Can I learn to play guitar with carpal tunnel?
August 3, 2017 10:18 AM   Subscribe

I'd like to learn how to play the guitar, but I have carpal tunnel and would like to know if it would be possible for me to learn to play without exacerbating my condition.

I've had carpal tunnel for several years, I think it was affected by drawing a lot with poor technique and by pregnancy. I found that wrist braces mostly take care of the problem; I wore them constantly for a year and ever since then I've worn them to sleep. My symptoms now are mild: holding a pen or pencil and writing for more than a few minutes makes my thumb numb, and if I hold something too tightly in one position for too long, such as an umbrella handle, my hand can feel numb. But on a day to day level, as long as I avoid doing those particular things and wear my braces I don't feel any pain or numbness.

I'd like to learn how to play the guitar, but I'm worried that I'll put time into learning it only to find that it makes my hand numb. I know nothing at all about guitar playing. If I take the time to learn proper form from the beginning, am I likely to be able to play? Or are the movements involved similar to the ones I've described that cause problems for me? Should I wear wrist braces from the start? Are there any adjustments I could make to avoid numbness? Is there anything in particular I should look for in a teacher, besides asking if they have experience with carpal tunnel?

I have dreams of taking my guitar out to the beach and playing and singing with my kids... but I'm so anxious that I'd make my carpal tunnel worse that it's been paralyzing me and I haven't been able to start finding a teacher or learning more about how to play. Thank you for your advice!
posted by shirobara to Sports, Hobbies, & Recreation (8 answers total)
Pedal steel instrument? Or learn slide technique?
posted by Freedomboy at 10:33 AM on August 3, 2017

I was also going to suggest steel (lap/pedal/console) as it favors a straight wrist. But it is not really a beach/campfire singalong with the kids kind of instrument. Perhaps try ukulele. Inexpensive, much easier on your hands than a guitar, and it will be way faster to learn enough to meet your objectives.

Just remember to keep your wrists straight (it's not natural at first--you need to pay attention) and not use more strength than required. Many musicians, trained and untrained, use waaay more effort than they need to.
posted by quarterframer at 11:35 AM on August 3, 2017 [2 favorites]

I think you really need to talk to a specialist. Carpal tunnel is very much an issue for guitar players and other insturmentalists, and there must be doctors or physical therapists who specialize in their issues playing, or returning to playing after diagnosis and treatment. Consulting with such a person seems like a good idea.

On the guitar side, proper technique is going to be really important to avoid making your CTS worse, and I think you should try to find a guitar teacher who is aware of teaching correct playing with reference to avoiding overuse injuries.

on preview:
Just remember to keep your wrists straight (it's not natural at first--you need to pay attention) and not use more strength than required. Many musicians, trained and untrained, use waaay more effort than they need to.

......that's about the sum of what I know about safe technique, and those are both extremely important points
posted by thelonius at 11:38 AM on August 3, 2017

I'm not a doctor or guitar teacher, I've not had carpel tunnel, and the person I know who has, never tried to play the guitar. So take what I say in that context.

I play. Holding tightly could be a challenge for your left hand, where you will need to finger chords. Until you build finger strength, it can be very tiring and beginners often feel as though they must grip very tightly to compensate. But with the right technique (I was taught to curl my fingers as though holding an egg), your wrist is held straight and should take relatively little stress.

Your right wrist will be under even less strain, especially for the "strum-and-sing" scene you envision. The action in your right arm is mostly from the elbow. Playing with a wrist band on that hand is quite possible.

But I agree with quarterframer that your choice of instrument may be key. A uke would be a much less expensive route to the same goal of fireside singalongs, with less chance of strain due to its size. The strings tend to be "gut" or nylon, rather than steel, which is easier to finger, especially as you are learning. If you're game to try, that may be the best place to start.
posted by peakcomm at 11:48 AM on August 3, 2017

Thanks to everyone for the answers so far! I forgot to mention in my question that I'm left handed; both hands and wrists have issues but it's slightly more severe in my left hand. Just in case that makes a difference.
posted by shirobara at 12:06 PM on August 3, 2017

If you set up your guitar left-handed, you'll be strumming with your left hand, which may be less of a strain. You actually have a choice to make on whether you want to play lefty or righty. One way will likely be more comfortable, hopefully obviously so.

