Update on Knuckle Joint Stiffness Issue

[FiggyPudding18]

Hey AGF,

I have recently taken one month off of playing guitar due to some finger pain.

I wrote this post about one month ago: https://www.acousticguitarforum.com/...d.php?t=544997

The short version: I got really into guitar and practicing every spare chance I had for about two months, then noticed finger pain in my fretting hand index finger (when I tried to bend it in towards palm at the knuckle) that wouldn't go away for two weeks.

Possible Causes I Have Come up with:
-bad technique-was trying to play a lot of thumb over barre chords perfectly, also perhaps putting too much pressure down for c shapes
-never got guitar set up - while I don't think the action was awful (picture of action: https://www.flickr.com/photos/169497...posted-public/, 2.75 mm at 6th string, 12th fret, and 2.25 mm at the 1st string, 12th fret.), I'm currently waiting on my first set up to be completed to see if that makes things any better.

Treatment attempted:
-Went to doctor for unrelated reasons, they suggested a strain and said to take two weeks off.
-tried heat and ice, neither seemed to have much of an effect.
-have tried stretching some, although from my experience the stretching did a great job of making me feel good for when I'm playing but it felt almost more sore the next morning.
-have been taking turmeric and fish oil supplements
-and here's the big one...I have taken the entire month off in fear of causing a more severe injury. Maybe unnecessary, but I don't want to be out for longer...I did play the other day for about 30-45 minutes on a guitar at my school and it maybe felt just a little worse the next day.

Overall I would say my finger feels generally better after a month off. I can bend it fully now. However, there is a feeling of a slight twinge still, whereas a month ago it was quite painful to bend it all the way.

Do any of you have advice for me in regards to whether or not I should dive right back in at this once I get my guitar back any day now, or wait for an absolute full recovery? I'd like to avoid long term problems obviously, but please, if somebody thinks I'm really overthinking this and shouldn't be worrying about this kind of pain at all, let me know. Thanks for your insights in advance!

[Paddy1951]

Originally Posted by FiggyPudding18

Hey AGF,



I have recently taken one month off of playing guitar due to some finger pain.



I wrote this post about one month ago: https://www.acousticguitarforum.com/...d.php?t=544997



The short version: I got really into guitar and practicing every spare chance I had for about two months, then noticed finger pain in my fretting hand index finger (when I tried to bend it in towards palm at the knuckle) that wouldn't go away for two weeks.



Possible Causes I Have Come up with:

-bad technique-was trying to play a lot of thumb over barre chords perfectly, also perhaps putting too much pressure down for c shapes

-never got guitar set up - while I don't think the action was awful (picture of action: https://www.flickr.com/photos/169497...posted-public/, 2.75 mm at 6th string, 12th fret, and 2.25 mm at the 1st string, 12th fret.), I'm currently waiting on my first set up to be completed to see if that makes things any better.



Treatment attempted:

-Went to doctor for unrelated reasons, they suggested a strain and said to take two weeks off.

-tried heat and ice, neither seemed to have much of an effect.

-have tried stretching some, although from my experience the stretching did a great job of making me feel good for when I'm playing but it felt almost more sore the next morning.

-have been taking turmeric and fish oil supplements

-and here's the big one...I have taken the entire month off in fear of causing a more severe injury. Maybe unnecessary, but I don't want to be out for longer...I did play the other day for about 30-45 minutes on a guitar at my school and it maybe felt just a little worse the next day.



Overall I would say my finger feels generally better after a month off. I can bend it fully now. However, there is a feeling of a slight twinge still, whereas a month ago it was quite painful to bend it all the way.



Do any of you have advice for me in regards to whether or not I should dive right back in at this once I get my guitar back any day now, or wait for an absolute full recovery? I'd like to avoid long term problems obviously, but please, if somebody thinks I'm really overthinking this and shouldn't be worrying about this kind of pain at all, let me know. Thanks for your insights in advance!

If you haven't done so already, it might be worth seeing an Occupational Therapist.

These folks really know their stuff. IMO, because the work with people every day, they can evaluate better than most doctors.

They are especially about use of hands.

They could watch you play and move you in the right direction to solve your issue.

At least, investigate this approach. It may be a solution.

[RJVB]

COntinue to do warm up and warm down exercises (before the stretching!), and don't hesitate to continue to use Voltaren balm or similar on your finger (possibly alternating with an Arnica-based balm to fight swelling).
Integrate exercises to minimise pressure during your on-guitar warm-up sequence, which can be simply playing pieces you know by heart very slowly, and figuring out for each finger how much you can release it before you lose a clean sound.

