I've been playing guitar (both electric and acoustic) pretty seriously for about a year, 2-3 hours a day most days. I couple months ago I developed tendonitis in my fretting arm, which my doctor diagnosed as lateral epicondylitis, i.e. tennis elbow. My doctor predictably recommended laying off guitar for a while, using a compression bandage, icing it, taking ibuprofen, that sort of thing. I didn't see a specialist or physical therapist so the advice was sort of general.

I did more research on my own and found this article which describes a simple exercise that does eccentric loading of the tendon and is supposed to be great for this sort of injury, and it's been helping over the past few weeks. I do that plus daily icing of the tendons, which is also good. After a few weeks of abstinence I've worked up to playing a total of maybe 20 minutes every other day in short sessions (it's really bumming me out and I want to play a little). If anyone has more helpful advice on how I can treat it, I'm open, but I think it's just one of those things where you have to give it a few months to sort itself out.

My main question is this: assume I do all these things and in a few more weeks or a couple months, the pain is gone. How I prevent it from coming back? Do I need to make changes in my warmup/practice or my technique? I've read other questions from guitarists who have had fretting finger or hand pain; mine is related but in a different place.

My teacher, who's been teaching for 30+ years, didn't have anything at all to say about it; he's hardly heard of anyone having this sort of problem. I've talked to others and haven't learned a lot, other than that if you let it heal, you're not doomed to have it come back once you start playing again. I should definitely learn to develop a lighter touch when fretting notes and chords, which is something I've been working on, but other than that while I've heard of other guitarists who have had my condition, I haven't read a lot about what got them there and how they could avoid it.


Here's some additional information on my exact symptoms in case folks find this question because they're looking for info.

The pain is in my forearm, on the top/outside, a few inches below my elbow. When I first started getting it, I thought I might have had pain in the inside of my elbow too, but that wasn't the case -- I just wasn't locating the pain precisely. The pain isn't in the muscle, but the tendons that attach the muscles to the elbow. The pain isn't constant, but only comes on when I move my elbow to the extremes of its range, either bending or straightening, and also if I rotate my forearm outward. I have noticeable pain and greatly decreased grip strength if I extend my arm all the way and grasp something by pinching it between my thumb and other fingers. From what I've read these are all classic symptoms of tennis elbow.

Ironically, I have very little pain while playing, and I don't notice a particular pattern of more or less pain after I play or don't play, even into the next day. The pain isn't that intense; I wouldn't describe it as sharp, but any sort of chronic pain is something to be concerned about and correct; I don't want permanent damage.

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    I can't offer any advice on the physical condition that hasn't already been mentioned. But I have an idea to help with being bummed out about not being able to play: try playing a different instrument (with different arm mechanics) while healing. Or try to sharpen your singing. You can still make music and keep your ear sharp.
    – Steve
    Commented Feb 16, 2018 at 9:15

18 Answers 18


After a mononucleosis I had tendonitis twice in my right forearm. The things you can do:

  • RELAX WHILE YOU PLAY!!!! That's the most important. Period. Ridiculously small amount of force you need when you play guitar. The approach of most people (including me, before I get to know methods of Jamie Andreas) is to use a lot of force, to ensure the string is pushed down, the strings are picked, etc. This is entirely wrong. You have to start from lightly touching the fingers and the neck of the guitar, and then figuring out the minimal required force to achieve your goals. First it will be very odd, as you will be losing the control. Then you understand that you can very much control the guitar with minimal energy as well. Later on, you will use force wisely, when needed.
  • My experience with the inflammation is that if you pay attention to your muscles, they will be telling you that you've worked too much. You had tendonitis, you KNOW that burning pain. You will start to feel that burning sensation again when you play too much; that's the limit your body can endure - injuries occur when people ignoring their limits. If you stop there, it will heal and strengthen for tomorrow. Take your time. Work on different talents: rhythm, train your ears, etc.
  • As Tim said, you better be playing daily less then having one-day marathons. Especially in the healing period. It's like if you are a runner who has inflammation, it's much better to walk daily a small amount, then sitting on your ass whole weeks. Also, muscles used for guitar playing are the same muscles then the rest. They performance is better with frequent small practice.

With the above methods I didn't have tendonitis for (about 7-8) years. I listened to my body and acknowledged my limits.

