Recently I’ve noticed my picking wrist feels a little stiff and clunky, and it clicks when I move it around a lot, unlike my fretting wrist. There’s no pain at all though. I don’t know if its a problem, I tend to make a big deal over little things. Anyone get something similar?
I developed arthritis on the back of my fret hand wrist. Not only does arthritis run in my family, but just like @JustinArmstrong I made things worse by having poor lifting form in the gym. I had my wrists cocked back during bench press and squats and put WAY too much strain on the wrist joint. I’ve seen learned how to keep it straight, and even use wrists wraps for added support.
Although, after reading what @Hanky_Pooh said, I question if I actually bursitis instead. Either way, inflammation really is the key here.
My pain has subsided greatly. I make sure to get most of my fats from omega-3s, because that fat combats inflammation. Most of us westerners get too much omega-6 in comparison to omega-3s. We DO need omega-6 in our diet, but having a ratio of about 2:1 for omega-6 to omega-3 is considered ideal from what I’ve read from medical professionals.
I’m pretty sure I’ve seen some people say a 1:1 ration is also good. I use cronometer.com to see how much of each I’m getting with a given diet plan. Right now I’m eating hemp seeds(aka: shelled hemp hearts) and ground flax seed which both have lots of omega-3s. Eggs enriched with omega-3 is another thing I’m trying to do more of. I plan on learning how to cook wild caught salmon so I’ll actually enjoy it since that stuff is also high in omega-3s and not omega-6s.
Changing my wrist angle like @Hanky_Pooh talks about also greatly reduced stress on my wrist. I’ve always played with the wrist having a lot of ulnar deviation. I believe that turned out to be a big cause of the strain due to those tendons being pulled and stretched a LOT.
This made me realize you can’t always have your fret hand elbow tucked into your side. Sometimes you can’t do that or else the wrist strain is too much. It might feel awkward, but it’s just something new to get used to.
The muscles that help with that part of your wrist may need some strengthening. What I’ve learned is that tendons/ligaments take on the work of weak muscles and will lead to injury. So, I started doing more forearm exercises. I saw something that works the back of your forearms by placing resistance bands on your fingers and then you open your hand. Definitely a movement we can’t really work on with traditional weights. Only thing I can think of to strengthen the top of the forearms is finger-tip pushups and reverse curls.
Last thing that helped me get my wrist pain under control (besides no gym for two weeks) was to try managing stress better. Shit has been crazy stressful for me lately, and I believe it is a result of my wrist arthritis acting up again a bit more. Deep breathing meditation helps me. Destress teas with Kava are nice too.
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Oh yeah, and Glucosamine with MSM is something I take now.
https://www.vitacost.com/now-glucosamine-msm-vegetarian?q=glucosamine+msm&ta=glucosamine+msm
I WAS taking fish oil but got sick of the fish oil burps. Might try an algae based one someday.
Might want to look into Calcium/Magnesium/Zinc supplements as well. I take them as a “just in case” sort of thing. Supposed to help with your bone and muscle repair. I WAS taking collagen when my pain was really bad. Ran out. Just haven’t bought anymore. Might do so again when I have extra money to do so.
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Remembered ANOTHER thing!
I use a wrist splint to keep my wrist from getting into uncomfortable positions that my exacerbate the problem. They make different arthritis gloves and carpal tunnel gloves that may help give you added stability and help prevent further injury.
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Thanks for the insight. I started taking Hemp seed oil supplements which supposedly has Omega 3s. Apparently people find it very effective at reducing inflammation. The supplement person I got it from says it works fairly quickly. If that doesn’t work, I might just switch to glucosamine / multivitamin.
I got a terrible RSI that affected my right arm and hand. Took me 5 years with a lot of physiotherapy and away from guitar to recover. Today if I stretch before playing, and took at least 15 minutes to warm up and then no problem. I just have to take a few breaks sometimes, but something like 1 or 2 minutes, 3 minutes max.