And maybe get a book like Classic Guitar Technique -- Supplement 1: Slur, Ornament, and Reach Development Exercises (Shearer Series) by Aaron Shearer which was suggested to me recently (with the strong suggestion to learn the exercises by heart first).

[Gordon Currie]

Originally Posted by FiggyPudding18

Do any of you have advice for me in regards to whether or not I should dive right back in at this once I get my guitar back any day now, or wait for an absolute full recovery?

My advice: do neither.

It is extremely likely that your finger is feeling better because you stopped playing. That leads to the assumption that there is something you are doing that is injuring your finger. You haven't determined yet what that thing is, so to "dive back in" is to risk the same thing happening again weeks or months down the road.

Even though you are feeling better after taking some time off, I doubt whether that is contributing to a "full recovery" - again, you don't know what might have caused it so it WILL recur.

As I posted in the original thread, and others have mentioned, I'd recommend seeing a hand specialist (generally a physical therapist that focuses on the hand). Or you could see an orthopedic surgeon, or both.

(I have been dealing with this exact situation for the last year. Stiffness and ache in the middle knuckle of the left index finger. PT helped a little. Surgeon did 2 cortisone shots; 1st one helped a lot for a couple of months, 2nd one helped for a month at most. Had trigger finger release surgery which in retrospect was unneeded right now, will ward off trigger finger in the future. X-ray shows a cyst floating above the knuckle joint. If it gets worse will have that drained or removed.)

[Silly Moustache]

I've got all sorts of similr issues. Trigger fingers, Dupuyrtrens contracture.

My left hand hurts all the time from dull pain to excruciating spasms.

Occ- therapy gave me some pressure gloves a wrist support (I already have a better one) a night splint and exercises, I'm taking Ibroprufen 500 mg, and naxopren, and on Wednesday, a cortisone jab.

It's getting difficult to hold cutlery.

[GBS]

For the guitar set-up make sure the tech/luthier gets the strings at the nut as low as possible. That part of the setup is frequently overlooked.

My tale - bought a very expensive Bozo 12 string back in the 80's (Japanese version). Had set-ups done multiple times. By the mid 80's my hand hurt so bad I couldn't play more than 10 min. Doctors advised surgery for carpal tunnel. I quit playing instead. Every few years, I'd attempt, but the hand still hurt after a short while.
Roll forward 25 years. Wife thought I should get rid of the guitar, since I didn't play at all. Took it in for appraisal, was told to take it to the inshop Luthier for his review, before they would think about accepting it on commision.
Without a word, he opened the case. With it still lying on the bench, he pressed on the strings. First words: "Bet your hand hurt." He re-filed the nut, and sent me on my way. Guitar was amazing, and even after decades of not playing, there was no hand pain.
Now I spend time trying to make up those lost decades where I could have learned so much....

[jaymarsch]

I had an index finger injury years ago and it flared up making fretting guitar chords painful. I took about a month off and it was better but didn't really go away. I had my hand looked at by a hand specialist and he said that I should lay off the guitar playing for at least three months. I was going on a trip anyway so ended up taking 4 months off from playing. It was challenging but I went back to playing and was much more mindful of technique (as you mentioned) and got into a gentle hand stretching routine. I also had the necks reshaped on the two guitars that I play the most as they were both on the beefy side. I have not had a recurrence of the problem and that was a number of years ago. I hope that you are able to recover and keep your hand relaxed and healthy so you can enjoy playing pain free.

Best,
Jayne

[FiggyPudding18]

Thanks everyone...obviously this is a tricky question because nobody can feel my finger but me. I think I will try playing again carefully when my guitar is returned to me, if gets worse I’ll take more time off, and potentially look into seeing a specialist eventually. All part of the learning experience I guess !

[macoshark]

Hi, I've been dealing with finger stiffness for awhile. Had to get trigger finger surgery on my left ring finger. Couldn't really flex it fully anymore. My left index finger is stiff in the Am and have to warm up by just playing some scales for about 5 min.
Probably have to do the trigger finger surgery for that one. The steroid shot thing helped for awhile on a few of my fingers but not enough on the ones I mentioned. I think doing other work related jobs like painting and maintenance work was just too much at this stage. Long periods of gripping tools might have done me in
Not much for Docs but the surgery was a good move for me. Some do OK with the natural approach. Gotta get away from the pain and then manage the things you do that promote decreased ROM.

[Laughingboy68]

In my practice, I’ve had good success treating patients with trigger fingers using acupuncture, manual therapy and microcurrent treatment. It is one conservative approach that can be tried before going the surgery route.

In my opinion, activity often reveals dysfunction, rather than causes injury. Determine what is functionally wrong and then do what you can to fix the dysfunction. “If it hurts when you do that - don’t do that”, is a very lazy answer and should be advised only when all else fails.