Healing tendon injury and avoiding re-injury

If youíve injured yourself, donít practice! Your first priority is to heal. Seek qualified medical attention if necessary. In fact, even if you have tendon problems that bother you only occasionally, still, take them seriously. You wonít be doing yourself any favors if you constantly re-injure yourself. So first and foremost, give yourself a chance to heal up.

In that regard, let me tell you one experience I had. Years ago I injured a tendon on my little finger, while overdoing to stretches in preparation for a Conservatory solo performance of Paganini's 24 Caprices. It seemed to go away, but every since, when pushed hard enough the pain would always return, even years later. Well, Dale Turner's "Best of Joe Satriani" Sig Licks book came my way, to lay down all the solos. I hadn't touched a guitar for about 6 months! So I started practicing. Even being hyper-vigilent about using reduced tension (covered below), by the second day, I couldn't even open and close my left hand without pain. This sucked! I had heard about the nutritional supplement "Glucosamine Sulfate" and "Chondroiten" in regard to healing joints in people suffering from arthritis and thought it would be worth a try. My God, what a change! The next day, all pain was gone, and I resumed practice. After another day, my chops were back and I was tracking Satriani solos... which as you may know, are about as intense as anything could be. I keep my bottom of "Joint Fuel" (as it's labeled) on the shelf just in case. Now, I'm certainly not a doctor and I'm not suggesting any medical advice here for anyone's specific condition. You're situation may be similar to mine, or it may not be. I'm simply telling you my story.

Whether you get medical help, try what I did, or just let it heal on it's own, the next step is how to approach the guitar again. You must be hyper-vigilant to avoid re-injury. Start practicing just a few minutes at a time, maybe even just 10-15 minutes, and slowly build it up. Keep in mind the four rules mentioned in 11. Avoiding tendon problems before they start. That is, always warm up well; practice regularly and avoid marathon sessions; recognize that so-called "difficult" licks shouldn't include extra tension; and if something hurts, stop doing it.

Still, though, if you have already injured yourself, youíll likely have to go even further. Let's consider that third point again. Basically, if you learn to practice with less inherent tension, you should be able to go longer before the negative effects of overstress on your weakened tendons will kick in.

Remember when you first started playing guitar? It seemed like you had to press the strings down really hard against the fretboard to keep them from buzzing, right? But as you played more and more, it seemed that you didnít have to press as hard, and the buzzing began to go away. It just got easier and easier to play. Why? Are you really getting that much stronger? No. You see, at first the muscles that control your fingers are uncoordinated. So they are fighting one another. Over time, the muscles that are in opposition to one another learn to relax when they arenít needed. Then you suddenly notice that you donít need to press so hard to get the desired result. Because your muscles have learned to work together, more efficiently, you can accomplish the same thing less far less effort. Playing guitar doesnít require a lot of pressure, but it does require a small amount of correctly applied pressure.

Put this knowledge to your advantage. Play some of the lead exercises or licks from Speed Mechanics or the Metal Lead Guitar Method as softly and quietly as possible, using the smallest and easiest motions. Also, try practicing with a lot of distortion so the sound is very compressed and even the softest notes ring out readily. Play very slowly, using the minimum required movements: just what is necessary to move the correct finger and no more. You see, when you really get right down to it, moving one finger here or there is quite a simple matter. The difficulty arises in getting all the other fingers to relax, so you donít have to force them to stay put by clenching them in place with the opposing muscle groups. When you practice like this: quietly, softly, easily, and slowly: for long enough, youíll find that it will require almost no strength, or muscular effort. Make this into a habit, so you always play this way, and it will greatly diminish the strain on your tendons and allow you to play longer without the negative effects of excess tension, and subsequent re-injury. Of course, this is also a good practice approach for people without tendon injuries, but it is critical for those of you who have had the misfortune of this nasty situation. It forces you to be extra cautious.

Carry this idea of "force reduction" into all other aspects of your playing. For example, donít increase tension as you push to increase your speed. Youíll just have to be patient and let the speed come to you, rather than going to it. And believe me, in time it will: as long as you donít damage your hands permanently. It may take you a little longer than others, but you can only do the best that you can with what you have.

Also, practice in a seated position as opposed to standing, as this will be easier on your fretting hand. If you still want to practice in a standing position, make sure your strap is holding the guitar higher than usual. The lower it hangs, the more difficult your left hand stretch will be, and therefore, the more strain it will cause. Put your guitar and strap on, and sit down. Then, tighten the strap up so that when you stand, the guitar does not noticeably move. It might not look as cool, but hey! Whatís more important, here!?! Anything you can do to play in a more relaxed state, without any unnecessary strain, will help.

Finally, keep in mind that you donít have to play like Eddie Van Halen or Steve Vai. You know, many players are very successful with only basic lead skills. If your injuries prevent you from putting in the time to necessary to develop virtuoso technique, maybe you can turn your attention elsewhere. How about songwriting, production, or singing? Thereís a lot more to music than playing blazing solos!

Bottom Line:

First of all, heal. Glucosamine helped me, it may help you. When you do begin practicing again, start with only a few minutes at a time. Play softly and quietly, focusing on control and not speed. Make it feel relaxed and effortless. Donít push for speed. Play sitting down or with the guitar raised quite high with the strap. Increase your practice times gradually, being cautious of any irritation in the problem areas. If discomfort returns, stop playing, or reduce the amount. Practicing in spite of trouble will only do more damage and set you back.

Player feedback:

Troy, I was checking out your site and I read about your tendonitis problem. I had tendonitis and later, carpal tunnel syndrome. I'm o.k now as long as I keep doing what got me well & I thought I 'd share some of my experience with you.I went to a chiropractor who specializes in extremity adjustments and a message therapist. The chiro had me start taking a natural multi-vitamin and colloidal minerals. I also take glucosmine chondroitin. I'm on a "maintenence" with the chiro and message therapist, which is a visit every 4 -6 weeks. I know this stuff works because I stopped doing it and the pain came back, and after resuming, it's gone again. Of course I changed my technique to reduce tension also. I agree that once you have an injury you will always be more prone to have problems.The main thing is that you don't have to have surgery for CTS. The doctors just give anti-inflammatories and if that doesnt work- thery're ready to slice you up. That is very wrong! I didn't have surgery and I play 2 or 3 gigs a week, teach 35 students and do an occassional recording session. The only thing that ever gets me is when I play alot of acoustic. Also, I exercise with this device called the Flextend glove. What this does is balance out the flexor and extensor tendons/muscle groups. Even the chiro told me to do an exercise with a rubber band,like this: Put a wide rubber band around your finger tips. Double it on your index, pinky and thumb to create more tension. Hang your hand down as if it were hanging off of a table and extend your fingers while raising your wrist. This also exercises the extensors, although I think the glove does the job a little better. Anyway, I just wanted to pass this info on. When I was dealing with this, I had a hard time finding info on the subject. You're in a high profile postition, so maybe this could help someone. There's an excellent site @musicianshealth.com -- tons of info there as well as chiro referrals.
Take care, Danny

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