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 Tendonitis...
Author: xmisskate07x 
Date:   2005-02-24 00:36

Hi everyone...I was just wondering if anyone has a problem with tendonitis in your right wrist from playing clarinet...

I was diagnosed with it in 7th grade...now I'm in tenth grade and my doctor is having me take four to six ibuprofen a day just to keep the inflammation of the tendon down. I also put ice on it for fifteen minutes a night and twice a day when I can. I have a neck strap, but my lesson teacher doesn't like me to use it...she says I shouldn't let my hand position become dependent on it. Also, it's impossible to do marching band with a neckstrap, so even if I use the neckstrap now I'll have to play without it next fall.

Cutting down on practice time isnt something I'm really willing to do...I missed the Texas all-state band by two people this year...and I'm trying to do all I can to make it next year. Plus, I really love to play.

It seems like I've tried everything...any ideas? somebody help please!



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 Re: Tendonitis...
Author: DavidBlumberg 
Date:   2005-02-24 00:43

Your teacher telling you not to use the neckstrap is wrong. She is being very shortsighted. (sorry, I had to write that as is).

4 to 6 ibuprofen a day is not very much. There was a time when I was taking 16 of em daily. (4 doses of 4). That was me (and I have a cast iron stomach) - you need to listen to your Doctor and what he/she tells you to take, etc.

The teacher is just "being a clarinet teacher" and not thinking of your medical needs.

Face it, with Tendonitis you don't have a "hand position" - you need to get well.

The rest of your life depends on it. It will heal over time (long time), but you have to rest it for that to happen. Consider seeing a Hand Surgeon to get another opinion and possibly a cortizone shot to help it - worked wonders for myself.

But do not play with pain!!!



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 Re: Tendonitis...
Author: sfalexi 
Date:   2005-02-24 01:40

As to missing the Texas state band, well, it stinks. But there's always other opportunities to play. But only if your right hand works. So whether you're willing to cut down on practice time now or not, it might be better to cut down now and heal correctly, than practice a lot not, and not be able to use your hand forever after a few years of too much abuse.

Listen to whatever the doc tells you. Your health should come first, above anything else.

Alexi

PS - I agree with Dave B's post, and probably just re-iterated a lot of it, but I felt compelled to say it also instead of keeping my trap shut. Cause then I'd probably see you back here telling us that you can't play anymore because of tendonitis, and how you would've listened to us if more of us had chipped in, and I'll feel like a jerk for not having done so.

US Army Japan Band

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 Re: Tendonitis...
Author: sonatina1234 
Date:   2005-02-24 01:51

I posted a brief summary of my journey with deQuervain's (tendinitis) in response to another post, but I'll go into more detail. I hope you get some advice from my 'experiences' ;-)

Like you, I'm in 10th grade now, and I was also diagnosed when I was in 7th grade. My doctor put me on ibuprofen (2 pills 3X a day) as well. He told me to ice it whenever it bothers me, and to avoid lifting heavy things with my right hand, such as my bookbag. When it didn't improve, I saw a doctor who specializes in hand and wrist injuries (an orthopedic doctor?) Anyways he gave me a brace that practically eliminated movement of my wrist and thumb, and had me wear it all the time. He knew that quitting simply wasn't an option, so when it hadn't improved in 6 months (we're in fall of my freshman year now) he put me in physical therapy for 6 weeks. My condition hadn't really improved, so my doc scheduled me for another appointment 2 months later. Well, about a month after my PT ended, my wrist suddenly got better- almost overnight! It was amazing. When I went back to the doc, he opted not to give me the cortizone shot, which is what he was going to do, since I was feeling much better. Unfortunately, I took advantage of it, and after All-County, it came back (though thankfully it hasn't been NEARLY as bad as it was last year). Oh crap, right? So anyways now its been about a year and a week since I was last at the doctor, and since it came back I've just been trying the home remedies my therapist showed me.

Sorry for anyone who actually read that whole thing. It was probably incredibly boring.

So anyways, here are some of the things I would recommend you try:

1. Every night - 20 minutes of ice, followed by 20 minutes of wet heat, such as a heating pad or a sock filled with rice put in the microwave for 2 minutes or so. The ice, as you know, reduces inflammation, and the heat does something with the blood flow.

