 The Clarinet BBoard
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Author: jan
Date: 2001-04-17 14:19
over the few years i have returned to playing clarinet i have had increasing pain in my upper body...neck, shoulders, arms, wrists, hands, knuckles. i dont think i am a tense player. i went to my doctor a couple years ago and asked if it could be from playing clarinet and she laughed at me. she then prescribed an arthritis medication which i take twice a day now and its losing its effectiveness. she did NOT give me any tests to even find the cause of the pain and its getting worse now. im also playing A LOT more than when it began. im just wondering if others out there have this kind of pain...im kinda young to have arthritis (30's) and do you think its from clarinet playing or maybe something else that is aggrevated by the playing? are there any doctors that specialize in musician medicine like the docs who specialize in sports med. i feel like im being laughed at for making the association of the pain with clarinet playing.
jan
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Author: Dee
Date: 2001-04-17 15:35
It is *very* possible that it can come from playing clarinet. Find a different doctor before the damage is irreversible. The thumb was never designed to hold these types of weights for the length of time that people play. The fact that a lot of people don't have problems is merely a matter of luck.
Several things to look at.
1. Is your hand position correct? If not this can greatly increase the chance of problems and aggravate existing problems. A lot of people have their right hand too far under the horn.
2. Is the thumb rest position appropriate for you as an individual? You might need to have it moved or get one of the aftermarket types that redistribute the load entirely.
3. Try using a neckstrap.
4. Maybe a combination of the above.
Other possible causes and/or aggravators.
1. How much typing do you do? This is known to cause problems if hand positions are incorrect. Combined with clarinet, it could be adding up on you.
2. How much computer "mousing" do you do? Again this is known to cause problems if hand position is incorrect. Combining with other activities would add up.
If it is a combo of computer and clarinet work, the items listed under clarinet will still help you.
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Author: connie
Date: 2001-04-17 16:03
First get a new doctor. You should never feel like your doctor is laughing at you. Moreover, there is a difference between arthritis (joint inflammation) and muscle pain.
Surely there are some sympathetic doctors, but you might also consider physical therapy or occupational therapy to help with analyzing contributing factors and helping you devise some other ways. There's no "musician medicine" as such, but you may well be having some chronic overuse syndrome, and there are doctors who are more knowledgeable about those.
I was diagnosed with fibromyalgia several years ago. My upper body muscles are the ones that bother me the most, playing clarinet, driving, whatever. The program my doctor gave me includes relaxation techniques, some medication when appropriate, physical therapy from time to time, and so forth. You might want to check into this apparently widespread but under-recognized disorder.
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Author: Lauren
Date: 2001-04-17 17:18
Hi there,
I started having some of those same problems about 2 years ago, and I'm only 16! My doctor put me on celebrex, which is an arthritis medicine. It does help reduce the swelling that usually comes with tendonitis and such, but didn't really help with the pain. I was in physical therapy for a while to regain strength in my wrist, but nothing I've tried actually "cured" the problem. My suggestion is buy a wrist support or brace. They're fairly inexpensive and should help with the arm and hand pain. Good luck!
Lauren
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Author: Ken Shaw
Date: 2001-04-17 17:54
Jan -
You say you've been having pain since you returned to playing clarinet. Does that seem to be the cause? That is, does the pain build up as you play and fade away when you stop?
Check for muscular tension before you start playing. Reach around with one hand and feel the muscle across the other shoulder. Then check after you've been playing to see whether it's more tense. If that's the problem, physical therapy "lessons" that teach you to recognize tension and relieve it will help, as will yoga. There absolutely are physical therapists who specialize in musicians. You can get some guidance here on Sneezy. Go to http://www.sneezy.org/clarinet/Resources/OnlineResources.html for links to musicians' health resources. Also, go on the Klarinet board, where there are a number of experts. For example, Diane Karius is a regular there. She is a Ph.D. physiologist and clarinetist who has been very generous with her expertise and advice.
You say your fingers hurt, though, which suggests inflammation. If so, try taking some aspirin to see if this relieves it. You should try this even if you want to avoid taking any medications, since it will help you pinpoint the problem. If it's inflammation, you should see a specialist doctor.
If you're hurting, you should get professional medical advice right away.
Best regards.
Ken Shaw
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Author: Brenda Siewert
Date: 2001-04-17 19:08
Really need to do the neckstrap. Taking the weight of the instrument off the thumb is excellent advice. Also, do some finger stretching (tip to tip both hands together like a spider spreading its legs) frequently. I also got a squeeze ball to help with similar pain. Repetitive stress causes things like carpal tunnel syndrome and other related things like the arthritis symptoms you've mentioned.
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Author: Danielle
Date: 2001-04-17 19:10
hmmm...that sort of pain sounds familiar to me. Whenever I play for a long period of time (more than an hour), I get pain in my left shoulder, all the way down my arm. It's very uncomfortable, and i think it may be due to the fact that i have extremely straight posture...i sit up very tall when I play. I'm only 13, but this pain has been going on for about a year...any ideas, or is it just from my posture and playing for a while?
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Author: jan
Date: 2001-04-17 19:21
i tried a neckstrap when all this started and just couldnt get use to it. maybe i tried the wrong kind. but its more than thumb, wrist pain. my neck and especially my elbows. i think its time to get more serious about fixing this since giving up the clarinet is not something i want to do.
thanks everyone who replied and ken for the links (they gave me some ideas) . i think i need to find the right type of doctor so i can get the appropriate treatment. i think my doc thot i was nuts when i told her i thot it was from playing clarinet. now i see it really could be.
jan
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Author: Bob Arney
Date: 2001-04-17 19:45
Connie, please be good enough to email me concerning your treatment for fibro. I also suffer from it and find nothing really helps. I am looking for something that will help. Thanks,
Bob A
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Author: Anji
Date: 2001-04-17 21:29
Jan, my teeth are clenching in sympathy!
