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 Major Problem in my Right Hand
Author: Mario Poirier 
Date:   2010-10-06 16:44

Dear fellow clarinetists:

First, many thanks for this excellent resource and for your responsiveness to all of us on this board. I have read your thoughts for many years and learned immensely from them. This e-mail is to share with you a major developing problem in my right hand in order to see if some of you have seen it before and most importantly to understand what to do about it.

My specifications:

1. Serious, advanced 50+ amateur with 30 years of experience.
2. Active musician in my community.
3. Extensive training (still on-going) with first rate teachers both in Montréal and Ottawa.
4. Practice extensively every day and is thus in good shape.
5. Both hand static positions appear to be fine according to my teachers.

Symptoms:

1. Over the last year, my right hand small finger (R.H. pinky) has simply refused to move up from any static position. For instance, a Bb scale (with a transition C-D-Eb involving a pinky arc from C to E-b) is now impossible to play.
2. When the R.H. pinky move ups, it wants to bring the R.H. ring finger with it, thus forcing me consciously to apply lot of pressure and concentration on this ring finger pivot. Physical tension and mental fatigue of having always to worry about these 2 fingers quickly sets it – let alone basic fluency which no longer exists.
3. This is not a speed problem. Even at super slow speeds, the tension sets in my R.H. which locks and refuses to move. Naturally, any fast movement is now out of the question.
4. Pinky hovering over the R.H. keys (say, for a D) is also extremely difficult. The pinky wants to stay low (curled) or way high, straight up.
5. A natural position on top of the R.H. key is extremely difficult to maintain and generates lot of tension which I can feel (and my teacher can see) all the way up my arm. I sometimes experience a slight discomfort in my right shoulder when I play a sustained D with my pinky at the right place.
6. I had my teacher holds my R.H. fingers onto their tone holes while I move my R.H. pinky. He could feel the pressure upward in my R.H. as all fingers (especially the first pivot) attempts to move up in synch with the pinky.
7. I have absolutely no problem with the left hand. I did an experiment whereby I reversed my hands to see if the problem would follow the position of the lower hand. When reversed, the left hand (now holding the clarinet and hovering on top of imaginary keys) works perfectly, while the right one remains extremely sluggish and tense when its pinky moves.

I have tried neck straps, thumb rests adjustment and various pinky movements, under coaching. I am currently seeing a physiotherapist who cannot explain what is going on. I might have to go to Montréal to see a real specialist in musician issues.

I am actually desperate. This problem prevents me from playing anything cleanly. Even simple material containing some manner of upward movement from the R.H. pinky is now extremely difficult. For instance, try to play the Brahms sonatas or the Mozart quintet with a R.H. pinky which refuses to move up - works I played many times (and relatively well) in public in recent years and are now out of reach.

If you have seen this problem before or have any insight at to its causes and remedy, I would be eternally grateful.

A million thanks in advance for your help.

Mario Poirier

Post Edited (2010-10-06 18:00)

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 Re: Major Problem in my Right Hand
Author: salzo 
Date:   2010-10-06 18:23

Hope it is only tension, and not a medical issue.
Just a suggestion- play in a way that does not require much support with your right hand, ie, play resting the clarinet on your thighs, or knee.
Try playing with your thumb independent of the thumb rest- I play with the the thumb resting "on top" of the thumb rest. For whatever reason, I find playing on top much more relaxing for my right hand.

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 Re: Major Problem in my Right Hand
Author: JJAlbrecht 
Date:   2010-10-06 18:38

I would sugest seeing a qualified medical specialist (orthopedic specialist) who is experienced with issue involving the hand and fingers. I had a tendon problem last year in the palm area of my left hand that was not allowing me to close the hand tightly, or to play my clarinet well at all. A simple injection fixed my problem. That was MY issue, however. Your issue is different, but you will never know what to do to fix it until you see an expert. If s/he is experienced with musicians, it's all the better, but most hand specialists should be able to give you a preliminary examination and make recommendations.

Jeff

“Everyone discovers their own way of destroying themselves, and some people choose the clarinet.” Kalman Opperman, 1919-2010

"A drummer is a musician's best friend."


