Klarinet Archive - Posting 000534.txt from 1998/10

From: Jacqueline Eastwood <eastwooj@-----.EDU>
Subj: Re: [kl] Carpal Tunnel Syndrome
Date: Tue, 13 Oct 1998 17:02:26 -0400

On Mon, 12 Oct 1998, Lee Hickling wrote:

> 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>
>
> -------------------------------------------------------------------------
>
>
I agree 100% with this "prescription" -- proper posture/positioning and
relaxation of tension in the body are vital to injury treatment and
prevention. I have always made a point of adjusting my work
station/environment to accommodate this (I even have a special table for
my adding machine, with casters so it can roll around the office!). And
computer monitor height is much more important than many people think --
putting it on top of the CPU box is common, but the resulting angle can
really strain your eyes and neck if it's too high.

Jacqueline Eastwood
Business Manager, School of Music Principal Clarinet, Arizona Opera
University of Arizona 98-99 Season Website:www.azopera.com
eastwooj@-----.edu

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