Tendinitis in elbow. Advice greatly appreciated!

General Music Discussion
#1

Hey all, I’ve been having sharp pains just behind my elbow for a while now. In particular when playing fast or stretching to play a certain chord etc.

I’ve had tendinitis before and it felt the same so I made an appointment with a physiotherapist.
He did an examination and confirmed it was tendinitis. Crap!! :confused:

He did some dry needling on it and told me to ice it. He also said to use a sort of tape you can put there and it’s supposed to help support the tendon. My appointment was very rushed though due to various restrictions we still have here and it seemed we ran out of time as I was kind of rushed out the door.

Unfortunately, it seems to be getting worse. I’m not sure what I did a few years back when I had it before, it feels like it’s in the same tendon.

Should I make another appointment with him? Or maybe try a different therapist?

I really don’t want to have to take time off of practice if I can avoid it. I didn’t take time off when I had it the first time and somehow it eventually went away.

Has anyone dealt with elbow tendinitis before and have any tips on how to overcome it? Any exercises I can do or precautions I can take? It’s in my fretting arm.

Any advice greatly appreciated!

#2

In my experience, it always gets a bit worse after you start noticing it.

Tendonitis falls into the repeatitve strain category, so working through it isn’t advisable - at least some rest is required.

I’ve had some crappy nerve and tendon issues over the last few months and it took a lot of patience to resolve, including some decent amounts of time away from the guitar. On the upside, I actually feel like some aspects of my playing is better for it.

I’m no physio/doctor, but whether or not you get a second opinion,my suggestion is to at least follow the advice that you have had so far - some rest and ice. Its not just the guitar that could be contributing, so look at everything you do and try to avoid other things that might be contributing to it.

Also, I find that 9 times out of time when something like this happens, I am dehydrated. If like me, you drink a lot of tea or coffee, reduce this and increase the water intake.

There is a YouTube guy with a channel called ‘DIY Joint Pain Relief’ that I found useful - he has a playlist for guitar related stuff and other videos about the elbow (which are largely the same principles). I used these techniques to helpnand now as a preventitive measure against tight muscles and tendons.

Good luck!

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#3

Pretty surprised to hear it’s your fretting arm. What tendon is affected? What motions exacerbate it?

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#4

I would definitely go to a licensed professional and get a real medical opinion, if possible. The longer you wait on these sorts of things the worse they will get. At the very minimum stop playing or doing anything that will aggravate it.

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#5

I’ve dealt with it on my picking hand from being tense and an elbow picker. I bought a tennis elbow band at the pharmacy, which did help. You have to wear it 24/7 for at least a week to really start to get the benefit. Essentially, it creates a fulcrum at the forearm, instead of the elbow, which takes some of the pressure off it.

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#7

I am not a medical doctor, but it sounds like your fretting arm has issues. I would suggest (a) looking at if you want the guitar on your right leg or in “classical” style, (b) consulting a physician, (c ) consulting an Alexander Technique practitioner [the ones that specialize in music RSI], and (d) resting.

Can you share a photo of what you look like when you’re playing guitar? Perhaps that might give some people some ideas.

I hope that you have a quick recovery!

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#8

I never do big stretches. I move my hands in stead when i play single note solos. I felt a bit weird at first but is takes away lot of the strain i had before i injured myself. Perhaps that is something you can try?
when it comes to hard and complicated cords, i just don’t do them at all.

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#9

Thanks for all the replies. I will take all advice on board.

I went to a different physiotherapist this morning and he did his own examination.
I have issues in both elbows, fretting elbow feels like tendinitis as I have had that before and it’s the same pain. The picking elbow pain is a little different, more discomfort than anything else.

He did some dry needling at certain points in the arms and also has sent me exercises I need to do daily.

I asked about what I should do about practice and he said it’s ok to practice, but scale it down for a while. When I start to feel the pain, take a break, or do something different. I’ll have to use my own judgement on this. I’ll know when I feel the pain and should then take a break and possibly do some of the exercises during this time.

I have a follow up appointment next week to see how things are progressing. Hopefully I’m on the right path now.

As I said, I did have tendinitis some years ago and I can’t really remember what actually helped. I do remember it took a long time though and I scaled down practice of certain things in this time.

Thanks again, hopefully it’ll get sorted in the coming weeks.

#10

I’ve had tendonitis on and off for the last 20 years.

The one thing I think is the absolute worst is a computer trackpad…particularly if you use a lot of gestures, and use it to hold and move and stuff…so switch to a mouse or trackball if you use that a lot.

