 The Clarinet BBoard
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Author: BobD
Date: 2006-12-08 13:31
Having had carpal tunnel surgery a few years ago it came as a surprise when symptoms recently reappeared. An internet search eventually turned up a book, "End Your Carpal Tunnel Pain Without Surgery" by Kate Montgomery which I purchased and can highly recommend for all clarinet players.
Bob Draznik
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Author: Ken Shaw ★2017
Date: 2006-12-08 14:33
I had hand problems several years ago -- not sure whether it was carpal tunnel syndrome -- and went to a physical therapist in NYC who specialized in musicians. She saw what was wrong immediately and recommended a new position for the thumb rest and changes in hand and arm position.
As it happened, this cured the problem, but she said that if I continued to have trouble, she had a list of exercises, therapy centers and surgeons.
I type a lot, and switching to a Kinesis Contoured Keyboard made a big difference. http://www.kinesis-ergo.com/
Good luck, Bob.
Ken Shaw
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Author: joannew
Date: 2006-12-08 17:46
The Alexander technique is also an excellent way to learn better use of the body, in playing and everyday life. Best learned early to prevent injury, of course, but also very helpful in recovery and preventing further damage.
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Author: skygardener
Date: 2006-12-09 07:42
I learned to reduce pain with Tai Chi (I also learned how to lift people that are twice my size off the ground! => ).
Other than that- Ton Kooiman Maestro. No pain anymore for me.
-S
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Author: blue street
Date: 2006-12-10 10:36
I've suffered a lot because of carpal tunnel syndrome. Stretching exercises helped me to feel much better. It also may prevent the symptoms to reappear.
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Author: BobD
Date: 2006-12-10 14:21
"Stretching exercises helped "
Yes, that's part of the message of the book....plus the tip that one carpal tunnel surgery usually doesn't make the problem go away. Had my surgeon told me that up front I might have made a different decision.
Bob Draznik
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Author: blue street
Date: 2006-12-10 18:37
Stretching is indeed helpful for us windplayers. Some 25 years ago I got in touch with an American who was teaching music in Sweden. He had a great interest in e.g. stretching, yoga, relaxation/meditation. All those techniques were part of his teaching. Very soon I was practicing it also in daily life.
Through the years I've also learned something about pilates, tai chi and qi gong. It's worth trying! Find out what's best for you. You'll also notice that you're playing will improve as an extra bonus.
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Author: Ralph Katz
Date: 2006-12-12 00:57
Friends, relations, and I have had CT and other hand issue which have responded well to the help of Physical Therapists, to Alexander Technique, to losing weight, to stretching, and to surgery. Any one of these may or may not permanently solve your problem - when in doubt, us a "shotgun" approach.
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Author: sherman
Date: 2006-12-14 02:05
One wonders if everyone is speaking about Carpal Tunnel syndrom or perhaps DeQuairvain's syndrome? I had the latter and suffered rather considerable pain in my left thumb and hand. I wore custom made braces, extremely tight therapeutic gloves and anything I could find to help me.
Finally I was sent to a surgeon who diagnosed the aforementioned syndrome. I was scheduled for day surgery, a very incision was made in my left wrist, approximately where one takes one's pulse.
In about a half a week the healing started and I was able to play with no pain. As it was explained to me, there are many ligaments in that small space and swelling for any reason will cause pain. Making that small incision was all that was needed as the scar tissue made the space larger allowing the ligaments to move.
The only residual difficulty is in wearing a heavy or tight watchband which can give pain. Simply remove your watch and it is gone. I'm told it is very similar to Carpal Tunnel.
best for the holidays,
Sherman Friedland
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Author: Michelle R
Date: 2006-12-14 10:41
Hi there, I come from Sydney, Australia and I've not posted before but since this topic has come up and is often misunderstood I thought I would contribute some of my experience. [I have fibromyalgia and chronic myofascial pain syndrome and as a result have had to learn an awful lot about the body in conjunction with medical researchers and practitioners in order to continue playing the clarinet.]
This could be a bit long but very worthwhile....
A significant number of people who are diagnosed with carpal tunnel syndrome do not have this at all (hence why the symptoms may return even after surgery). While there are some other problems people might have, (some have been identified already in other posts) a significant proportion of clarinet players who have sore wrists and get nerve pain in the wrist can attribute this to trigger points nowhere near the wrist referring pain down to the wrist!
Trigger points are basically microscopic "knots" that refer pain to other parts of the body. They feel like very small peas and hurt like anything when you push on them. They occur when we overwork a muscle and it contracts some fibres into a "knot". Everybody would have at least a few of them...sometimes they're latent but when pain is referred they're known as "active".
For problems with the wrist, generally the pain is referred to the wrist from the following muscles: Serratus posterior superior (just to the inside of the shoulder blade, the right-hand one is of interest for clarinet playing); Subscapularis (get to it by pushing in between shoulder blade and armpit); and the upper part of the following lower arm muscles - extensor carpi radialis brevis/extensor carpi ulnaris/flexor carpi ulnaris. You'll probably need to look at an anatomy diagram or something to find out where these all are.
The shoulder muscles will be affected because your arm is always reaching forward while playing and then it tightens as it fatigues, causes the knots and you can't move your shoulder back. If the arm muscles are the problem, then you're probably gripping the instrument tighter than necessary and over time the arm can't relax anymore. The tight muscles basically seizes up the arm and wrist and pushes against the nerves. These same actions in the shoulder and arm happen when typing, driving etc.
Massage the trigger points and initially there is instant relief. Continue to massage over a 2-6 day period and it all goes away until the muscles are overloaded again.
That's where options such as Alexander Technique, looking at the position of the thumb rest etc. come in. If you try these but never address the trigger points, the pain will not go away in a significant manner. Similarly, if you address the trigger points but not what's causing them, then they'll keep coming back and you'll get the pain back regularly.
There is proven scientific evidence for this information on referred pain, done by researchers Simon and Travell. An excellent book for those of us who don't want to read their 1000s of pages is found at www.triggerpointbook.com The book has great diagrams and it's easy to read. Note that pain in the thumb, TMJ and other things such as sore neck/bad back/hips can also be fixed with trigger-point therapy.
I play anywhere between 3-8 hours each day (performing, teaching, practising) and when in trouble I just find the points associated with the referred pain and push against them. I get instant relief, can continue on and very few people realise I have a problem (unless I tell them). I wouldn't survive very long without this knowledge!
I hope that someone finds this useful and gets some relief from their pain. Sorry it was so long!
Happy holidays,
Michelle
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Author: BobD
Date: 2006-12-14 13:50
Thanks to all for very interesting comments. I will follow-up on all suggestions. By the way, I did go through the standard tests and was diagnosed with cts prior to the surgery.
Bob Draznik
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