Keeping the wrist healthy

Teacher's Lounge
#1

I’m bummed out for my teenage son. He took up guitar a little while back and was making nice progress - until the wrist of his fretting hand started to hurt.

I’ve been on YT, but somehow no one’s really nailing the issue. It’s the kind of soreness that I imagine a lot of you have had some of your students complain about. It’s his wrist, not mine, but sounds like it has something to do with tendons or ligaments. I don’t know if I’d call it an ‘overuse injury’; he had only been playing a month or two, and hardly ever more than 1/2 hr a day.

If anyone’s helped a student overcome this successfully, I’d love to hear more about it. Thanks.

(btw, I don’t think his acoustic has crazy high action; it feels pretty comfortable to me. he’s a bigger kid - over 6’ and 200 lb+; think fingers, not skinny like mine. my hand’s close to avg. - i’ve checked;) - so by comparison i’d say his fingers are just a touch on the short side.)

#2

Not a teacher, but i’m sat here with an ice lolly and a spare hand. .

Definitely rest and see if it clears up in the next week, any persistant issues then definitely seek a health professional

What has he been trying to do? Bar chords? I can imagine that any amount of fretting on an acoustic is quite tough on the hands/wrist foe a beginner. I’d go as far to say that if I played on one now, i’d feel it tomorrow!

Also, it might not be the just the guitar, does he do anything else that might be heavy on the wrists? Sports? Work?

#3

I think I replied in a different thread about this:

I get issues like this pretty commonly because of climbing, which then impact my playing.

#4

I’ll check out that link… No, nothing else really stressing his wrist far as I can tell. He’s not even up to barreing yet; just open chords, pretty much.

#5

I had some trouble with tendon issues in college, to the degree that I ended up having to take a couple weeks almost entirely off guitar, after binge-practicing some VERY stretchy licks with my guitar slung way too low. I learned a LOT from that process. I’ll try to keep this short and bullet pointed to make it accessible.

  • Pain is a valuable teacher. If something hurts, then something’s wrong, and adjust things until it doesn’t hurt.
  • Wrist angle was the source of my issues, and likely thr source of your son’s too. I was playing a guitar slung down to punk-rock-approved levels, but doing patterns with 5-fret stretches and rapid position shifts down near the base of the neck. I was keeping the angle of the guiar fairly low/close to horizontal as well, so it was forcing me to bend my wrist at VERY unnatural angles. That plus lots of repetition = tendon inflammation and pain.
  • There are two fundamental thumb (and, in turn) wrist positions you’ll see asa guitarist - “classical” position, with your thumb centered behind the neck, and what I call the “blues” position, with your thumb wrapped around the neck. The latter gives you a WAY easier wrist angle, while the former allows wider stretches. Try both - the blues position is pretty neutral, almost what your hand would do if you reached out with ithalf open on its own, while the classical position lowers your hand and introduces a pronounced bend to it, and some perceptible tension on the joint becoming more pronounced as the guitar goes lower. Favoring the blues position as much as possible helps take strain off your wrist, shifting into the classical position when needed. Watch a few Joe Satriani videos - he does this very well (and I suspect this is probably why he’s never really had tendon issues).
  • A recent realization of mine is how much neck angle can matter too - lots of people who play with guitars slung pretty low compensate for this by holding them at increasingly steep angles. Slash is a great example of this, specifically how steep the angle of the neck gets while soloing. Again, this is all about keeping your wrist at a natural, relaxed angle.
  • Neck thickness can make a difference too - I was playing a RG520 at the time with a Wizard neck profile, which is awfully thin, and even at the worst I was surprised that I had much less pain while playing my (somewhat thicker) Strat neck. I poked around google some and sure enough found some conversation about this on the Taylor forum, where enough players who had prior RSI issues had posted about hwo the relatively thin Taylor neck profile caused them problems, that Bob Taylor was contemplating added a thicker neck profile as a RSI feature for his guitars.
  • beyond that, just general health and wellness stuff - hydration can really help with tendon issues, and an ibuprofen regimine for a little while will help with some of the swelling too, over and above helping with pain.

My guess though is he’s playing with a strap fairly low, neck fairly flat to the ground, and has adopted something akin to the classical position for the most part, leaving a sharp break angle at his wrist. Sound about right?

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#6

Thanks for posting that; gonna get my hands on this book soon.

Like so many things guitar, another surprise. Why would a thinner neck create stress in the wrist, I wonder?

