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 Another Wrist Pain Question
Author: CarlT 
Date:   2012-03-02 01:27

I have a bit of arthritus in my right wrist from 40+ years of playing racquetball. After about an hour of playing the clarinet, it starts to really ache.

Now I know a good hand/wrist doc in my area, and I plan to get an appointment with him, but I was wondering if any of you older guys might have actually been helped by such a doctor, or do they just tell you to "take two ibuprofens and call me in the morning"?

I've tried the neck strap and resting the bell on my knee, and I just can't get comfy with either, and I don't think I'd care for the thing that sits on the floor and supports the clarinet (I forget what it's called...sold in England I believe). I'd really like to think it could be helped by the doctor, but I'm afraid it won't be.

Sorry for the rambling.

CarlT

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 Re: Another Wrist Pain Question
Author: mvjohnso 
Date:   2012-03-02 02:35

I'm only 21 but Iv'e had back/wrist issues/inefficiencies due to playing. What I got a few years back was the Ton Kooiman thumb rest. It works well but takes a little time to properly adjust. I have the Pro model and I like it a lot. Though, I recently decided that a thumb rest wasn't enough and I am now also using a neck strap, I like it a lot (no pain, comfort, and flexibility.

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 Re: Another Wrist Pain Question
Author: Buster 
Date:   2012-03-02 03:43

Only 33 (almost 34) so I don't know if that quite falls into the "older guy" category, but:

It won't help any arthritis that has already arisen, but I had success with alleviating some arm pain by moving my thumb-rest higher on the clarinet.

I located it (approximately) opposing my first finger (actually slightly higher than my first finger.) This won't fix the problem inherent in the way the thumb must support the clarinet, but it does at least allow the thumb to be in a bit more "natural" position to do its share of the work. (For my large hands at least.)

Though I moved it myself, any half-way competent repairman could relocate it for you.

Perhaps this, coupled with whatever the doctor can do (which I cannot speak of from first-hand experience re. artiritis) could be a 2 pronged approach to your problem--- address the under-lying medical issue and remove as much irritation that the thumb position is causing.

At the very least you can always just move the thumb rest back to its original place if you find no relief- that is if the repairman doesn't beautifully fill the original screw holes....

(and as you are of legal age, 2 Aleve and a good 18 year single-malt can help address the symptoms..... but alas not the cause.)

-Jason

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 Re: Another Wrist Pain Question
Author: bethmhil 
Date:   2012-03-02 04:17

I am also only 21, but have already done a great deal of damage to both my wrists from a lethal combination of playing both the clarinet and the piano for more than 12 years. The summer after I graduated from high school, I had to take over a month off from playing clarinet. I had done so much damage from playing with so much tension and having incorrect hand position that I could barely even hold a pencil. A lot of intensive physical therapy helped, but I had to begin using a neck strap. It has helped considerably, but I absolutely cannot play without it, and like you, I still experience pain with it.

One thing that has helped me significantly is to find ways of manipulating both the instrument and the hands to stay "open", and not collapsed. I cut foam into strips, and put it both around the thumb rest and against the clarinet (a customized version of Tom Ridenour's Thumb Saddle). This helps move the thumb away from the clarinet more, which eliminates excess tension. Moving the thumb rest downward is more ergonomically comfortable for me, but I have small hands and can't reach the trill keys if I move it down very much, so I don't. I have tried the Ton Kooiman thumb rest, and it's too goofy for me to get accustomed to. Might be worth a shot though.

Manipulating the hands takes more thought and concentration, of course. One basic problem that can be easily solved is ensuring the right thumb is not too far under the thumb rest-- for me, keeping the thumb rest between the thumb nail and first thumb joint is the most effective position (it might be different for others). If the thumb rest is right on top of the joint, it forces the hand to collapse and throws off finger position of the right hand, and thus creates a considerable amount of tension.
Remembering to keep a nice open "C" in the right hand has helped me a lot recently. This is actually a cello-ism I got from a string methods course, but I think it transfers here too!-- Feel like you are holding a can of soda. That relaxed openness of the palm is what I'm talking about. It has made a world of difference for me in both my technique and endurance.

BMH
Illinois State University, BME and BM Performance

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 Re: Another Wrist Pain Question
Author: Tony F 
Date:   2012-03-02 05:26

I have a similar problem, although mine is mostly related to pain in the hands. I find a Ridenour saddle in conjunction with relocating the thumbrest has made a considerable difference.

Tony F.

