Avoiding hand and wrist injury when playing guitar – part one

I’m talking about the right hand here (or left hand if you’re a South Paw) and injury management and remediating a playing style that has brought about injury is something I have first hand (ahem, ‘scuse the pun) experience of. Yup, I have experienced the pain and annoyance of an injured wrist, with carpal tunnel syndrome type symptoms. I also have experience in successfully remedying the situation – phew!

English: Transverse section of the wrist. Base...
English: Transverse section of the wrist. Based off Gray’s anatomy diagram of the same. (Photo credit: Wikipedia)

What I’ve learnt and then implemented (and then helped others with subsequently) is that your seated posture with your guitar is so very important, as this then influences the position of your right arm and hand in relation to that.

Problems can begin to arise over time where the wrist is being cramped up and squished up (technical term there) frequently over time. And this tends to occur if you’re playing with your right hand more or less at 90 degrees, or a similar angle, to your forearm. There are other influencing factors, but we’ll talk about those in other blog posts.

Some people seem to manage playing in this way without trouble. However, talking from my own personal experience, other teachers and a number of students that come my way, this is not the case for a significant number of guitarists.

One of the first steps in remedying that tingling, pins-and-needles, numb and often painful feeling in the wrist, thumb, palm and/ or fingers is to reposition yourself so that your hand and forearm are more or less in a straight line. It doesn’t have to be perfectly, ruler straight, but should be more straight than less so, most of the time.

Think about it – the wrist is not a massive space. This is the passageway that connects your forearm and your hand, with bone and connective making up its structure and a whole heap of tendons and nerves passing through it. Squishing up that area with a flexed 90 degree type playing style with your right hand is (a) going to make the fingers more difficult to move in the first instance as the tendons are not able to move as freely as they might otherwise, and (b) impinging on these tendons and nerves in this way over time – frequently, regularly and consistently (and with tension involved – but we’ll talk about that later) is going to increase the likelihood of inflammation, entrapment and compression. This can then lead to pain, pins-and-needles and weakness in the wrist, hand and fingers, which can then lead to reduced playing ability and in the severest cases may mean you need to stop playing altogether – not good!

Playing with a more open right wrist, facilitated by keeping a straighter line between hand and forearm, will set you on the path to remedying an existing situation (as it did with myself). Even better, if you’re just setting out on the path of learning to play the guitar or picking it up again after a hiatus, instil this as your “situation normal” way of playing from the outset. It will make things a heck of a lot easier and  a lot less painful instilling this as a new hair rather than undoing the painful and potentially debilitating alternative.

* NB – this blog post doesn’t in any way represent any medical advice and if you have pain you should always seek medical attention.

Posture for playing classical guitar

Getting your seated posture sorted for playing is pivotal to physically enjoying your playing, reducing the chance of overuse or incorrect use injuries and ensuring the longevity of your playing. You really don’t want to end up 10 or 20 years down the line being forced to play only in small goes or being forced to stop playing at all. It’s worth taking the time just to slow down or stop and assess your posture.

Portrait of an articulated skeleton on a bentw...
Sit up properly! Photo credit: Powerhouse Museum Collection

Big to small

When looking at posture I always work from the biggest structures first (i.e. the larger body parts or muscles) before then moving thought to successively smaller elements. Getting your overall seated position needs sorting out before moving on to the movement on the hands and fingers. Your seated position and posture is the framework, the basis from which you’re building your playing and your finer movements.

Building a good solid base for yourself, a bit like practicing your daily scales, is key to much faster, or rather much easier progress, down the line.

Pointers on posture

When seated make sure your legs are bent at roughly 90 degrees, with both feet flat on the ground. Then holding the guitar (using either your preference of foot stool or rest), make sure that your back is straight, using your stomach muscles to help keep that nice straight form. Sit towards the front of your seat; don’t sit too far back on the chair or lean on the back of the chair.

Think about tucking your tail bone under your bum. Lengthen your spine by imagining you’re a puppet with a string attached to the crown of your head keeping you upright.

Legs

Whatever your choice of foot stool versus guitar rest (and I recommend rest as I believe it reduces adverse impacts to the hips and lower back) ensure that your left foot, knee and shoulder are all aligned – no knee or foot sticking out to the side. This neutral position is the most natural and ultimately comfortable position to play in. With the right leg, bending this in at a similar angle, or even slightly closer to the chair acts as a stabiliser rooting you to the ground and creating a solid playing position.

One key tip, passed on to me by the great Phillip Houghton that I in turn pass on to my students, is a non-slip mat on my right leg where the body of the guitar contacts with my leg (of course, swap that to left leg if you’re a left-handed player). This helps to stabilise the guitar, make it feel really solid and in control, particularly if your guitar is heavy (as some of the newer style lattice braced guitars are) or you’re wearing potentially slippery clothing. The grip of the mat takes a bit of the tension away from your right arm in pinning the guitar back or limiting the guitar’s movements.

Arms

Your right arm should be soft and heavy, positioned over the bell of the body, with just the minimal amount of tension through it to hold that relaxed form. The feel is almost as if you’re embracing the guitar. Just be careful though not to drop and round the shoulder; hold your form through the shoulder joint too.

With the left arm, also be careful not to drop the shoulder and ensure your wrist is nice and straight, and in line with the hand and arm most of the time. Movement to reach the strings should primarily come from the shoulder in a vertical pivot like movement – make use of this big muscle group, rather than putting undue stress and strain on the smaller muscles of the wrist and lower arm.

Similarly when moving up and down and around the fretboard, use you shoulder as a horizontal pivot. Use the bigger muscles to do the majority of the work. This is what the shoulder is designed for and you’re really going to protect yourself from carpal tunnel syndrome type symptoms this way. I should know – I learnt the hard way on this and went through a long journey of correcting my previously poor technique.

So the key, “take home” message today is to make use of the body’s natural movements. Use leverage by using the biggest muscle groups to carry out the bulk of the work – that’s your back muscles, shoulder and arms – before moving on to think about smaller movements from the hands, fingers and thumbs. Movements are not massive either, probably much less than you’d think.

And relax!

Here’s a great You Tube clip I found on setting up your posture that may also help….