A reader of the Musicians and Injuries Web page wanted to know how I recovered my playing after being injured. Here's how that discussion went: Eric asks: So on to my real point I m curious how you ve approached your return to guitar. It s still a ways off for me I ve learned not to equate freedom from symptoms with freedom from injury but I do work best with a plan. I realize the ergonomic factors are paramount, and I ve already devised a set up where I can sit in a mostly anatomically correct position (I don t think guitar playing can ever be totally anatomically correct&). I also plan to use a mirror to watch my fingers while learning new things to avoid having to turn the head. Specific questions I have are: What has your experience been? Are you playing completely pain free, or is it more of a balance between your desire to play and what you can tolerate? As much as I love guitar, I ve enjoyed 38 years of top notch health and if playing guitar means anything less than that, into the ashcan it goes. Paul replies: I stopped completely for some time. Then there was a long plateau where I had daily discomfort, not so much severe pain. I could play a little. About the point I was getting past having even daily discomfort, I started to play again. It was a balancing act: as my page at http://www.engr.unl.edu/eeshop/changes.html relates, too much playing (say a half hour testing out new guitars at the music store) and my fingers would stop responding or I might get cramping and pain. Over time, this went away and my playing time increased. I didn't monitor it carefully; it just became second nature not to push too hard or practice too extensively. The scary thing was agreeing to play weekly in our praise band, three years ago. Playing every Sunday and practicing every Wednesday was daunting. Sometimes I'd get twinges and aches. But given that it was a handful of songs on Sunday and maybe an hour practicing (not always using the guitar) on Wednesday, it wasn't excessive. Now, I'm effectively "unlimited" in that I don't watch the clock and I pretty much play what I want, when I want, but habits of pacing myself, not doing marathon practices, constantly stretching, are woven into everything I do. Our annual Christmas concerts have always required extra rehearsing and playing time and I'm very cautious then, because it tests my endurance. But in the last couple of years, while I've had discomfort or pain from overdoing things at times, it generally doesn't last more than a day or so - unlike past flareups that were more severe and long lasting. Generally speaking, I am able to play without giving my limitations much thought. Eric: Did you follow any particular schedule to return to playing? Paul: As above: not really. just playing as much as was practical. Eric: Are there any particular playing styles or guitar techniques which you now find are particularly aggravating and can t or won t do? Paul: I used to play classical and own a nice Dauphin. I play a lot of fingerstyle acoustic on my steel string but rarely attempt the classical because it requires reaches and contortions that are trouble. I had it out a couple days ago: it could be I may be able to return to some of that playing now, but I'm kind of spooked. I use medium-gauge strings on my Alvarez dreadnaught, but detuned a whole step, to give you an idea of the string effort I'm dealing with. In the last year I was able to buy a wonderful electric (Ibanez RG570) and now use it about the same amount as the acoustic (in fact did the entire last Christmas concert with it), and I attribute the very gentle pressure it requires to be one thing that keeps me performing. Doing lots of the acoustic can sometimes test me. My playing changed, too, to favor chords that are more "open" and don't require clamping down every string with every finger. Fewer full barres. Using the "bad" technique of clamping the thumb over onto the bass E instead of a full barre. USING LESS PRESSURE. I've always enjoyed using open tunings and do so more now, but they don't always make playing easier - and I find I've brought an "open tuning mindset" of using open strings with partial chords to songs that use normal concert tuning too. My more recent troubles have been similar to yours: shoulder/neck stuff that reaching around a guitar or hanging it 'round your neck can really exacerbate. I use a Gracie guitar stand to play my acoustic while standing and also have used it with my electric, although now I have an ergonomic two-shoulder strap for the electric and tend to strap it on. Eric: Anything else you think an RSI sufferer should know about returning to the original offending activity, particularly a musical instrument? Paul: I don't think you are ever "fixed" and can just go back to playing any length of time using any old technique you want. Stretching and exercising my shoulders and hands is a lifelong habit now, and how I play is changed forever - for the better, I think. If you want something more tangible than words to judge my recovery by, some of my horrendously raw "rough demos" of some songs I wrote (some of which are currently in production for release on CD) are accessible online here: http://eeshop.unl.edu/mp3/Courage.mp3 http://eeshop.unl.edu/mp3/329.mp3 http://eeshop.unl.edu/mp3/Doomsday.mp3 http://eeshop.unl.edu/mp3/Elijah.mp3 http://eeshop.unl.edu/mp3/HalfwayHome.mp3 http://eeshop.unl.edu/mp3/IForget.mp3 http://eeshop.unl.edu/mp3/Learning2Fall.mp3 (recorded with a MiniDisc stuffed in a pocket and mike capsules taped to an old headset) and here's a live electric tune from Christmas: http://eeshop.unl.edu/mp3/joy.mp3 But here's the big thing I want you to remember: you may be doing everything right that you need to be doing - changes in playing, exercise, *everything else*. And it may still take significant time to recover. I had a long, weary road where I had made many changes and I still had trouble. It takes time for all those good things to have their salutory effects and for your tendons to heal up. So hang in there and don't give up. Your attitude makes a big difference. (see on my web page mentioned above, the stuff about John Sarno's theories. These made a big difference to me.) You've got my best wishes and prayers for recovery of health and music making. ADDENDUM, 2007: Up until a couple months ago, what I said above about my classical guitar being too hard to play now remained true - didn't play it much and in fact was getting ready to trade it in because I needed expensive repairs on my steel-string guitar. My repairman questioned this, and I noticed that playing on HIS classical guitar was not nearly as difficult. I gave him permission to lower my Dauphin's playing action, although it used to be lower and would give me too much buzz. Lo and behold, I got it back and suddenly it's easy to play, and no buzz, and no pain. Likewise, when he refretted my steel-string, when I was trying it out it just felt like it was somehow a little harder to play, although he said the neck was adjusted correctly. He tweaked the neck to lower the action just a hair - maybe 1/64" - and then it felt right. LESSON IS: having your guitar set up correctly is CRUCIAL especially if you are vulnerable to injury. Find a good guitar tech and have him tweak your instrument to meet your needs.