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 AAAAAHHHHHHHHHH!!!!!
Author: clarinet713 
Date:   2001-07-16 03:21

ANY encouragement from clarinet players who have had TENDONITIS would be really great right now-not any advice on what to do-but encouragement telling me it DOES go away and that I won't be a complete FAILURE because of this bout of this incredibly annoying ailment! I don't mean to complain but I WANT TO PLAY SO BADLY because I really miss it but I can't because I am in pain and no one understands around here because no one else has it and there are currently no other clarinet players around or musicians. I would just love to sit down and play for 12 hours straight-so those of you who complain about practice-don't because you will miss it when you can't do it like you used to........oh I feel so old and I'm only 19!!!!!!!!!!!!!!!! Ok sorry just had to vent--thanks for allowing me to vent-this really is a GREAT board!

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 RE: AAAAAHHHHHHHHHH!!!!!
Author: mw 
Date:   2001-07-16 04:07

I truly believe that skills develop from practice don't go away. In fact, I have this belief (not backed by a study or factual surveys or evidence) that you can lay off for a time and jump right back on the horse ... in a very short amount of time be right where you were, ready to forge ahead. Relax & get well.

Best,
mw

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 RE: AAAAAHHHHHHHHHH!!!!!
Author: David Pegel 
Date:   2001-07-16 04:39

Everything is possible if you only believe and don't waste belief on the wrong things. I wish the best of luck to you, and I believe that your tendonitis will not stop you. No one should go through life without the joy of making beautiful music. And the nice thing about beauty is that it's subjective. If others discourage you, just remember that you have a dream that they are jealous of or pessimistic about. They no longer matter. Only your belief matters.

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 RE: AAAAAHHHHHHHHHH!!!!!
Author: Claude 
Date:   2001-07-16 04:57

Hi,

I read the thread (Can anyone help me ) may 27-28-29, 2001. Can you tell me what you have done since? You were suggested to see: generalist, orthopedic, therapist, physiatrist, neurologist and acupuncturist. You were given many other advices like: rest, change instrument to bass clarinet, the Ton Kooiman thumbrest, neck strap, readings (Dr. Montgomery), glucosamine and NSAID (non steroid anti inflammatory drug) and last the PHRED device.

First, are you sure that your problem is a « carpal tunnel syndrome ».? What have you done since you were given all these advices and who did you go to see?

Claude.

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 RE: AAAAAHHHHHHHHHH!!!!!
Author: Azzacca 
Date:   2001-07-16 12:17

I have had tendonitis (from typing not playing) since 1992. The first thing I would suggest is going to your family doctor. S/he should be able to determine if it is tendonitis or carpal tunnel syndrome and then refer you to an orthopedic specialist. Tendonitis usually hurts on the "outside" and you can usually see/feel a tendon when it flares up. Carpal Tunnel tends to hurt on the inside.

I wore wrist braces for a very long time, just to type mostly, but sometimes when it hurt outside of working. It may be enough just to wear one of the cheapie wrist supports you can buy at the store (they look like elastic cuffs), for support. These won't interfere with your finger.

I was also given wrist strengthening exercises in order to develop muscles that would support the tendon. I did really do them, but recently took up swimming again. This strengthened my wrists apparently, as I have noticed a marked improvement in my pain. In fact, I rarely wear braces anymore! I would definately ask your doctor (general or orthopedic) for exercises that could help.

Finally, during times that they seem to hurt worst, take some aspirin/ibuprophen. These are both anti inflammatories. If you do have tendonitis, that will help (tendonitis literaly is inflammation of the tendon). Also, icing your wrists will reduce swelling and pain.

Course, even though I don't wear braces for typing anymore, I think I'll go back to wearing them while practicing - I've noticed that supporting the clarinet has caused a little pain during and briefly after practicing. I've also heard that adjustable thumb rests and neck straps would help with this - I may look into these - I'm just a "casual player" (I play for me and not with anyone else yet); if you are a serious player, I would definately say try one or both of these modifications to your clarinet!

Good luck, and see your doctor!

