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View Poll Results: Do you have tendonitis?

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36. You may not vote on this poll
  • Yes

    14 38.89%
  • No

    15 41.67%
  • I don't know/not sure

    7 19.44%
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  1. #1
    Little Dreamer
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    Default Got Tendonitis? What To Do

    Got Tendonitis? What To Do
    by Randy Ellefson

    Like most guitarists, I never thought I’d get tendonitis, not to mention several times. One side effect is that, since launching my music career, I’ve fielded hundreds of questions about it. These range from how to avoid it, diagnose it, get treatment (and from whom), do home therapy, and continue with playing – and more importantly, get on with your life.

    The goal of this article is to enable you to take your first informed steps when you suspect you’re injured, but since I'm not a doctor or other medical professional, I don't give out details of treatment. You'll have to consult a medical professional for that.

    What To Do Now

    If you have pain, muscle tightness, or soreness now, you should stop playing guitar now until a medical professional assesses your situation. Otherwise it will just get worse. You should also avoid unnecessary arm activities like sports, lifting, or heavy computer use.

    If the pain goes away after some time off, it may still return when you resume action, so see a doctor anyway. It is much easier to prevent this than to deal with it (see under “Perspective” below).

    Insurance

    To see any professional aside from a doctor, your health insurance (such as an HMO) might require you to see a doctor first and get a referral. Without one, your insurance may refuse to pay for your treatment.

    Medical Professionals

    There are many medical professionals who can diagnose and treat tendonitis, but some are more effective than others. Your primary resources are doctors and physical therapists, but in either case it’s important to have someone who seems competent and informed about tendonitis. If they sound hesitant, unsure, or dismissive, get a second opinion.

    Doctors generally see people once or twice about an issue, not the many times often needed for something like tendonitis. It is a repetitive stress injury that needs repetitive attention to heal. A multitude of appointments is more typical of physical therapy.

    Acupuncture and acupressure are secondary options of less certain benefit, and a chiropractor is not likely to help you unless existing neck trauma, for example, is exacerbating your arms.

    Doctors

    You should first see your doctor partly because they know your general health and can ascertain whether other factors play a role in your symptoms or not. A doctor can also confirm whether it is tendonitis or something similar, such as carpal tunnel syndrome, arthritis, or trigger finger. They can also diagnose severity and which type of tendonitis it is (lateral or medial).

    A doctor may prescribe anti-inflammatories stronger than the over the counter variety and provide or recommend removable arm braces. He may recommend ice, heat, or both, and advise you on how and when to do these. Doctors will sometimes want to administer a cortisone shot directly into the forearm muscles during this appointment. Personally I did not find this effective and refused a second shot weeks later because it made symptoms worse.

    If the doctor says you have tendonitis, ask them to recommend a physical therapist, preferably one with experience with tendonitis. Be forewarned that some physicians do not believe physical therapy can help with anything at all and be dismissive of its value. This is often not caused by knowledge of therapy but contempt for some treatments (also including acupuncture and acupressure) popularized after the doctor’s initial education. You might want to find yourself a more enlightened doctor in general, not just in regard to tendonitis.

    Physical Therapists (PT)

    Physical therapists are specifically trained to diagnose and treat tendonitis and muscle injuries. That said, you should see a doctor first anyway (see above). Compared to a general practitioner doctor, qualified physical therapists are specialists.

    They offer various kinds of treatments done while you lay down on a massage table:

    · Manual therapy – This involves the PT positioning your arm and wrist in various positions to maneuver muscles, thereby revealing to the PT’s trained fingers the muscle problems needing resolution. Hard pressure via fingers releases the knots, which feel tender and sore even before this. With some practice you can learn to do this yourself, but save that for later.

    · Ultrasound – Just like what they use to see a baby in the womb but without the graphics, ultrasound is used to penetrate heat deep into the arm to increase blood flow (oxygen) to the wounded muscles.

    · Electric stimulation – A pair of small pads are placed on the arm with electric current passing in between and through the muscles to cause contraction. The PT continues with manual therapy during this.

    · Home therapy – Since you must be an active participant in your recovery, there are many activities you must do outside of the physical therapist's office. These may include stretching exercises, forearm curl exercises, and how and when to do ice and heat (and the purpose of each). They can also advise you on anti-inflammatories, vitamins, and topical pain gels.

    · Device recommendations – There are a multitude of arm bands and braces available to either immobilize your arm to aid recovery, or lessen the strain on the injury during common daily tasks. Alternate computer accessories are also available. A physical therapist can recommend which ones to get and use under what circumstances.

