Klarinet Archive - Posting 000494.txt from 1998/10

From: Lee Hickling <hickling@-----.Net>
Subj: [kl] Carpal Tunnel Syndrome
Date: Mon, 12 Oct 1998 05:46:14 -0400

I'm not a physician, and I'm not going to diagnose or prescribe for any of
the people on the Klarinet list who are afflicted with carpal tunnel
syndrome, but I think I have some advice on how to avoid it.

The carpals are hollow bones in one's hands, through which run the tendons
that move the fingers. Those muscles run up into the forearm. Picture a
piece of string running through a spool, and you won't be far off. Now
imagine the string being pulled back and forth through the spool. If it's
running straight and free, it won't become abraded. Pull one end sidewise
so it scrapes against the hole in the spool, and it will start to abrade
after a while, from the rubbing.

When your wrists are bent and your fingers are being used for many
repetitive motions, you are risking carpal tunnel syndrome. When your
wrists are straight and your hands are relaxed, the risk is perhaps not
zero, but far, far less.

I may just be lucky, but I spend from six to ten hours a day, sometimes
even more, at the computer keyboard, playing the clarinet or saxophone, and
playing the piano or organ. I began having some discomfort in my hands and
fingers a few years ago. I make what I laughingly refer to as my living
with music and writing, and that was very worrisome. I started thinking
about and researching the ergonomics of repetitive hand motions.

Here's what I did, which has been working for me.

First, on the clarinet, I made certain that I was playing in the classic
position, with the instrument held away from my body at a 40 degree angle
or thereabouts, and my elbows away from my sides. That balances the
instrument on the ball of my thumb, and straightens out the angle in my
wrists.

Read that last sentence again. It's crucial. Holding the clarinet closer to
one's body, with the elbows close to one's side, makes the weight of the
instrument rest on the side of one's right thumb, stressing it constantly,
and forces the tendons of the fingers to run at an angle through the wrists
into the forearms. Result, tension, abrasion, injury. And I know of public
school teachers who even advocate that position. In my opinion, they're
doing their clarinet students serious and lasting harm.

On the piano, no problem, because again I learned to use the proper
posture, body erect, elbows slightly above the wrists, backs of the hands
level, fingers relaxed in the curve that they naturally assume when
relaxed. On the organ, I have modified the height of the benches in the two
churches where I play, to approximate the same posture.

With all instruments, the goal is to have the fingers absolutely free and
relaxed, bearing no weight and under no stress. Not only is it better for
the player, but it also makes for better technique.

On the computer, I installed an under-desk sliding tray to get the keyboard
down to a level at which I can use the same relaxed forearm, wrist and hand
position as at the piano. Ever see an old-fashioned typewriter table? It
was designed to put the keys down at a level where the arms and hands were
relaxed. People come in different sizes, but for most of us, that means
from 20 to 22 inches above the floor.

I think it's far from coincidental that carpal tunnel syndrome only became
a major problem after computers began being used everywhere. Almost every
computer work station I've ever seen might have been designed to cause it.
Get the keyboard down well below desktop level, and get the monitor down
too, so you don't have to look up at it, but straight ahead and down a little.

Lee Hickling <hickling@-----.net>

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