  • The interesting thing with my injury is that I don't have any discomfort at all while playing, maybe only slightly if I'm stretching for a barre chord. I also didn't notice a particular pattern of having more or less pain the next day after practicing a lot or not at all. Commented Dec 20, 2013 at 15:44
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    And what about the days after the next day? If there's no pain on those, you can increase the amount of practice. Also, please note that I had a serious viral infection that I wasn't aware of (after the visible syndroms I would have to be train lightly for a year!), so probably you can have a hidden inflammation in your body or an infection which wasn't completely healed.
    – atoth
    Commented Dec 20, 2013 at 15:52
  • The pain seems to follow overuse by maybe 2-3 days, though with a response that slow it's hard to tell if it's a real pattern or not. Commented Dec 20, 2013 at 16:00
  • To be honest, I'm not familiar with that pattern. My common sense would say you got to practice small amount every day (20 mins seems OK, to me). Seek out someone with a similar sport injury pattern, who has dealt with it. Also if a professional hasn't adjusted the neck of your guitar for you, it can be a huge a difference in terms of force needed to play the guitar.
    – atoth
    Commented Dec 20, 2013 at 16:19
  • Since the problem was in your right arm, I'm hoping you play left-handed. Otherwise you've been holding your pick too tightly.
    – Tim
    Commented Jan 1, 2014 at 13:01

Sounds like you need to address several issues. You're probably squeezing the guitar neck way too tightly using your thumb more as a vice than a guide. Not necessary at all. You may need to change the angle you hold the guitar at- it could be pulled into your body.Let it out so that your fretting arm has fresh air all around it : too many players have the arm resting on or touching their leg. You may need to consider the height you have your guitar at - if it's low, there's too much bending of the wrist. You may need to think about the angle of the guitar compared to the floor. If it's pointing upwards, it'll relieve the strain.

Apart from all the stuff above - play little and often. Your teacher should have picked up on any/ many of these points, and suggested alternatives. I'm guessing that in the long periods of playing, you're sitting down. Try different seat heights.You may even find that a change to lighter strings, or setting the guitar up properly, so you don't have to press so hard will make a big difference. Cure the cause rather than the symptom !!

  • I've definitely been squeezing too hard with the thumb, and I've also been pressing too hard when fretting notes, which puts even more stress on the thumb... I've been paying more attention to that since I started having pain. It hasn't made the pain go away, but I think I may need to let it heal completely and then better technique will hopefully keep it from recurring. Do you know more about problems with these specific tendons? They're involved with extending the fingers, not contracting them, which always I thought counterintuitive in a guitar RSI. Commented Dec 16, 2013 at 1:53
  • @Scott - it's not a problem I've come across in guitarists. The muscles/tendons of the thumb/wrist are more commonly affected, again, through gripping the neck too hard. I've posted on this site that one actually doesn't need to squeeze the neck to produce clear notes/chords.Tennis elbow is a misnomer - any overuse of a joint will produce some problems. Overuse in your case may well be physical positioning combined with prolonged playing. However, I'm not a doctor - never had the patients...
    – Tim
    Commented Dec 16, 2013 at 15:59

How I prevent it from coming back?

To build on atoth's answer and his first point about relaxing your hand and arm: I feel it is worth mentioning to all others who come and see this question, the possibility of changing your seated guitar playing position to help in the prevention of these sorts of problems.

Having started with a classical guitar and its traditional position and then moving to the electric guitar and its common position, I noticed increased strain on both the left and right arms (the right especially with fast picking sections) and more left-hand fatigue as well. I recommend, as my old guitar teacher did, trying the classical guitar position for seated practices.

The position is very comparable to the way which one must sit with a flying-V style guitar (A quick image search of "classical guitar position" will yield great visual examples), with the bridge at about a 45 degree angle to the floor, the butt of the guitar resting on the inside of the right leg, the left leg raised (no need to buy a foot stool, just use some old books or small box if you have one lying around) and the crook of the guitar resting on the left leg. This position mechanically benefits both the elbows by opening up their bends to about 90 degrees (a more natural position, allowing more circulation) and reduces how much ccw rotation the left arm requires for the hand to properly work its way around the fingerboard.