I agree that nylon strings are the way to go. There are a ton of cheap student guitars that are perfectly fun to play and learn on. Consider going without a pick, at least in the beginning.

I don't see a problem wearing the brace with your strumming hand, but on your fretting hand it will probably be in the way, unless you can use a sports brace that gives you a little more flexibility.

If fingering chords in standard tuning turns out to be too difficult, you might consider learning an open tuning like DADGAD, especially if your goal is to play folksy-like music.

(*guitarist, not a doctor, not a carpal sufferer)
posted by RobotVoodooPower at 3:15 PM on August 3, 2017 [1 favorite]

(On preview... yeah I didn't mean to turn this into an essay! But I apparently have a lot to say about it, so I hope this helps.)

Hi shirobara - while I'm no expert on the subject, I can tell you about my experiences. I had carpal tunnel syndrome (thankfully not severe) for a few years and played guitar during those years -- not as a pro musician or anything like that, but fairly regularly for maybe an hour or so a few days a week.

This was back when I was a student many years ago and was on the computer for hours and hours at a time, and also took weekly classical guitar lessons (which involved pretty concentrated practicing). I had pain shooting up my arm when grabbing a doorknob to open it, or when holding a pen or fork, or clicking a button on the mouse, or typing, etc. Eventually after graduating and stopping lessons and being more careful about how I used the computer and mouse, I haven't had to worry about it as much as I did. (For me the mouse was/is the worst aggravator, so out of necessity I switched to using the mouse with my non-dominant hand, and I customized as many mouse settings as I could to avoid having to double click or hold down a button too long.)

But yeah, during that period, I wore wrist braces all the time; then like you, only when I was sleeping; then occasionally only if something flared up again; then later (and now), not at all.

I wore at least one wrist brace for a while when playing (even to the lessons): on the more affected hand/wrist, which was my dominant (right) hand. My guitar teacher was totally fine with me doing this -- I made sure to explain what my limitations were, and he helped me with techniques to minimize stress to the hand. I took a lot more small breaks than usual (this is really important). Sometimes if I couldn't play something with the brace on, I would take it off and rehearse for a bit, and then put the brace on again later. Maybe you can try leaving off the brace on your right hand, since that's not as severe, and start with a brace on your left hand.

I also agree with the suggestions above about the nylon string-guitar (usually the bass nylon strings will be wound with a silverplated copper). It will also help a lot if the strings don't have as much resistance, so definitely avoid "extra high tension" strings. I would suggest "normal" tension strings to start, such as D'Addario EJ45 strings. There are also "light" tension which are even easier to play. The sound will change though and might be "thinner" sounding. YMMV.

Ideally, the guitar should have a nut width of 1 3/4" (this is roughly the width at the top of the neck/fingerboard -- the nut is the slotted thing where the strings pass through the notches on their way to the fingerboard). I think most, if not all, classical guitars will fit the 1 3/4" nut width. The reason I think the width is important is because it really helps to have a wide fingerboard and every little bit of space helps. I remember having more difficulty playing a guitar with a thinner neck (1 11/16") because my hand would cramp up more.

Classical guitar technique includes learning to sit properly, paying attention to placement and positioning of not only hands, but arms, shoulders, legs, etc. There's a little foot stool you can get to raise your leg to the correct height for your body and support the guitar, which should help with the wrist too.

Even if you're not interested in classical music, I think it would be something to consider doing, at least to learn the basics and get familiar with playing guitar. Once you have the basics down (sitting, resting your hands when practicing/playing, chords, etc) you can use what you've learned and play other music. I played a lot more of non-classical styles, but I'm glad to have learned proper form and techniques on how to take breaks with my hands as I learned a piece so I don't strain them, and also how to read music for guitar (which I've mostly forgotten unfortunately, but that's beside the point).

You can get a sense of the positioning from the wikipedia article above, or online classical guitar resources or youtube videos, but unlike an actual teacher, those resources can't see you and make adjustments to your arms as you're playing. :)

If plucking the strings with your left hand is too painful (even with the brace), then you could look into getting lessons from a classical guitar instructor who'll focus on teaching the basics without the fingerstyle part, and substituting strumming for fingerstyle (if you're more comfortable with just strumming).