2. A 'contrast bath' - this one is a pain in the neck, but apparently it's pretty helpful. Fill one large bucket with hot water, and one with cold. Put your hand/wrist in the warm bucket fot 10 minutes, immediately followed by one in the cold. Then 4 minutes in hot/1 in cold. Repeat the 4 min/1 min cycle for 15 minutes, ending with hot water. This has the same effects as ice/heat, I think.

3. Rest is really important. If you have an egg timer, practice for 15 minutes at a time, and then rest for 5. I usually ice right after I practice, too. In fact, I'm icing right now.

4. If possible, limit your computer time. The typing irritates the wrist unless you have some sort of amazing computer station (which I do not). Sometimes I keep the mouse on the left side, even though I'm right handed. Also, when it's really bad (like right now) I type with my left hand only (this whole thing is typed with my left hand only, hehe).

5. If you're right handed, you've probably realized that writing often irritates your wrist. If you can get one of those huge pencil grips or use a really fat pen or pencil, that helps too.

6. When I first started using the neckstrap in 7th grade, I though it was practically a godsend. True, you occasionally get strange looks, but thats when you say 'hey, I don't see *you* with one of these.' Just kidding, I've never actually said that. Anyways, my teacher and I realized about 3 weeks ago that the neckstrap is affecting my tonguing - I'm letting almost all the weight rest on my neckstrap, so I wasn't pushing up against my teeth, and my tongue wasn't making contact with the reed. Well, that's what my teacher said, and I guess she has a point. Anyways, so be careful with that, because since I've gotten so used to it, I can't use the strap for my NYSSMA solo (NY's yearly statewide competition thing). Also, with the strap I've found that sometimes my right shoulder gets really stiff after a while, but I don't know if that has much to do with the strap.

7. If it hurts, DON'T DO IT.

8. See a good orthopedic doctor. S/He can recommend you for therapy or give you a cortizone shot much easier than a regular doctor can (or so I've heard).

Anyways, I hope this helps. If you want to know more, my e-mail and AIM are in my profile (I think?) and I'd be happy to answer any questions, having been there, gone back, and am currently there now. We can fight together! :-D

-------------------------------------------------
Det. Lennie Briscoe: Maybe he's got some other life-long pursuits.
Lt. Anita Van Buren: Like what? You think he plays the clarinet?
Det. Lennie Briscoe: I *hope* he plays the clarinet.
~Law & Order

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 Re: Tendonitis...
Author: diz 
Date:   2005-02-24 02:45

I recommond you do not seek medical advice from this bulletin board ... go see your physician if you're worried ...

Without music, the world would be grey, very grey.

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 Re: Tendonitis...
Author: chicagoclar 
Date:   2005-02-24 03:20

I've had tendonitis for a few years, but this year it has been better than any other. I found it was helpful to :

1. Rest when I got sore or tight
2. Make sure hand position is correct
3. Use a neckstrap
4. Wear a wrist brace when sleeping (I found that I would sometimes aggrivate my wrist when I slept on it wrong)

Most important, listen to the doctors and see what they say.

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 Re: Tendonitis...
Author: EEBaum 
Date:   2005-02-24 03:37

You might also seek the opinion of a good chiropractor. In some cases, the condition is irritated by something out of alignment, and a proper adjustment can significantly alleviate the problem.

Also, when you're feeling better, get your thumbrest adjusted. I just got my clarinet overhauled, including a repositioning of the thumbrest (the highest position of the adjustable R13 thumbrest was still too low), and it's significantly easier on my thumb and wrist.

Be sure to stretch properly before playing, especially if you expect an intense session. It really does make a difference.

As for marching, perhaps you could take up an easy-on-the-thumb instrument, such as flute, for the next season?

-Alex
www.mostlydifferent.com

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 Re: Tendonitis...
Author: Claire 
Date:   2005-02-24 05:48

Well, I hope that there are more people than those with tendonitis reading this thread, because the truth is that clarinet players are just really hard on their bodies and need to take precautions before getting tendonitis. The best thing you can do for yourself is either see a Chiropractor or a Registered Massage Therapist. Not only will this help to relax tense muscles, but it will also make you much more aware of what is happening in your body as you play. The main key to remember is to drink lots of water (at least 8 glasses a day or more if you're going to be doing any strenuous activity) Remember though to only consider surgery as a last option as certain tissues will be cut and you will not be able to perform at full abilities.

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 Re: Tendonitis...
Author: DavidBlumberg 
Date:   2005-02-24 11:19

I consider chiropractors to be quacks.

