 The Clarinet BBoard
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Author: Carolyn
Date: 1999-04-15 02:58
Note: my mom is typing this for me coz of my hand.
Oh, it has finally happened. All that occasional pain in my right hand has manifested into constant pain. As in aching all the time, hurting when I do simple things like open a door, type, and of course (horribly) playing the clarinet.
I went to the chiropractor today (my regular doctor was of no help) and he poked and prodded and squeezed my arm and pronounced that I have brachial tendonitis in my forearm, which has moved one of the bones in my hand out of place.
Of course I would take this news badly, but on Saturday I have NYSSMA (All County and All State auditions combined), so you can imagine that I am upset. I can still play well, I have pretty good, if not normal, range of movement in my fingers. But my forearm and wrist hurt quite a bit, more so when I am not playing.
With everyone always talking about carpal tunnel I am relieved that it isn't that. As usual this comes at the worst time possible, but that's life. <b>Anyone who is experiencing occasional pain may have strained one of their tendons.</b> It is really surprising to find out that a tendon by my elbow is what is affecting my wrist...but it is. I mean, I am only seventeen, I really didn't forsee having hand problems now. The doctor says this should go away, with some exercises and rest, but it's really upsetting to know that this whole problem was basically caused by my clarinet playing.
I'm just curious to know if anyone else has had this same problem, and if what my doctor is telling me (it will go away soon) holds true.
Carolyn (and her mom)
P.S. Sorry this post has gotten so long...you know how being in pain makes you rant on and on!
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Author: lis
Date: 1999-04-15 03:31
Hi.... I too have tendonitis. The doctor has me on Naproxen, which keeps the tendons from becoming inflamed. (it's like Aleve) The medicine has helped me a LOT. I don't know what I'd do w/o it.
I had to cut back on my playing for about 5 months....I've slowly added time back on (I'm up to 3 hours a day). I also use a neck strap now.
My doctor also told me that the pain would go away after awhile, but I have yet to see it. If I miss a pill, my wrist kills me.
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Author: Dee
Date: 1999-04-15 11:58
I would suggest that you consult a specialist in muscle, joint, and tendon problems. Perhaps someone who specializes in sports medicine or the problems of musicians.
It would seem to me that neither a regular doctor or a chiropractor is the right member of the medical profession to deal with this type of problem.
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Author: Katherine Pincock
Date: 1999-04-15 14:47
I agree with Dee that you should try to get a specialist to look at your hand. However, I do have something to say about your question about whether you'll get better soon: yes (at least after several months) but ONLY if you really rest your hand. Don't tempt yourself into the "it's only five minutes..." routine or you won't get better. Switch a mouse to your left hand if you have to use the computer, get a dictaphone for notes if it's necessary, and above all DON'T PLAY until you're told it's safe. When you get back to playing, you should use a neckstrap at least to start, so that you don't re-inflame everything, and you should continue to use it if you still have problems. If you need to keep yourself in shape for playing during this time, two suggestions: do lots of mental practice (you'd be amazed at how much of pieces you can learn just by concentrating on the score, and it'll improve your understanding of the accompaniment parts too; and to keep your embouchure in shape, go to a mirror once a day and practice forming the embouchure without the clarinet in your mouth. You'd be amazed at how hard this is, even if you've been practicing hours a day.
This letter has also turned into a bit of a rant, but my boyfriend recently had this problem, and because he kept using his hands just a LITTLE bit, it still isn't healing properly. He fell into some of the traps I mentioned--things like playing a video game for a few minutes, or just trying a little playing to see if he could handle it. So please don't do that. You have an excellent chance of healing very well, if only you give your hand the rest it needs.
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Author: David Blumberg
Date: 1999-04-15 15:07
You should (must) use a neckstrap. Neotech makes a great one for Clarinet. That condition takes a lot of rest, anti-inflamatories, and time. Get to an orthopedic hand specialist ASAP, or it may affect you for the rest of your life. I've been bothered by it since 1989, and it has not improved one bit since about 1991. Even the top Orthopedic Doctors are still way behind in terms of an effective cure for it (and I've seen 7).
