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Thread: Tennis elbow in the picking arm - how to avoid it?

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    Default Tennis elbow in the picking arm - how to avoid it?

    Hi: having just got over tennis/golf/mandolin elbow in my right arm (I don't play tennis or golf), I'm fairly keen to avoid it happening again. I've read of very experienced pro musicians being out of action for a while mid career due to this. I think I got it by trying to play through an elbow ache. Does anyone have advice on how to avoid it, apart from 'sit in your chair and play nothing'?

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    Registered User Jill McAuley's Avatar
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    Default Re: Tennis elbow in the picking arm - how to avoid it?

    I've suffered from this on and off for the past year, brought on by some prolonged bouts of scything the paddocks on my property. What I've noticed is that it flares up again if I'm doing anything that involves both the elbow repeating the same motion over and over and the hand grasping something (mandolin pick, handle of a gardening tool etc.) tightly. I've even had it flare up after long distance driving due to the elbows being bent and the hands grasping the steering wheel for a prolonged period of time. I took a break from the manual work that was bringing it on (facilitated by some torrential rain here, so I didn't feel so guilty about it!) and also now make sure to take regular breaks when I'm working.

    With the mandolin I've lengthened the strap I use and now sling it over the right shoulder Bill Monroe style vs. putting the strap over my left shoulder - those changes have resulted in my elbows being less bent which is way more comforable when playing. I'm also really focusing on having a relaxed grip on the pick and similar to when I'm doing manual work outdoors, I take frequent breaks between playing to extend the arms and stretch. My recent routine is to get up and do the morning chores around the farm, and then have a well deserved cup of tea and play a bit of mandolin. Just finished doing that a moment ago and touch wood, am pain free. I definitely no longer engage in back to back hours of mandolin playing though - it's about 30-40 min at a time. I'm fine to do that a few times throughout the day/evening and feel no ill effects. On my longer scale instruments (tenor banjo and tenor guitar) I can still play for long periods of time and feel grand, so I definitely think the difference for me is how extreme the bend of the elbows are.

    I know I've seen a link to a website somewhere (either here or another forum) that has stretches and exercises musicians can do to keep the hands and joints healthy, but I can't find it now - bah!
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    Default Re: Tennis elbow in the picking arm - how to avoid it?

    Think I read somewhere that David Griseman had trouble with this, and his chiropractor recommended he hold his mando farther to the left, which may fit with Jill's 'Monroe' style stance modification above. Anyone know more about that?

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    Default Re: Tennis elbow in the picking arm - how to avoid it?

    I struggled with this years ago. I read about doing wrist curls to strengthen the forearm muscles which helps to hold the tendons in their proper positions which is where the pain comes from. I sit in a chair with my forearm supported on my thigh and do wrist curls with a small dumbbell. This can be painful at first so if it's bad start off with something lite like a can of soup. You can also get a wrap to go around the forearm which helps hold things together while you build the muscle.

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    The Amateur Mandolinist Mark Gunter's Avatar
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    Default Re: Tennis elbow in the picking arm - how to avoid it?

    Iíve had this sort of tendinitis before on numerous occasions - never brought on from simply playing - and my experience has been that a bad case of it takes a very long time to heal. Best recommendation is to rest it as much as possible, and use a good brace just below the elbow. The brace will allow the tendons to pull somewhat against the brace as opposed to pulling only against the injured attachment points on the bones.

    I suspect that if picking and playing causes or badly exacerbates the injury it may indicate too tight a grip on the pick or too much tension in the picking hand.
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    Default Re: Tennis elbow in the picking arm - how to avoid it?

    NEVER play through pain. I know a few great players who will never be able to play again as they tried to ‘play through the pain’.

    In my book any discomfort is the body telling you to evaluate how you are doing something. Less tension is key.

    You may want to look at my ergonomic videos.

    https://www.petemartin.info/mandolin-basics-videos.html
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    Default Re: Tennis elbow in the picking arm - how to avoid it?

    One other thing that helps me a lot when I get elbow tendinitis is Gua Sha. Look up “Gua Sha elbow’ on youtube. Several good videos there.
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    Default Re: Tennis elbow in the picking arm - how to avoid it?

    Quote Originally Posted by Joed View Post
    ...I read about doing wrist curls to strengthen the forearm muscles which helps to hold the tendons in their proper positions which is where the pain comes from. I sit in a chair with my forearm supported on my thigh and do wrist curls with a small dumbbell....
    Ah, so that's what the wrist curls do. I've seen these recommended, but never understood their relation to the pain.

    Thanks all for your uggestions. Max

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    Default Re: Tennis elbow in the picking arm - how to avoid it?

    I've had physical therapy for this, brought on by a lot of overly enthusiastic mountain (lap) dulcimer playing several years ago. I've seen more than one dulcimer player wearing a support band around their upper forearm. The physical therapist was intent on reducing inflammation and ended each session with a block of ice applied directly to the troublesome area; nothing in between, just rubbing the ice directly on the skin. It sort of burns at first, and then that goes away completely by the end of five minutes. He suggested freezing small paper cups of water then tearing off the paper as needed to expose the ice. I found it really helpful. NSAIDS may help as well, but I have to limit my use of them. I recommend physical therapy if feasible. That's usually been the fastest route to recovery when I've had injuries of this nature.

