Managing hand pain: should you push through it?

We’ve all heard the old adage “no pain, no gain”. It might be the right mindset for the gym. But when it comes to playing music, pushing through pain can cause chronic problems. If you’re serious about learning to play well, it’s important to be able to distinguish between normal “growing pains” and something that might be more serious.

Your susceptibility to pain and strain depends on a number of things, but it starts with how much you play. Some people get lost in their playing and look up to find two or three hours have gone by. That’s fantastic for developing your skills, and that kind of devotion to the instrument is a must if you really want to play well.

But playing music is physical, and often involves intricate and highly controlled muscle movement. These muscles are made for facility, not stamina. It takes time to build up the coordination and strength to be able to play for long stretches. This is one of the reasons why an organized practice routine is so important, in that it lets you plan your “workout” the same way you might at the gym. The difference is, you really don’t want to be sore the next day.

Here are some of the common places people feel pain from playing, and how to manage it. Keep in mind that my experience is anecdotal, and I’m not offering medical advice. If a problem persists or you have any question about the seriousness of what you’re feeling, ask a doctor.

1. Fingertips

Most beginners find that their hands get tired or even sore. For a complete beginner or someone who hasn’t played in a long time, pain in the fingertips can be an issue. Building up calluses on the fretting hand takes time and the fingertips can become very sensitive. Even if your calluses are well-developed, periods of more intense playing can leave you with sore fingers. This is a common issue but not a serious one, and it gets better over time.

2. Fret hand thumb

A perfect player with ideal technique on a perfect instrument would never apply any pressure with the fret hand thumb. But regular people do, and beginners and near-beginners tend to push much too hard. This can make the thumb sore at the first joint or at the base, depending on the proportion and shape of your hand.

For most people, adjusting the position of the thumb will relieve some of the pressure. Your hand position should naturally create leverage against the neck; this is usually best achieved with a level, relaxed wrist and curled fingers. But because both hands and guitar necks come in different shapes and sizes, there are always variables.

 

If you’ve ever been told to just push harder, put that thought out of your head for good.

You can almost always make an adjustment to your hand position that will produce more leverage. Start with a level wrist, palm up, and bring your hand to the strings. Let your thumb fall wherever it feels natural. Feel the strings with your fingertips and move the hand around a little to feel how the weight of your hand and arm help hold the string against the fingerboard. If you feel any strain, go with it…allow the tension to release and see what happens. The thumb might lightly rest against the back of the neck, or it might wrap over the top. Trust your body’s feedback and find the position that feels most relaxed and balanced.

If you’re really working hard no matter what you do, your guitar might need an adjustment. Heavier strings and higher action produce a bigger sound, but if you need to really grip to hold them down you should switch to lighter strings or lower the action (height of the strings relative to the fingerboard). Your guitar should be set up to be as playable as possible, while still giving you the sound you want.

Keep in mind as well that your picking hand approach has a huge impact on the tone. If heavier strings are too much work but lighter strings feel too thin, lighten your attack. Minimizing work and effort from the picking hand helps lighten the fret hand as well.

If you have minimized fret hand effort and set up your guitar and still have pain in the joint or at the base of the thumb (especially when you’re not playing), it might be a sign of a more serious issue you should look into.

 

3. Wrist and arm

Pain in the wrist or forearm is potentially more serious. Gripping with the fret hand can make the muscles in the wrist and forearm compress as well, and over time this compression can lead to chronic tension and pain. Many people work too hard when strumming or picking, and overwork the muscles of that arm as well. This can lead to chronic inflammation and, in the worst cases, tendinitis or carpal tunnel syndrome.

If you feel pain in the wrists or forearms when you practice, stop. Take a good look at your hand position to see if you can minimize the effort. If you overdo it and get sore, anti-inflammatory meds like Advil can help. A cold pack or heating pad can really help, just like you would use on any other sore muscle. Some people respond better to one than the other; your body will tell you what works best for you. If pain doesn’t improve after a few days, or becomes chronic, you may want to see a professional. See a doctor if you feel you need to; you may need physical therapy or in worst cases, corrective surgery. There are many other treatment modalities that have proven to be helpful. Massage therapy, Active Release Technique (a form of hands-on physical therapy), acupuncture, and chiropractic can all be beneficial.

 

If you do ever develop a chronic condition, there’s a very good possibility you will need to make some adjustments to your technique.

Hopefully, you’ll never have to deal with any of these problems, or need to fully revamp your technique. It’s not easy to alter the way you play: both good and bad habits become fixed as the movements lock into muscle memory. But whether you’re dealing with a problem now or looking to prevent one, muscles can be trained to develop new ways of working.

 

Minimizing the risk of pain and injury

1. Have your instrument set up to be as playable as possible.

2. Evaluate your technique and cultivate a relaxed, efficient hand position.

3. Be aware of posture. Guitarists tend to slouch, which exacerbates all these problems. Fighting it is a life sentence.

4. Take frequent breaks when you practice, or split your practice sessions up across your day.

5. Stretches and warmups can really help, but only if you do them right. It’s easy to overdo it, so pay attention to your body.