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 Re: Another Wrist Pain Question
Author: Campana 
Date:   2012-03-02 08:28

30 years ago I had the meniscus cartilages removed from my left knee, the old fashioned way, knee jacked open and 6 week recovery period. Great solution then but one that left my knee totally knackered about 20 years later and rubbing bone on bone. Nearly crippled in that leg I was advised to exercise it. Yeah, I thought, give a worn out joint even more work, totally unintuitive. I ignored this advice for a while but eventually bought an exercise bike...It worked like magic. Without, of course repairing the joint, it has greatly alleviated the symptoms. The knee remains swollen but I am without pain and walk without a limp. The theory is that the extra muscle strength takes the strain and for me it really works.
So, I wonder, if doing exercises, like squeezing a resilient ball, would transfer some of the work from the joint to the muscles.

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 Re: Another Wrist Pain Question
Author: JonTheReeds 
Date:   2012-03-02 09:33

This is what I do when the joints are a bit achy. Don't know if it would help you as I'm not a doctor, but it seems to work for me

- Take Ibuprofen
- Make sure everything is relaxed, posture and positioning is good, not forcing anything or tensing any muscle/joint
- Warm up gently
- Make sure everything is relaxed, posture and positioning is good, not forcing anything or tensing any muscle/joint
- Take regular breaks every 20 mins
- Make sure everything is relaxed, posture and positioning is good, not forcing anything or tensing any muscle/joint
- Ice down
- Take Ibuprofen

--------------------------------------
The older I get, the better I was

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 Re: Another Wrist Pain Question
Author: kilo 
Date:   2012-03-02 12:33

I've mentioned this before, but it was a few years ago so I don't feel too bad about posting it again:
Quote:

I took an old black silk necktie and tied it in a loop with a sheet bend. Slipping it over my head and onto my left shoulder I then slid my right elbow into the other end of the loop, as one might do in a sling for a broken arm, but it only cradles the elbow. A few adjustments to the knot and the loop was the correct length to support my right elbow perfectly.

It doesn't hang around the neck like a sax strap, it doesn't hook on to the clarinet. It provides just the right amount of support and resistance to keep the clarinet at the right angle and when I put the instrument down there's no pain whatsoever.

There are different types of elbow and wrist pain and what works for one may not work for all. You might also want to consider looking at the Fhred devices.



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 Re: Another Wrist Pain Question
Author: mvjohnso 
Date:   2012-03-02 14:07

The Ton Kooiman is a bit more goofy than the Ridnor, but the flexibility of the mechanism and its ability to get your hands more "open" it think it really is the best tool. Also the sheer fact that one relocates their point of leverage higher up on their thumb leads to a more intuitive control of the angle of the instrument. And, I use this technique largely in order to make minor adjustments to intonation while playing. This is a skill that one looses if they switch to a Fhred system, and I think such a loss is of great detriment. But, there is no mistaking that the thumb rest IS weird and takes a little getting used too.

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 Re: Another Wrist Pain Question
Author: nezziesgappy 
Date:   2012-03-02 20:02

I had a similar problem with severe arthritic pain (RA) in my right wrist that began to resonate up through the forearm and into the elbow. It got to the point where playing for longer than twenty minutes was impossible and my arm was constantly drooping from fatigue. A medical specialist (also a musician) referred me to a physiotherapist who treats a number of professional musicians for both arthritic problems as well as repetitive strain syndrome.

His advice, in my case, was fairly direct in that as long as there was any weight on the wrist for a prolonged period of time the problem would only worsen. He suggested finding a method to play that provided no weight on the wrist. The most common method used amongst his other patients was, of course, a neck strap.

Although awkward and uncomfortable at first in my case it was either get used to it or stop playing because any change or improvement to just the thumb rest still meant weight on the wrist.

For me it's made all the difference and as long as I can adjust the strap in a way that my right wrist is free of weight I'm able to play pain-free.

I hope you're able to find a solution that works for you.

Cheers.

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 Re: Another Wrist Pain Question
Author: CarlT 
Date:   2012-03-03 00:00

Many thanks to all who posted. All responses are very much worth considering. The only one I tried so far (as it was the simplest) was Jason's. Although I didn't remove and relocate the thumb rest, my R13 has 4 different thumb rest settings, so I was able to move it up so that my thumb was almost even with my index finger.

I just finished almost a 2 hour practice session (with a 30 minute rest in between, plus shorter rests as needed), and I have very little wrist pain, so I just might have relieved the situation somewhat (I'm hoping anyway).

If that doesn't work permanently, then I'll keep trying more of your methods, but I do know that after adjusting the thumb rest, I have little-to-no-pain, so thanks a bunch, Jason.

BTW, Tom Ridenour's thumb rest is reasonably priced, and I do suffer from a bad case of GAS (for any that don't know: Gadget Acquisition Syndrome), so I might also try that.

CarlT

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