    · Behavior modification – There are things you might be doing to unknowingly contribute to the injury, such as your position while playing an instrument or using a computer. You might even be sleeping on one of your arms at night, applying pressure to the now inflamed joint. Your physical therapist should discuss these things with you to help you avoid straining the injury.

    Perspective

    Sometimes I hear people complain about not playing guitar a few days or weeks when their arms first hurt, so to help your perspective, here are some details on my situation. I could not play at all for an entire year, then could play really simple music for 30 minutes, twice a week. Three months later I reached 90 minutes every other day and slightly harder music. At two years I developed a second case of tendonitis in both arms and started over. After five years, I was up to 2-3 hours at once, still alternating days on and off, and could finally play most of my own music. It wasn’t until 8 years passed that I could play guitar two days in a row, with one day being a “light day” of easier music, though I could get away with up to 6 hours at once, depending on complexity. It is now 10 years later, and three days in a row is still unwise.

    These numbers are rough, but I received physical therapy once a week for about five years, sometimes more often, sometimes less, and slowly tapered off to nothing after about 8 years. I did stretching for 9 years, heat for 9, ice for 8, ibuprofen for 7, vitamins for 3, slept in arm bands for 3, and used a foot mouse in place of a hand mouse for 5 years, and a dictation program for most typing (especially heavy) for 8 years.

    In short, tendonitis does not affect only your guitar playing, but can impact every activity you use them for, including things you take for granted like sleeping, dressing, grooming, driving a car, opening things, and even how you are perceived by others. After all, there’s still contempt for the seriousness of the injury and some people will disrespect you for having it.

    Coda

    If your arms are already bothering you, getting treatment sooner is much better than later. With lifestyle adjustments and good treatment, it is possible to live your life pretty well, albeit differently. It just takes time and rest, and sometimes a lot of both. The impatience you exhibited in over-using your arms may now force you to learn patience the really hard way.

    If you have any questions, feel free to write me at mail@randyellefson.com.

    Best of luck to you!

    Randy Ellefson

    Biography

    Randy Ellefson is an instrumental guitarist with endorsements from Alvarez Guitars, Peavey, and Morley Pedals, and a Bachelors of Music in classical guitar, Magna Cum Laude. His debut album was independently released in June 2004, and he is now recording a follow-up and performing in the U.S. The album's title, The Firebard, is a nod to his experience with tendonitis, which took away his playing for five years before he fully recovered it and rose from his ashes. For more details, mp3s, tabs, articles, videos and other cool stuff, visit the official site, www.randyellefson.com.

  2. #2
    Little Dreamer
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    would my thumbs hurting fall under tendonitis ? if so ive got it Baaad baad bad.

    my mom said I should stop playin guitar for a month

  3. #3
    Little Dreamer
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    possibly. Never heard that before. See a doctor.
    Visit instrumental guitarist Randy Ellefson's official site for free mp3s, videos, lessons, tab and other cool stuff.

  4. #4
    Sinner's Swing! Rick S's Avatar
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    06.23.17 @ 09:49 PM
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    i have tendonitis in my right shoulder/arm and a little in my left. surprisingly its my picking hand/arm that got the brunt of it. im guessing from all the speed / altenate picking.

    kinda sucks because im not sure if its from playing guitar , drawing , or lifting weights. or combo of all three.

    as of now i play guitar once or twice a week (i save it for band practice) , lift once a week , draw occasionally. i was prescribed cortisone and it was awesome felt great. but doc said once a year was all he d give me.

    but there have been times where i cant even lift my arm over my head , going to the orthepedic specialist in september.

    that dude is right , when the recomendation is to stop doing all those things , and youre like but thats everything i love to do. lol. it can make you depressed.
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  5. #5
    Forum Frontman Double Down's Avatar
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    11.17.17 @ 12:11 PM
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    This has become a huge problem for me this past week. I've had the worst pain in BOTH wrists for about a week now and it's got me pretty bummed out.

    Surprisingly the worst wrist is my picking hand. I've never had this problem before on this hand and I'm trying to think of reasons why it all of a sudden started up. Up until recently I've mostly played acoustic the past several years which is mostly strumming up and down. Now that I've switched to electric I've been doing a hell of a lot more alternate picking and I'm thinking this is the difference?

    On the outside of the picking wrist (right at the bone) it not only hurts when I play but it actually throbs throughout the day. I also have the same pain on the left hand and it's especially noticeable on string bends and forming chords. Even simple things like grabbing a gallon of milk or doing workouts with dumbells can create sharp pains right at the wrist.