I think I'm getting a little ahead of myself though --if you know someone with a nylon-string guitar, can you borrow it for a bit? If not, can you go to an instrument store that sells guitars, and try just holding some classical guitars. Look at the guidelines for the classical guitar position, and try to hold the guitar that way (remember to keep your shoulders, arms, and wrists loose as much as possible). Use books or something as a substitute for the footstool (a good music store will let you try one in-store). The goal is to find out if your wrists can handle holding the guitar comfortably or if you get red flags right away. Since you're left-handed:

- Hold the neck with your right hand (fairly loosely -- as much strength as you need but watch out for your right thumb and avoid using a death grip) and press down on the strings gently in various combinations: four fingers in a straight line, three fingers, forefinger and ring finger, forefinger and middle finger, middle finger and ring finger. See if it's painful without a brace, and with a brace.

- Hold the neck steady with your right hand (just comfortably), and try plucking the strings with your left hand, using each finger gently, to see if that's okay. (Again, with and without brace.) One way to experiment (and this is just seeing if it's comfortable or not): you can lean your right/pinky fingers (or just pinky) lightly against the guitar, and use your thumb to pluck a string (direction away from you), then using your forefinger to pluck a string toward you, then middle finger. Then lift your left hand away from the guitar and do the same thing without leaning your ring finger/pinky on it, and also try the ring and pinky fingers. Don't worry about feeling uncoordinated -- just see if you get any warning signs from your wrist when you do this.

- Hold the guitar and strum the strings with the hand (with and without brace). You can do this a few different ways: lean your left hand light against the guitar like above, and use your thumbpad to strum down across all the strings (moving away from you). If your thumb doesn't like that, you can strum with the other fingers instead: lift your whole hand and keeping your 2-5 fingers together, strum across all the strings using the backs of their fingernails.

- Find out if you're okay with holding a pick (with and without brace). This one might be tougher with the carpal tunnel, but there are a LOT of different types of picks, and you might be able to find one that works for you. Ask to try out a bunch at a store -- wear a wrist brace and you won't even have to explain too much why you're trying out picks. Hold each pick (usually between thumb and forefinger, for a flat pick) and see what is the most comfortable for your left hand. Strum the strings up and down with the pick (forget about what it sounds like). Are you able to hold the pick comfortably after a while? There are the traditional flat picks, but I recommend looking for the larger size picks which will be easier to hold. There are also picks that have grippy surfaces. Also try out thumbpicks -- you can slide one over your thumb so you don't have to press to hold it as much as a traditional flat pick. If you're not comfortable with holding any picks, not even thumbpicks, then probably avoid them and stick to strumming without a pick for now (that is, if that is okay for you).

- Then try the above steps on a ukulele, maybe a larger one if you can find one.

Anyway, since your dream is to play guitar, I say try it! I think it'll be really obvious to you if it's too much -- your hands/wrists will tell you, and you know them better than anyone. IANAD and this is definitely not medical advice (and it may be terrible advice), but if you can play for like 15 minutes before things start getting uncomfortable, I think it might be possible to play -- you just stop at 15 minutes (or a little before that) and try again the next day or two. During lessons, you don't have to play for a long period of time anyway. The initial period of training your fingers will be the hardest but once you're past that, it'll get easier. Good luck and feel free to MeFiMail me if you want to talk more about this off-thread.
posted by rangefinder 1.4 at 1:24 AM on August 8, 2017

One thing I forgot to cover: the guitars at the stores / borrowed from friends may have high tension strings on them; it's tough to know unless someone is familiar with string tensions. If the strings are too hard to work with and nobody can confirm they're normal or light tension strings, I wouldn't give up. You might have luck contacting a local classical guitar teacher (maybe at a university near you) or a good guitar shop to explain you really would like to play guitar but aren't sure if you can literally play with your carpal tunnel, and if they can help with you trying a classical guitar with normal or light tension strings. Or they might know someone who can help.
posted by rangefinder 1.4 at 1:36 AM on August 8, 2017

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