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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