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 major ergonomic problems, need advice!
Author: beavertoof 
Date:   2007-10-01 15:25

hi all,

I am a 45yo violin and guitar player (also clarinet a bit, maybe more now), but have been experiencing on and off severe problems with my hands and arms... tendonitis in arms, numbness and nerve pain in hands etc...

for a living i am a computer programmer, so am using the keyboard daily, which is the real problem.

i have been dealing with this for years and have some luck doing all the standard things to help, but it always comes back, and each setback seems more severe.

The latest has led me to seriously ponder setting aside guitar and violin as they both really seem to cause alot of problems, and going more towards clarinet, as the position of holding the clarinet is very neutral.

of course as i am sure you all know, the pressure though on the right hand thumb joint can be pretty painful. i have a cheap strap, which does help.

my question: what has been anyone's experience with any higher end strap systems out there... can I really expect to remove the weight of the clarinet from my right hand with one? and if so, which one(s)?

though I do not love the sax like the clarinet, I am even pondering the alto sax, as I did play one years ago, and it seems that that would be a very ergonomicly friendly instrument as you can use a body strap.

thanks for any input.

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 Re: major ergonomic problems, need advice!
Author: claritoot26 
Date:   2007-10-01 15:41

BG makes some nice neckstraps. I have a less expensive (~$30) one, but they make some that go over the back and attach to your pants. You can also get the thumbrest raised so that it is across from the index finger. Or use a different thumbrest...J Moses recommended a Loree English horn rest in another post.

Also, if you haven't yet, you should see a doctor about the problem. Physical therapy may help. I have also had problems with tendonitis and tingling, possibly due to a pinched nerve. PT helped me a lot while I did it, but it still comes and goes. Now I try to stay more physically fit, and strengthening my core muscles and improving my posture seems to help the problem.

Another thing that helps is making sure your neck doesn't bend forward when practicing (or using the computer). Standing up against a wall with the back of your head touching while practicing is good for improving posture. If the neck bends forward as you work, that can aggravate a pinched nerve, if that's what it is. It causes tension, too. You could also invest in ergonomic office equipment, like a chair with a high back for neck support, and make sure the monitor is high enough so your head doesn't droop.

Good luck with this. It seems many instruments and other occupations have risks for repetitive motion type injuries. But, there are ways to alleviate the problems if you pay attention to what your body (or your doctor) tells you.

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 Re: major ergonomic problems, need advice!
Author: Bob Phillips 
Date:   2007-10-01 16:26

I've been using the BG elastic strap on my Buffet since ClarinetFest in mid-July and am experiencing an improvement in my "carpal tunnel" syndrome in my right forearm.

The elastic strap is neat because you can set it to gently hold the clarinet mouthpiece where you want it. Then, your right thumb just keeps the instrument away from your body --not, it turns out to be, a minor load on that thumb.

A nice benefit of the strap is that it keeps me from letting the mouthpiece slip out of my mouth --worsening my tone and control of my altissimo.

I think it would be worth a try-out.

Bob Phillips

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 Re: major ergonomic problems, need advice!
Author: Ken Shaw 2017
Date:   2007-10-01 17:14

beavertoof -

Don't try to fight through the pain. That only makes it worse. Get help immediately.

Go to a physical therapist who specializes in both musicians and keyboarders. When I had hand and wrist problems a few years ago, a single visit improved things tremendously. The therapist immediately saw several problems and showed me where to reposition the thumb rest, plus where to put an eyelet for a neck stap. She then worked with me on hand and arm position and recommended a clinic where I could go if necessary (it wasn't).

Another solution is to use the fhred instrument support, which holds the entire weight of the instrument. http://www.quodlibet.com/FhredGen.htm

Finally, I switched to a Kinesis Advantage contoured keyboard, which has the keys in a cup-shaped depression that matches finger length and angle. The "plain vanilla" version isn't cheap ($299), but it immediately stopped hand and wrist pain. http://www.kinesis-ergo.com/ Be sure to get the Advantage model.

For more, you can search here on Kinesis and fhred.

Good luck.

Ken Shaw

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 Re: major ergonomic problems, need advice!
Author: beavertoof 
Date:   2007-10-01 17:15

claritoot26,

thx, I have already done/doing all the stuff that is supposed to help, and it all does help, but at times depending upon workload etc... it comes back, and what is worrisome is the severity always seems to deepen.

I simply can not quit my job, which i think is the core problem, but what really exasperates it is trying to hold the dang violin, and dealing with the guitars' wide and long neck is bad too.

I try to mostly play swing (hot club of france stuff my fav), which the clarinet works fine for. I have been playing it on and off for some years, and getting better to where I think the switch is realistic, -if- I could get past the thumb thing.

