Dealing with Repetitive Strain Injury (RSI)…

Ergonomics, as defined by The National Pain Foundation , is “the science of designing the job to fit the worker, rather than physically forcing the worker’s body to fit the job.” This site contains an excellent introductory article by Dr. Greg Worrell on how ergonomic design can help us minimize injury and pain – Ergonomics as a Tool for Pain Management. It provides some basic ideas on how ergonomic design can help to deal with issues that arise from repetitive stress. This is what my pursuit of building an ergonomic guitar is all about – finding ways to make the tool, in this case, the guitar, fit the way the human body works and not the other way around. Unfortunately, much of guitar design is about designing with an eye toward aesthetics and not a consideration for how the human body works.

For the last few weeks, I have been suffering pain in my right wrist and shoulder. In addition, I have been suffering from a degree of pain in my right thumb. These are symptoms of RSI or Repetitive Strain Injury – Carpal Tunnel Syndrome being the most commonly known example. The pain I am experiencing in my right thumb is known as DeQuervain’s syndrome which is an overuse injury of the thumb extensors and is typically brought on by repeated tapping of the space bar.

Typically, these injuries arise from two principal factors – overuse of the affected areas and improper use of the affected areas. As a Systems Engineer, I spend my days at the keyboard. As an avid user of the Internet, I also spend my evenings at the keyboard since I’m going to school online and spending time researching and reading about a variety of subjects. Finally, as a guitar newbie I’m engaged in yet another activity that can lead to RSI. Fortunately, there are a number of things that can be done to prevent and mitigate these issues. I will focus on those that are guitar related…

Frequent stretching and proper warm up are critical. Stretching helps to reduce stress and increase circulation in and around the tissues and tendons. Movement is critical. Much of what we do on both keyboard and guitar puts us in static positions for extended periods. This leads to reduced circulation and the build of tension in the tissues. Ergocise has a little application that will run in your Windows system tray and remind you to stretch. It will pop open a link to their site at the assigned time and take you to their site. Their site contains small animations of stretches that target different areas of the body. Of course, we’re most interested in the hands and arms but guitarists as well as keyboard users also suffer from tension building up in the shoulders and back as well. Shelter Online has a mini poster you can print out and hang at your desk with illustrations of stretches you can perform at the office.

Yet another important way of protecting against RSI is through proper technique. Classical position is considered optimal for good technique and generally, it is. The angle at which the neck is held, for instance, helps to relieve stress on the wrist. For great information on guitar technique and practice methodology see Jamie Andreas’ site, Guitar Principles. Jamie has produced a DVD video and several books which focus on proper technique and how to build it properly and safely.

That said, one of the potential issues that RSI suffers might encounter is the emphasis of classical technique on maintaining the thumb in the middle of the neck. This can lead to overuse injuries within the thumb. An alternative, though frowned upon by classical guitar technique, is cradling the guitar in the crook between the thumb and the first finger. This relieves the thumb of pressure and transfers it into the much stronger structure of the hand itself. At the very least, it can be used as an alternate position to help alleviate stresses on the thumb.

UPDATE 12.17.2007: For a great bunch of specific techniques, read Eight ( 8 ) Ways to Combat Repetitive Strain Injury (RSI).

BIG HONKING DISCLAIMER: I am not a medical professional nor do I claim to have any specialized knowledge in this area. These are merely some thoughts based on my own research. Anyone who is suffering from Carpal Tunnel Syndrome or any other form of Repetitive Stress Injury should look to a health care professional for advice. Repetitive Strain Injury is a SERIOUS condition. Working through the pain, is not an option unless you’re willing to risk your health, livelihood and music.

6 Responses to “Dealing with Repetitive Strain Injury (RSI)…”

  1. Heh I find that my fretboard hand (left) often gets very sore, especially my thumb and the pad where your thumb joins your hand.

    Gotta figure out some exercises or soemthing to help that out 🙁

    1. Hi Zaphod, see my other thoughts on comments on sore thumb.

      Eight (8) Ways to Avoid RSI

      On LOW frets, the ergonomics of high frets, and that the thumb should really really only be a guide for stopping the neck from moving inwards when pushing fingers at the opposite side. It should point straight up as well and joints should not be bent. See if you can fret any chord without using the thumb AT ALL! Notice how you keep your right elbow and arm tighter to the body to keep it still. The guitar NEEDS to be secured tight and not moved in any way from playing style. Hence my “attach-the-guitar-to-a-stand” ergonomic stance.


      Not everyone uses classical position style. Especially hard when standing. The thing is, when alternating between sitting down and standing up, I prefer to have the Klein in non classical position, and rather resting it on the right leg, then it stays the same when leaving the chair, it remains in position. Of course, the strap is tightened accordingly to maintain this distance. This is crucial. And especially sitting at the computer recording things, one can turn either way around your desk without knocking the studio monitors with the neck, it moves freely above everything.

  2. Hey Zaphod! Thanks for stopping in! Although my primary focus is on the form of the guitar as it relates to ergonomics, technique is an important element as well. You didn’t mention what left hand position you use. I experienced the same issue while trying to use a classical position (thumb centered on the back of the neck) and trying to play chords. The pain became intolerable and I switched to a rock position (cradling the neck) which helped immensely. I appreciate that it may limit some of my chording but I’m interested in rock and blues anyway so generally I can get away with it. I can always switch back as well for chords that demand it.

  3. Robert, I don`t if others are interested in the subject of holding the guitar in the “classical” position, waist of the guitar resting on the left leg thigh, raised with the lower bout resting against the inner thigh of the right leg. I play my homemade electric this way. This method does bring the neck up at a 45 degree angle. I have never been successfull doing it with my Ovation. The lower bout is too large. Truth is, I have to use a strap with the bowl back to stop the body from slipping away. Very annoying.
    copy and paste if need be. Good clear photos of the position.

    1. Personally, I find the classical position superior from an ergonomics perspective although results may vary among players. It’s how I generally play my Klein based build. Because of the shape, it has the added advantage that I have no need for a footstool. Instead, the guitar sits at a good height and my feet rest comfortably on the ground. By avoiding the footstool, you avoid the twisting effect it imparts on the spine which can lead to stress on the lower spine. Thanks for pointing it out.

      BTW – I have an Applause which is basically a lower cost version of the Ovation. The bowl is far from ergonomic and I also find the guitar slips away without a strap.

      Thanks for the link – I’m definitely a fan of Jamie Andreas’ work and own her Guitar Principles book and video. Jamie’s work was a big influence on my interest in ergonomics.

  4. Hi,
    Is it true that the smaller classical guitars, such as the Kremona’s 3/4 or 1/2 sizes, have weird sounding low E and A strings? I’m in my second year of classical guitar lessons with a full size Orpheus Valley guitar, and think I’d be more comfortable with a smaller size. I was told by a guitar store that the smaller classical guitar won’t sound nearly as good. Is this true? Do luthiers make smaller guitars for small handed ladies like me?