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Author: Ginny
Date: 1999-04-15 17:59
In my locality some musicians occasionally go to a sports clinic that does motion analysis. They study effective motion, minimizing injury and increasing ability. Obviously sports generates so much money that such a clinic has prospered. I have had little physical trouble from playing, myself and no personal experience to draw on. You may be doing some tension things and moving in a contrary sort of way and this may hurt you and lessen your playing ability in the short term (as well the future.) Just a thought, my sympathy too.
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Author: paul wusow
Date: 1999-04-15 18:18
I had carpal tunnel after I changed hand positions... originally I thought is was tendonitis. I went to a specialist at the Cleveland Clinic. I could not play for a few months (back in 1994...) But I used a lot of ice packs to relieve the pain. I am not sure if this should be done with tendonitis, so you may want to check with a doctor. Heat made the pain worse. After a few months of exercise and using a hand brace to slightly hyper-extend my fingers and wrist, I was fine and I have never has another problem since. The key is to avoid surgury at any costs, although there are great doctors out there, better safe than sorry.
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Author: John C.
Date: 1999-04-15 19:37
My advice: Get to an orthopedic hand specialist (MD) and his/her recommended physical therapist (OTR/L,CHT) before you do any further damage to your hand/wrist. It's a long story, but I am not trusting of chiropractors - I'll leave it at that. The therapist may be able to form a splint that can remove some of the stress, as well as help you strengthen the hand/wrist/arm.
I broke my left wrist two months ago (playing hockey, fell on the ice) and had major reconstructive surgery to put it back together. It has required physical therapy & daily exercise since then and I only have 50-60% ramnge of motion back so far, but can play again without pain. As mentioned elsewhere, the physical therapist is part of the sports therapy/rehab clinic that coordinates with the surgeon.
It's important to do this right - or you risk causing long term damage to the tendons, ligaments, and even nerves. There isn't much else in the wrist area, so it's easier to do harm than good if not properly trained and guided.
I don't know where you live, but of it is in the CT area, I can refer you to an excellent surgeon and therapist. Not only are they very competent, but they are extremely nice people.
Best Regards,
John C.
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Author: John Cole
Date: 1999-04-15 23:07
Musicians have a lot of problems with "Tendonitis"
In 1988 my son age 16 was at Interlochen Arts Academy (high school), and his organ teacher had him doing finger exercise on the piano. They were exercises where you hold down some fingers and try to lift another to give "independence".
He had been a bit lazy about practice, but he got inspired during summer and decided if some was good, a lot was better so in his senior year, by October, he was having pain, and had to quit playing.
Looking back, we concluded that the reason other students never got hurt by these exercises was that they were so boring and painful that the students simply didn't do them.
It didn't go away. Took him to a good sports medicine Dr. (whose wife is a violinist). He prescribed some squeezing exercises and said o practice as much as he wanted so long as it did not hurt. Well, every note hurt, so this was no help.
His teacher said forget a postgrad year at IAA and apply to
college, since it was doubtful if he could ever play again. IAA is a wonderful place but nothing was being done to find the answer, so I took him to a Gillian Weir concert at Hope College to see if she had any ideas.
She called 2 wks later with some references.
We also met Dr. Koiker backstage, a piano teacher at Hope who told us about an upcoming 3-day course at Eastern Michigan University called Playing without Pain" sponsored by the Dorothy Taubman Institute. Can't remember the EMU teacher's name (Joe Gurt, maybe?)
With IAA's permission he attended, and he found out he had been using an unnatural hand position-- wrists too low--. Some musicians naturally have good position and never have pain, but the overall message was-- if it hurts, DON'T DO IT!. Relax and find ways to avoid pain.