    Needless to say I haven't touched the guitar for a couple of days now and I'm incredibly pissed off about it. My wrists do feel a little better and I'm sure with more time off I'll feel fine again, but what good is that? I'm sure it'll start up again as soon as I start playing again so what do I do?

    I've been more focused lately than ever in terms of my playing and now I've got this bullshit problem to deal with and this unexpected setback. What a pisser.
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  6. #6
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    Hey Dude,

    First off - sorry to hear that. I know it sucks.

    Second - you're describing pretty serious pain so I would get your butt to a doctor fast and stop most of what you're doing, including playing guitar and certainly lifting weights. Are you nuts?

    Don't worry about not playing - your playing will still be there. Unless, ironically, you don't leave it be, in which case yes, it may disappear for a very long time.

    You also need to see a phyical therapist, but if your insurance is through an HMO you may need a referral from your primary doctor first. Get one.

    You also need to stop doing things like picking up heavy stuff unless you really need to. Your arms need serious rest. Also, stop typing so much.

    String bends take more out of your arm. So does holding down chords (more strings to hold down). That's why these hurt more.

    Bottom line - you have a serious injury and need to treat it seriously.
    Visit instrumental guitarist Randy Ellefson's official site for free mp3s, videos, lessons, tab and other cool stuff.

  7. #7
    Sinner's Swing! Rick S's Avatar
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    06.23.17 @ 09:49 PM
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    i still have tendonitis in my shoulder/arm , the pt s tell you to exercise they dont say to not do anything. i know you may not understand but to tell someone who lifts weights(and i dont lift heavy anymore) to just give it up is not that easy.

    i believe its wear and tear with some cartlidge debris in the joint from playing sports all through my teens and 20s.

    im glad you can Empathize(not sympathize , like you said some people say to just suck it up) with me since you understand what its like.

    im just saying its frustrating when the doctors just say its tendonitis and send you to pt , where they give you a bunch of rotator cuff exercises which i just do on my own. id rather have the heat therapy and massage.

    i still play guitar once a week at most for about 2 hours, i think ive reached my apex anyway at 38 so why cause more irratation. i only play extended at practice and live shows . but i do know the frustration of really playing a good show or practice only to have a throbbing arm the next morning.

    lastly you have to understand the person themselves. im always been a real active person , lifting weights , running , hiking i love all that stuff do it at least 3 times a week but no doctor has told me to not exercise anymore. also to just give all that up would be pretty depressing.

    lastly im an illusrator/graphic artist . how can i not draw artwork or work in photoshop anymore ?

    i think there should/could be alternative exercises or lifestyle changes or something .

    thanks for letting me vent. thanks for understanding the frustration too.
    (heh , i swear im not really as grumpy as that sounds)
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  8. #8
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    Quote Originally Posted by Double Down View Post
    This has become a huge problem for me this past week. I've had the worst pain in BOTH wrists for about a week now and it's got me pretty bummed out.

    Surprisingly the worst wrist is my picking hand. I've never had this problem before on this hand and I'm trying to think of reasons why it all of a sudden started up. Up until recently I've mostly played acoustic the past several years which is mostly strumming up and down. Now that I've switched to electric I've been doing a hell of a lot more alternate picking and I'm thinking this is the difference?

    On the outside of the picking wrist (right at the bone) it not only hurts when I play but it actually throbs throughout the day. I also have the same pain on the left hand and it's especially noticeable on string bends and forming chords. Even simple things like grabbing a gallon of milk or doing workouts with dumbells can create sharp pains right at the wrist.


    Needless to say I haven't touched the guitar for a couple of days now and I'm incredibly pissed off about it. My wrists do feel a little better and I'm sure with more time off I'll feel fine again, but what good is that? I'm sure it'll start up again as soon as I start playing again so what do I do?

    I've been more focused lately than ever in terms of my playing and now I've got this bullshit problem to deal with and this unexpected setback. What a pisser.
    I can't say it better than this:

    Quote Originally Posted by RandyEllefson View Post
    Hey Dude,

    First off - sorry to hear that. I know it sucks.

    Second - you're describing pretty serious pain so I would get your butt to a doctor fast and stop most of what you're doing, including playing guitar and certainly lifting weights. Are you nuts?

    Don't worry about not playing - your playing will still be there. Unless, ironically, you don't leave it be, in which case yes, it may disappear for a very long time.

    You also need to see a phyical therapist, but if your insurance is through an HMO you may need a referral from your primary doctor first. Get one.

    You also need to stop doing things like picking up heavy stuff unless you really need to. Your arms need serious rest. Also, stop typing so much.

