Pain-Free Guitar Playing:
How to Avoid and Resolve Guitar Injuries

Playing guitar can be painful, particularly if put in long practice sessions. Whether you experience neck and shoulder soreness from guitar practice, aching in your elbow or wrist, or pain in your hand, your symptoms can be relieved with some knowledge and practice.

Start by considering the asymmetrical way we have to hold the guitar. We cave in our chests as we wrap around the instrument. We distort our necks. And when we concentrate, we tense our muscles. These are postures and habits that can lead to muscle imbalances, misalignment, and compressed vertebra. As if that weren’t enough, we risk injury from repetitive motion.

Even the most body-conscious players can fall victim to guitar pain and injury at times. But you can avoid or resolve these problems and enjoy pain-free guitar playing! The following stretches, exercises and therapies are very powerful and may be all you need to quickly recover from your pain. Please keep in mind, however, that regardless of the amount of therapy you receive or the number of stretches you perform, you will continue to experience pain if you continue to injure yourself while playing guitar or in your daily life. If you are experiencing pain related to guitar playing, it is imperative that you learn to hold the guitar correctly and use your body in a balanced manner.

Try any or all of the exercises and stretches below, and be sure to give attention to the last section on the breath. Warming up, relaxing, and breathing deeply may seem insignificant, but they’re game changers. Don’t miss out on these important skills for life-long learning on the guitar!

Arm and Hand Stretches

As guitar players, we’re usually more aware of our arms and hands when we play than we are any other part of our bodies. Use these stretches daily, not only as a warm-up, but also during and after playing. Don’t stop here, though. Most pain occurring in the arms and hands actually has its source higher in the body. This type pf pain can be addressed with exercises that stretch and strengthen the neck and torso.

Stretch the fingers out to avoid tendonitis and the resulting pain. Before playing and every fifteen or twenty minutes, relax the flexors by pulling the fingers of the left hand out to the count ten.

Stretch the forearm by extending the arm out straight in front of you with fingers pointing upward. With the other hand, gently pull the fingers toward your body. Feel the stretch. Next, turn the fingers downward and use the opposite hand to pull them toward you.

Feeling for any tight or painful spots, massage your left forearm with your right thumb, starting at the elbow and working all the way to the wrist. Massage your right arm in the same manner.

Neck and Upper Body Stretches

It’s important to be slow and gentle with stretching. Never force through pain or make sharp or rapid movements.

To stretch the neck, bring your left ear to your shoulder, as you do in the beginning of a neck roll. Instead of continuing through the roll, stay with the stretch for a full thirty seconds. Try to create as much space between the right shoulder and the ear as possible. Really breathe into the stretch.

While keeping the stretch, turn your head toward the floor. Breathe and hold for thirty seconds. Finally, look toward the sky (or ceiling). Hold and stretch.

Repeat the stretches on the other side.

To open the front of your body and stretch the shoulders, stand in a doorway, with your left side close to the door frame and your left foot forward, as if you were stepping through the opening. Bend your left arm 90 degrees at the elbow so that your fingertips are pointing up (think of the classic “traffic cop” position). Rest your forearm on the door frame and gently lean in to a slow count of thirty. Relax and breathe. Be certain to keep your head up and your back straight. Move your forearm up along the door frame until you feel a place that is tight in your body and repeat the 30-second stretch. While you are stretching with your arm high, you can practice your neck stretches.

Repeat the entire process on the on the other side.

Tennis Balls 

Of all the exercises and stretches that I have used to open my body and overcome pain, working with the tennis balls has offered the most profound relief. I have long used the balls to massage my own back and break up tension. Much as I enjoyed the temporary relief they provided in the past, I only recently discovered the deeper value of reclining on them for more extended periods of time. I feel that they are ultimately the solution for the chronically problematic area in my back. (This area is such a common source of pain in guitar players that I refer to it as “the guitar spot”.)

To use the tennis balls, take two tennis balls and drop them into the toe of a long sock. (You will be able to use the top of the sock to adjust the position of the balls during your session.) Place the balls on the floor. Lie on your back on the floor with the balls on either side of your spine and about six or eight inches below your shoulders. With a little experimentation, you will be able to feel the spot that is most beneficial. Let your body fall heavily into the floor and the tennis balls. Breathe deeply and focus on relaxing. You can lie in this position for as long as fifteen minutes for maximum benefit. As in any exercise or therapy, it is important to tune in to your body and follow your intuition.

When you’re ready, remove the balls and rest quietly on the floor for several minutes before rolling up gently. Remain quiet for the time immediately following your session.

Holding the Guitar

It’s a quite a challenge to hold a guitar in a healthy way while sitting. You will find it difficult if not impossible, though, to achieve pain-free guitar playing without achieving consistently healthy posture.

Ideally, we distribute our weight evenly over both seat bones when we sit. This is difficult to manage, however, while keeping the guitar in a reachable position! Although some people prefer to use a guitar strap, supporting the weight of a guitar with your shoulders can cause more pain and injury than sitting asymmetrically. The ideal solution is to bring the guitar to a comfortable height by using a prop (apoyo).  You can also use a footstool to bring the guitar to the proper level, just be sure that you don’t lock into one position and stay there. Also, if you use a footstool, it’s important to do exercises that stretch your hip-flexor to avoid back pain.

