 The Clarinet BBoard
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Author: Nick Stabler
Date: 2001-05-12 18:21
Hi, I am an 18 year old out of Kamloops BC, I have had some injuries to my right arm that I need some advice in dealing with. If you have seen anything similar, I would appreciate any suggestions.
I have, since October, experienced huge amounts of pain centered around my right elbow, and moving into my right arm. The early symptoms were of tendonitis and carpal tunnel syndrome. An electrical study showed no carpal tunnel, but small amounts of ulnar neuropathy... essentially a pinched nerve in the elbow. The pain in my hand has subsided, but has remained in my elbow, and has intensified over time. There is also a huge amount of numbness in my hand when I type, write, or play for about 2 min (during a recent lesson with a grade 6 on slow basic scales.) there is also a large bump on the underside of my arm which I can see when I lay my arm on a desk.
My question is: should I have surgery to release the nerve, or will this create more problems, and is the pain likely caused by tendonitis, and if so, what should I do about it?
Any help would be greatly appreciated, and I am willing to forward medical history to anybody that thinks they could give more detailed input. Please e-mail me directly if you can, and THANK YOU in advance
Nick Stabler
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Author: C. Hogue
Date: 2001-05-12 18:43
Nick --
I'm no doctor, so I won't advise you what to do. But I will share my experienes.
I've had chronic tendinitis in my right arm since 1988, golfer's elbow on the ulnar side (rather than tennis elbow, on the radial side), a repetitive strain injury from the nasty computers we used at work. It definitely put a crimp in my clarineting when I was flared up. I had to change the way I did little things in my everyday life quite a bit. You should see me cross stitch left-handed!
The surgery was unconnected to my injury. I fell on an eroded sidewalk in Homer, Alaska, nearly two years ago and broke my injured elbow -- I cracked off a part of the my right radius, the bone on the thumb side of the arm. I flew home a day later and soon had surgery on my elbow to address the break. I was quite apprehensive but I had no choice.
It took months before my fingers could squeeze the lower keys (low E, F, Ab, etc.) on my clarinet. I did all sorts of physical therapy. And my arm is now in better shape than it was two years ago.
My work paid off and now I can mash down those big keys on my bass clarinet.
So -- get a second or third opinion re: surgery, decide what's best for you, REST your injured arm, and, if physical therapy is prescribed for you, stick with it.
Good luck!!
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Author: Anji
Date: 2001-05-12 20:44
For God's sake don't let them start cutting on you... it never stops!
Find a Physiatrist, or a Hand specialist with a connection to the musical community. Your proximity to Vancouver should provide you some inroads with the symphony or school of music.
This is an unfortunately common problem, and I'm again dealing with much the same symptoms you describe.
The basic regimen is rest, ice to bring down inflammation, a regular use of NSAIDs like Tylenol, Ibuprofen or Aspirin (again, you need to see a doctor, don't fool about with this!) and range of motion exercises.
I also switched to a track ball instead of computer mouse.
I use the Ton Kooiman thumbrest and carefully stretch the arms and back after playing. You might also investigate use of a neck strap. My teacher uses an inelastic neck strap to good result.
I don't know of anyone with complete satisfaction from surgery to relieve carpal tunnel syndrome.
My guess is that some time away from the horn is a safe place to start.
Bottom line...
See the doctor!
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Author: Mark Charette
Date: 2001-05-12 22:02
Anji wrote:
>
> For God's sake don't let them start cutting on you
Or do. Each case is different, and none of us is qualified to diagnose remotely. Get second or third opinions, but if they're all saying that you need an operation - the chances are that all of them are right.
There are specialists in occupational and musical injuries; if you can, they'd be some of the ones to see.
I hesitate keeping posts like this online. Do not follow any ttreatment advice given here other than to let it rest while you see qualified medical opinions. Even someone who has symptoms similar to yours may not have anything even close to the same as you.
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Author: Jim
Date: 2001-05-13 03:43
You are young to be having such problems, they seem to affect people in their 30s and 40s. My wife has problems with both wrists from typing and playing piano. She is presently delaying surgery. Switching from mouse to trackball at work and home helped quite a bit and she uses ice frequently. Her greatest relief seems to come from sleeping with wrist braces. This was a suggestion I found in "Fine Homebuilding" magazine. It seems carpenters are prone to these problems as well, due to hammering. Good luck!