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 RE: AAAAAHHHHHHHHHH!!!!!
Author: Jenny 
Date:   2001-07-16 13:52

I totally understand. I'm 17 and I have the same problem. The doctors told me that there was nothing I could do and I almost broke down. It is a horrible feeling knowing that you are young with a problem you shouldn't have at this age. I just got to the point where I stopped playing a lot like I used to. My private teacher has it too so we greave together. It is hard. This is what I've always wanted to do for the rest of my life and the doctors told me no. Screw them! I will push myself until I can no longer go. I guess it's all part of the price you pay. Don't listen to people when they say "Check you technique. You are probably doing something wrong." They don't know what they are talking about. It's all genetics. Take care of yourself -K- Write if you want to greave with me too. Chao- Jenny
Beaners563@hotmail.com

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 RE: AAAAAHHHHHHHHHH!!!!!
Author: Terry Horlick 
Date:   2001-07-16 14:36

Jenny,
There is such a thing as a second, or third opinion. You just might be able to be helped to get better, or you can just give up and suffer.
Sorry you chose the latter, others don't have to.
Terry

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 RE: AAAAAHHHHHHHHHH!!!!!
Author: connie 
Date:   2001-07-16 15:20

You ask and you receive...my deepest sympathies and prayers for your recovery. I have had trouble with wrist pain from time to time, from different reasons apparently...tendinitis, tennis elbow, fibromyalgia...go figure. Two weeks ago I got an avulsion fracture of my finger while playing volleyball, and I'm trying to work through that. So...I know where you're coming from, don't despair, things tend to go in cycles and you can come back from this!

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 RE: AAAAAHHHHHHHHHH!!!!!
Author: Sylvain 
Date:   2001-07-16 15:30

Well,
If you really have tendonitis you need to rest. You also need to get a neck strap for your clarinet to remove the weight of the instrument from your right hand.

Practise no more than 20minutes at a time with the neckstrap, and stop as soon as pain kicks in, take long breaks. It is very important that you do not worsen the problem or you might not be able to play at all.

And I have a good news for you, you can still improve while not playing. Listen to recordings of the great players, try to understand their phrasing, discern their different tone colors, compare different interpretation fo the same work. Next time you pick up the instrument you will have many new ideas on how to approach music, and that's what really matters, music and what you put in it.

Best of luck,
-S

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 RE: AAAAAHHHHHHHHHH!!!!!
Author: Dee 
Date:   2001-07-16 16:01

Do not give up without investigating all possible avenues. It may require a combination of approaches.

1. Visit family doctor but don't stop there. Go to specialists. When the family doctor says nothing can be done, he's probably wrong. If necessary visit a variety of specialists. No one person can know everything so even if one says it's impossible, try another. Physicians who specialize in musician's injuries or sports medicine would be your best bet as they are used to dealing with people who want to continue in their chosen activity despite injuries or hereditary problems.

2. Look into gadgets. Special thumbrests and neckstraps are not the limit. There are also stands designed to support the instrument while you play so that no weight is supported by the body. The typists has mentioned braces. Of course consult your physician.

3. Even if one is genetically predisposed to problems, correct hand positions and techniques will reduce the stress, etc . This combined with medical treatment and/or gadgets enhance your chances to continue.

Giving up is a poor solution as you will regret it the rest of your life. It may be difficult to find a combination that brings you back into playing condition and that lets you continue but it can be done. There are just too many people (see below) that have overcome worse problems to let ourselves be discouraged.

Glen Cunningham - lost part of his foot in a fire as a child but went on to become one of the first to run the four minute mile.

Rocky Bleier - pro football player, lost part of his leg muscles in Vietnam and was told he might walk but would never play football again, went on to play in several Super Bowls afterwards.

Wilma Rudolph - wore leg braces as a child but became an Olympic gold medalist in track.

Scott Hamilton - polio (?) or some other crippling disease as a child but became an Olympic gold medalist in skating.

There are many more but these are the ones that I can think of at the time. Nor is this determination and dedication limited to athletes and future athletes. My own husband had a land mine blow up underneath him in Vietnam and was told that he would never walk again. Yet by the time that I met him, he could walk as normally as anyone else.