As a former jock, I thought this sort of thing was overstated until suffering the same sort of response to playing the horn. Mine was so bad I couldn't turn the ignition key! Recovery took six weeks, followed by some changes.
The stack of nerves running along the wrist is tightly bound together, and irritation in one can lead to irritation in another (mimicry and motility of the sensation).
This is the same sort of sensation in Sciatica, where the lumbar disks impinge on the sensory nerves of either leg.
No one has yet suggested massage therapy as an adjuvant treatment for inflammation (which is what this sounds like) of the elbow. If you are carrying the weight of the horn on the right hand and constricting the arm to your side, the elbow joint way be the inflammation center.
A qualified physical therapist may help in illustrating some stretching to prevent the sort of inflexibility that causes this.
You obviously need to put the horn down until this blows over (that's the worst part). When you get limber and pain-free address the way you cary the horn.
I use the Ton Kooiman Gizmo, and love it. There is an inexpensive version made of plastic, that incorporates most of the features. The TK still PLACES ALL THE WEIGHT ON THE RIGHT hand, just away from the distal portion of the thumb.
My teacher uses a neck strap (ineslastic) with a hook and ring. This is the best, cheap compromise and requires some modification to your thumbrest (more on that later).
I tried the Claricord, and didn't care for the way it kept the mouthpiece snug (but for $12, who can argue with results?) which led to the TK.
At a minimum, move the thumbrest up so that the thumb and first finger are directly opposed. The TK adds girth to the horn, so there is a more open hand position.
Stretch before playing, ice the sore parts and break up your practice sessions.
Like they said, even if you go out of plan...any professional in your employ that laughs at your complaint deserves to be fired. FIND ANOTHER DOCTOR, they're everywhere.
We, the brothers and sisters of the rigid wrist feel for you.
Good luck in your recovery,
anji
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Author: Irwin
Date: 2001-04-18 00:35
Ask your doctor what he thinks about Vioxx 25 mg. It's a new type of anti-inflamitory that is designed to not cause stomach problems that repeated use of Motrin and other similar non-steroidal anti inflamatory meds can cause over time. I'm 47 and was starting to get lower back pains and the beginning of other assorted tightness and stiffness. Now, I take one Vioxx probably once or twice a week, and for me it's been nothing short of a miracle. I feel like I'm 20 again. It may be worthwhile for you to try.
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Author: David Kinder
Date: 2001-04-18 01:34
I still recommend the BG neckstrap with the "reversable marching lyre" hook attachment gizmo. It's worked quite well for me for quite some time. I bought the neckstrap to "free" up my lower fingers and improve in my dexterity, even though if I don't use the neckstrap, I find I've got a little pain.
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Author: joseph o'kelly
Date: 2001-04-18 02:04
Yes it could be from clarinet playing but is common. if you are a returning player your body will have to reajust. Even I who practice hours upon hours a day find these pains after not playing my usual duration of time. After you reajust these, problems will probably fade. You might want to use a neckstrap to support the weight untill this happens. Don't take my word for it though. Try consulting with another doctor.
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Author: rina
Date: 2001-04-18 08:26
I had pain developing at the age of eighteen and ignored it. Discovered at 24 that I had curvature of the spine and a variety of other back problems. Solutions?
1) I had to get my back straighted out with the combined help of a chiropractor and an osteopath.
2) I've started going to the gym and doing weight exercises that strengthen my torso and chest muscles. This seems to have been the most effective, as I can now play without a nec-strap - which I have had to rely on for 7 or 8 years now .
Don't ignore it - make sure you get it checked out by another doctor.
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Author: jan
Date: 2001-04-18 12:28
irwin...i do take vioxx for the very painful days. usually relefen twice a day unless the pain is really bad then i use the vioxx. i was thinking yesterday that maybe she can switch me to just vioxx and the more i thot about it i became angry over the whole situation and decided to ask this board about it.
joseph...i returned to playing a little over 3 years ago
and anyone else...what "type" of doc should i see?
jan
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Author: Anji
Date: 2001-04-18 13:31
http://health.yahoo.com/health/physicians
Will allow you a quick search of physicians, based on City and State.
I think a Physiatrist or Physical Therapy center would be a good start.
Pain management clinics are about dealing with the pain, first. (That usually means drugs.)
Physiatry can be researched at the following link; http://www.aapmr.org/consumers/public/what.htm
I would want the least invasive course, first.
Unless you have incipient arthritis, drug therapy will likely be only an interim step.
(My elbow is throbbing, just thinking about this!)
Of course, there are no big lettas b'hind mah naym...
But if they start talking about Cortisone injections without P.T. you'll be in for a ride (expensive, too).
anji
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Author: jan
Date: 2001-04-18 16:17
thanks anji...i found a physiatrist in my area. now i just need to get a referral. i also found out that my NEW ins. as of 2weeks ago does not cover vioxx! :(
jan
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Author: connie
Date: 2001-04-18 20:17
Physiatrist is a good idea. A physical therapist cannot diagnose or prescribe treatment, he can only follow the dr.'s orders. (However, a good PT can tell the doctor what he finds, and make suggestions.) Actually, a sports-medicine doc (usually an orthopedist) would also be able to analyze body mechanics and help you find the cause of your pain. I would be leery of anyone wanting to treat me unless I had some kind of working diagnosis thing going.
DON'T get me started on HMO's and prescription coverage!!! But most plans have some contingency for off-formulary drugs, even if it's just partial coverage requiring paperwork for pre-authorization.
Anji is right...drugs don't solve the problem, they just temporize. At your age, you should not be resigned to a lifetime of Vioxx in order to play the clarinet.
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