But if your are feeling your hands I would recomend to get one of those compression gloves. When I got back at guitar, I used a lot this compression gloves and compression arm sleeve after any guitar session.
I just do the stretchs, warm up, take a few breaks and then I have zero pain in most of the cases. When I have any pain is a small one and when I put the compression glove and/or sleeve it goes away pretty fast.
Also I started going to the gym, it helped me with the pain, especially in the arm, and started took some vitamins, this healthier style improved the solution.
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I had some pain in my fretting hand in the thumb side of the wrist and this exercise helped me a lot. Pain went completely away in just a couple of days and never came back (so far). I did this exercise for probably three minutes daily for less than a week.
I’ve seen special equipment for this training but I used a simple hair band.
@milehighshred about omega3 fatty acids: I’m not sure if plant origin omega3 are as great as those of animal sources. Plants have ALA while animals have EPA and DHA. Based on what I’ve read, when people praise omega3, they usually mean mostly EPA & DHA (and some ALA but mostly EPA&DHA)
However, I am extremely unsure of what can I believe about nutrition anymore. Nutrition on internet became more biased than religion.
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Hahaha!! Very true!
ALA converts to EPA and DHA though: http://www.veganhealth.org/articles/omega3
You are correct though; EPA and DHA are what’s talked about most. I think because the omega 3s are in that form already that your body can absorb them quicker. Again, I THINK that’s correct, but I do not know for sure. Kind of like how BCAAs supposedly get used by the body a lot faster than just taking protein or protein powder. The body doesn’t have to break the protein down into the individual amino acids, so the idea is that BCAAs can be absorbed faster. Just like the already broken down omega 3s can be absorbed faster.
I’ll definitely give the hair band thing a try. Crazy how something so simple might be the missing piece of my own puzzle for a better wrist.
I’ve read the article. I didn’t read the referenced studies though but I assume that everything author wrote there is true.
I don’t have much to comment. Vegans say that conversion to EPA & DHA is sufficient enough while other people say it is poor and everybody brings studies to support their convictions.
It’s ridiculous. It doesn’t really look like science at this point. Unless there is a huge difference in how different people react to the same substances. Speaking of interpersonal variability, the table 5 and the table 7 studies show conflicting results while using the same amount of ALA. Well ok, I have something to comment: the author concludes that 3,7g of ALA daily is needed to see higher DHA levels despite the data of these studies being not consistent. Some of them showed improvements when taking 3,7g ALA, some did not show improvements even when taking more than that.
I guess we shouldn’t make this forum into another nutrition hell fest.
It seems we both agree that this topic is highly biased and/or inconclusive and perhaps we should leave it at that. (and I, as a biased person, wrote that previous post about ALA. I probably shouldn’t have done so.)
Hair band worked well for me but you might find out that a wider band will work better than the band which has a round cross section. The round one tends to slip up or down the fingers. It is possible to get it to stay in a place but it’s easier with a wider band.
Let us know whether it helped you 
(just to make sure, I’m not claiming that this exercise will solve all the problems of all wrists. Nah. It did help me but I don’t even know what was the cause of my wrist pain. It may not work for other causes or for other people.)
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I developed rizartrhosis in my picking hand,I almost didn’t play guitar because of the pain
I have undergone a therapy wich is called ortokhine in europe,(i think in the usa the name is regenokine,or something like that)
Right now i almost feel no pain,i think I am al 95% or so,that thing really works,but it is expensive and I don’t know how much time is going to last
There is also a swiss luthier called Patrick hufschmid,who claims that his hand made picks,(about 10 milimeters thick or so)can help people suffering from arthritis,because the extra thickness can help release some muscle tension
I’ve bought one,and I do play more relaxed,but acoustically this thing is noisy as hell,I can’try it with a real amp here,but once you put medium or high gain,picking noise usually increases
Hope this helps
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When I had serious pain in one of my hands I sought out the help of a sports medicine doctor whose specialty was being an orthopedic doctor whose patients included many athletes. Since the strain we put on our hands and wrists is similar to the strain athletes put on various parts of their bodies, depending upon their sport, I thought it was a wise decision and he did help me be able to resume playing. It was so long ago I can’t remember exactlly how he treated my condition. He may have written me a prescription for physical therapy. That can be very helpful in these types of repetitive strain injuries. One thing I do remember him specifically telling me to do was to take relatively frequent breaks when practicing. I think it was something along the lines of: “Rest for 5 to 10 minutes after every 45 straight minutes of practicing you do.” That wasn’t just for while I was injured; it was advice to always use for the rest of my career as a guitarist.
