Name a way to hurt yourself playing the guitar, and I've probably done it. Twice. From inflamed and dislocated tendons to neck injuries to carpal tunnel to lower back problems to dislocated knuckles—in my forty-plus years of guitar obsession, I have spent a lot of time on ice.

As I've gotten older, these injuries have become much more inconvenient, and the recovery time has more than doubled for most of them. Not cool, ice notwithstanding. So what's a girl to do? Lucky for me, I found a guy by the name of Dr. Douglas Dennis, chiropractor and author of the ironically named (and sadly out of print) DVD, How to Avoid Your Chiropractor. I go into his office, whine, he laughs, and goes yoink—suddenly it doesn't hurt anymore. Then he tells me what to do so I don't have to come back and see him again. Ah, yes, there's the key—tell me how to do what I do safely, so I don't do this to myself anymore.

“When you’re playing—whether for pleasure, money, or anything else—it’s a job. And once you realize that you need to work out your body in order to build up stamina, balance, and endurance, you’ll be able to do it longer with fewer injuries,” says Dennis.

So in the spirit of keeping us all healthy and gigging as long as possible, Dennis and I (along with the help of models Byrn Paul and Lucy Campie), will explain the science behind the injuries and the exercises you can do to prevent and treat them. While you don’t need to do the exercises every day, taking some time to stretch on the days you’ll be playing a lot will help you do so with minimal pain. Keep in mind that most of the examples have right-handed players in mind—just reverse them if you’re a lefty.

But First: Why We Get Injured
Guitarists’ injuries typically occur because we overuse certain muscles. Explains Dennis, “Muscles that have one action have an opposing action, so if your fretting-hand is your left, you're gripping with your fingers more than you're extending with your fingers. The grip muscles, which are in the forearm, are going to get too tight. This will tend to give people carpal tunnel injuries or possibly elbow injuries, because of the gripping action. These ‘flexion’ muscles are too tight, and the ‘extension’ muscles are too weak.”

This phenomenon extends beyond the hands and throughout the body. If you repeatedly stand with one leg in front of the other, the muscles in the front of the front leg get tight and the back of the front leg get weak, and vice-versa for the back leg. “So if you’re standing in a stance with your left foot forward, right foot back, and turned slightly to the left,” explains Dennis, “assuming you’re a right-handed guitar player, you’re going to have an imbalance in the pelvic muscles, and an imbalance in the forearm muscles on the left side.”

Exercises:
-Overextensions: Shoulders and Forearms
-Chest and Shoulder Tightness
-Hands and Fingers
-Leg and Back Pain for Seated Guitarists
-Neck Pain

Overextensions 
Overextensions will occur when playing for too long, or playing an instrument that is too big. Personally, I’ve experienced this in my right shoulder where I’d lose feeling in my right hand after playing a little while. Dennis explains that when a person plays guitar, their forearm is down and the shoulder is rotating in. Instead of being in a notch in the humerus bone, the short head of the bicep tendon (on the inside of your shoulder) flips outward. 

How do you fix that? Dennis says, “Hold your elbow in with your arm turned to the outside, and lower a weight out as you’re lowering that arm down with your arm turned to the outside—this actually pulls that tendon back into place.” 

To illustrate, Lucy uses a Thera-Band Soft Weight to pull the bicep tendon back into place: 



How to do it:

• Hold the elbow of your picking hand against the side of your body with a round, light weight in your hand held up near your shoulder, forearm turned toward your body.
• Holding the weight, extend your arm slowly until it is extended fully, keeping the elbow near your side and your forearm facing out.
• Repeat.

Sore Forearms
In addition to using a weight, guitarists can use a simple, non-weighted stick (think dowel or broomstick) to relieve soreness in the forearm. Dr. Dennis explains, “With the forearms, your left forearm is rotated out while your right forearm is rotated in, so that the muscles that rotate your right arm over (pronation) are going to be tighter than those that turn it out (supination).” To fix that imbalance, just grab a two-foot-long stick in the center and flick it back and forth about 20 times. 

To illustrate, Lucy flips the stick back and forth several times: 



How to do it: 

• Hold a two-foot, non-weighted stick in a closed fist with your arm flat against your side, your elbow at a 90 degree angle, and your forearm facing down.
• Rotate only your forearm 180 degrees, so your fist and forearm are facing upward.
• Repeat at a brisk pace for about 20 rotations, then switch hands.

Tight Chest 
Of course, if you’re sitting at a desk all day and going to play guitar all night, you have double the aches and pains to contend with. Almost everybody—guitarist or not—suffers from tight muscles in their chest, in comparison to shoulder muscles. “When we were running through the forest from ‘lions and tigers and bears, oh my,’ we were using those muscles, pulling our shoulders back. We never use those today,” says Dennis. Chest problems can be amplified for guitarists who play turned in at a slight angle, as the ribs may sit higher on one side than the other. 

“When people have a lot of pain in their upper shoulders, it’s usually because a rib has gotten twisted down on the front and up on the back,” Dennis explains. He suggests a simple stretch that can be done anywhere with a doorway. 

Place your hands on a door frame at shoulder height, with your feet about a foot back from the doorway, and lean in. Do this stretch four or five times. 