Bob Phillips,

thanks, I think I possibly already have the elastic strap you refer to. My only problem with it is that it seems to make my clari hang too low, so i am still holding the thing up.

why I was wondering about other strap systems, and even alto sax.

thx again all

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 Re: major ergonomic problems, need advice!
Author: beavertoof 
Date:   2007-10-01 17:18

Ken

>>Another solution is to use the fhred instrument support<<

Thanks! This is something like what i was hoping would be out there!

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 Re: major ergonomic problems, need advice!
Author: DavidBlumberg 
Date:   2007-10-01 18:36

Microsoft makes a split keyboard which is great. I can't type without one - injury from 1989 which still bothers me.

http://www.SkypeClarinetLessons.com


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 Re: major ergonomic problems, need advice!
Author: EEBaum 
Date:   2007-10-01 19:07

I can't live without a split keyboard. There's a full range of them, from the Microsoft-style regular split (which I'm typing on work) to the $80 or so GoldTouch (very adjustable, which I have at home) to the glorious Kinesis Advantage that Ken was talking about (looking into buying one, a couple friends of mine swear by it).

Aside from the keyboard and the clarinet, the two things I found that bugged my thumb tendonitis the most were long hours with a standard mouse and downward pressure on the steering wheel during long drives. For the drives, I just am more aware at how I'm positioned and make sure I'm not pulling downward. For mousing, I bought a big Kensington trackball for use at home, where I do the most mousing.

Keyboard position is also a concern. Get the keyboard as close to lap level as possible. I bought a fully adjustable keyboard tray for that.

The BG neckstrap has worked well for me for the clarinet.

-Alex
www.mostlydifferent.com

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 Re: major ergonomic problems, need advice!
Author: Morrigan 
Date:   2007-10-01 19:46

Look into seeing someone qualified in Alexander Technique. Not only will it likely fix the problem, but stop it and other similar problems ever coming back.

If you haven't heard of it, Alexander Technique is a method of using the body effectively and efficiently, ie. ways of doing things to avoid tension and unnecessary stress. Once you've learned a bit about it, you'll be able to solve such problems effectively and permanently.

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 Re: major ergonomic problems, need advice!
Author: Ken Shaw 2017
Date:   2007-10-01 20:41

I can't stand the Microsoft "ergonomic" keyboard. The keys are mushy, or quickly become so, and many keys are hard to reach. Worst of all, it's **convex**, which accentuates the different finger lengths rather than minimizing them, as the Kinesis does. My hands and wrists start hurting after 5 minutes on the Microsoft.

You only pay for the Kinesis once, and it's a pleasure each time you use it. Grit your teeth and pay the money.

Ken Shaw

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 Re: major ergonomic problems, need advice!
Author: claritoot26 
Date:   2007-10-02 14:56

Beavertoof,

BG makes neckstraps that are not elastic. I much prefer those, so the clarinet doesn't "bounce". They're more adjustable, I think. Good luck.

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 Re: major ergonomic problems, need advice!
Author: skygardener 
Date:   2007-10-03 09:00

An other 'excercise' that's good is Tai Chi.
As for Sax- I think that would only make things worse. I quit sax cold turkey and started clarinet with no prior experience because I was tired of pain.
As for your job, and your keyboard, etc... a good chair can help a lot.



Post Edited (2007-10-03 10:36)

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 Re: major ergonomic problems, need advice!
Author: S. Friedland 
Date:   2007-10-05 19:51

The strap has always bothered me, probably poor toilet training or some kind of ridiculous bias. I do think however, that Mr Ridenours thumb saddle is quite a help in opening the hand,supporting the weight and giving one the courage to keep playing . And, you can always alternate, which helps the thumb two ways. I have found it is a good learning tool

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 Re: major ergonomic problems, need advice!
Author: Andy Firth 
Date:   2007-10-05 21:15

Hi there,

I'm certainly no expert in the medical issues involved with the types of symptoms you have described, but I'd suggest that you need to find out what's causing the problem and treat this before you look for ways to lessen the burden of the instrument's impact on your body. Allow me to relay two long-winded but perhaps relevant stories of this type of thing that happened to me.

When I was in my final year of my music degree in classical clarinet (1986) I wrote an album of big band charts to feature my clarinet and sax playing, but I did it, (don't ask me why), in biro. Half way through the year I began to experience burning sensations in my hands and arms whenever I played for a few hours. The alarm bells sounded and I hauled myself off to a doctor who then referred me to an occupational health therapist. Given my obsession with practice at that time (5-7 hours a day), I was treated for RSI caused by clarinet & sax playing. Finally as it got to the point where I couldn't even hold a toothbrush, I stopped playing all together and deferred my final recital to the following year. The strangest thing is that, all the time I was writing essays to complete the degree, I felt no immediate pain response, only whenever I picked up a clarinet, so I put two and two together and came up with five, and assumed that it was my clarinet's weight that was the issue. On one of my visits to the therapist, I was wired up to a feedback monitor via suction cupped sensors and had been trying to play to get the sensors to register where the problems were in my hands and arms. After not getting the data that they were looking for, I picked up a biro to sign a health insurance document for the receptionist and the therapist just happened to notice a response. My whole problem was caused by the way I was holding a biro! I had been taught to write incorrectly and was putting too much pressure on my hand which then in tern transferred this to my arm and eventually through my neck and other arm. It was just maddening to think that I'd stopped playing and kept writing! I had to write with a pen encased in a plaster cast of my hand's grip for 6 months and within weeks was doing a few hours a day with no problems and then finally it completely resolved! Now I understand the a mouse can cause the very same issues! The same gripping of a mouse can create a similar injury to the tendons in the arm and nerve casings.