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My hands sometimes get sore because I am a bit heavy-handed, and I definitely fret too hard with the left hand. In fact the harder I pick, the harder I press with the left. I know rationally it’s wrong/unnecessary, but it is an ingrained habit.
These days I am trying to practice with quite a bit more gain, and I must say that it does help me to reduce tension (since I am getting more attack and sustain “for free”, without the need to dig in). This is a kind of workaround I know, but having limited time to practice I’ll gladly cheat a bit when I can 
.
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@milehighshred I’ve always been curious about this: Have you ever had an injury to your elbow from the extreme tremolo picking you do - the technique you use when you are picking your fastest which I believe you said involves tensing up the elbow and creating something like a muscle spasm in your arm which causes the pick to move back and forth faster than you would otherwise be able to move it with conventional techniques.
If you haven’t been injured, does you elbow even feel sore or stiff after a practice session where you do a good deal of that type of elbow picking I mentioned above?
I’ve have issues with Repetitive Strain Injuries, but mine we’re due to poor typing form when writing up my thesis, not guitar playing.
I developed tendinitis, specifically the flexor carpi radialis tendon in both wrists and the palmaris longus tendon in my left wrist. The root cause was typing with my wrists extended, which results in constant strain on the extensor muscles.
Initially, the issue was short term inflammation, which I could treat with ice, and ibuprofen. My physiotherapist performed dry-needling, which I found gave tremendous relief. However, since I wasn’t addressing the root cause, the pain and inflammation would come back, usually worse than before.
Eventually, I developed tendinosis, which is not an inflammatory condition. From what I understand, tendinosis is when the tendons become covered in scar tissue due to repeated inflammation, which impedes movement and causes chronic pain. Since it’s not itself an inflammation, it can’t be treated in the same manner. Infact, long icings and ibuprofen impede blood flow to the affected area, which slows healing further. If not addressed appropriately, the damage to the tendon can become permanent and the body can’t heal correctly.
What worked for me was to try to promote blood flow to the affected area by cycling between hot and cold baths.
My routine was as follows:
Submerge both arms (past my elbows) in a bucket full of the hottest water I can stand for 4 minutes. Immediately remove both arms and submerge in a bucket full of ice water for 1 minute. Remove arms and warm up arms with specific exercises (arm swings, dynamic stretches). Repeat 4 times, ending with the warm up exercises. Moisturize skin.
I was told that the hot stage of the cycle encouraged new blood to flow to the affected areas and encouraged the breakdown of the scar tissue. The cold phase then draws the blood back to your core, removing some of the scar tissue and giving some pain relief. The dynamic stretches provide a natural warm-up and loosen the tight muscles.
The rapid changes in temperature can cause sensitive skin to dry out and peel, so moisturizing helps to prevent this.
I was unconvinced about how effective this method would be, but I was desperate at the time, so although I was skeptical, I was willing to try.
I also learned how to perform deep tissue massage on the tight muscles, which I did after every icing/warming session. I did this entire routine every evening for about 3-4 months. After that time, I felt completely healed.
I’ve also retrained myself to type with correct form and posture. Apparently, much of the muscle tension in my arms was sympathetic to tension in my back and shoulders, due to sitting with poor posture, which caused a small amount of nerve impingement. Considering how much typing I have to do as part of my job, this was absolutely essential for me.
Now, I know how to recognize the telltale signs which indicate that I’m building tension, and deal with the tension before it causes me problems.
