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 Repetetive Strain Injury.
Author: Dad 
Date:   2003-09-21 22:14

Hi there. My Daughter is currently playing Clarinet and Alto Sax with various musical groups, also taking lessons for both instruments and self learning the Piano at home. My concern is that my Daughter has developed symptoms similar to Rsi, I am beginning to wonder if it is due to the fact that she spends so much time on the internet (typing) or if it is indeed too much time spent playing Musical instruments? Thanks, Dad.



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 Re: Repetetive Strain Injury.
Author: Hank Lehrer 
Date:   2003-09-21 22:26

Hi Dad,

I do many of the same things (except no piano lately) and have switched to a track ball rather than a mouse. I had some bothersome wrist problems prior to the switch and now have none. I'm pretty certain that the culprit is the internet-related mouse use, not the instruments but not being an MD, I'm not 100% sure.

I think there is great danger in not having the forearm that works the mouse supported. This lack of support can also effect the shoulder as well (see mouse shoulder from a web search).

An orthopod should probably be consulted and be sure to have your daughter tell the doctor about the music and internet use. I would not delay making an appointment as I do know that damage can be done quite easily.

HRL

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 Re: Repetetive Strain Injury.
Author: Dad 
Date:   2003-09-21 22:52

Hi Hank and thanks for the quick response. Your point regarding the Mouse, I recently bought a Trackball and did away with the old Mouse and also the Mousemat which had the wrist support built in. As I sit here at the computor I realise my wrist is an inch or so above the desk and it is becoming uncomfortable. I have now put the old Mousemat back into use and we'll see if it works any better. Thanks for your help. Regards, Dad.



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 Re: Repetetive Strain Injury.
Author: hans 
Date:   2003-09-22 01:02

I tried a track ball and it didn't suit me well; however, I was able to solve the problem that Hank described by making some changes to a wooden two drawer filing cabinet: I made a shelf that fits on top of the top drawer. The mousepad and cordless mouse sit on this shelf and my forearm is supported by the front end of the drawer, where I added a ledge padded with a foam strip. It helped me recover from a severe case of tendinitis.
It is not very complicated and was not a lot of work to make. If anyone wants to see what it looks like, I would be happy to post a picture.
Hans

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 Re: Repetetive Strain Injury.
Author: diz 
Date:   2003-09-22 01:32

I wouldn't be obtaining advise about this sort of thing from a Bulletin Board ... often no proveable credentials ... I suggest you speak to a physican or appropriately qualified medical professional (some even understand musicians' problems).

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 Re: Repetetive Strain Injury.
Author: Hank Lehrer 
Date:   2003-09-22 02:48

Diz,

This exactly why I said "An orthopod should probably be consulted and be sure to have your daughter tell the doctor about the music and internet use. I would not delay making an appointment as I do know that damage can be done quite easily."

However, I think there is a lot of evidence that the lack of proper support in the correct plane of the mouse-using forearm can cause wrist as well as shoulder problems. I'm not sure but I suspect that some of my emerging rotor cuff problems have been amplified by too much mouse use. The mechanics of it make sense (which is what orthodepics is pretty much all about). Levers, fulcrums, and forces seem to be pretty basic even with our bodies.

HRL

PS I was a pre-med major at one time though :-).



Post Edited (2003-09-22 02:51)

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 Re: Repetetive Strain Injury.
Author: supernova_khr 
Date:   2003-09-22 03:39

I have both carpal and cubital tunnel problems (both may be RSIs). Another RSI is tendonitus. All can have very different causes, and treatments, and it is possible that none are directly attributible to one activity. My orthopedic surgeon told me that they really can't pinpoint a specific activity as causing many RSIs, but know that certain wrist/arm/nerve physiologies are more suseptible. For instance, women tend to have smaller wrists (and carpal tunnels), and are more likely to be affected.

First thing to do is get to a doctor (GP, internist) for an assessment to determine what kind of specialist your daughter needs to see. You may be sent to a neurologist, a neuro-surgeon, an orthopedic specialist (possibly a surgeon), a sports medicine specialist, or to physical therapy. (I've been to all of them in my medical journey.) A physical therapist office may also have a ergonomic specialist you can consult with in regards to a computer set up, if that is indeed the problem. An ergonomic specialist can also watch your daughter play, and try to determine if the way she is supporting the instrument is the problem. Something as simple as a strap on the clarinet, a change in strap type on the sax, or a change in the height of the piano bench may help.

Some things I just can't do anymore. I used to play piano a lot, now am limited to about 15 minute sessions. With clarinet, I can play about 30 minutes, but not more. Things I used to lift with one hand now require two. I can't write by hand for more than 10 or 15 minutes. I can't knit anymore. There are some basic cleaning tasks (like scrubbing out a pot) than I can't do, my kids have to. I save my wrists for work (which involves extensive typing, as I am a research physicist.)

Your daughter is too young to be stuck with problems like this, so definitely get help from a medical doctor. Good luck! Kay

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 Re: Repetetive Strain Injury.
Author: BobD 
Date:   2003-09-22 16:45

diz wrote: "I wouldn't be obtaining advise about this sort of thing from a Bulletin Board "

Perhaps "you" wouldn't, diz but there's a wealth of actual experience with clarinet related medical problems among the members who participate here.

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 Re: Repetetive Strain Injury.
Author: hans 
Date:   2003-09-22 18:09

BobD (above) makes an important point; e.g., I was considering having my uvula burned out by an ear/nose/throat surgeon to reduce my snoring until I read on this BB that it would impair my ability to keep air from flowing out my nose while playing clarinet. The doctor did not warn me about this consequence of the surgery.
I am very grateful to the person who posted that information.
Hans

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 Re: Repetetive Strain Injury.
Author: D Dow 
Date:   2003-09-22 18:15

As an Alexander technique teacher I feel there may be a serious problem unless excercises and attention to the symptoms of RSI are stopping her from doing anything.

Could you please inform us to the symptoms she exhibits and whether or not they prevent her from practicing and doing what she normally does?
Sincerely,

David Dow

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 Re: Repetetive Strain Injury.
Author: Dad 
Date:   2003-09-23 21:45

Hi there. My daughter has complained of pains on the inside (the side closest to her body) of the lower right arm. It hurts when she writes and types and when she plays the clarinet the bottom-of-her-thumb-and-to-the-right is painful.
It doesn't affect her saxophone playing.
The piano playing is painful when she stretches her hands to reach keys.
She also has a new wooden clarinet on order and she tells me these are heavier - will this make the problem worse? If so, could you recommend a neck strap for a Buffet E-13?

Thanks in advance,

Dad

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 Re: Repetetive Strain Injury.
Author: David Spiegelthal 2017
Date:   2003-09-23 21:56

As some of the others have advised, please have your daughter see a doctor/orthopedist, rather than having the well-meaning but not necessarily medically-competent clarinetists here on the BB diagnose her from a distance!
My own recent experience (just for your data bank) is that, after around 30 years of playing clarinets and saxes (and of course using a computer extensively at work), this summer I started having pain and weakness in my wrists and hands, went to an orthopedic surgeon who referred me to a neurologist who did what they call EMG/CGS tests (something like that); basically 30 minutes of prodding, poking and measuring with little needles and electrodes, not too awful-----diagnosis was mild carpal tunnel syndrome in both wrists. Now I'm a real clarinettist! I'm controlling it by wearing elastic wrist braces at night (available at pharmacies) and so far, so good --- life goes on and I continue to terrorize family, pets, and unsuspecting locals with my {playing}.

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 Re: Repetetive Strain Injury.
Author: BobD 
Date:   2003-09-23 22:04

I went through the same regimen as Dave relates, with the same diagnosis. In discussion with the doctor I elected to abstain from surgery at that time. I found the wrist straps that Dave mentions "on my own" with no suggestion from the doctor and my problem hasn't gotten any worse. My point is that , bless them, doctors don't always have all the answers and that's why consulting with friends is a good idea. My opinion, however, coincides with many others here......have your daughter see a doctor.

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 Re: Repetetive Strain Injury.
Author: Synonymous Botch 
Date:   2003-09-23 23:50

No reason why she couldn't take a little rest, is there?

Just the right hand involved?

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 Re: Repetetive Strain Injury.
Author: supernova_khr 
Date:   2003-09-24 02:38

Going to the doctor for an xray may be a good thing to do. The thumb and lower hand pains, especially when stretching to play piano, may indicate some kind of injury (sounds similar to when my son severely bruised the muscle right below his thumb). This required a special kind of wrist brace that supported the wrist and thumb, and took about 6 months to heal. The symptoms you describe don't sound like what I've experienced with both carpal tunnel and cubital tunnel syndromes (diagnosed by a neurologist, and the carpal tunnel already operated on by an orthopedic surgeon.)

So, before you worry about the best neck straps...get your daughter to a doctor! If you're lucky, you'll find out the cause of the pain, and be able to fix it.

Goodf luck,

Kay

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 Re: Repetetive Strain Injury.
Author: Hank Lehrer 
Date:   2003-09-24 02:56

Hi Dad,

I would suspect that the repetitive use of a compter mouse could be more the culprit that anything else. We do things with our mouse arm that we do not realize. While doing them over a long period of time, slow but steady damage is likely occuring.

Take your daughter to a doctor.

HRL



Post Edited (2003-09-24 03:27)

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 Re: Repetetive Strain Injury.
Author: JMcAulay 
Date:   2003-09-24 06:11

This is a suggestion, not advice (I don't offer advice unless I'm qualified and get paid for it):

Try to see a specialist in Physical Medicine. Such a physician is likely to be the most qualified in isolating her problem; and if surgery is indicated, an orthopedic surgeon will be recommended.

Good luck and regards,
John
who had right ulnar nerve (cubital tunnel) translation surgery a while back

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 Re: Repetetive Strain Injury.
Author: Dad 
Date:   2003-09-25 14:47

Thanks for your responses. My daughter has an appointment with her doctor for next week. I don't think it is an injury as it is recurring(sp?). It will affect her for a week or two and then go away for a month or so. Either way, we'll find out next week. Thanks again,

Dad

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 Re: Repetetive Strain Injury (informative web sit)
Author: supernova_khr 
Date:   2003-09-25 15:56

If you'd like to see a lot of references on RSI and musicians, I found this recently.


http://eeshop.unl.edu/music.html

Kay

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 Re: Repetetive Strain Injury.
Author: C. Hogue 
Date:   2003-09-26 21:10

I have recurring pain in my right arm, on the inside, by the elbow. It's an orthopedic-diagnosed RSI, a tendinitis called golfer's elbow (tennis elbow is on the outside of the elbow).

The culprit was a computer. I mouse left-handed now. It took about two weeks to make the switch so it finally felt normal. This takes a heck of a lot of strain off my permanently injured right arm.

When I have flare-ups, it affects my clarinet playing, especially on the low horns with their big keys.

I take over-the-counter anti-inflamatories (Alleve, Ibuprofen, aspirin) to deal with the pain.

My experience should not guide your daughter's treatment, but perhaps this information could be helpful to you.



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 Re: Repetetive Strain Injury.
Author: azuka 
Date:   2003-09-29 15:07

I have had significant trouble with both arms due, I'm certain, to many hours of typing at the PC at my old job. Although having quit a couple years ago to be a stay at home dad, it hasn't really improved all that much.

I find that playing sax, piano and clarinet don't bother me much, if at all, but using the mouse and extensive typing is a big problem.

I invested $300 in an ergonomic keyboard. Not the wimpy and cheap Microsoft one with a 15 degree correction, but a serious keyboard. This baby is not for those who can't touchtype, since you can't see the keyboard. For info, there is a great website that shows a bunch of different ergonomic keyboards. http://www.keyalt.com/kkeybrdp.htm

The one I bought was the "Safetype" can be seen at http://www.keyalt.com/keyboards/safetype.htm

Best of luck.

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