How I beat tendonitis

At a workshop in London earlier this month I was asked if I had ever had to deal with any physical problems related to playing guitar, and specifically tendonitis.

Many times over the years guitarists have asked me a similar question, so I have decided to offer an account of my experience with it, for what it’s worth.

Tendonitis, carpal tunnel syndrome and other repetitive strain injuries strike fear in the hearts of musicians. We have all heard  stories of great players in their prime who were no longer able to play — in some cases ever again.

As musicians we want to get better and excel at our craft. That tends to make us push our physical limits in striving to improve — and pushing your physical limits can put you in the zone for a repetitive strain injury like tendonitis.

My path to recovery from a personal crisis with tendonitis may not work for every musician suffering from it. Indeed, it may not work for any other person but me. I was neither a doctor nor a scientist when I was confronted with a scary situation that necessitated a solution. I want to share the story of how I dealt with it.

Many years ago, around 1981, I had a  sudden, acute onset of tendonitis. It affected both hands. It was crippling and painful. And I had no idea what was wrong. As a working musician I was terrified.

At the time I was living outside of Hartford, Connecticut, working on material for my third album. I was broke and had a run of gigs coming up that were needed to pay the rent and the bills for the month.

It was crucial that I be able to play those gigs.

But my hands had swollen up like lobster claws. My fingers looked like thick, red chorizo sausages. They were screaming with pain — whether I played guitar or not.

In a panic, I went to a doctor (I never went to doctors). After looking at my hands and listening to my story, he told me I had tendonitis and would have to stop playing guitar until it went away. The treatment? Take aspirin and put ice on your hands.

I was a jogger in those days and subscribed to a running magazine. There was an article in a recent issue about tendonitis that basically said the same thing the doctor had said: stop running and put ice on the inflamed area. It went on to say there were some things — e.g. minor injuries and sprains — that  you can “run through”, but that you should never try that with tendonitis. The writer added in the last paragraph: “Once you get it, it’s the devil to get rid of.”

Unfortunately, neither piece of advice was an acceptable solution. I had to be able to continue working.

Everyone else I spoke to about it — friends, family, fellow musicians — produced the same look of fear and bewilderment. No one had any advice other than inactivity.

I was afraid my career was over.

The terrifying thing about acute tendonitis is that it can seem to have come out of nowhere. It can be hard to imagine that it could have come from you, or be the result of something you are doing.

As I was in physical agony and the advice I received all around was unhelpful, I set out to be a sleuth and try to figure it out on my own.

First, I asked myself, what have I been doing differently — lately — that could have brought this about?

Well…I had been feverishly practicing a new, difficult, high-speed fingerpicking tune called “Accufuse”.

I was in a state of limbo waiting to find out about a possible record deal.

Winter was setting in. It was cold and the air was very dry, which was causing me to tense up physically.

In general I had been pushing myself hard, worrying constantly about money and career progress.

And then it popped into my head to check my guitar tuning.

It was a whole step sharp.

I had been practicing on over-tensioned strings without knowing it. That was a dangerous thing to do…and probably the trigger for the attack.

A strong case was forming that I had done this to myself.

The next thing was to find a way to treat it.

When I tried putting my hands on ice it did nothing but make them feel numb. The background feeling of tension and quivering weakness was still there.

I asked myself, if ice doesn’t make my hands feel better, what would make them feel better?

I had noticed when I took a shower in the morning that the hot water felt good on my hands.

I went into the bathroom and ran hot water over them. It felt wonderful, made my hands relax, and reduced the pain.

So my therapy would be hot water, not ice.

Over the next few days I filled up the bathroom sink with the hottest water I could stand and immersed my hands in it for several minutes whenever the weakness and pain started.

After several days I began to feel my hands coming back, and with it an insight into what I had been doing — or overdoing — that had brought me to this place.

After several more days of self-administered hot water therapy I resumed practicing in micro bits — one minute the first day, two minutes the next day, five minutes the third day — paying attention to what felt good and what didn’t, how my hands were feeling generally, and what I was asking myself to do physically. As soon as my hands registered any feeling of fatigue or pain, I stopped and headed straight for the hot water.

For the shows coming up, I concluded that over-practicing at home — not performing shows — had caused this. Maybe if I continue the hot water therapy and kept the practicing to an absolute minimum, I could get through the shows.

My plan would be to immerse my hands in hot water before going on, play the gig at the most relaxed, undemanding pace I could, and then return my hands to the hot water immediately afterwards.

But what if I was wrong? What if this pushed the tendonitis in the wrong direction? What if I physically failed on stage? I would just have to see what happened.

To my utter shock, the first show went great. I was able to play, and not only that, it felt wonderful to play again. I was amazed to observe my hands playing normally for an audience, and without any pain.

From this I learned that there was a huge difference in the way I was using my hands, body and muscles when I performed versus when I practiced.

After the show, my hands actually felt better than they had in weeks.  Stronger, more relaxed, less inflamed. My hands — and tendons — seemed to have no problem playing music in front of an audience.

It was my practicing — or the way I was practicing — that was causing the tendonitis.

Subsequent gigs went the same way. My hands felt better and better with every gig. The swelling and the redness were disappearing.

I had played myself into the problem. Now, through becoming aware of what was going on and communicating with myself physically, I was playing myself back out of it.

It was an empowering discovery that the way back from tendonitis was not to stop playing, but to work with it and keep playing.

The entire ordeal from onset to full recovery lasted about six weeks.

Looking back, I realise that I solved the problem myself because I had no choice. There was very little useful information or research available at the time. In desperation I decided to listen to what my hands were telling me and use my intuition to support what they told me they needed…which was, in the end, for me to pay closer attention to what I was doing when I was practicing.

Getting rid of tendonitis was not about giving up playing guitar. That would have been a disastrous choice. Stress, fatigue and over-practicing had brought it on. Finding my way back had everything to do with changing how I was communicating with myself and the kind of energy I was putting into my hands.

Tendonitis is a tricky condition, intimately connected to your emotional state as well as your physical behaviour while playing your instrument.

I have felt the beginnings of tendonitis coming back multiple times in the decades since. But now that I know the warning signs, I know what to do — and what to stop doing.

Bringing awareness to it always makes it go away.

If you have made it this far in this post, then here is some parting advice:

Never give in to tendonitis. Yes, once you get it, it must be carefully babied. But remember that it’s you who created it, one way or another. And it is you who can make it go away…by communicating with yourself.

Do you have a tendonitis story?

If so, how did you deal with it?

What advice would you offer to others?