fretboard wood will stop you. There’s always a certain amount of angle that is needed behind any fret, in case it should NOT rattle, just the same as at the nut.

    These frets were not level with the fretboard, but ALMOST, and I told this guy this, and he understood it. We capoed the guitar with a capo SET and clamped so hard it went out of tune, but the rattle/buzz was gone.Yes, there were marks in the fretboard from the capo !But this didn’t matter since refretting was the only solution. Too higher frets.
    Period.

    /Mats

  24. i have developed this weird sensation on my fretting hand middle finger. its not numb or tingly or painful, but its definetly not right. it feels like jammed or stiff or something but i can bend it without any problems. ive seen 3 hand surgeons and a couple of chiropractors. i know its not cts or trigger finger or anything. where should i go? what should i do? i have not gotten a definite diagnosis yet or even a possible one for that matter.

  25. and its only there when im playing. sometimes i can play for an hour sometimes 5 minutes before i feel it. its really noticeable on my middle finger when i play the six string major barre chords.

  26. Kyle, I have had the same thing, but not from playing, BUT, from – believe it or not – mixing at a live desk mixing board. A couple of years ago I was “in house” mixing guy, and had to hold my fingers at ceratin cues during a show, in my local town. However, I could not rest my wrist on anything but had to keep up my fingers in the air, for several minutes, each night. After a few weeks I had this sensation in the middle fingers during nights, sleeps, morning, and I thought “hell, I play guitar too much”. But it was the mixing things fault.

    One had to be on ones toes all of the time, compare it too sitting in a tv broadcast studio when airing direct and you just have to cue the faders on time. Once the show season ended, the pain and sensation in middle finger was gone. I could not play guitar during that period. Main thing, I was too tense, and held up my left mixing hand for too long in the air, I had a great time though, and was not stressed out. I paid attention to it after a while, and noticed that I simply was too tensed in the fingers/hands for absolutely no reason. It was a positively “exciting comedy show” which needed sound effects to come in at a cue, so I had a great time doing it, but couldn’t understand this phenomenon at first.

    After a while, I found a different angle to put my hands in, I rerouted the cue faders to some other bus (Sorry for resorting to mixer lingo here) and varied the position. The problem disapperaed eventually. This is almost the same like keyboard typing at you computer, and “mouse” finger consequences.

    Stretching out fingers muscles, and giving it massage helps. Funny thing is, when my hands has been doing some woodworking with sanding, filing, and such things, my guitar playing is better and I feel more relaxed. It’s like it’s some kind of warming up that are good for your fingers.

    The problem is when you’ve learned the wrong way from the start on. If you’ve developed a bad habit. Some pianists do. I’ve even heard that old keyboard wizard Keith Emerson had tremendous problems with his hand injuries. Despite him being classically trained and are supposed to have “good” hand positions. But he’s been informed that his hand positions are – by and large – bad. Bruce Hornsby is on the other hand, an exception. His hands are in perfect position. Never had a problem.

  27. i do have an unconventional way of bracing the neck like a blues player ALL the time. when i play fast or practice scales i have to have my hand angled in order to make the streches. while most people make their hand perpendicular to the neck. i have been playing like this for 12 years and havent had a problem until i started practicing a lot of chicken pickin stuff where my middle finger plays just about every other note with a pull off. i haven’t practiced for about a month now, but i can still play a little when i teach lessons. i do not have any kind of pain that wakes me in the night either.

  28. Thank you everyone for the info. I recently got DeQuervain’s Tenosynovitis and I blame Guitar Hero for it. I have played guitar (the good kind, not GH), bass and piano for decades. I also work at a computer all day for a living. I never had any problems, I mean RSI-wise, before… until my daughter brought Guitar Hero home. I think it must be because the guitar controller is so little, and also you don’t get to move your hands up and down like in a real guitar; you have to keep them in the same exact place all the time so, I don’t think these controllers are ergonomic at all. I have had pain in my wrist for a few months now and I will probably have to get some cortisone injections to repair the damage to my tenosyvium. Live and learn, right? I will try to bring some attention to this issue, which is how I found your website.

    Thanks again,
    -Gabe

  29. Guitar Hero? well that’s a lot of playing GH Gabe! I tried it once and had absolutely NO HELP at all, that I could play for real. I found it boring, but I am not that young anymore either, so I don’t care about any computer game at all. Couldn’t even play Quake or Doom, when those games used to be about, I got motion sick after one minute and threw up. Never heard of anyone getting RSI from GH, but you!

    Hope it heals, and just relax and do not play ANYTHING for a while. My problems were completely gone after a month. Next time:
    RELAX while you play too!

  30. @Gabe – I’m glad you find the information useful. Guitar Hero isn’t the only game that’s causing folks problems. Wii-itis is also a common problem.

    And I agree with Mats advice – rest is critical and relaxation is helpful.

    But the biggest problem is that we’re increasingly bombarded with activities that predispose us to RSI. Long hours in front of a computer, repetitive actions from playing video games, guitar playing and an increasingly sedentary culture all make this an increasing issue.

  31. i actually found out that my r.s.i. is all in my head. no hand specialist told me that. its some kind of mechanism the body has that sends pain to a weak, overused, or previously injured area in order to distract you from dealing with subconcious emotions. its like i fear playing guitar because it causes pain. but it causes pain because i fear it. weird huh?

    1. Very interesting Kyle. RSI falls under the general category of “syndrome” – a collection of symptoms that occur together which don’t always have a clearly determined source. And so the issue is that it can come from a variety of physical and, at times, mental sources.

      Aside from all the physical sources, stress is a big factor as well. The first time I came across the idea of stress causing pain in the body was in Dr. Sarno’s Healing Back Pain. The book was very influential on my thinking about RSI and other musculoskeletal disorders or MSD’s.

      But getting back to the idea of these problems tending to be syndromes, oftentimes there is no magic bullet – no single problem that eliminates the others. More often than not, its a series of things that we do that are contributing factors and the more we can eliminate the closer we get to returning to a state of wellness.

      1. thanks for the reply, i tried to get that book already but it was checked out at the library, so i got The Divided Mind: The Epidemic of Mindbody Disorders instead. it’s also by Dr. Sarno. anyway, i’m about halfway through it and i can’t believe how many things describe my personality so far. i will definitely check out healing back pain.