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 Left hand issues
Author: bethmhil 
Date:   2013-05-22 17:51

So, we all know the horror stories of tendinitis and pain that clarinetists seem to be plagued with. Recently, one of my colleagues went to the emergency room because she was having unbearable shooting pain in her right wrist & arm while playing. Very scary. About a year before I began going to college, I was also heading down this dark road. Thankfully, I began using a neckstrap, and the pain & numbness in my right hand stopped within a month.

However, the neckstrap doesn't help with the pain & numbness that I get in my left hand. Yes, my left hand. It's strange and makes no sense, since the left hand does not support the weight of the instrument. But honestly, 80% of the pain that I get from playing this instrument is in my left hand & arm nowadays. It started in about February of 2012 and has gotten gradually worse since. I'm meeting with prospective clarinet instructors for grad schools this summer, and in the midst of all that stress, I can't afford to be dealing with this right now.

Any thoughts as to what could be causing this? I've talked to my clarinet instructor about this several times, and he really has no idea; He has noted that most of my excess tension is in my right hand, but not really in the left hand at all. Obviously, I'm doing something wrong... any thoughts?

BMH
Illinois State University, BME and BM Performance

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 Re: Left hand issues
Author: JJAlbrecht 
Date:   2013-05-22 17:55

It would be foolish to guess what is causing your issue. See a qualified doctor/exercise physiologist/therapist and get a definitive answer and an effective treatment. Opinions from amateurs who have no knowledge of your personal physical issues can cause you more harm than help you.

Jeff

“Everyone discovers their own way of destroying themselves, and some people choose the clarinet.” Kalman Opperman, 1919-2010

"A drummer is a musician's best friend."


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 Re: Left hand issues
Author: MarlboroughMan 
Date:   2013-05-22 18:01

Hi Beth,

First and Foremost: consult a real doctor.

Second: I'm one of those lucky players who has been able to log any number of hours, on mutliple instruments, and not feel any fatigue or pain. All except for one period of a couple of weeks this past winter--now this might not apply to your situation, but here's what happened to me:

I was looking at ligature setups, and decided to give the old Artie/Benny/Kell style of turning a Selmer metal lig to an inverted position. I liked the sound and response, so I kept doing it for awhile--shortly after switching I began experiencing fatigue, slowness, and pain in my right hand. After a few days of trying to figure out the problem, I realized that I was adjusting the screws on the lig in an awkward way, and that was causing the problem. So I made some adjustments to an old Rovner Eddie Daniels model, got the same response from it as the turned Selmer, and my hand got back to normal.

Now I don't think you're experiencing this left hand pain for the same reason...BUT, all of the more obvious things aside, you might look at anything you're doing with your hands--even in daily life aside from the clarinet--that you weren't before Feb 2012.

Good luck--I hope you find a solution. But once again, I'd strongly suggest you go to a doctor.

Eric

******************************
The Jazz Clarinet
http://thejazzclarinet.blogspot.com/

Post Edited (2013-05-22 18:04)

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 Re: Left hand issues
Author: Maruja 
Date:   2013-05-22 19:04

I was having trouble with my right arm - par for the course. I went to the physio and she suggested tension from the shoulder -nothing to do with playing the clarinet. She did work on the shoulder area, I changed my pillow to a sort of triangular thing which seems to support my head better without hoisting up neck and shoulders - and bingo, the problem has disappeared.

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 Re: Left hand issues
Author: kdk 
Date:   2013-05-22 19:13

This isn't something for a clarinet teacher to diagnose. My hand pain and numbness come from "pinched" nerves in both my neck and my elbow. Yours could be caused by any number of things, but chalking it up to "tension" without a medical diagnosis is probably just postponing meaningful treatment.

Start with your family doctor. He/she may refer you to one of two or three specialists, depending on what he or she finds in an in-person exam. At your age this is almost certainly treatable.

Karl

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 Re: Left hand issues
Author: Ken Shaw 2017
Date:   2013-05-22 19:59

Nothing can replace the hands-on diagnosis of a doctor or physical therapist.

Nevertheless, there are a few non-invasive things I've tried.

Look in a mirror at your left hand position. Ideally there should be a straight line from your elbow, down the top of your arm and across your wrist to your knuckles. I've found that cocking my wrist back inevitably produces pain.

Experiment with hand positions. First, lay your fingers as diagonally as possible on the upper joint, so that your left index finger almost touches the throat Ab key and your ring finger is extended flat to cover its hole. This produces economy of movement, particularly for your index finger. However, for my hands it cocks the wrist back.

Next, lower your left palm so that your fingers come in at (or almost at) a 90 degree angle. Pretend you're picking up a tennis ball.

Try in-between positions to find the most comfortable position that requires the least movement and produces the least strain.

It's HARD to pick and hold a better position than the one you're used to. The moment your attention wanders, you go back to the familiar way. I think watching in a mirror is the best way to work on this.

Work to minimize movement in your left hand. Pretend you're trying to hide your finger movements from a spy.

Part 3 of the Langenus Method has three excellent exercises for the left hand. They take less than a page. I run through them every so often, and my left hand always feels good when I finish.

Ken Shaw

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 Re: Left hand issues
Author: Paula S 
Date:   2013-05-22 20:27

Beth,

Some sound advice here about consulting a doctor/physio as it could be a number of things. I have to watch my neck as I had two prolapsed discs about ten years ago which trapped a nerve to my left arm which was agony. I am okay with a neck strap for my Bb clarinet but I have to wear a strap around my waist to support the alto I have been playing recently. It might not be due to the weight of the clarinet but the posture you adopt when playing?

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 Re: Left hand issues
Author: Taras12 
Date:   2013-05-23 02:04

I echo all who advise you to seek professional medical help, Beth. There are many factors which influence pain and function. It wouldn't be a bad idea to take your instrument with you to your appointment.