    String bends take more out of your arm. So does holding down chords (more strings to hold down). That's why these hurt more.

    Bottom line - you have a serious injury and need to treat it seriously.
    Take care of yourself, DD. I've heard entirely too many stories of guys having to give up playing because they've caused too much damage. I don't want to hear another one. It's no coincidence you're having these problems just after focusing on the guitar a lot again.

  9. #9
    Good Enough EJC's Avatar
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    Quote Originally Posted by Rick S View Post
    i still have tendonitis in my shoulder/arm , the pt s tell you to exercise they dont say to not do anything. i know you may not understand but to tell someone who lifts weights(and i dont lift heavy anymore) to just give it up is not that easy.

    i believe its wear and tear with some cartlidge debris in the joint from playing sports all through my teens and 20s.
    I went through the whole shoulder injury thing from lifting weights... My therapist gave me some great excercises... I thought I sent them to you before?

    The cortisone is useless... It just masks the pain, and doesn't really heal anything. You've gotta get those rotator cuffs stronger, and then your shoulders will feel better all over... Another thing that helped was only playing guitars with contoured body's (like a strat). I was playing a wolfgang special for awhile, and the awkward posistion I had to hold my right shoulder in to play cleanly caused alot of pain when lifting wieghts....

    I came up with a different way to do shoulder presses that causes way less stress on your joints... Do your military presses on a slight incline so you can keep your back totally flat against the bench. When you come down with the weight, rotate your wrists inward so that in the mirror you would see the plates on the dumbell and not the handle. When you go back up, rotate your wrists outward. For benching, try using dumbbells off one of those giant plastic inflatable balls... WAY easier on your shoulders as well...

    ALSO... If you work at a computer all day, be VERY aware of your posture. Most of my shoulder issues developed not from lifting weights 4-5 hours a week, but from using a mouse 40 hours a week... I didn't even realize how bad my posture was, and how bad I leaned on my shoulder when using a mouse until my PT pointed it out to me. Sounds silly, but sitting in front of a computer all day can really mess your body up... Repetitive motion injuries take alot longer to develop, but also take alot longer to heal... One thing that really made my shoulders feel better too, was using nun-chuks. If you think about it, you are moving your shoulders in almost every direction, and it really loosens them up... Hope some of this helps....



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  10. #10
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    What I failed to understand when I was younger, was very simply:

    My muscles weren't "musically fit" enough to deal with what I was doing before, so WHY OH WHY would I think they'd be "fit" enough to deal with it after 2 weeks' rest and some anti-inflammatories?

    First, I needed to REST properly.

    Then, I should've rehabbed the muscles to a strength/fitness/flexibility that was SUPERIOR to pre-injury levels.

    Then, and ONLY THEN should I have begun even "light" practicing again, followed by gradual increases.

    It's funny that this popped-up now, because I've gone for probably 4-5 years without any problems....until this week, and even then, it's not tendinitis. Just a slight case of soreness/stiffness, which I've been monitoring. Changed up my back/bicep routine in the gym, which bombed my forearms, while incorporating some new stretch legato licks right around the same time, which was probably a stitch too much, looking back on it.

    Not worried about it....I'm paying attention and practicing intelligently.

  11. #11
    Forum Frontman Double Down's Avatar
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    Well for me it's been 3 full days now of no guitar and there's no question much of the pain has subsided. I'm able to grip things much better and almost free of discomfort. A HUGE difference just in 3 days.

    My biggest priorities are being able to workout with weights, play hockey, and mountain bike. Any injuries keeping me from these activities really depresses the hell out of me. So laying off the guitar this week is really driven by how it was interfering with these activities. But you can't imagine how maddening it is to sit here with free time and NOT be able to pick up the guitar and continue working on the things I've been working on. I don't have to be to the rink until 10:30 tonight and these next couple of hours are being wasted by not being able to pick up the guitar. It's so frustrating.

    But hey, what can you do.....
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  12. #12
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    As Marty Friedman once said, "Once I calmed down, I thought: I've been playing all my life. What is 2 weeks off going to do?"

    That said, I'd still consider doing things to strengthen one's self to higher levels than previously attained.

    And consider rest periods, etc.

  13. #13
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    I didn't know Friedman got it.

    Actually I know exactly how maddening it is to sit around and do nothing. My entire life vanished over 2 months as I realized one thing after another hurt my arms. I ended up sitting there for another 3 months afer that with NOTHING to do, literally pacing around all day in genuine torment that all the stuff I'd done in my life had just led to this and I could find no way out. I lost my job, savings, friends, hobbies, career paths, etc., and was forced to live with my parents for the next 2 and a half years, unable to support myself. This means not only $$$ but I could not do my own laundry or lift groceries or other basic activities.