Continue seeing a real doctor. Not that they can do much for it, but a chiropractor can make it worse instead of better.



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 Re: Tendonitis...
Author: Mark Charette 
Date:   2005-02-24 12:06

DavidBlumberg wrote:
>
> Not that they can do much for
> it, but a chiropractor can make it worse instead of better.

As can any doctor - medicine is not yet an exact science. There a number of "real" doctors who refer their clients to chiropractors for specific cases and treatments.

My personal belief is an MD for primary care, and using their judgement (with second & third opinions where warranted) for further treatment. People think nothing of being referred to a physical therapist for further work; a true chiropractor's field is similar to that.

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 Re: Tendonitis...
Author: DavidBlumberg 
Date:   2005-02-24 13:13

Agreed, but never first.



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 Re: Tendonitis...
Author: DavidBlumberg 
Date:   2005-02-24 13:47

There's a new therapy which re-injures the injury (tendon, muscle) which many who have done it get major relief from. It involves using a plastic "paddle" which digs from scraping over the injury thus reinjuring it, and then treating the injury like it just occured in the expectation that it will heal properly with proper treatment.


2 years ago I basically did the equal to myself by accident and got instant relief. I had really bad tendonitis from a car accident, and it lasted for months. I was sort of getting better, but not very much. I reached into a toaster oven to grab something, and bumped the top of the door by accident. I (reflex) pulled my hand back sharply and did the equivalent of snapping a whip with my hand - it hurt like all he*l, but it completely healed in 2 days. When I had "reinjured it" so sharply like I did by accident, I thought "jeez, here we go again, all that healing time wasted as I done did it again....", but the relief was in only 2 days and then the hand felt great.

Don't try that yourself though as murphy's law will probably come into play.



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 Re: Tendonitis...
Author: xmisskate07x 
Date:   2005-02-25 00:15

Thanks so much for all the info!

Much of it I've already tried...i had my thumbrest raised and i do ice/heat and stuff...but it was quite reassuring to know that those were actually good ideas that work.

It was also good to see how many other people are dealing with it...none of the clarinet players I know have it...and my doctor had never seen an instrument-related case of tendonitis before. I was kind of worried about taking so much ibuprofen...but six a day is nothing compared to 16...haha

So thanks for the sympathy and advice everyone! And for now I'm just going to buy another container of ibuprofen...keep on the ice...and continue seeing my doctor about it (honestly the whole chiropractor thing kind of scares me...).

And as much as I hate to say it...looks like I'm going to be cutting down on how often I play for a while...good time to learn that there is more to life than clarinet i guess...haha

and im thinking...if i take care of it now...and gradually work my practice time back up...i should be ok to practice lots and lots on all-state audition music next fall...thanks again!

~Katie



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 Re: Tendonitis...
Author: DavidBlumberg 
Date:   2005-02-25 02:05

Drink a lot of water and don't ever take the advil on an empty stomach. Even 2 though not really strong as an anti-inflamitory, can be hard on the stomach for some folks.

Fortunately it never did damage to my stomach, but certainly could have!!

And never play with pain - nothing in Clarinet is worth re-injuring yourself.



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 Re: Tendonitis...
Author: EEBaum 
Date:   2005-02-25 04:33

There's nothing to be scared of at a chiropractor (though perhaps David has some horror story), though if you do go that route I recommend asking people you trust (doctor included) for trusted recommendations of a good, experienced chiro. I've met people with good and bad experiences. Thankfully, mine have been only positive (10-minute painless visits, no medication).

MDs and chiropractors are often at each other's throats, each claiming that the other treats the injury improperly, and I'm sure there are misconceptions on both ends.

It's a matter I'd suggest investigating for yourself, rather than taking our word for it.

-Alex
www.mostlydifferent.com

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 Re: Tendonitis...
Author: DavidBlumberg 
Date:   2005-02-25 20:36

If the Insurance company covers it, it's legit.


If it doesn't........... Personally I feel that they are shysters (the ones that crack infants backs as they must have suffered sublixations in the womb....)


Either way, medically it is completely questionable.


You don't have to worry about getting medicine from a chiropractor as they can't dispense medication (see deffinition of a quack)



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 Re: Tendonitis...
Author: Mark Charette 
Date:   2005-02-25 22:12

DavidBlumberg wrote:

> If the Insurance company covers it, it's legit.
>

Many insurance companies cover chiropractic.

We know your position - it's been reiterated often enough. Time to get off the soapbox.

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