Strain Case Study #1
When I developed deep pains in my forearms in March of
1994 following three intense weeks of unaccustomed 8-hour
days at the computer, I knew it was serious trouble. I even
knew it was called Repetitive Strain Injury. But I was pretty
sure some good ergonomic computing equipment would fix it,
that and the splints and ibuprofen my physician's assistant
prescribed for me.
What I didn't know yet was that my approach to playing
guitar and other instruments may have been a significant
contributing cause of my bilateral flexor tendinitis. Despite
splints, drugs and ergonomic computer equipment, real recovery
was elusive, not the least because I hardly slowed down
my frenetic pace on computer OR on my instruments. But after
I rehearsed and performed a Christmas oratorio on violin,
I found myself in frightening pain and having increasing
trouble with dexterity. I asked for and got a referral to
a physical therapist, who after a time of evaluation laid
it out for me: I was in for a long, difficult recovery,
and I needed to reduce or modify all activities that aggravated
No phrase is more common to musicians experiencing physical
problems than "I can't stop practicing" . . .
" because we have a recital", or "we need
to keep a paying gig", or "our music is in our
blood and we can't bear to leave it be". But reality
is reality: my guitar and violin went in their cases and
stayed there untouched for months while the damage slowly
There were a great many things that contributed to the
return to functionality and relative freedom from pain I
enjoy today: physical reeducation for my body, ice water
baths for my arms, gentle stretching, microcurrent therapy,
meditation to reduce stress, and more. But I'd like to address
some specific points about the steel string acoustic guitar,
which is my main instrument and which I believe caused me
the most trouble.
Maybe one of the most important things to learn is you
don't have to fret so darn hard. Some instructors suggest
fretting notes with ever-decreasing pressure, until finally
the string actually buzzes because it's not fretted enough.
Just a little bit more than that is all it takes to play
cleanly, even during vigorous pieces. "Digging in"
may feel like you are wrenching more tone from the string,
but it just ain't so. (When you strike the strings harder
you may have to increase your fretting pressure a bit.)
The same rationale applies to the picking hand, as well:
excess tension in finger- or flat-picking does not add to
your tone, and besides causing injurious strain it impedes
your speed and dexterity. If you are fond of using a flat
pick, you may find using a thumb pick may reduce the amount
of force needed to hold the pick. Using more of your whole
arm to pick instead of doing it all with your wrist is frequently
recommended as well.
And the moment pressure or movement is no longer required
from any finger, relax it. Give those muscles and tendons
a momentary chance to recharge and flush waste products
Electric guitarists are notorious for preferring postures
and positions that look cool over those which are least
stressful and most musically effective, but even a classic
guitarist sitting in the refined one-foot-elevated position
may be creating physical problems through hunched shoulders,
cocked wrists, and the tilted hips that come with the use
of the footstool. I can't begin to address all the aspects
of correct posture, but I will pass along Aaron Shearer's
sound advice that to the greatest extent possible, all joints
- shoulders, elbows, knuckles, fingers, wrists - should
operate in the middle of their range of movement. Shearer
explains correct positioning in depth in his excellent book
LEARNING THE CLASSIC GUITAR, Part I which while intended
for the classic guitarist provides principals that can be
applied to steel string and solid-body guitars.
My own practice has changed in that I try to play standing
up with a strap whenever possible, which permits me to move
and avoid any fixed, tense position. Instead of the neck
extending out parallel to the floor, I minimize my left-hand
contortions by angling the neck up at about 45 degrees from
the horizontal. One injurious habit I'm finding hard to
break is holding my left shoulder up when I play. Shoulders
should be allowed to drop, and raising the arm done through
the rotation of the shoulder joint, without any "help"
from a raised shoulder.
A controversial point of positioning is placing the left-hand
thumb behind the neck to optimize reach and fretting strength:
this is generally accepted as "correct" classic
technique. But it can be very hard on the thumb, and letting
the neck fall into the web between the thumb and fingers
instead should at least be considered as an optional change
of pace to rest the thumb. Too, overuse of full barre chords
maximizes the amount of left hand strain; my playing and
writing style has changed to emphasize partial chords and
alternatives to full 6-string barres.
Changes to the instrument may help avoid injury. Lighter
strings are an obvious method to reduce strain on the hands.
This will likely alter your tone and may require a change
in your playing style or an adjustment in your instrument
setup. Along the same lines, tuning down a half or whole
step not only reduces string tension further but opens up
new tonal possibilities.
Using a capo restores the concert pitch of a guitar detuned
in this way, but in addition it shortens the effective scale
of the guitar to minimize left hand stretches. My "standard"
setup has my guitar detuned one whole step and then capoed
two frets up.
One option to ease playing problems is to get an instrument
that is shorter, narrower, and/or shallower than the popular
dreadnaught-style acoustics. Options include small bodied
"parlor" guitars, very shallow-bodied acoustics/electrics,
the round-backed Ovations, and
at least one "ergonomic" acoustic model where
the body is shallower on one side than the other, so the
right arm and hand do not have to reach around so much body.
Though it may sound unthinkable to the acoustic purist,
solid-body electric guitars offer advantages in shape and
easy playing action, and with sophisticated electronic processing
can provide usable "acoustic" tone. Chet Atkins
and Joni Mitchell are two acoustic guitar masters who are
using solid-body guitars in concert venues.
While these and other changes, and the healing of time,
have given me back the ability to practice guitar and write
new material, endurance remains a problem for me. After
a half-hour trying out guitars in a music store recently,
I found my fingers slipping, missing notes, and simply refusing
to obey the commands of my brain. I'm hoping that gentle
exercise over the coming months rebuilds endurance.
More resources on this subject can be found
on-line on my Web site
Musicians and Injuries, http://www.engr.unl.edu/eeshop/music.html
LEARNING THE CLASSIC GUITAR, Part I
Aaron Shearer Mel Bay Publications, Inc.
#4 Industrial Drive, Pacific, MO 63069-0066
Toll Free 1-800-325-9518
Copyright 1998 Paul Marxhausen. All Rights Reserved.