As for posture… He plays sitting mostly, so I actually don’t think the strap is so much the issue. Like a lot of newcomers, he may be angling the neck so that he can see the fretboard - that can cause a sharper angle in the wrist. I know you’re right about the ‘blues position’ (as I gain experience, I find I’m doing it more myself, and naturally), but it’s tough to pull off when you’re new and every chord is a chore.

Still, we’ll try it all and see what works. Thanks again!

#7

Do you have a picture to share of how he typically holds the guitar?

Does your son hold the guitar low with a very bent wrist?

PS: I’m not a guitar teacher, so take this with a pinch of salt.

#8

Just a hunch, but if you put your hand out in front of you, facing forward, with your wrist bent up a bit, and then you slowly open and close your hand, moving your fingers closer to and further away from your thumb, like an Italian talking with his hands in slow motion, maybe (I’m part Italian, I can make Italian jokes, lol), you SHOULD feel the tension in your wrist increase somewhat as your fingers get closer to your thumb. I suspect that’s what makes thinner necks a little harder on your wrist, in the classical position.

#9

Have him find a tolerable amount of practice (say, 5 min, but it can be any amount) that doesn’t exacerbate his symptoms and gradually increase the time over several weeks. It may take some trial-and-error to find the starting point, and he’ll need to be patient during the process. That’s the best way to address chronic, inexplicable pain. I highly doubt he has any kind of tissue damage whatsoever. Its most likely nervous system sensitization.

#10

Is he playing with too much pressure? This was problematic for me when I first started, especially with fretting chords. The tendency was to push down hard into the fretboard to get every note sounding clear, which really takes a toll on the hands after a short while.

#11

That 5 minute thing is a good idea. As for excess pressure, it’s hard for me to tell. But it’s all grist for the mill; we’ll give everything a shot. Thanks:)

#12

I was reading the Why no Left Hand thread, and people there made a big deal out of thumb placement. I think you mentioned that, @Drew. Thinking we’ve gotta focus on that especially.

#13

I should go back and reread that thread, as Tom Gilroy really changed my attitude on a lot of that. I think, to a point fretting hand technique is pretty self explanatory and it’s pretty clear to tell what works and what doesn’t, but at extremely high speeds, there ARE some biomechanical factors that do start to become limiting. It just seems like those become limiting for the picking hand WAY before they do for the fretting hand.

#14

i saw a video recently by Al Joseph who said something about the fretting hand positioning. Basically if you hyperextend your thumb (so points away from your hand) you will start feeling cramps in your hand and wrist.

It starts at 3 min

#15

One thing I’ll add is that I have made almost zero effort to play all the cool “wide stretch” licks that all rock and metal players seem to love. I just have no appetite for that kind of discomfort. Jazz stuff, one finger per fret, four or five fret reach at most, lots of slides to minimize stretching, it’s like old man guitar. You ever watch videos of old jazz cats it’s like they can’t be bothered using more than two or three fingers and sliding.

The moment I try to do anything resembling Shawn Lane or Rusty Cooley type patterns, I already feel the strain. That’s the kind of stuff where you need to make sure your form is on point and as others have pointed out Tom Gilroy had some good tips for that.

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#16

Someone often pops up on Guthrie Govan videos to opine that he needs to use his little finger more.

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#17

Yeah that guy needs to work on his fretting, he’s got potential!

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#18

Generally thumb behind the neck a.k.a. classical is BS because what u do is put your thumb in an unhealthy position ( like between middle ring is really bad), this leads to all sorts o’ pain and there are 2 fixes

  1. if u wanna keep the classical move the thumb to the left ( to its natural position actually), id’s say the rule of the thumb ( Pun not intended) is aprox not going further than the index to the right ( in 1234 4 being flat3 fingering). Just move your thumb left to right and ull see how going further to the right tenses up the whole wrist. Now for stretches thumb goes further right so u have to experiment
  2. go to the half blues position which i think is the best of the both worlds

If its no the thumb which it is almost all the time check the wrist angle and the relaxation of the whole hand (shoulder’s and downw from there) if it aint it still check the posture.

#19

Only thing is, for a newbie (my kid just started playing), it’s tough to fret a chord cleanly with the “blues” thumb. But we’ll work on a compromise position and see how that goes.

Glad to hear an experienced player beg-off on the super stretch chords. I went through the Grimoire chord book a while ago; you could laugh at some of the torture grips in there (but it is a great book, though).

#20

Man I remember myself as a kid wishing so bad someone would teach me all the stuff, would’ve saved me years… I’ll make a vid explaining the left hand for your kid maybe even today. Keep up the playin.
ps. hand position isn’t set in stone its okay to move it