Was just now on Reddit and had a person pop up in the Mountain Dulcimer community there with questions about playing the Mountain Dulcimer with health issues in his hands that he’s working on a diagnosis for. I wanted to share the answer I gave him here, and would welcome any other insight folks might have for future reference:

” I’ve got some kind of general connective tissue disorder that runs in my family that resembles hypermobile Ehlers-Danlos syndrome but comes with a side of Dupuytren’s contracture, which I have in my right hand, so far not in my left but I suspect it will arrive eventually. I also have congenital MCP joint lock in the thumbs of both hands. So, my hands have reduced strength and flexibility all around and yet dulcimer is a dream instrument because it matches my ergonomic needs better than any other instrument I’ve tried. Some info I’ve figured out as a still beginner player:

Picking/strumming hand: I’ve got a whole collection of different picks as I’ve tried to find what works for me, as my hand flexibility decreases over time. I find I like a pick with good flexibility as it compensates for my lack of same. Dunlop nylon .46 mm are my go-to for flat picking, but they might be too small for some folks. Blue Mountain blue thumb picks for finger picking are great, and I’ve been playing around a bit with Oud picks for fast strumming, which isn’t something I do much of, as their length and flexibility makes for less hand/wrist strain for me.

Chord/noter hand: Set up of the instrument is key. I had a previous dulcimer with high action, among other problems, and it was a complete life changer when I got a dulcimer with lower, easier action. Depending on your playing style you might find a three string (no doubled melody string) easier to manage. VSL is also key - don’t overstrain your hands by trying to play an instrument that’s VSL is just too long. My dulcimer at the moment has doubled strings and it’s VSL is a little too long for me to chord easily so it’s going to be my noter/drone dulcimer and I’ll be getting a New Harmony Pudge Pro soon, which has the VSL and three string setup I need, on the advice of my dulcimer teacher.

Hope this helps!”