After that, raise one hand up about a foot and the other down a foot and lean forward, so that you’re stretching the upper part of the pectoralis on one side and the lower part on the other. Do this four or five times, then switch your hand positions. After stretching four or five times in the reverse position, raise both hands up about a foot and lean forward four or five times. “By stretching like this, it stretches the muscles and uses them to actually pull your ribs up on the front,” Dennis explains, “and it relaxes the muscles on the back.” 



How to do it:

• Stand in a door frame with your feet about a foot back from the doorway and your hands each at shoulder height.
• Lean into the doorway and back four or five times.
• Raise your right hand up about a foot on the door frame, and lower your left hand about a foot.
• Lean into the doorway and back four or five times.
• Reverse the positioning of your hands (right hand a foot below your shoulders, left hand a foot above).
• Lean into the doorway and back four or five times.
• Raise your lower hand to be even with your upper hand (both hands on the door frame about a foot above your shoulders).
• Lean into the doorway and back four or five times.

The final step, which we’ll call “door frame pull-ups,” will then strengthen the shoulder muscles. Byrn illustrates: 



How to do it:

• Stand in a door frame with your feet directly in the doorway and your hands holding the door frame at shoulder level (palms facing back—your hands will be supporting your weight as you lean backward).
• Extend your arms and lean backward, then pull your body back toward the door frame.
• Repeat four or five times.

Hand Muscle Stretches
“If you want to work the extensor muscles [in your hands], I tell people they need more broccoli,” Dennis says. Likely responding to my quizzical expression, he elaborates, “Get the broccoli, take it home, and take that rubber band off that holds the bunches together. Then throw the broccoli away, and use the rubber band for an extension exercise to strengthen the muscles that extend your fingers.” Byrn demonstrates stretching the band: 


How to do it:

• Find a heavy rubber band, like those that wrap produce in the grocery store.
• Bring your fingertips together and put the band over them, resting it loosely on the fleshy area between the fingertips and joints. 
• Spread out your fingers as far as you can against the resistance of the band, 10-15 times.
• Switch hands and repeat.

Another exercise that will be beneficial to your hands is one that applies to those with carpal tunnel as well—so if you spend most of your non-playing time typing and clicking, pay attention. You can use a Thera-Band Soft Weight for this, by extending and flexing your wrist to stretch the area affected by carpal tunnel. 

“If you stretch against resistance like this, it helps to line up the molecules in the tendons and muscles in the right fashion so they’ll heal—lined up the way they’re supposed to be,” explains Dennis. 

Byrn demonstrates using the Thera-Band Soft Weight to prevent carpal tunnel: 



How to do it:

• Hold a small round weight, like a Thera-Band Soft Weight, in your upward-facing palm. Your forearm should be facing up and parallel with the floor.
• Roll the hand holding the ball from each extreme of its extension forward and back without turning your forearm 10-15 times
• Repeat exercise for the opposite hand

Leg and Back Pain for Seated Guitarists 
Some guitarists who perform seated have their own host of pain problems. This is another area that can be improved on by stretching the muscles in the front (as shown in our third example) to strengthen the muscles in the back—and keep your shoulders from rolling forward and putting additional strain on your back. Says Dennis, “The straighter your spine is, the less strain you’re putting on your muscles—so sitting straighter by stretching out these tight muscles will help you sit up straighter for longer periods of time without putting a strain on the back.” 

But the back and shoulders are only part of the equation. A right-handed player seated in a chair will tend to turn, with their left leg up and out, and the right leg down and back. This repeated position causes one leg to be stronger in front, while the other is stronger in back. Starting to sound like a recurring phenomenon? This can pull the pelvis out of position, as well as the lower lumbar vertebrae. 

Stretches for leg pain can be as simple as stretching the quad on the weaker leg by pulling your knee up toward your back. In addition, you can pick up your weak leg further as you’re walking, or put a 1 or 2 pound weight on your weak leg’s ankle. These activities will strengthen the quad, which is important because, Dennis says, “We use this muscle to pull your pelvis back where it’s supposed to be.” You can determine the weaker quad by attempting to resist pressure placed on your knee in a sitting position. He adds, “You don’t have to stretch the hamstring and quad every day, just every day you don’t want your back to be out of position.” 

How to do it:

• When seated, have a friend press on each knee, one at a time, as you try to push their hand up with your leg. It should be easy to determine your weaker quad.
• Stretch the weaker leg by standing, bending at the knee, and pulling the knee back toward your back—a typical runner’s stretch.
• Incorporate strengthening into your daily routine: pick up the weak leg further when waking, or wear a light ankle weight.

Neck Pain 
“If you turn your head to the left all the time because you’re looking at the frets, you’re more likely to turn a vertebrae in your lower neck and get it stuck to the right, which is going to make all the muscles in the right shoulder weaker than the muscles of the left,” says Dennis. Stretch your neck by turning your head to the right. 

Dennis also recommends stretching in the “child’s pose,” which stretches the lower back and strengthens the neck. Lucy demonstrates: 



How to do it:

• Begin by simply turning your head fully in the opposite direction you normally look. Bring your head back to facing forward, and slowly repeat the stretch.
• Stretch in the “child’s pose” by sitting on the floor on your knees and your bottom resting on your heels (shins flat against the floor). 
• Stretch out your arms and lean as far forward as you can with your back, while keeping your lower body anchored and your neck straight—your head should be “floating,” not bent down and resting on the floor.