The guitar should be held upright and close to your body. By bringing the guitar neck (and, consequently, your left arm and hand) close to your body, you the lower your risk of pain and injury to your shoulder and back. Go to The Basics for a complete written description. For visual instruction, watch the DVD in Getting Started or Comprehensive Guitar, or go to the Virtual Studio.

Healthy Body Use While Playing

While you’re playing, remember to lengthen your spine and to move your body frequently to avoid energy blocks and tight muscles. Remind yourself to breathe deeply from your abdomen.

To keep your arms and hands soft and pain-free (and improve your sound!), visualize your neck and shoulders filled with a warm, liquid light. Let the light pour down your arms, through you hands and into your guitar. When you press on the frets, use only the amount of pressure necessary to produce a clear sound – no more!

Be certain that when you’re reading music you use a music stand and set it at a comfortable height and distance. You don’t want to have to strain or contort your body to see the music!

The most common injuries can often be totally avoided simply by playing a guitar that is properly set up and is suited to your body type. Be sure that your guitar isn’t too large for you. (I recently acquired a parlor guitar that I love to play  and find more comfortable than any acoustic guitar that I’ve owned. I wrote about it – and about playing with small hands – on this page.)

Breathwork

Learning to breathe properly is the foundation for all of the other exercises and stretches. It is also the foundation of health! I can’t overemphasize the importance of doing this work daily, for as long as you play guitar!

Conscious breathing from the diaphragm can diminish or even eliminate pain. It also nourishes, cleanses and alkalizes your entire body, bringing it to a higher level of health and energy. As you progress with your breathwork, your ability to tune in to your body will become more acute and consistent and your capacity for relaxed concentration will improve. And relaxation is key for learning and performing.

When possible, practice breathing while lying on the floor in the constructive rest position. After you’ve become familiar with proper breathing techniques, you’ll be able to practice correctly in a sitting position, as well.

Slow, Abdominal Breathing (Vagal Breathing)

Conscious breathing can stimulate the vagus nerve, enhancing many aspects of your health and helping you move through physical or emotional pain. The following technique is invaluable in managing performance anxiety. It’s also the first step of visualization exercises that are invaluyable for learning or reviewing material.

Begin by placing one hand on your abdomen and the other hand on your chest. Take a deep breath low in your body. Fill up your lower body and feel the expansion. You’ll be able to tell if you are mistakenly breathing into your chest, as your upper hand will rise. Mentally send the breath deep into your body, feeling your lower hand rise with each inhalation. Take several breaths into your abdomen until you’re comfortable with the technique. Then begin three-part breaths, filling first the belly, then the ribs, and finally, the chest. Bring your awareness to your shoulders, allowing them to sink into the floor, away from your neck. Let your lower back relax deep into the floor.

As your comfort level deepens, begin to slow the breath even more. Aim for six breaths per minute and make your exhalations longer than your inhalations. After a few minutes, allow your breath to return to its normal tempo and relax.

Very slowly come up to a seated position and relax quietly for a moment before picking up your guitar or progressing to alternate-nostril breathing.

Alternate-Nostril Breathing

This technique will create energy for your practice session, while allowing you to stay calm and focused. Because it facilitates right and left-brain integration, it’s excellent before guitar practice or performance.

Begin by sitting in a comfortable position. Make a gentle fist with your dominant hand and extend your index and middle fingers, placing them on the bridge of your nose. Place your thumb on one side of your nose and your ring finger on the other, creating a tripod. (If you prefer, you can tuck the index and middle fingers into the palm of your hand.) Close off each nostril a few times, until you feel comfortable and relaxed with the sensation and you’re ready to begin the breathing practice.

Begin by closing off the right nostril and exhaling through the left nostril. Inhale through the same nostril, and then switch sides by closing off the left nostril and exhaling through the right. Inhale through the right nostril and switch sides. Continue closing off alternate sides, always beginning the new side with the out-breath. Breathe from a relaxed abdomen and allow each breath to be slow, gentle and calm. Focus on the sensation of the breath coming in and out of your body and on the energy moving up your spine. If at any time you feel stress, return to normal breathing and try again when you have regained your sense of calm. Continue to practice alternate-nostril breathing for at least two minutes or until you feel that you’ve received the benefits you’re seeking.

The Mind-Body Connection

Your best ally in eliminating pain in guitar playing may be your mind. Your body follows your thoughts, so it pays to understand and work with your thoughts, feelings and beliefs. There are plenty of studies explaining the science behind it, but if the concept is new to you—or if it seems far-fetched—try starting with The Biology of Belief by Bruce Lipton. You’ll be glad you did!

More Resources

A few of the therapies that I recommend include: the  Egoscue Method, Alexander Technique, Feldenkrais, Reiki, biofeedback, massage (including deep tissue massage, myofascial release, cranial-sacral work and more); EFT (tapping), acupuncture, and chiropractic.