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Author: Nick Stabler
Date: 2001-05-13 06:41
Hi.... me again to clear up some points... I have seen five doctors, all of which have said that if I wasn't a musician, they would leave me as is, but with a useless right hand for the next 50 years... My hand has gone numb typing thus far, and the pain is setting in, I am mostly wondering if anybody else here has had any similar surgery, and what the recovery rates are. I am not rushing into this, and it is the last option, thanks, just wanted to clear that up.
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Author: Leesh :-)
Date: 2001-05-13 06:43
Hi Nick,
I'm only 20 and have had problems with my right arm also. I, however, know the reason why mine is so painful. When I was 18 I was involved in a car accident where a drunken driver ran up the back of our tiny car when we were stationary at the red lights. My sister and I were sitting in the back seat and the boot (trunk) of our car was completely demolished, crumpled right up to the back of our seats. Luckily I wasn't injured enough to be hospitalised but a few days after I experienced a severe tingling sensation in my wrist and also shooting up to my elbow. I had some tests done on my nerves but the doctor said there was only about 3% damage (yeah right! I bet he hasn't tried holding a clarinet for 4 hours a day). Anyway, he said there was nothing else he could do for me, except sign a form to get some money off the drunk man's insurance company (which made the pain dissapear for a breif while). My teacher suggested that I buy a clarinet strap of some kind (preferably NOT a neck strap because if you start to put all the weight on your neck, you most probably will end up with more problems/pain). You might want to think about using this contraption, it's really quite simple (you might have already heard about this before). Take a pair of elastic mens braces (you know the things that hold up your pants) turn them around the other way (so the two front straps are at the back). Clip them onto your pants, cut off the clip on the single front strap, then cut a hole just big enough to put your thumb rest in (in the elastic part of the strap) and wha-lah! Inexpensive and very effective (for me anyway). Otherwise you might try to see a specialist in prosthetics (artificial limbs). My parents have a friend who works in the prosthetics department of a public hospital (in Australia though) who made many contraptions to try and support my arm/wrist but I found that the braces worked better because they don't restrict the movement of my wrist/thumb. My fingers still (occasionally) tingle but it has improved a lot.
I hope I have helped a little, all the best, and I hope you get better real soon.
Make sure you seek proper medical advice and get that lump seen to.
See ya!
Leesh :-)
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Author: deejay
Date: 2001-05-13 16:51
I got cut badly in my arm and had stiches and I find it hard to play. I think some nerves got cut cause I can't feel anything around the cuts very well. It hurts alot to play.. my fingers don't want to move as fast. The day after I got them my band director had me to play and after band was over my cut was bleeding and little tore open. I have a concert Tuesday and I need to get all better cause I have a soli with a sax..
deejay
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Author: Mark Charette
Date: 2001-05-13 17:53
deejay,
Once a very long, long time ago I played guitar in a rock band. My girlfriend at the time was a cellist, and she broke one of her strings. I took a look at it (it was flatwound and I was wondering if it'd work on a guitar) and ran my finger over the broken part ...
Whereupon I found out that the flat winding and a razor blade are of approximately equal sharpness. I got to see the bone and tendons in my left hand index finger really close up.
Needless to say I was unable to play for 2 weeks due to numbness in the finger - some nerves were severed. I still have no feeling in a few small areas on that finger, but i was able to play within a monght (and since the side of my finger was still numb for a few months, I was able to perfect bar chord slides without the pain normally associated with the building up of a usable callus!)
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Author: deejay
Date: 2001-05-13 21:15
I was glad I wasn't hurt worse, I also got cut on my back.. I fell backwards onto a glass fish tank.