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 Re: Major Problem in my Right Hand
Author: kdk 2017
Date:   2010-10-06 19:21

I've been having some similar - though not identical nor as severe - problems moving and controlling my right pinky and ring finger. My diagnosis at this point is a pinched nerve in my cervical spine and, possibly, in my elbow. Pressure anywhere along the ulnar nerve can cause symptoms in the pinky and ring finger as well as pain at various points along the arm, so if this kind of problem hasn't already been investigated, it might be worth exploring. The tendons that connect the muscles in the forearm to the various points of movement in the fingers may themselves be inflamed. (Disclaimer - I'm not a physician, so my description is limited to what I've understood from my doctors' and physical therapist's explanations.)

Karl

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 Re: Major Problem in my Right Hand
Author: mikeyarbulu 
Date:   2010-10-06 20:27

I'm not a physician, either. But, it sounds like you have a serious issue.

Does this occur only when you're playing clarinet? Or does it apply to other situations?

If it's task specific, it might be something as serious as a dystonia. More specifically, focal hand dystonia. I only know a few serious musicians that have run into this, but it can happen to anyone.

I hope everything goes well when you seek out further advice/treatment. Best of luck.

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 Re: Major Problem in my Right Hand
Author: EEBaum 
Date:   2010-10-06 20:35

What kind of stretching and soft tissue work do you do, if any?

-Alex
www.mostlydifferent.com

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 Re: Major Problem in my Right Hand
Author: Sylvain 
Date:   2010-10-06 21:45

If it's not a muscle/tendon problem, it may be a neurological condition called focal dystonia, which can result from extensive practice.

Ask your doctor about it.

--
Sylvain Bouix <sbouix@gmail.com>

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 Re: Major Problem in my Right Hand
Author: dansil 
Date:   2010-10-07 11:47

Hi Mario

have you tried playing "air clarinet" to see if the problem exists without the stress of holding down keys. If you concentrate and slowly try to do exactly the same movements with your right pinky while playing air clarinet that can't seem to do with a clarinet in your hands does the pinky work?

If you can then I suspect you have developed a form of muscle dystonia whereby your muscles have learned an incorrect way of moving. I'm not certain what is the best way to reverse this but perhaps repeatedly and slowly practising the movements you want to achieve but without a clarinet weighing down your hands might well work.

cheers, Danny Silver

a family doctor in Castlemaine, rural Victoria, Australia for the past 30+ years, also a plucked string musician (mandolin, classical guitar) for far too long before discovering the clarinet - what a missed opportunity!

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 Re: Major Problem in my Right Hand
Author: Mario Poirier 
Date:   2010-10-08 05:05

Dear friends:

Many thanks for your valuable input. I am consolidating them, doing some research, speaking to new medical people. I do not have any chronic pain in my right hand and normal dexterity. Playing air clarinet (specifically, using my left hand knuckles as simulated tone hole with the R.H. playing them nicely curved) I have full control without fuss.

Of course I have done much exercises and experimented with hand position, neck strap, thumb rest position, etc. As I wrote before, it is only when my R.H. is in its place that the pinky locks for upward movements (going down - no problem at all).

I will explore the hand focal dystonia hypothesis with my specialist as the problem "might have" started when I joined a top notch wind ensemble whose technical demands are way up there with me starting a brutal practice regiment (hence leading me to a dystonia scenario).

As well, a couple of years ago, I severely pinched my neck doing some home improvements. I used rub-a-dub-dub to alleviate the pain and immediately developed a severe allergic reaction which had to be threated by a doctor. Since then, I always have a slightly stiff neck. I wonder whether my strained neck did not damage something deep into my spine which could block signals to my R.H. This is something I will also discuss my a specialist next week - thanks Karl!

Mario Poirier

Post Edited (2010-10-08 05:09)

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 Re: Major Problem in my Right Hand
Author: daustin 
Date:   2010-10-08 13:43

Two years ago I had the same problem. An Orthopedic doctor moved the nerve that controls those two fingers, which crosses the boney oart of the elbow, to a position away from that restricted area. He stated the the nerve would heal or regenerate at an inch per month. For me that is at least fifteen inches but now, two ears later I can play the Ab/Eb key. For what it is worth my age is 89.

Donald L. Austin

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 Re: Major Problem in my Right Hand
Author: GeorgeL 2017
Date:   2010-10-08 15:24

I also had (about 15 years ago) the same surgery Donald described. The pinky and ring fingers of my hand became weak. The surgery moved the nerve off the elbow. My hand regained its strength fairly quickly and has remained that way.

Check out "ulnar nerve" on-line for more information about this problem.

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