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 RE: AAAAAHHHHHHHHHH!!!!!
Author: clarinet713 
Date:   2001-07-16 17:08

Thank you all for your words-let me first tell you that there is NO WAY I am giving up-I didn't mean it to sound like that-I was just incredibly frustrated last night after a 20 minute practice session-I LOVE playing but not for that short of a period of time though I know that's how I have to do it now. Claude-Since I wrote that last thread, I have seen a doctor in sports medicine-he is either an osteopath or an orthopedic surgeon or maybe it's the same thing-I don't know it confuses me-anyway since then, he advised me to stretch and ice and all the stuff that I already knew. He put me on anti-inflammatory drugs-these are the second ones I have been on and I have about 3 more days on them-however I have not noticed any changes at all. He told me that if these didn't work that he would like to try cortisone shots-I am debating this because I have heard negative things about them though I have heard that they could eliminate the problem all together. I have been using a neck strap-that was the first thing I tried. I have used one of those weight lifter things and it didn't do anything for me. I am going to order the Kooiman thumbrest though I don't know which model would be good-I was thinking to try it out just to get the student model because if it doesn't work, then I won't waste about $200. The doctor that I went to most recently did tell me a brace to wear while playing but it's for tennis elbow and it makes my wrist and forearm hurt more for some reason so I stopped using that. I haven't tried wrist braces though I did wrap it with an ace bandage for awhile and it didn't hurt while playing but as soon as I took it off-the pain was there and bad. I will have to try a wrist brace as well. Like I said, I am not giving up and I know that this will go away at some point but I am impatient right now (yes I know, patience is a virtue) and I have been getting my patience tested A LOT lately. Anyway I wonder if any big famous clarinet players have had this????????? Thanks

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 RE: AAAAAHHHHHHHHHH!!!!!
Author: Anon. 
Date:   2001-07-16 17:54

My two cents:
Merely changing your setup (thumbrests and technique) aren't of much use unless you take a bit of time off. If you are suffering from ulnar neuropathy or the like, you have a part of your body that is inflamed or irritated and being further inflamed or irritated through the use of that hand and its tendon. Generally, time off is prescribed as a predecessor to a change in equipment. This is to provide a less irritated set of nerves and tendons.
If you begin taking anti-inflammatory drugs, remember their side-effects. Many, when taken in higher doses, aren't very good to your body. I mention high doses because you might find that, as you continue, higher and higher doses are all that provide you with a brief respite from the pain or debilitating tension.
All of this is based on personal experience with a slew of gen. practicioners, physical therapists, sports doctors, and a specialist or two. I managed to get the problem, and my methods of dealing with it, under control during my first year of college after a great deal of money was spent on doctors and Advil. Even now, I must recognize when I'm about to do something dangerous, so I plan around it (ex. Had to perform Berio Sequenza IXa after Debussy Rhasody. I sat for the Deb. so I would have the stamina and less tension for the Berio. ) Now, my hands aren't keeping me from playing the clarinet by any means, but I learned to pay more attention to my body while I was playing. When doing the Debussy again later, this time with orchestra, I just lay my clarinet aside while discussing orchestral matters to reduce unneeded stress on the hands. I had no problems with my hands during this rehearsal cycle, but it had become second nature. This, I believe, is the key: One must make healthy motions the norm while avoiding needless stress on parts of your body that have a tendency towards injury.
If you believe that pain in your hands is keeping you from your career, it might be worth giving Dr. Michael Charnass in Boston a call. He's quite knowledgeable about musicians (he's an accomplished amateur pianist himself) and has worked with/on many of us. He was the man who did the second operation (the one that took) on Arnold Steinhardt's bowing arm. I don't have his number handy since I'm currently on a bit of a vacation, but it would be easy for you to find.
Alright...That was closer to 4 cents...Good luck and above all, be careful with your hands.