Try it at least once or twice and see if you feel any immediate benefit, but of course bodies are different: If you feel more pain in the short or long term, stop and return to the position which gives you the least discomfort


I haven't heard of this in any of my colleagues (guitarists) either, but I would say that you're right when you say that time will heal it. You'll probably have to put your gat aside for a couple of weeks for the sake of letting it heal, do some semi-regular stretches and light, easy strength exercises.

As for preventing it in future, my experience with this sort of injury is that once you've had it once, it's a whole lot more likely to come back again. You could try some physio on it while you're recovering (acupuncture, radiology, massage etc) - but keep doing light stretches and exercises on it and take it easy!


I'm answering my own question to document what I've been doing in case others find this question looking for help.

As of right now, I can only talk about what I've done to try to treat the injury; time will tell if changes I make to my technique (the other answers which suggest relaxing and not squeezing so hard seem right-on) prevent it from coming back.

Researching my symptoms more carefully, it seems like I may have tendonosis more than tendonitis. -itis is inflammation of the tendon, and I haven't seen other symptoms of inflammation -- no swelling, no redness, the pain isn't constant, and it didn't respond well to ibuprofen or basically not playing at all for about three weeks. -osis is degeneration of the tendon, from micro-tears that build up scar tissue.

I continued playing for maybe a couple months after first noticing the onset of symptoms (the pain was never so great that it was a dire concern, and I reached a good stopping place). Then I stopped playing and started trying to treat it.

In my question, I linked to an article about an exercise for tennis elbow. That describes an inexpensive piece of exercise equipment, a Thera-Band FlexBar, which is a rubber bar about a foot long that comes in varying diameters which correspond to resistance; I started with the red (10 lb) one and have worked up to the green (15 lb) one. You do an exercise where you grasp it in both hands, twisting it to force the hand of your bad elbow to try to curl inward, and do reps of straightening and slowly releasing your hand at the wrist; you can find pictures and videos of the exercise. This builds muscle and tendon strength by loading the tissues while they're stretching, which is supposed to be good for this type of injury (there's a similar type of thing you can do for -osis of the Achilles tendon in runners).

That exercise has helped somewhat. I've been icing the joint a couple times a day (always after doing that exercise to knock down any inflammation it may cause), and the icing has helped somewhat. I haven't been taking ibuprofen. I used an elbow brace for some number of weeks but stopped when it didn't really seem to be helping me. I stopped playing altogether for about three weeks, and after that would play a total of maybe 20 minutes every other day in short sessions, and only doing easy stuff.

All of these measures helped to a small degree, but after maybe six weeks of that I was at the point where the pain had lessened by maybe a third to half on a good day, but it was far from gone, and I still had decreased grip strength. The nature of the pain had changed a little, becoming slightly less localized and more diffuse, maybe due to the exercises, but I was starting to get a little discouraged even though I know these injuries can take a very long time to heal.

Within the past few days I've started heat treatment as well (a heating pad wrapped around my forearm), usually alternating with icing the joint, and that has made a huge improvement almost immediately. Within a couple days my pain is down by about 75%, even though I've been playing more (I got a new guitar, can't help myself). We'll see if this takes me to complete recovery, but I'm hopeful. If you're reading this because you have similar symptoms, you might want to evaluate your injury carefully to see if it's inflammation or not, because heat may not be the best treatment for inflammation, but if you're like me and ice alone isn't doing it, give it a shot.


I play bass and have had tennis elbow 4 times (3 in the plucking, 1 in the fretting). Each time I've gotten TE has been because of marathon practice sessions. I did not realize until after practice, that I'd gone too far and TE had started.

I've done everything out there to remedy TE- exercises/stretches, icing, heat, anti-inflammatories, playing relaxed, trigger point therapy, accupressure, massage, using an elbow straps, etc... unfortunately, the only way I've gotten completely gotten rid of if it to STOP playing (100% cold turkey) until it heals. In my case each time has taken 7-8 weeks.

Good luck with healing, Paul


i play guitar a lot, and new years eve the pain in my left arm was so constant and intense i had to call the emergency services. apart from the worry of nerve damage from the doctor that night my own doctor has diagnosed carpal tunnel and is booking me in for an op. it is very difficult to stop playing, been two weeks now and i can eel that my arm is still bad, or at least isnt gonna let me play too much. i havent tried any of the above treatments like cold compress or heat pads but am going to try them as i am getting to the point where i have to try everything to help. i think mine is a combination of tennis elbow and carpal tunnel problems. in the mean time i found this and boy, straight away i could feel it helped. check it out http://www.tennisarm.ch/ i am going to go easy with the exercises but his advice is to not stop what your doing, that there isnt a real trigger rather it is been a barrel filling up for years and you've just tipped obver the edge. the whole site makes a lot of sense and i felt the tension/pain ease almost immediatly. not to the point that it was healed but it has been the only thing that felt good and that was helping! hopefully it will help you.