    During that time I was unemployed and penniless for a year, then only worked part time (12-15 hrs a week) for the next 18 months. I was still broke, making $200-600 a month and with $400 in bills a month for school loans, health insurance (which ironically would not pay for any treatment), and a car loan.

    After the first 5 months my parents bought me a computer and a dictation program (Dragon Naturally Speaking, aka DNS), and I could at least stop dying of complete and utter boredom. For another 18 months I placed the regular mouse on the floor and used my feet to navigate, with most words dictated. After getting some ankle pain I finally bought a special footmouse and used that for the next FIVE years or more, slowly tapering off of it. And yes people looked at me funny for both of these.

    After the first 2 1/2 years I finally found a career that didn't use my arms - software development. Why? I used the foot mouse and modern programming environments allow you to minimize typing (DNS does not go over well in a cube environment).

    That's when I finally started getting my life - and oh yeah, my guitar playing - back.

    Those are rough guesses but not exaggerations. I could go on and on. It's been 12 years. I seldom lift anything even remotely heavy.

    Bottom line - NOT playing guitar will NOT hurt you now. PLAYING guitar will hurt you now So will anything that is not worth it. Note to non-self - all of your favorite and most precious hobbies? Not worth it. Seriously.

    Here is your priority list (based on mine):
    #1 Be able to get through the day (shower, brushing teeth, dressing) without pain
    #2 Earn a living and be self-reliant again
    #3 Regain precious hobbies one by one

    BTW, I was up to 100 push-ups before the injury. Yep, I got to watch all my hard work disappear, seeing all my muscles slowly shrinking in the mirror day after day. It was not fun. That was 1996. I still can't do a push-up. I have flabby loose muscle where my tight pecs, biceps, and triceps used to be. I got over it, mostly. I don't like seeing it in the mirror, and yeah I think about it everytime I'm at the pool and a hot girl goes by.

    Oh, as for my guitar playing, I didn't play for an entire year. Then I could only do 30 minutes twice a week for 4 months. Then after a neck injury caused treatment to by neck, it shot up to 90 min every other day. That was early 1997. In 2001 I could play all the things I could play before, except classical guitar. I only played every other day until 2006. Now I can reliably play 2 days on, 1 day off.

    Take it seriously or pay a price far greater than anything you are imagining.

    P.S. Sorry if I seem mean.

    Incidentally, despite all this, I've released two albums of instrumental guitar, in 2004 and 2007, which you can hear at www.randyellefson.com
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  14. #14
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    Well as a licensed massage therapist this is what I can tell you....first thing...
    before you play and during your breaks, increase blood flow to the forearm and hands by stretching and performing self-massage to the area. (You may want to visit your library or bookstore and look into some massage techniques - I can't really describe what to do on this board! There should be some books with pics. These will be to help to increase the blood flow to your arms and flush out toxins. For complete prevention, invest in an occasional massage by a professional massage therapist. YES I had to throw that in! For relief of pain and to help promote healing this is what I suggest...

    1) Use heat on the forearm before practicing, and ice the elbow and forearm area after playing. The heat will encourage more blood to the tissues while playing, and the ice will discourage swelling afterwards. Perform stretching to the forearm three to four times daily. 2) If you are experiencing nerve related symptoms like tingling and numbness, see a health professional immediately who is experienced in treating musician's injuries. Many musician's make the mistake of seeing their general practictioner who is not trained about treating repetitive strain injuries. Ask the doctor or therapist if they have treated similar cases, and what type of results they achieved. 3) Always try conservative measures first, such as chiropractic, physical therapy, massage therapy, or acupuncture. Give yourself at least six to eight weeks to heal. 4) If you notice symptoms worsening, or weakness occurring in the hands, your health care provider should refer you to a medical doctor for a consultation and neurological testing. 5) Nerve-related conditions are serious because the nerve can actually die due to compression and decreased blood flow. This could lead to a permanent disability in your forearm and hand - not what a guitarist needs! Hope this helps!
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  15. #15
    Atomic Punk MF5150's Avatar
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    I'm surprised that this wasn't listed..... one of the things to do when a guitar player has tendinitis would be to get David Lee Roth back to sing lead......oh should I not have said that
    My man, when you are fantasizing, don't go for attainable, you can get attainable at the local Applebee's. - Dave's Dreidel

 

 

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