I was scared enough with what I had. That was the first time I was ever in my life hurt this bad.
deejay
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Author: Andy Roberts
Date: 2001-05-13 22:27
I have just written (and had published by CASS in the UK) an article reviewing the Kooiman Etude thumbrest. This is a cheap and easily modified to fit piec of kit, which should really help with your problem. I have had 3 op's to repair my shoulder post RTA, and have found that using the thumbrests helps a lot. You should also try using a TENS machine both to stimulate the the nerves and muscle groups,and to block the pain.Long term use of anti inflams is really bad, aknowledged side effects include high frequency hearing loss!!!You should work with a good physio and develop a plan maybe using theraband to strengthen the muscles in your arm. If you haven't heard of it, there is a great book called the "Athletic Musician" which was written by a physio and a professional violinist who had similar surgery to that which I had. It contains some really good info and contacts. Good luck
Andy R
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Author: Bob Curtis
Date: 2001-05-14 02:24
Nick:
I am 70, going on 71, and had some problems with my left arm although not as severs as you state. My physician gave me an injecdtion of cortisone and it worked wonders. That was over three years ago and I have had no problems at all. I am sure that your problem is different than mine, but I would suggest that you ask your physician if they could recommend alternatives to surgery first and then surgery second. What ever the choice, think carefully about the prognosis for recovery and success. Don't base your decision on emotions. Get the facts and evaluate it. Only you can make this decision. Good Luck.
Bob Curtis
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Author: Nick Stabler
Date: 2001-05-14 21:59
Bob, thanks for the encouragement, I also have tried repeated cortozine and steroid shots, with no avail... the volume of flued seems to irritate things even more. I especially appreciate the comment about the emotions, that is a great point for anybody considering any surgical procedure Thanks
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Author: Anji
Date: 2001-05-15 02:40
So, prompted by the Webmaster's appropriate warning, I did a little more research into surgical intervention and outcomes.
(Remember that there are no BIG letters after my name, so caution applies.)
We're groping in the dark here, considering that you mention your trips to 5 physicians AFTER your first inquiry, so I'm feeling suckered.
Layout your history and physical, maybe you will find common ground amongst players.
Look up Sherman Friedland's previous strings in the Archives.
(Transcript; Rest, Layoff the horn, Rest, see the Doctor, yadda-yadda, Rest.)
It actually works, following the advice of those that have gone before.
My wife has the big letters after her name and says many outcomes from surgery to correct carpal tunnel syndrome are quite good. She has a 'trigger finger' and won't let them cut her, so draw your own conclusions.
I just wouldn't go to a surgeon for a primary opinion, they make there money from procedures and have an incentive to keep the OR schedule full.
I just have the story of Leon Fleisher at the forefront of my mind when considering musicians with hand problems.
Maybe this is an appropriate forum to discuss how you feel about this all-too-common problem, but real answers will come from working through professional circles.
There's no magic pill, no simple exercise, no immediate relief.
If it hurts, lay off the playing (that much is benign). If you insist on doing the things that are painful...
anji
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Author: Chris Hill
Date: 2001-05-15 04:53
I had similar problems with pain, and I had success eradicating it with the help of Dr. Alan Bishop at the Mayo clinic in Rochester Minnesota. He's a hand specialist who happens to play principal oboe in the Rochester Symphony. He saved my career, along with the careers of two of my friends.
Chris
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Author: Chris Hill
Date: 2001-05-15 04:55
I had similar problems with pain, and I had
success eradicating it with the help of Dr. Alan
Bishop at the Mayo clinic in Rochester Minnesota.
He's a hand specialist who happens to play
principal oboe in the Rochester Symphony. He saved
my career, along with the careers of two of my
friends.
Chris
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Author: Wes
Date: 2001-05-16 04:54
Hi!
Sorry to hear of your arm problem. About 8 or 10 years ago, I had tendonitis in my right forearm and could barely stand to lift the clarinet. It disappeared after I started a daily exercise program of warm up, weights, and calisthenics for only 10 to 15 minutes a day total. Could exercise help you?
Good Wishes!
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Author: jenna
Date: 2001-05-17 02:07
just from my experience
simple ibuprofin (motrin, nuprin, advil) works wonders for things like that, just no more than 3. start with one, then go to 2, but a stress - no more than 3. from what i understand that opnes the door to liver trouble
last year our oboe player developed a painful cyst in her left wrist (i think). she had surgery and was out for about 2 months, but then started playing again and just built her strength back up, wearing a light brace the entire time. she's playing in a college orchestra now, i believe
have you tried taping? this probably sounds odd but when i played softball ad tennis competitivly i had really bad tennis elbow. if you go to a sports store you can buy a thin taping foam and injury tape. wrap the foam (basically to keep you from pulling all that hair off) around your arm about an inch and a half, 2 inches, above the elbow, then tape that so it stays.. tight, but not cutting off you circulation tight. i believe they also sell braces along the same lines.
good luck
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