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    If the injury really is more of a muscle cramp as that website says, it would explain why heat worked so well on it -- heat is great for cramped muscles. Be careful you have no inflammation if you try heat though, because inflammation needs ice, not heat. Also, check out that exercise equipment I linked to -- it does the same thing as the stretches the website talks about, but it does a fantastic job really targeting the muscles and tendons to be stretched. Also, if you have carpal tunnel at the same time, be careful you don't aggravate that while treating the elbow. Commented Jan 18, 2014 at 16:24

I have unfortunately had tennis elbow in both my elbows over the years. I am a panel beater and a guitar player. I've tried icing and stretching exercises and had cortisone injections when it got unbearable. By far the best for pain relief is a clasp that fits over my forearm just below my elbow. A simple device made of material and Velcro , a bit Like a tourniquet. It stops the tendon from pulling away from the bone.i use it at work so I can continue to operate even when afflicted. Worth a try. Good luck

  • They make those devices specifically for tennis elbow. I have used them in playing tennis. They defiantly help. Commented May 7, 2015 at 17:13

I have also played guitar (classical) for 4 years. I practised a lot, especially the last 2 years 4 hours a day, and I was diagnosed with Epicondilitys. I did some exercises and I got much better, I'm about to start using a brace.

The most important thing to do is relax while playing, as mentioned earlier. Very wise, but also very difficult if are not trained to hear your body. You must stop regularly, even if you don't hurt, for a minute or two. Relax and "contact" with your hands. Breaks are very important.

I think that patience and working with yourself will yield faster and better results.


I am a violinist, and lateral epicondylitis is common among classical string players, in my experience. I have suffered from tennis elbow and various tendon injuries of the forearm for 10 years. Please please, take it easy on the playing, even if it bums you out. Here's what happened to me: I played long hours, ignoring pain and stiffness, and caused an injury. I didn't do the exercises that my physical therapist prescribed(just like the eccentric ones you found). I have re-injured myself quite easily after a 6-month break. Icing, taking a break and loading up on NSAIDS seems to help me, along with doing stretches and exercises from the PT. . Try to practice mindfully, thinking about where in your left hand you CAN relax, and practicing slowly enough so your left hand can relax in between chords or fingerings.

In reality though, tendons are really susceptible to re-injury. Be careful!


Well, you asked how to prevent this in the future. You need to build those muscles back up, preferably stronger than they were before the injury, without causing muscle strain/damage. How do you do this? Just do your guitar stretches!!! Do your stretches!!! And do them well. If your fingers and arms do not feel limber (appropriately lubricated) before you begin playing, you are not ready yet. You should literally be able to feel that your muscles are stretched and ready to be pulled. It's like working a rubber band, warming and stretching those molecules, rather than just pulling it tight right off the bat.


I've never heard of or had this in my fretting hand/arm. But I do have the same thing you have in my picking hand/arm. I wear a Tommy Copper sleeve for the elbow 3 to 4 times a week, plus a compression wrap. I also have a friend that has the same thing I do in his picking hand/arm. What I do is stretch constantly, I find the tendons in both my forearms are very tight most days. I played last night, all I did was record 2 rhythm tracks, and today I'm sore. Also like you, when I'm playing I don't feel it, possibly because I'm so focused on playing, or maybe because I'm loose. Good luck to you getting healed up, its been my experience that this is a chronic type thing that will always return as long as your playing heavily.


I've been suffering similar tendonitis, but was diagnosed with both Tennis and Golf Elbow which basically means that the tendons on the top of my forearm, and the bottom, as if you were putting your palm out were badly inflamed along with inflammation of several nerve sheaths that were actually visibly inflamed. Basically my fretting arm was a train wreck!

