Joe A Shaw PA-C - 7/31/2008

Question
I've been playing guitar about 20 years. About 10 years ago I noticed that my left forearm/wrist will start feeling kinda "out of gear" and I have to rotate my forearm and it cracks. I've noticed lately (within the last year) it's starting to require the rotate/crack more. That and my left wrist and forearm seem to fatigue very quickly.

Are there any exercises or therapies I should do to get rid of this? When I play guitar, I'm required to play very fast with my left hand. So it's probably the equivalent to typing 130 words per minute.

I'm taking glutamine and glucosomine supplements which seem to help a little. I've also taken time off (about a week) and it doesn't seem to help. one of my friends and fellow guitar player recommended the Dynoflex gyro ball. Immediately after I use it my wrist doesn't seem to want to crack and it feels better overall (maybe it's just warmed up) but then it seems to go back to normal after about five minutes. When I wake up in the morning my left forearm kind of cracks but not really. As I rotate my forearm it sounds more like a thud and as I keep doing it the thud gets tighter then finally it cracks.

Is my wrist on the downhill slope of its life? I've noticed that wearing a wrist band helps. I think the heat improves the circulation and my wrist definitely cracks less with it.  

Any advice is welcome. A miracle would be awesome.

Answer
Mike,
I play acoustic and electric guitar some..so I know the awkward position of the wrist and fingers. You didn't say if you play electric or acoustic but as you know there is typically less force needed for the electric strings..but if your doing some heavy riffs it is a lot of stress.
Unfortunatley when you have been playing 20 yrs and having "symptoms" for 10 yrs..7 days off isn't going to do much of anything..you would probably need to lay off 3- 6 mos see if it would help?..fat chance in that happening right?
You can keep taking the glucosomine,if you want to spend the $$ but several studies have shown that they are no more effective than OTC advil..in double blind studies (the dr or the pt didn't know which pill they were taking) generic advil is Ibuprofen..$2.00 a bottle? of course if you can't take anti-inflammatories than you can go w
tylenol or(the gluco as long as your not diabetic)
Yes the gyro balls are interesting and I sell some on my site, I think thats about the best thing..it feels good when doing it. I wouldn't really want to advise anything more aggressive unil I knew exactly the diagnosis. Cracking is normal in our wrists..some people crack their joints more than others, some people like to crack their necks..from side to side etc..I don't think it really does anything one way or the other, sometimes out of habit, you might have gotten into this a little bit over the years. The cracking can be from the membrane surface of the bones gliding over each other, the surface may be worn down some..and it may be from useage over the yrs..but there's not a whole lot to do about it at this point. It would be very difficult to try and change your wrist posture on the neck, but this may cause your wrist joints to wear a little differently. Instead of the same rut for 20 yrs so to speak.
If it conts I would get the or use the ice/heat wrist wraps like active wear brand. Also I would try the nerve and tendon glide exercises for about a month..if no better than see a ortho for xRAYS AND maybe even a MRI..looking for degenerative tears in the wrist which maybe could be scoped and cleaned up..but I would need to be in about 7 out of 10 pain for this..

http://www.carpal-tunnel-symptoms.com/ice-wraps.html
http://www.carpal-tunnel-symptoms.com/carpal-tunnel-exercises.html