Watch out for other movements…like don’t use those gripmaster things…and for example spray trigger bottles…basically really look into everything else you do that might be putting stress on your tendons besides guitar first…

Oh and alcohol can make it worse…it slows down the healing…I have a bit of a problem so trust me on this…I know this by test: )

I generally agree re not to stop playing completely…but if it’s really bad, like your finger feels like it’s on fire etc., then you should rest a few days and very gradually ease back in…any time I’ve ignored tendonitis, it ends up taking much much longer to go away…

Swimming is also really good I find…also if you’re in a gym and there’s a sauna and a cold shower, try a few reps of that, I find it helps a lot, especially if you do it a few times a week…yoga is another good one, but more prevention, it can aggravate an injury…basically staying fit overall makes a big difference, particularly regarding everything up to your wrists and fingers (I say that because i’ve had finger tendonitis even when I was really fit/healthy, it’s a bit of a separate thing, but I have only had it in my arms/elbows when I was unfit and not doing exercise, ditto back pain etc.)…

I mostly play piano and have been studying Taubman over the last year…tldr is you use more rotation of your forearm and less finger movements…it definitely helps…tbh, I haven’t really figured out how to apply their principles fully to guitar, other than some of the basic ideas…it’s really designed for piano. But anyway here’s a few re fretting hand…

  1. Keep your wrist straight as much as possible at all times…avoid using shapes that cause you to bend your wrist at all…it’s possible to adjust most chords, but it takes a while…but some shapes you should just drop until it settles down…basically try and keep that fulcrum, so you have the strength of your arm behind your fingers without ever stressing your wrist…as an example, take a simple G cowboy chord (the one with the fifth), adjust that so it’s a very closed position and your wrist is bang on straight (though you’ll need a bit more callous around the nail of your pinky), that kind of thing…

  2. Avoid stretching at all times, find another way of doing it…move position instead for example…and ditch those one finger per fret exercises completely while you’re injured…another one I’ve been doing lately is using bass fingering when close to the nut, so 1,2,4, particularly on the E/A string…even up until the 7th fret…try this, F-G-F#-G# on the low E string, tell me it’s not more comfortable using 1,4, 1,4 (index pinky) than 1,3,2,4…

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#11

I have had an issue with my piriformis muscle (muscle in my buttock) for four years now. The only thing I would strongly advise is to go and speak to your doctor to see about getting a solid diagnosis, and to do this as soon as possible. I let my issue go on for too long and now it has become chronic and I wish I did something about it sooner.

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#12

If your problem is similar to a golfers elbow, this weird stretch helped me quite a bit.

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#13

Hi, sorry to hear you’re suffering like this I’ve been having issues for the past 3 years and suffer from both golfers elbow and tennis elbow.

I’ve tried everything and the only thing which worked for me was wrist curls/reverse wrist curls with a dumbbell and to take 10 seconds when letting the weight fall, speed on the lift doesn’t matter. Start light, 3 sets of 10. Also stop playing the guitar either completely or stop at the point where you feel slight discomfort.
I don’t stretch that just aggravates it. Something else which helped a bit was a massage gun, I used to use that daily but not at all now.

Also if you’re s heavy computer user switch to a trackball and learn to touch type, this made a huge difference to me.

Good luck

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#14

Thanks for the replies and advice!

I had my follow up appointment with the physio last Thursday. There was no real improvement so he did his examinations and some dry needling again.

There is issues with both elbows. The worst being my fretting arm. That’s where the tendinitis is. It’s not tennis or golfers elbow, but it’s a similar type of thing. Just a different tendon.

The right arm is sore in multiple places around the elbow. This is most likely due to tension in the picking hand. It’s something I struggle a lot with when trying to develop my picking. I can be quite tense before I even notice it. It’s something I’m going to have to pay close attention to and minimise tension as much as I can.

I have a follow up appointment in a few weeks. Between now and then, I have some basic exercises to do and I can still practice, but I need to stop if I start to feel the pain and either do something else, or take a break. I don’t want to make the problem worse!

I’ll give an update soon and hopefully there will be an improvement…

Last time I had tendinitis was 2018 and it seems to be the same tendon, or at least feels like it’s the same one.

#15

Just to update.

So, the pain in one of my elbows has decreased significantly. I don’t know whether it’s due to the exercises I was given to do or just time, but thankfully it’s not there every time I pick up the guitar now.

The other elbow is a problem though. It doesn’t hurt bad, but it is there most of the time, even when not playing.
So I must have done some damage to each elbow that time I practiced with bad posture for a while.
I had some more dry needling done on it yesterday and he gave me a couple more exercises to do. He also recommended hot and cold treatment for it. So I’ll see how that goes over the next few weeks.