Tristan

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 Re: Left hand issues
Author: Paul Aviles 
Date:   2013-05-23 02:21

Well, I'd like to throw out a thought.


Recently (within the last few years) I've come to the conclusion that even though I have large hands, my fingers are somewhat short. When executing the "diagonal approach" for the left hand (though this might seem most economical on the surface) I found that my pinky was stretched to its limit (and beyond !!) moving to the alternate B key. This causes quite a bit of strain throughout the entire palm after awhile.


I found this by accident, trying to mirror the perpendicular approach of the RH once I started to incorporate the "upward slant" of the RH thumb that is taught by Elsa Ludwig-Verdehr. As I did this more and more with the LH, I found that reaching the pinky keys was much easier (for me) and not at all stressful. Of course this means you are more conscientiously moving your index finger UP to activate the A key, but that's not much of a difference at all.

I'm NOT saying this is your solution, but I'd just like to have that out there in case it may help anyone in general.





..........................Paul Aviles



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 Re: Left hand issues
Author: clarinetguy 2017
Date:   2013-05-23 02:27

I agree that it would be wise to consult a physician who specializes in these things. Before you go to a doctor, though, there might be a few things to consider.

I'm assuming that you do some piano/keyboard playing now and then. What happens if you try to play rapid scales with your left hand? Do you get the same pain?

Is there any pain when you're using a computer keyboard?

Finally--and I know this is not easy for many people to give up--do you use an iPhone or Smartphone (or something similar) frequently? Do you do a lot of texting? It's possible that your pain has little to do with playing the clarinet. There are numerous articles on the topic, but here are two:
http://www.theregister.co.uk/2006/02/22/text_injury/
http://www.dallasnews.com/health/diseases-cures/headlines/20111107-fight-off-common-hand-pain-caused-by-texting-typing.ece

I'll confess that I'm old fashioned because I don't have an iPhone or Smartphone and I seldom text. Still, it might be worth limiting computer use and using your phone for only phone calls for the next several days to see if it makes a difference.



Post Edited (2013-05-23 02:31)

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 Re: Left hand issues
Author: bethmhil 
Date:   2013-05-23 03:18

Thank you all for you very helpful responses. To respond to a few...

To everyone who suggested going to a doctor:
Yes, obviously this is the best solution. Unfortunately, my health insurance does not cover visits to specialists and I am in no position to pay for something like this. I've been researching stretches & exercises on the internet that I might encounter with a physical therapist and am hoping I can find a beneficial solution without having to go to a doctor.

To Clarinetguy:
I used to be a full-time pianist when I was in high school. I never had the shooting pains that I have now, but my endurance for playing fast, scalar passages for long periods of time was very low, which led to me giving it up completely. However, I do get some pain when typing on a keyboard. I will definitely take this into consideration. The pain I get (and am having right now) is the same pain that I get when playing-- pain & tingling extending from my elbow to my index & middle fingers.

Paul, your ideas are helpful, but I'm not sure if I totally understand. The diagonal approach would then force the fingers to be angling upwards and lock, yes? I do not do this. My fingers are at an 80/100 degree angle with the instrument, which helps them to not lock and stay somewhat curved and reach the pinky keys with ease. Ken, using the diagonal approach like you suggest actually hurts a lot. Forcing my fingers to be perpendicular with the instrument forces my hand to collapse and is awkward... however, no pain.

Maruja, it is possible that there could be tension coming from my shoulder. I have a tendency to tense it upwards when I'm playing technically hard passages. However, I'm very conscious of this nowadays and don't do that as much as I used to. It is possible though that it caused lasting damage. I'll ask my clarinet teacher about it.

BMH
Illinois State University, BME and BM Performance

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 Re: Left hand issues
Author: gsurosey 
Date:   2013-05-23 04:13

Index and middle finger pain/tingling make me think of carpal tunnel syndrome. Do you do a lot of repetitive motion (musically and/or otherwise)? I'm not totally sure, but I think a primary care physician can do some testing for that, so you wouldn't need to worry about a specialist (at first at least).

Is there a specific motion or position that brings on the pain or makes it worse? Or that makes it better?

----------
Rachel

Clarinet Stash:
Bb/A: Buffet R13
Eb: Bundy
Bass: Royal Global Max

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 Re: Left hand issues
Author: JonTheReeds 
Date:   2013-05-23 10:30

I agree with those who have said get the advice of a professional - ie. a doctor who specialises in musicians. This is not something that you can diagnose from a forum, or even something that your teacher can help you with

A few years ago I had severe problems with my left wrist caused by work but exacerbated by playing an instrument (then a guitar). I was lucky to be referred quickly to a physio, who specialised in musicians, who was able to quickly diagnose the problem and propose steps - from the point of view of a musician who needed to play - to minimise the pain

Two points though: depending on what the specialist tells you, be prepared to scale things back in the short-term to enable you to continue to play in the long-term; and also be prepared that this may be something that will never go away completely but will need to be managed for the rest of your playing career

--------------------------------------
The older I get, the better I was

Post Edited (2013-05-23 10:45)

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 Re: Left hand issues
Author: Paul Aviles 
Date:   2013-05-23 11:39

Hmmm...... .what you describe is more an issue with the extensor muscles of the hand (they run up the top of the fore arm).


I may not have described my position in detail (though it's clearly not your issue at all). I have my finger of the left hand approach at a perpendicular to the clarinet or even with the index finger having to point UP !!!! In this position my pinky is heavily curled and I move from one pinky to to another by adjusting the amount of curl, NOT by pivoting from the base of the finger (so much). Again this worked in my short finger situation but pain in the index finger is a different story.




...............Paul Aviles



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