My son corrected his position, began practicing that summer and went on to Kalamazoo College that fall, where he continued with organ lessons,while majoring in chemistry. He never had any more pain!!! (only when he lowered his wrists, and he quickly learned to avoid it)
I found Taubman School of Piano, on the net. I don't know what they do today--she was pretty old-- but it's wasn't just piano-- they mentioned a violinist who could not straighten fingers avoided imminent surgery and learned to play again.
Dorothy Taubman Institute
Medusa, NY 12120
Enid Stettner, Executive Director
Phone: (518)239-4284
Fax: (518)239-6822
The point of all this is that pain is unnatural, and if it hurts, you need to find that niche which doesn't. I use a neckstrap, and I can play clarinet for hours. Before that, my thumb and wrist would just kill me. I moved my thumb rest up a quarter inch or so. That helped but it was the strap that made the difference. Hard to get used to. You have to find a compromise between letting the strap do all the work and the thumb doing it all.
Clarinets aren't made to fit everyone. Don't be afraid to modify it. I shortened the right hand low F key because I was always hitting it. So play with the thumb rest, etc.
This is long and I hope it helps--- Let me know. What I learned is that the answer won't come by itself and there are a lot of experts out there who can either hurt you or at least not help. You have to go after the answer yourself.
John
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Author: Arnold the basset hornist
Date: 1999-04-16 09:42
Well, I play a basset horn (much more weight than the clarinet, and I play the 'standard' clarinet very, very rarely) and I didn't like the (simple) neckstrap delivered with it - I found, it hurts my neck. So I'm allways playing with floor support, both standing and sitting. After a few years of practising in this way (and watching not to byte), just keeping the instrument in ballance with the thumb (or acting on the four basset keys of the german system), I found my right hand has moved it's position to a more comfort one for the fingers, mostly just touching the keys "forceless" when no key is to be actuated. I gained a 'free feeling' playing the instrument never known before.
Today, my basset horn is at a reapairs shop for complete overhaul, thus I practice on an A clarinet, and thought the weight of the instrument (I'm not used to it any more) is terrible - I cannot play more than approx. one half hour (short brakes after a few minutes) or it would handicap the other fingers of the hand. So I'm thinking to add floor support to my clarinet, too.
Another information I want to give to you is: I found (at the time I learned clarinet) that 'short' brakes (two weeks) during the holidays helped me to restart in a more relaxed way - but do not forget to reserve another two weeks for 'restarting practicing'.
So, what would I recommend:
You need not to buy a basset horn or alto clarinet (with floor support) - nevertheless switching to basset horn would be fine, but try to use a (brass) tube (approx. 3/8 to 1/2 in. outside diameter) as floor support, put the thumb rest into the top to the tube (which is protected from scratching the wood with some adhesive tape) an try playing whithout using your right hand thumb at all. If this is acceptabe, cut the tube to the correct length you need when sitting at a height adjustable chair, e.g. one for the piano. Then you may try to find somone creating a lenght adjustabe floor support (to play when standing).
You may wish to 'relax' your right hand for two or three days makeing some 'left hand only exercises', too.
If it's a hand position problem, this should help even on havy problems (but will take a few years).
Good luck and success!
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Author: Carolyn
Date: 1999-04-17 20:21
A big thank you to everyone who responded. I'm so glad to have a lot of different advice and opinions on the subject.
I went to the doctor, who is supposed to give me a referal to see an orthopedist who suppoosedly specializes in hands, however the office didn't file the referal with my insurance yet, so I'm still waiting on this. (don't get me started on how that annoys me)
Going to the chiropractor seemed to help a lot, in addition to taking Aleve and icing it down after practicing. Now that NYSSMA is done with (I went this morning and played pretty well, without much pain, and should get my score during the week)I will take a break from playing, which is kind of depressing, but it will help my hand heal. (Plus, Katherine's story scared me! ;-) ) Meanwhile, I have another chiropractor appointment on Monday to discuss how to deal with my injury in the long-term. And hopefully I can see the orthopedist this week.
Thank you again to everyone for their assistance. I'd better stop typing before I injure myself more.
Carolyn
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