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 RE: AAAAAHHHHHHHHHH!!!!!
Author: David Pegel 
Date:   2001-07-16 19:19

I'm not too sure about the cortizone shots. My father always said that the only shot that's worse than that is a vaccination for bubonic plague. (Which he had when he enlisted in the army and went overseas.) And if you're a diabetic than it will send your blood sugar through the roof.

Of course, if that's one of the only avenues and you have no glycemic disorders, then you should be fine.

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 RE: AAAAAHHHHHHHHHH!!!!!
Author: connie 
Date:   2001-07-16 21:14

I wouldn't be afraid of the cortisone shot. Injected into a inflamed area, it helps calm down the inflammation. Usually. it's mixed with xylocaine so you feel great immediately, then when the xylocaine wears off in about an hour is when it really hurts. But after a few days, things should be significantly better. I've had muscles injected when necessary, and it was the ONLY thing that helped.

The others are correct, however. You need to rest some, and you need to alter something of what you're doing so the problem doesn't come right back.

Good luck, once again.

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 RE: AAAAAHHHHHHHHHH!!!!!
Author: Suzanne 
Date:   2001-07-16 22:23

Dear Clarinet713,

I understand what it is like to not be able to practice at all, as I had embouchure problems for over a year that prevented me from playing. It is a really hard thing to cope with when all you want to do is play. The doctors told me to find another career so I finally went to Chicago to see one of the best doctors at the Medical Program for Performing Artists. She helped me a great deal, and two years later, I am playing, only a bit at a time, but over a day I can get in four hours of practice, which is a miracle to me. You might want to consider seeing the doctor I saw (Dr. Alice Brandfonbrener, e-mail is agbmppa@nwu.edu, I believe, and you could always e-mail her first), or somebody like her if you are this serious about playing. There are many great doctors who specialize in treating musicians. E-mail me if you want a list--I think I have it somewhere... :P It is possible to get better. I also have hand pain, and I cheat by often practicing sitting down and resting the bell on my knees. It's not the best posture, but it takes ALL of the pressure off of my right hand.

I feel for you, and I hope things work out.

Suzanne

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 RE: AAAAAHHHHHHHHHH!!!!!
Author: Simon 
Date:   2001-07-17 20:35

I had the same problem which stopped me playing for 2 months - thought I was going to have to give up or be permanently in pain - tried ibruprofen tablets + gel (messy and not much help). In the end I found a tiny "clarinet problem helper" book which said that the problem is caused by too much pressure on the SIDE of the thumb. It recommended holding the clarinet up higher - more horizontal - which keeps the pressure on the flat pad of the thumb. It WORKED !!!
Apparently our hands are designed to cope with pressure on the flat of the thumb, but not sideways force. I'd also had a long (complete) rest and limited practising to 30 mins a day for several weeks. I can truly say that it has gone now, although it does hurt a bit after 2 hr sessions.

Good luck ... take it easy and I'm sure you will find a way to get back playing.

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 RE: AAAAAHHHHHHHHHH!!!!!
Author: Claude 
Date:   2001-07-18 02:25

HiClarinet713,

I think you did the right things. You have reached the point of no return and you should not be afraid of cortisone-lidacaine injection. If given properly and at the right spot it may cure your problem for good and it may take more than one injection. If ever this treatment fails, you may need a decompression of the tendon which is the ultimate treatment. See for yourself at these two addresses if this is really your problem and follow your specialist advice. Good luck and keep us informed. Never quit playing, but stop as soon as you feel the pain. Follow your doctor's advice. Mother nature will do the rest and time will cure.

http://www.wphtc.com/therapy/commonproblems/dequervainstendonitis.pl

http://www.2ndopinionstore.com/pop/wrist.htm

Claude

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 RE: AAAAAHHHHHHHHHH!!!!!
Author: Gdog G Gdog Gd 
Date:   2001-07-18 12:32

Some older players don't like to do this, but it does help. Try a claricord neck strap, or one of the BG neck straps to take the weight of the instrument off your wrists. Then follow all the other advise. I have a grip ball that I squeeze from time to time and that helps. Plus lots of stretching excercises with my hands. Finger tips together, flatten and then arch back up ( like a spider doing push ups).

Cortisone should be a last resort because of the side effects.

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