Last year, I helped my wife's uncle clear up my late father in laws estate and property. We lifted this and that, bags of cement, pianos etc, things that men are "supposed" to be able to do. Now almost 6 months down the track, I was playing with the dogs in the back yard and twisted my neck quite badly. Soon afterwards I noticed a slight tingle in my right hand's little finger. As the night progressed it increased in severity and then sub-sided. The next morning I awoke with a numb right hand and tingling in the left fingers! I mentioned this to a doctor friend of mine in passing and he immediately rang a neurosurgeon friend of his. The neurosurgeon's receptionist rang me at 9am the next morning and said can you get here but 10am? I, of course did so. After a thorough examination of my neck and finger/hand reflexes, he told me that he felt that I should have an MRI scan just to see what the issue is. He felt that although it was not caused by a neck disc prolapse that we had to be certain, especially given my Carnegie practice schedule is pretty heavy at the moment.

After a very noisy 30 min MRI scanning session, we found a minor disc bluge in my lower back had agrovated a nerve in my my lower back that was causing the problems. He told me that no surgery or further therapy is needed and that it would resolve and dissipate. However, I'm not the guy to be hauling concrete bags around in the future! I'm relieved to say that I'm completely cured with no tingling or any symptoms whatsoever. However, I am convinced that I caused this latent injury to reveal itself by bad working habits. You see, I'm writing 2-3 big band charts a day for a big band website in the UK and having done about 60 so far my wife, (clever lady that she is), pointed out that the monitor and G5 are on the desk to my left and the keyboards on my right and that I'm doing back and neck damage.

As I had felt no serious pain in either, I thought that this wasn't the case. Now here's the thing. I use "hyperscribe" in Finale (you play the keyboard and it writes the notes) to write my charts directly from my head into the G5 and in doing this, I twist my head to the left to watch the notes appearing on the screen as I intend them to-correct rhythms etc. After 5 hours of this I usually take a break and take the dogs for a walk. It's usually then that I was getting the sensations in the fingers and hands. A few weeks back we moved my screen to sit in front of me and put my mouse (a laser one-cordless) of an adjustable table. I think that it was this that has cured the tingling/numbness issues as I've never had any problems with this before I started writing big band charts for 5-6 hours a day! If you are a computer operator and you're doing 5-6 hours a day with bad posture or your neck twisted or hand gripping the mouse, I'd strongly recommend getting some advice from an ergonomonist (if such a person exists) on how to best set up your working environment. I understand that anyone reading this will think, Oh Derr! However, when you're in the thick of writing or practicing, you tend to ignore little aches and pains and put it down to silly things like, getting older or not sleeping right the night before. I am convinced that my numbness and tingling was, as the surgeon indicated, the nerve root in my lower back but I am equally as convinced that my poor set up and 5-6 hour sessions caused this injury to flair up and become much more severe.

I sincerely hope that you can find the CAUSE of your symptoms rather than spending money and time trying to lessen the strain on injuries that are caused by something else. My gut feeling is that your work at the computer is one to immediately address.

Good luck mate!

Andy



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 Re: major ergonomic problems, need advice!
Author: Andy Firth 
Date:   2007-10-05 21:27

Sorry to burden you further with my advice. However, I also have found that the issue with pain in the thumb is caused by the thumb rest being positioned too far down the body of the clarinet. I don't know why on Earth clarinet makers do this.

I immediately adjust my thumb rests on ALL clarinets I buy so that I can hold the instrument between my RH 1st finger and thumb with it balanced perfectly. Mouthpiece and bell are on an I hold the instrument like this up in front of me at chest height to check it. I then try holding it the same way but down in playing position-not in the mouth though. My reasoning for all of this is that we are born and designed with opposing thumb and first finger and I firmly believe that anything that we do as players that goes against our bodies miraculous design will ultimately give us grief. I'd recommend moving the thumb rest so that the instrument balances without tipping forward or back.

Cheers!

Andy

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 Re: major ergonomic problems, need advice!
Author: DavidBlumberg 
Date:   2007-10-06 00:39

Absolutely. It's strange that adjustable thumbrests that come with Clarinets adjust DOWN..........

http://www.SkypeClarinetLessons.com


Post Edited (2015-09-03 04:11)

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