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'''{{crumbs|blue|3|Injury#Guidelines to Avoid and Recover from Injuries|Guidelines|Injury#Repetitive Stress Disorder (RSD) or Repetitive Strain Injury (RSI)|RSI|Injury#Carpal Tunnel Syndrome''' is caused by compression of the median nerve in the wrist. There are numerous ways this can happen, but it is commonly associated with repetitive, low impact movements of the wrist (CTS)|CTS|Injury#Tendinitis and fingers, such as working on computers or playing guitarTendinosis|Tendinitis|Injury#Arthritis|Arthritis|Injury#Strained/Pulled Muscles|Strain|Injury#Saturday Night Wrist (Radial Nerve Compression)|Sat.Night Wrist|Injury#Hearing Loss|Hearing Loss|Injury#Bulging/Herniated Disks|Bulging Disk}}
→Guidelines to Avoid and Recover from Injuries
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This page details physical injuries related to guitar playing. Most are related to muscles, the skeleton, and nerve compression, which can be avoided with care to [[Warm-Up Exercises|warming up]] and good posture.
'''Disclaimer: I am not a medical doctor, nor was one consulted in writing this page. This page should not be considered expert medical advice.'''
[http://rsi.unl.edu/music.html Here is an extensive set of resources from University of Nebraska-Lincoln on this subject.]
== Guidelines to Avoid and Recover from Injuries ==
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* '''Always [[Warm-Up Exercises|warm up]]!!!'''
** Stretch before and after playing, and during breaks.
** Slowly play warm-up exercises that use all the muscle groups of the hands.
* [[Holding_the_Guitar_and_Pick|Hold or sling your guitar properly]] to prevent unnecessary strain on the wrists, shoulders, or elbows.
* Use [[Basic Technique|good technique]] and find comfort in holding the pick and gripping the neck, with the wrists as straight as possible.
* Try [[Setup/Adjustments|setting up your instrument]] for easier playing - lower action, thinner strings.
* Don't play beyond your ability - work up to difficulty over time.
* Don't over-strain the wrists and hands - use only as much force as is needed. Feeling like you need to tighten up is a sign you are trying to play beyond your ability.
* See a doctor if pain is extreme and persists several days. Do not continue playing guitar if it is painful.
* Pay attention to other activities and ensure they follow the same guidelines in breaks and ergonomics. Computer use, playing video games, using certain hand tools, cooking, using a smartphone, and even smoking can all present additional stress on the hands.
== Repetitive Stress Disorder (RSD) or Repetitive Strain Injury (RSI) ==
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'''Repetitive Stress Disorder''' or '''Repetitive Strain Injury''' is an umbrella term vaguely related to a variety of conditions that seem to resolve around repetitive motions and/or vibrations. Most of these revolve around pain in the muscles and joints of the hands, wrists, elbows, shoulders, and neck. Unfortunately, there is not a lot of solid information in this field, other than saying to avoid lots of small, repetitive motions and prolonged exposure to vibrating machinery. Most seem to revolve around holding a joint outside of its resting position for enough time to cause a nerve compression, or otherwise irritating a sensitive nerve.
== Carpal Tunnel Syndrome (CTS) ==
'''Carpal Tunnel Syndrome''' is caused by compression of the median nerve in the wrist. There are numerous ways this can happen, but it is commonly associated with repetitive, low impact movements of the wrist and fingers, such as working on computers or playing guitar. It is also associated with holding one's wrist in a prolonged bent position. The best way to combat CTS is by stretching the muscles and tendons surrounding the wrist as described in the [[Warm-Up Exercises#Stretching|warm-up page]]. You should also be sure to [[Holding the Guitar and Pick|hold the guitar]] in a comfortable position where the wrists are straight as possible.
For more information, see [https://en.wikipedia.org/wiki/Carpal_tunnel_syndrome Wikipedia].
== Tendinitis and Tendinosis ==
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'''Tendinitis''' is the inflammation of tendons, causing pain and joint stiffness. It is often caused by harsh exercise of the connected muscles, such as prolonged activities without rest. For guitarists, the main risk is playing for long periods without taking breaks, using poor technique which forces more stress on certain muscles, over-straining the hands/wrists/elbows rather than using as relaxed grip/movement as possible, and holding the guitar in a position that makes playing more difficult (like slinging the guitar too low).
'''Tendinosis''' is not simply inflammation of tendon tissue but its breakdown at the cellular level, with the typical inflammation absent. As there is no inflammation as in tendinitis, anti-inflammatories are not effective treatment. It takes a long time for the body to repair tendon tissue - recovery requires lots of rest and very gradual rehabilitation.
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== Arthritis ==
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'''Arthritis''' is the wearing down of the cartilage separating the bones in joints. This can be due to a variety of sources, mainly high-stress activities on joints, inflammation, and lack of nutrition/exercise. While not strongly caused by guitar playing (unless holding the guitar terribly incorrectly), it can make playing unbearable. The best way to combat this is to practice good ergonomics in all areas of life and avoiding activities that involve high joint stress. If you do find yourself with joint inflammation, be sure to combat it with anti-inflammatory drugs. And be sure to get enough fatty acids (fish oil) in your diet, or use supplements.
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== Strained/Pulled Muscles ==
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A muscular '''strain''' (often called a '''pulled muscle''') is a tear in the muscle tissue due to overstretching or extreme overuse. It is a relatively rare condition for guitar players; however, it can happen. If playing for long periods of time, doing technically-difficult types of playing, like large stretches, holding exotic chord shapes or large barre chords, playing long fast passages, and extreme picking. As always, you should work your way up to performing technically-difficult techniques or passages. Trying to jump right into things can over-exert your hands and injure them, especially if you fail to [[Warm-Up Exercises|warm-up]]. Cardio to get blood flow to the muscles and stretching will reduce the likelihood that a difficult movement will result in a strain.
== Saturday Night Wrist (Radial Nerve Compression) ==
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Dave Mustaine suffered this injury and basically had to relearn how to play guitar for several weeks before regaining his former technical ability. It is caused by a nerve compression in the armpit/inner upper arm, which basically causes paralysis of the wrist and finger muscles. The "Saturday Night" portion of the name is due to it being associated with getting drunk/wasted and passing out in a chair, with one's arm draped over the backrest.
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== Hearing Loss and Tinnitus ==
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Exposure to loud sound will injure and kill sensitive hearing cells, leading to hearing loss. This can be gradual due to moderately loud sound over many years or immediate due to ''extremely'' loud sound. '''Once the cells are dead, they do not grow back - ''there is no treatment or recovery''.''' '''Tinnitus''' is the perception of sound although none is present, and it often accompanies hearing loss.
Obviously these are serious maladies that all musicians should be very concerned about. The important thing is prevention. Whether practicing or gigging, or even just listening to music, you should use earplugs to protect your ears. This also goes for non-music related activities such as industrial jobs and shooting guns. If you do experience ringing after exposure to loud sound, be sure to let your ears rest before exposing them again - there is a chance the cells are injured and can recover.
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== Bulging/Herniated Disks ==
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|Injury#Bulging/Herniated Disks|Bulging Disk}}
A '''bulging or herniated disk''' is a condition where the lining that surrounds a spinal disk (ring of cartilage that keeps the vertebrae from touching each other) is torn, allowing some of the disk's internal tissue to press against the spinal cord, causing debilitating pain. Often a severe injury cannot heal and requires surgery.
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[[Category:Warming Up]]
[[Category:Injury]]