How to treat medial epicondilytis and how long does it take to heal?

Question

I have been playing blues/jazz and shred guitar on mostly electric guitars for many years. Four months ago, I bought a new classical guitar and in my excitement played continuously through a weekend. On Sunday night, I started feeling some pain in my Forearm Flexor muscles(Fretting Arm). I didn't think much of it, and stopped for the day. The next day when I tried to play again, I couldn't go on for more than 10 seconds due to the severe pain. To be fair, I have been playing for nearly 10 years and marathon sessions are not uncommon, but I had never experienced any discomfort in my arm. I stopped playing completely and went to the doctor; was initially diagnosed as a forearm strain which resolves in 2-3 weeks. However after 2 months and no improvement, I went to a physical therapist who diagnosed it as medial epicondilytis( Golfer's elbow). This pain lasted for about 3 months in total, and was manageable with regular icing.

I have been using the FlexBar for strengthening exercises, and am doing what I can to be more physically fit (I work a stressful job and do not get much time) After the 3 month mark I felt like the pain was mild enough to give playing a try. Big mistake. Withing 20 seconds the pain was back and as bad as it had been initially. Now that my pain is subsidizing again ( I do still have a lot of inflammation on my forearm) , I want to know when I should start playing.

I also would like to hear stories/timelines of this issue, as I haven't found a unified answer anywhere. What methods did you use to treat this? Will I ever be back to my normal skill level again?

Please excuse the verbosity, Thank you

Note: I appreciate suggested changes in technique, and will implement them once I'm back on my instrument. However, I want to stress on how to get better in the first place. It has been 4 months of completely laying off guitar for me, and as mentioned trying to get back to it has been unsuccessful.

Answer 1

As a drummer I had some pretty severe tendinitis in my wrists and found that changing the height of a few drums and my throne forced me to sit with better posture and this help tremendously. I also changed the way I was gripping my sticks. This may be completely different for your situation but some things that you may be able to try:

1. Get a teacher to take a look at how you are holding your instrument, how you are sitting, etc. This may play a big part.
2. Make sure you are eating well, drinking a lot of water, getting enough sleep, and as you said continue to improve your overall fitness.
3. Try to eliminate any other stress to your arm through the day. Perhaps evaluate the way you are using your computer mouse and keyboard at work, or if you are doing physical labor of some sort make sure you are doing it properly to avoid injuries.
4. Have your physical therapist show you some proper warm up exercises and stretches.
5. Listen to your body. If you are in any pain stop. Sounds like you are doing this but make sure you are "listening" to your body. Also, once you are feeling better don't try to play for long periods of time. Slowly build things up.
6. Try a changing your instrument. If you played a long time ago and then took a long break you may not be as strong as you used to be. Switch to lighter gauge of sting, or play an electric instead of an acoustic for awhile if you have both. Slowly build back up your strength and then switch to heavier strings if things are going well.

Answer 2

Which arm? Picking or fretting hand? I see you say classical. The strain may be due to a change in position, especially if you mostly play electric then tried acoustic (classical) for the first time. I can't tell from your post if you are mainly a professional classical guitarist or like I said a guitarist who started classical recently.

I fall into the same category, I've been a guitarist for 40 years, mostly electric, and picked up classical seriously about 3-4 years ago. I've had just about every hand issue out there and managed to get past them or adapt.

I had "tennis elbow" in my picking arm 25 years ago, very severe. It turned out that a simple change in posture (specifically opening the elbow joint) fixed it in a short time. For me, I was sitting hunched over with the guitar on my right leg and my right arm folded closed in a very small angle. Being a "shredder" at the time the fast picking in that position caused severe inflammation. Ibuprofen and ice helped but the issue resolved itself only when I permanently changed my posture. Since you haven't stated any details about your posture I can't say more. But I will say that proper posture is key for your health.