My problems weren’t caused by my playing. In fact, I took a guitar to my physio’s office one day at her request, and she said my posture changed drastically for the better as soon as the guitar was in my hands. My wrist issues did affect my playing though, for a while I couldn’t do much at all with my left hand, so I learned to play slide.
I think in addition to typing, poor driving posture was part of the reason I had problems. I always feel that I’m much more relaxed and looser if I’ve had a long walk.
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I don’t know if this is tacky, but I’m going to paste/link my own response in a similar thread, as these are issues I’ve worked with quite a lot. Injury prevention hope that helps!
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Nope! Now, if I push it for too long, and too often, I’ll start feeling some wear and tear in my elbow in the tendon, but then I just take a break. I don’t consider that and injury. I feel that’s just part of pushing oneself in order to adapt and improve. Nothing ever snapped, tore, etc.
What’s funny, is I feel more stress in my fret hand arm where the forearm and biceps meet up. It’s really in the brachioradialus, and I believe it’s from just having my arm bent all the time in playing guitar for 20 years.
I’ve been massaging out the tension in that spot, and that seems to do the trick.
Sooooo many people say I’m going to jack up my picking elbow with how I play. So far, nothing has happened!
“Sooooo many people say I’m going to jack up my picking elbow with how I play. So far, nothing has happened!”
That’s what I’m concerned about as well. That your method of achieving those hyper speeds may place an unnatural stress on your elbow that could be damaging over time. I’m glad to hear that so far you haven’t had an injury.
I don;t do the 'spasmodic vibration" style of tremolo picking but I do use my elbow sometimes when I’m going at full speed. if I do it a lot in one practice session, by the end of the session it feels difficult to extend my arm out all he way; it wants to stay in a slightly flexed position. When that happens I take 3 Advils and use ice for 15 to 20 minutes and it works well.
Another thought: you’re playing the guitar, not digging a ditch. Use as light a touch/pressure as you can get away with to sound the note. Let your amp do the work if you need to. No need to clench your jaws and hold the guitar like you’re wrestling an alligator. Fundamental technique is something to work on over time. Look at some of Pebber Brown’s videos that emphasis the proper way to have the left hand positioned as well as the right. Some of you are already using the right technique but might be experiencing age related changes too or issues related to inflammation which can be caused by diet.
Some things I’ve learned through playing bass. Pain is often a matter of forcing your body to do something unnatural to your personal ergonomics. Perhaps a change in your technique could sidestep this?
As a side note, and this is not medical advice, go to a doctor if you want medical advice. This is just something that happened to me. I injured my fretting hand doing one finger per fret exercises on a full scale bass. By taking glucosamine and chondroitin and a little naproxen sodium once a day I was able to heal it up completely.
A visit to a sports medicine doctor is a good idea. They’re experts on these sorts of repetitive strain injuries, and can help you figure out what motion is causing it, and how to address that. Bring a guitar to the doctor’s office!
I discovered a mild repetitive strain issue in the tendons of my picking arm, where forearm meets elbow. I hadn’t noticed it until I started a weightlifting program back in October, when I quickly found pain interfering with bicep curls, particularly when my arm was nearly straight. I said something about it to the owner of the gym. He plays guitar and knew I play as well, so he figured out it was repetitive strain, and suggested an exercise for it. He started me doing curls with my palms facing down rather than up. I could do 70 pounds with palm up, but could barely do 20 with palm down! Those tendons were on fire that way!
Given my recent whole-body experience with the benefits of weight lifting, I’d suggest working with a professional to isolate where the pain is coming from, and assuming it’s muscular (or tendon), working on strength-building exercises for that particular point. Strength will help you with the repetition. It’s worked not just for my arm, but for my back and my knees as well.
And don’t think too much about whether you’re hyperextending anything. You’re not. My forearm/elbow issue isn’t caused by pushing it anywhere near limits, but rather from moving a little ten degree arc right in its sweet spot, over and over and over and over and over. It’s a repetitive strain, not pushing past limits strain!
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