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    Default Re: Tennis elbow in the picking arm - how to avoid it?

    The business about wrist curls (a flat out cure for me) is from the book "Sports Health" by Southmayd and Hoffman. There's more info there.

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    Default Re: Tennis elbow in the picking arm - how to avoid it?

    I also found some vids on 'scraping' (Gua Sha) technique, which looks like another variety of massage. Haven't tried it yet, but probably will.

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    Default Re: Tennis elbow in the picking arm - how to avoid it?

    Had this over 20 years ago. My main issue was remembering to open doors with my other arm. My doctor administered a cortzone injection. A couple of weeks later I was cured and I’ve never suffered with it since.

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    Default Re: Tennis elbow in the picking arm - how to avoid it?

    Quote Originally Posted by Pete Martin View Post
    One other thing that helps me a lot when I get elbow tendinitis is Gua Sha. Look up “Gua Sha elbow’ on youtube. Several good videos there.
    Thanks for this info. Several years ago I was suffering badly and the doctor didn't help. What did help was a few sessions of therapeutic massage, in my case from a guy who worked at a tennis club. But he worked the same parts of the arms as the Gua Sha video, but more aggressively using the tip of the thumb to really dig in. It hurt, but it worked.

    The Gua Sha looks really appealing as maintenance you can do yourself.

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    Default Re: Tennis elbow in the picking arm - how to avoid it?

    Quote Originally Posted by A 4 View Post
    The Gua Sha looks really appealing as maintenance you can do yourself.
    Yes, especially as it looks like you need no special equipment to do it. I found a YT vid with a lady demonstrating the technique with a big kitchen spoon.

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    Default Re: Tennis elbow in the picking arm - how to avoid it?

    Quote Originally Posted by Pete Martin View Post
    In my book any discomfort is the body telling you to evaluate how you are doing something. Less tension is key.

    You may want to look at my ergonomic videos.

    https://www.petemartin.info/mandolin-basics-videos.html
    Proper ergonomics while playing, well, saved my playing! I have two young kids which means carrying them a lot. This strain combined with holding the mandolin at too steep of an angle (headstock pointing up) meant that after an hour of playing, both arms were in pain.

    Peteís incredible videos helped me find good ergonomics for my body and have allowed me to play pain free and far more relaxed which has had amazing impact on my tone and speed (no shock there). It took a little bit to get used to the proper positioning, but Iíve never looked back

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    Default Re: Tennis elbow in the picking arm - how to avoid it?

    Quote Originally Posted by Jcdraayer View Post
    Proper ergonomics while playing, well, saved my playing! I have two young kids which means carrying them a lot. This strain combined with holding the mandolin at too steep of an angle (headstock pointing up) meant that after an hour of playing, both arms were in pain.

    Pete’s incredible videos helped me find good ergonomics for my body and have allowed me to play pain free and far more relaxed which has had amazing impact on my tone and speed (no shock there). It took a little bit to get used to the proper positioning, but I’ve never looked back
    Thanks so much for reminding me to watch Pete's economics videos! The one about holding the mandolin is a must view - I've been messing around with strap length, and how I wear the strap to accommodate my elbows, with some improvement but Pete's video was a game changer - I dug out a longer strap so I could go back to wearing the strap over my left shoulder rather than my right one, and adjusted it so that my elbows were aligned the way Pete recommends and the difference in comfort, not to mention less tension is like night and day!
    2018 Girouard Concert oval A
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    2018 Frank Tate tenor guitar
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    Default Re: Tennis elbow in the picking arm - how to avoid it?

    Quote Originally Posted by Pete Martin View Post
    You may want to look at my ergonomic videos. https://www.petemartin.info/mandolin-basics-videos.html
    Thanks Pete - I just went through those vids, and they're really useful. The bits I think applied to me the most are:

    1) Basic mandolin hold - these echo a book on cello playing I used, written to be ergonomic with the input of an Alexander Technique teacher (New Directions in Cello Playing by Victor Sazar). The basic aim, as you point out in the vids, is to fit the instrument to the shape of your body, not the other way round. I've been holding the mandolin too far to my right, with the headstock end too high. That results in my right arm pulling back and to the right awkwardly instead of just dropping onto the strings in the right place, and my left hand pulling in across my body. Your method sorts them out to where the mandolin just falls into place.

    2) Left hand - placing the 4th finger where you want it and stretching back to use the greater index and middle finger gap, and letting the thumb pretty much go where it wants. I was trying to reach up the neck with the 4th finger, but thinking about reaching back works much better. Combination of reaching back and thumb position on your video enables me to reach the common 'long' major chop chord shape without straining.

    Thanks again! Max

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