What I Do to Prevent Relapse of My Cubital Tunnel Syndrome

I’ve had wrist and elbow problems on and off for years, but ever since going through a more serious episode of cubital tunnel syndrome in 2013, I’ve taken strides to improve my health and keep physical problems at bay.  I still feel a slight burning sensation in my elbow sometimes, which reminds me that I need to stay vigilant. Other than that, I’m happy to report that I have been pain-free for the last 4 years.

So allow me to share a few things I keep in mind as I continue to take care of my conditioning as a musician.  Note that I am not a healthcare professional — consult a professional if you’re having serious issues.

Insufficient Muscle Strength Can Lead to Nerve and Join Problems

My understanding is that they all stem from asking our body to do things that it doesn’t have sufficient muscle strength to do.  When you’re experiencing symptoms isn’t the time to improve your muscle strength, but once you recover, training your body is essential in preventing relapse.  If you take nothing else away from this article, I hope you remember this fundamental principle.

That said, sometimes it’s hard to know what muscles need to be trained, and how to train them, to prevent stress to the nerve/joint affected.  This is a highly individual, specific thing, so you have to research and experiment to see what addresses your exact issue.   Below is what’s working for me personally.

How I Train My Left Forearm for Guitar Playing

My cubital tunnel syndrome was caused by asking my left ring and little fingers to move too fast in ways that they didn’t have the strength to.  It’s very important to keep your arms and hands relaxed when playing, but when you don’t have enough strength you can’t execute your moves while being relaxed.  The point is to build up fundamental muscle strength so that you can execute your moves while relaxing.

To that end, I use Hand Master to train my left forearm.  There are other devices that challenge your forearm/hand muscles, but a lot of them just focus on the act of gripping.  I believe my injury was caused by the fact that I couldn’t spread my fingers and execute fretting moves at the same time.  Hand Master is great because it trains your ability to spread your fingers. I originally started out with the light tension version, but since then moved on to the medium tension.

When I train, I alternate between the spread/grip motions and isometric hold by keeping the spread position for a long time.  This gives me a burning sensation in the forearm muscle, close to the elbow.

I also noticed that it’s good to do this with my elbow and wrist bent, in a similar way to when I’m playing the guitar.  The hand exercises are easier if you do them with your arm straight, but it gets much harder in the guitar-playing position.  See the video at the end for a demonstration.

Proper Order for Practicing

If I were to describe an ideal practice session for my left arm, it goes like this:

  1. Before playing, massage my left forearm and hand.
  2. When starting, play slowly at first, and run exercises that focus on ring and little fingers.  Having a light stretch between the ring and little fingers is helpful.
  3. If I start feeling tension in my forearm or if my arm feels tired, I stop.
  4. I may do the above Hand Master exercises as a wrap-up.  I don’t do it before playing as this fatigues the muscles.  I do it when I don’t plan to play again soon, so my muscles have time to recover.

When My Elbow Bothers

From time to time I do still feel some burning sensations in my elbow.  In the original article I was taking ginger capsules, but since then I switched to turmeric with black pepper.  They both have anti-inflammatory qualities, so you can experiment and see which suit your body better.  I usually take one capsule a day and the sensations will go away within 24 hours.

I also learned that cayenne pepper has anti-inflammatory qualities.  I have a bottle from Dr. Schulze’s that I sometimes take for improving my circulation, but I’ll try that if my elbow bothers me again.


I have experimented with this or that approach to exercising regularly for years now, not just my forearm but my whole body.  I’ve never been an athletic person so when I started exercising regularly I was surprised by how insufficient my muscle strength was in general.  To this day I am still working on my core muscles because I don’t have the strength to keep a good posture and my back develops pain a few times a year.

Wrist and elbow problems seem like a highly specific, localized issue but working on your foundations definitely help.  I stay cognizant of:

  • Staying hydrated
  • Eating healthy, whole foods
  • Exercising regularly
  • Keeping my body warm
  • Getting enough sleep

I am not militant about them and many days I fail at this or that, but I keep up enough so that over all I stay in good shape and seldom get sick.  I’ve been able to keep my elbow problem at bay for over 4 years, so my final frontier is strengthening my core/back to prevent my recurring lower back problem.

All Problems Have Roots in Mind

Playing the guitar is a physical activity and to excel at it you want to maintain your physical body.  But I also believe that physical and psychic bodies form one single continuum without a clear divide.  Meaning, problems you develop in your body originate from blockage and stagnation in your mind.

I can confess that I have struggled with giving myself permission to freely play the guitar.  I’ve had all kinds of limiting and self-judging thoughts, like:

  • I’m clumsy and there’s no way I can do something intricate like playing the guitar
  • Playing the rock guitar is a childish thing that an adult should grow out of
  • Playing the guitar is a selfish indulgence that benefits nobody but me, I can only do so after taking care of everybody else’s needs
  • When I play, I can only do so in hiding/a private, secluded place where it doesn’t disturb anybody else
  • If I claim to be a guitarist I better be amazing, and being amazing means playing fast and accurately

With a litany of harsh, limiting beliefs like these, no wonder my body feels like it has to force itself to do something it doesn’t have strength to.

Other self-improvement literature may suggest visualization to rewrite these sorts of limiting beliefs, but I believe there’s an important step before doing so.  These limiting beliefs stem from stuck emotions, some kind of uncomfortable feelings that you have been storing in your body because you didn’t want to fully experience them.  These form blockages in your system so that you unconsciously create opportunities for you to feel them so they can become unstuck.  In my experience the first order of business is to excavate these feelings first and process them, so the path becomes clear for writing new beliefs that you desire.  I’ve written often about processing stuck emotions recently — here are a few articles that refer specifically to the topic:

I’m still very much in-progress as far as excavating my own limiting beliefs and stuck emotions.  Very recently I realized that under my other issues there was a strong sense of shame from being inadequate.  Inadequacy and lack of self-esteem have dominated my life in ways I never realized — the pattern of trying too hard and then burning out stems from it, and so is this experience of feeling like I must have high level of virtuosity, failing to develop that, and not recognizing other strengths I have as a guitarist.  I’ve created many facets to my life in unconscious attempts to reproduce that sense of inadequacy, so that I can finally feel it fully and get it unstuck.

It’s not an easy or quick process, but I believe it’s a worthy challenge with rich rewards.  If you want to learn more about this, I highly recommend you read Michael Brown’s The Presence Process.


So we covered many different areas in discussing a physical debilitation.  The key take-aways are:

  • The body develops a problem where there isn’t sufficient muscle strength.  So training your muscles is key to prevent relapse.
  • Maintaining your overall health is important.
  • All physical problems have psychic roots.

I hope this article gave you some helpful insights.  My left arm has been relatively trouble-free the last few years, but writing this article was helpful to me as well, because it reminded me that I need to remain vigilant in maintaining my health and keep improving my fitness for my craft.  If there are other tips and approaches that you find successful in maintaining/improving your health as a musician, please let me know.