It’s more of an annoyance now than an actual pain that makes me feel I need to stop, which I’ll take as a plus for now!

#16

Hi, did they say what tendon is in pain? I’m really intrigued that it’s not tennis or golfers elbow. Where do you press to feel pain? Also what exercises are you doing?
Sounds like you are making fast progress thank god as I don’t think I’ll ever be fully rid of mine.

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#17

Hey, on my right arm, the pain is in two places. One is on the outer elbow, so that would be the tennis elbow side, but there is also pain across the back of the elbow.
If I clench my fist, I’ll feel pain on the outer elbow tendon.
The exercises I’m doing are not specific to the elbow joint itself. There are three which are motions coming from the shoulder joint. Each exercise moving the shoulder in a different way. Gentle stretches, not athletic. Also three wrist exercises. Flexion and extension stretches and also one using a stretchy band for mild extension exercises.
I need to go easy when doing them, especially the wrist ones. If I push too hard with the wrist exercises, I can feel the pain in the elbow and that just means i’m pushing it too hard.
They are a little difficult to describe in text. The place I go to they send you a login for their site which gives video demonstrations of what to do.
I normally do them three times a day. I practice piano and drums too so I tend to do them after each practice session.

Is there any action in particular that is affecting your elbow? What treatments have you tried?

#18

Hi,

Ever heard of GTN patches? I’ve been using them recently and they are helping quite a lot. You put the patch over the painful tendon area and the idea is it increases blood flow which increase healing.

I came across this as I’ve had tendonitis for many years now and it’s never fully gone away.

These patches give me headaches if I wear them too long though so can only handle them for 3 hours a day.

It’s relatively new science:

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#19

I have not, but I’ll give them a look. I’ve recovered from my injury, but it does tend to come back , so I’ll read up on them. Thanks!

#20

I had trouble with tendinitis when typing my thesis as a graduate student. I developed tendinitis in both wrists and in my right shoulder. My left wrist was the most severe, and the issue became chronic. I couldn’t hold a cup of coffee in my left hand for over a year.

The university had an on-campus physiotherapist who I went to regularly. She would dry needle the trigger points which were causing the problem, and use the ultrasound machine on the affected tendons to promote healing. I would feel some relief for a few days after a physiotherapy session, but the issue was persistent.

I would regularly ice the painful areas at home and I did the recommended stretching and strengthening exercises. Often the pain would keep me awake and I would take ibuprofen to help me sleep.

Over a few months, the problem got worse and worse, especially in my left wrist. The pain was constant.

I was worried initially that the problem might have been caused by my guitar playing, but I was asked to bring a guitar to a physio session for observation and she insisted the problem must be something else. Eventually we identified my typing form as the culprit.

I was eventually able to solve the problem. I started learning about ergonomics and I started re-training my typing form.

I also earned that after the initial stages of inflammation (tendinitis), there is the possibility of a condition called tendinosis. After repeated overuse, the tendons can be chronically damaged. The collagen degenerates and there is excessive scar tissue. Tendons are very slow to heal, and they can take 3-6 months to regenerate.

Regular use of ibuprofen and long icing was actually preventing blood from flowing to the damaged tendons and was preventing me from healing.

During some reading, I found a routine alternating between hot and cold. I was initially skeptical, but at this stage I was willing to try anything. The routine is as follows.

Fill one large container with the hottest water you can bear to submerge the affected area in. Fill another large container with ice water.

Begin by submerging the affected area in the hot water for 3-4 minutes. The rational is that this promotes blood flow to the affected area and breaks down scar tissue. After removing the affected area from the hot water, immediately submerge the affected area in the ice water for 1 minute. This causes a temperature shock which brings the blood back to your core, supposedly taking the broken down scar tissue with it. After removing the affected area from the ice water, warm up the affected area naturally through movement. Repeat the entire process 4-5 times.

I did this process every evening for months. Eventually the tendon damage healed and the chronic pain was gone. I was still prone to getting tight, but I learned to self massage the trigger points and keep the problem at bay.

I started working to improve my posture, looking into the Alexander Technique, etc. This was really what solved the problem for me in the long term, and I’ve been much less prone to the problem recurring since.

The simplest piece of postural advice I can give: When you stand, your vision should be centered on something at eye level.

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#21

This was actually something my physiotherapist recommended too, he didn’t explain the science so thanks for the clarification on that one!
I do occasionally feel the pain in my elbow but it hasn’t been persistent, so hopefully it’ll fully heal and won’t have to deal with it again :crossed_fingers: