 The Clarinet BBoard
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Author: claclaws
Date: 2004-12-27 10:44
Today I visited an orthopedic surgeon, took x-ray pictures, and even had a 50-min session of physical therapy...
To make a long story short, I have had pain on my left thumb for about 3 months, and I cannot deny my clarinet practising has something to do with it ( But, really, I didn't practice that much..! maximum 4 hours(only once), generally 1 hour or less per day..)..
And the surgeon, who examined the x-ray pictures, told me that I also had neck bone problem and may risk a neck disc and recommended physical therapy.
So, despite such a disheartening situation that I'm facing now, I have to say several eye-opening postings I found using 'search' here at this BBoard were of tremendous help and gave me great deal of hope.
It's really sad and even perplexing to think that I have to TOTALLY BAN my clarinet practicing time. My teacher advised me that perhaps I focus more on the breathing exercises and avoid using keys above B (that requires left thumb). I'm thinking about playing at least 15 to 30 minutes, but on the other hand a pianist friend of mine who had suffered carpal tunnel syndrome said "Just give it up till it gets better".
Any advice/recommendation/condolence(>) will be sincerely appreciated.
Lucy Lee Jang
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Author: Bnatural
Date: 2004-12-27 13:08
Give it up until it's better. I don't no your situation, if you have to play to put food on the table. But, give it up until it's better. Using some of the horn isn't worth it, you'll still use the thumb with out thinking abotu it.
You'll do better fi you do this now
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Author: clarinetwife
Date: 2004-12-27 13:32
My sympathies -- it is hard to give it a rest when you enjoy it so much. Likewise, I don't know your situation. However, a bit of rest is often a necessary early step in these situations. Your long term problems are likely to be greater if you push it now.
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Author: Brenda Siewert
Date: 2004-12-27 14:23
Not to encourage a bad situation, but you can get a clarinet stand that will hold the clarinet for you and you wouldn't be putting any weight on your thumb at all. The neck situation is another--change your position.
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Author: CPW
Date: 2004-12-27 14:44
Hmm....I can understand that u can have thumb pain from a neck disk, but wouldnt the disk effect other hand or arm parts, and not just specifically the thumb?
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Author: stebinus
Date: 2004-12-27 14:55
I have also had a problem in my left thumb. I agree about taking time off. Also it helped me to lessen the tension of the octave key spring. It can be very light and still funtion perfectly well. I actually removed the spring and replaced it with a hair tie but I'm sure the spring can be bent. You might even consider taking up tin or Irish whistle or fife for a while which are lighter and don't use the left thumb to cover a tone hole.
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Author: clarinetwife
Date: 2004-12-27 15:35
CPW brings up a good point--do the doctors think the thumb issue is indeed related to the neck disk or is it more of a motion issue in itself?
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Author: OpusII
Date: 2004-12-27 15:51
Don't play for a couple of months... believe me, the risk of greater injury isn't worth it! I've had the same troubles in my right hand and they are completely gone now...
But, I think the main question for you is...
- why do I have troubles with my LEFT hand...
- What can I do to prevent the injury in the future..
Possible solutions
- Let the arm rest for a couple of months and after that period take fitness lessons to strengthen the left arm/shoulder.
- Take so called micro pause, after 10 minutes a break of 10 seconds.
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Author: Brenda Siewert
Date: 2004-12-27 16:03
Sorry, I misread--you said LEFT thumb. Well, that changes everything. Guess you need to follow doctor's orders.
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Author: earlthomas
Date: 2004-12-27 16:09
Have you tried keeping he left cuticle of the left thumb in constant contact with the register (octave) key and simply opening that key by the slightest possible "twist of the left wrist'? That way one can keep the joints of the thumb immobile.
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Author: rc_clarinetlady
Date: 2004-12-27 16:18
Hi Lucy,
I wrote in to this board a while back about this very same issue. It was my first writing for advice. I also have had the pain in my thumb and wrist from over usage to the point that I had to have surgery about five years ago. I didn't want that to happen again so I needed some advice and quick about what to do to avoid it. This is what helped me.
I had been practicing from 1-4 hours a day so the first thing you must do is cut down on practice time. There is no substitute for rest.
You should also get a good neckstrap and use it every time you practice at least as long as your thumb is flared up. Also, look at the Kooiman thumb rest systems. One may be right for you. I like the Maestro but haven't put it on my clarinet yet due to expense. I will at some point though.
I also got a thumb and wrist splint called a "thumb spica" and wore it 24/7 for the first two weeks that I was in pain and that seemed to help a lot. My orthopedic surgeon had given it to me when I had surgery the firt time so I went back to using it this time to avoid any need for surgery a second time. It worked. I've seen those "thumb spica's" in the stores wherever pharmaceuticals are sold. They are with the knee braces, ankle braces etc....
Good luck to you and even though it's hard to rest.........it will help you the most. Rebecca
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Author: rc_clarinetlady
Date: 2004-12-27 16:24
Oops! I misread too. I thought you were having pain in the right thumb. I didn't know it was the LEFT thumb. Well, everything I said will mean nothing to you now other than the one about rest.
Good luck to you.
Rebecca
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Author: CPW
Date: 2004-12-27 16:30
I think we are missing a lot of facts here. Like where in the thumb is the pain and what kinda motion makes it hurt etc. "Does it hurt when you do this.....Oh, well stop doing that."
Wouldn't a neck (neck as in the thing underneath your skull) problem make it hurt all the time?
If it is a neck problem, using the thumb wouldnt make the disk worse, would it?
OR...I know the hip has a "neck" in the leg bone that joins the hip to the pelvic bone (femur?). Maybe the orthopedic surg. was talking about the "neck" of a thumb bone (raising the question, where is your tromb bone??)
So far you have 9 Clariboard opinions vs. one from a physician. Maybe u need another sawbones' opinion...just a thought. I think there are orthopedists who specialize in hand surgery (at least I have seen one listed in the local yellow pages that sez that) so maybe u need additional advice.
partly OT: Is a bone veterinarian for birds a orthoorinthologist? And is an aviary neurosurgeon a birdbrain?
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Author: Bnatural
Date: 2004-12-27 16:40
Can you tell us your approximate location, maybe one of us who has gone through this can send you towards a doc that will help
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Author: EEBaum
Date: 2004-12-27 17:30
While opinions on the board (re a recent discussion) are mixed on the issue, I'd personally recommend seeing a *good* chiropractor. I had wrist pain and a sore thumb, and a short visit cleared it up completely.
If a nerve is being pinched somewhere in your neck, a chiropractor might do a world of good there as well.
I'm currently toward the end of a series of visits to clear up damage from years of poor posture.
CPW has the best advice, I'd say... see another specialist or two.
-Alex
www.mostlydifferent.com
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Author: CPW
Date: 2004-12-27 17:47
..............And that would include a chiropractor.
I concur with my brethren (and sisteren) on the bench.
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Author: idahofats
Date: 2004-12-27 22:10
I am not a medical professional, but I play one on TV...by all means consult with your physician, but also a while back on this board Alseq, who is an MD, mentioned doing a google search on Thoracic Outlet Syndrome (one form of neck-related hand pain) which I and my sister found very helpful. Even a physical therapist or chiropractor will steer you in the direction of some of the exercises you'll find on the Web---some are TOC-specific while others relate to carpal tunnel syndrome. My personal remedies for pain involve rotation of the affected digits opposite to their "normal" positions and postures--your results may vary.
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Author: Alseg
Date: 2004-12-28 00:13
Thanks for the intro, Idaho.
I have to agree with the posts that indicate some skepticism.
I must admit that there are missing parts to this puzzle, including the findings of the exam.
Words of an old professor: "when all else fails, take a careful history, and do an exam!!"
We do NOT have a history....I dont even know the age of the patient (which has a great bearing when contemplating Thoracic outlet syndrome...which this case does not seem to represent), nor the motion that elicits the pain.
Yes...I am hesitant to think first of a pinched (lay term) neck nerve.
Aside from the above, all else is speculation.
I concur with "brother" CPW, although less poetically and certainly without CPW's usual sense of frivolity or cynicism.
added later......the condition "Gamekeeper's thumb" comes to mind.
Former creator of CUSTOM CLARINET TUNING BARRELS by DR. ALLAN SEGAL
-Where the Sound Matters Most(tm)-
Post Edited (2004-12-28 03:06)
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Author: Bnatural
Date: 2004-12-28 02:51
when she said advice I don't think she meant medical
important thing for her to hear is that she take a break
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Author: claclaws
Date: 2004-12-28 07:04
Many many thanks to all of you.
I was almost to tears as I read through your sincere and helpful postings. How can you be so nice to a total stranger, only because she plays the clarinet!?
Some more information(maybe for Alseq): I'm 36, Korean, mom of 2 kids and picked up the clarinet lesson after 10 year-pause since last year.
The neck problem was always there as far as I can remember. I sit quite long hours reading, working on computer etc, and my posture wasn't so good. Some stretching sessions and aerobics soothe my aching neck, but I never wanted to go to orthopedic doctor , I thought I can bear it.
It's really embarrasing to tell the following, but here it goes. The left thumb fiasco happened during last Harvest Festival in September. My younger son insisted we make traditional rice cakes, I happily agreed and made a nice dish...only it made me use my LEFT thumb very severely when making the dough for about 3 hours. Feeling the pain, I first visited a local acupuncturist. It didn't get better, so I visited another doctor (anesthesist) and he said there's a kind of knot or lump in the left thumb vein(?) so I needed an operation! I was dumbfounded but went with it. For a month, it felt okay. I even told myself that did good to my clarinetting as my left arm/hand became tension-less (of course..).
But after two performances with my amatuer groups in December I figured out it's not really wise to sit on my pain, and went to the orthopedic doctor.
Thanks for the chiropractor idea. Never thought about it.
I'll also check the TOC related sites or articles and find some doctors specialized in that.
Once again, thank you all, and I think I'll be practising wiser than harder in the future..
Lucy Lee Jang
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