This problem was exacerbated during a time of high stress in my life, I was playing guitar probably about 6-8 hours a week, and I was working on rebuilding an old car in my spare time, plus the usual stuff work family etc. I advise that physical therapy is very useful if your insurance covers it. I also received a cortisone shot that got me through the worst of it. It has been more than a year now and it has settled down considerably. I have not stopped playing, but I do play in short 20-30 min sessions and continue to use ibuprofen and icing after playing, which really work for me. I had inflammation of the ulnar nerve which is particularly painful, which is a nerve that runs through the notch on the tip of your elbow. This is aggravated by something as simple as the arm rest in your car, wrenching or lifting up a heavy frying pan or a 40 pound kid. So you have to look at all your activities as a whole I've found to get better. The pain has gone from something that kept me up at night to manageable.

There is a lot of good advice in this thread, strengthening exercises I learned during PT with the large elastic bands or small dumbbells have helped. I have stopped using a death grip in my fretting hand most of the time and found it improved my technique. Stretching has helped, and destressing my life has helped.

Another thing that my PT taught me is that the muscles in your back balance the muscles in your arm, so doing rowing type exercises for your back and pushups or bench presses for your chest, along with forearm, upper arm and wrist exercises all help to balance out the delicate instrument that is your body.


Another consideration: do you slouch at the table, resting your upper body weight on your elbows? I noticed that after correcting for this bad habit, my forearm pain diminished. Could be related.


Bro I think I'm starting to have the same issue, no inflammation, but tightness and pain in the forearm below the elbow - I've been stressing about it for the last week and scouring the net for solutions. This video is the best I've found - do the digging in exercises, in and around the areas in your forearm that are tight. Do your stretching as well. I've just been doing this today and noticed a big improvement!!!


I've been playing guitar since 13, and I will be 27 soon. This pain did not seem to show until I switched to playing more with my thumb. I was also heavy in the gym which seems to exacerbate the issue. Also big into saltwater and boy how that made the issue worse. It mostly seems to deal with the aggravation of the ulnar nerve. Try compression sleeves and wrist wraps it's just according where anatomically you are feeling the pain. From PT videos I've gathered, the Ulna side of the foreman is always trying to overcompensate during certain activities bc the radius bone is longer than the ulna. If I go weeks without playing which is rare and kick the bicep exercises it tends to subside. Fishing causes the pain immediately.


I play both classical and pick-led styles of guitar, so I utilise a variety of techniques, playing positions etc. I also play squash regularly - I'm right handed. I had a two year period during which i played no squash and very little classical guitar (with the raised right hand plucking fingers). I restarted both simultaneously - and within a matter of weeks, I had acute right hand wrist pain (carpal tunnel/tendonitis) and also acute 'golfer's' elbow in the right arm. It was so bad that my whole right arm from wrist upwards was very painful and virtually useless for a while - bad when you can no longer indulge in two of your favourites pastimes; not fun with young children around the house either.

Fast forward 6 years on. I have been a regular squash player over the last 4 years or so and I still get golfer's elbow, but just do basic stretches and it rarely gets so bad that I cant play squash, although sometimes it is sufficiently painful that it restricts movement/cramps my style. I wear a simple neoprene sleeve over my right elbow whilst playing. With regard to guitar, I still play different styles on different guitars, but since the acquisition of a hand made concert classical, I went through an 18 month period pf practicing classical quite seriously (90 - 120 minutes per day).

Here's the new part: I have now developed golfer's elbow shooting/sharp pains in my LEFT elbow as well, something I never had until recently. Like other players have stated, it rarely bothers me whilst actually playing - it is in doing normal day to day stuff when I notice it.

Maybe it's something to do with the rigour involved in going through technical warms ups/exercises on the classical guitar, which has a fatter/wider neck than most steel string acoustics or electric guitars.

Anyway, glad to have found this forum and I will certainly be looking at some of the videos and exercises shared - thanks to those who posted helpful tips.

  • I appreciate your sharing this story, but it doesn't really seem to answer OP's question. Maybe this could be made into a genuine answer if you added more detail about the stretches and warmups that you found useful. Do you wear the neoprene support sleeve when playing music or when playing squash (or both)?
    – user39614
    Commented Feb 16, 2018 at 22:11

You can wear a tennis-elbow brace while playing because that's when the irritation initiates. I do the strengthening and stretching exercises but need to wear the tennis-elbow brace when sleeping and playing. I think the need to compress my grip on the fretboard aggravated the elbow tendons. Two costs about $8-9 on Amazon.

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