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advice on dealing with long-term injuries

jamesshipp 5 April 2009

Hi All-

I'm typing one-handed to ask for everyone's advice on and experiences with tendonitis, repetitive stress, carpal tunnel, etc. I want to for my own situation, but also because I think any site that offers so many compelling and difficult things to practice should probably also offer some info on how to keep one's wrists from falling off!

My current problems are with my left wrist-- a lot of the nagging pain is running down my thumb and slightly into my forearm. It is not at a point where I can't hold things, but it is certainly enough to make me take notice. Part of my problem is that I play and practice many different instruments, nearly all of which could conceivably be causing the injury. For this site, I use Burton grip, and I have been known to experiment with 'dead-stroking,' though not much lately.

Fortunately, I am far from the end of my rope-- I can easily think of about 10 things that have gotten me here, from not stretching or warming up to too much typing to trying to reduce the number of trips from car to club, etc.

Any accounts of experiences with problems like mine would be very much appreciated. My plan is to consult a therapist when I am able... right now I'm stretching for a few days and not otherwise using the affected hand.

Here's my own offering on the subject-- this is a video on the subject by a German frame drummer who I believe knows what he's talking about.

http://www.youtube.com/watch?v=hUyMNyrOHJQ

Comments

Marie-Noëlle Sun, 04/05/2009 - 12:36

James,

For whatever this may bring you or not, I'm sorry to hear about your wrist pain.

Of course, I am not someone who could give advice...

Other than: take good care of yourself.

Get well soon, to be able to play again with both hands, and bring us back your great music!

MN

PS: had you seen that incredible video of Patty playing with one arm, while recovering from an injury? Much impressive... and who knows, maybe inspiring?! http://www.vibesworkshop.com/video/friedman-etude-13-patty-franceschy/p…

tifoo Sun, 04/05/2009 - 14:25

Hello James,
I'm not a professional doctor so take my writing with all the distance it deserves...
but I'll give you my routine whenever I feel pain (I had one tendinite alert few years ago).

First, you have to drink a LOT of water to help your body eliminate all the crystals that could have fixed on your nerves and that can rip the "gaine" that covers it, then make the pain unbareable.
In this context I drink at least 3 liters of water per a day...
If you drink always that amount of water, you just wash your body (the good thing and the bad thing)so you don't want to do that infinitely, but I have done it for a week, and it made really the change for me.
About Carpal Tunnel, I own a Powerball : using it very slow can really help your wrist tensing out and rebuild gently, also rebuild confidence about your arm capacity (that is important not to lose).
I'd finish by saying that, drinking water, stretching gently,breathing, sleeping enough in a good position, are positive attitudes that will help you rebuild your arm and your confidence in it.
I have seen some musicians with severe tendinite problems getting into sport massage, and it was not really obvious benefit for them... that is my opinion.
Once again, I have written that with the intention to support not to tell you what to do.

have a good recovery,

Tifoo

vibeman27 Sun, 04/05/2009 - 23:40

Hi James,

And Patty. James, I don't know if you are developing Trigger Finger or not, not familiar with the thumb situation, but an orthopedic surgeon can tell you. (that is, if you have medical coverage). Patty, the same for you. A regular family doctor should at least refer you to a surgeon for consultation and examination. Trigger fingers are nothing to play with (not a pun). I have had four Trigger fingers (two on each hand and each separate of the other) in my musical life and each contributed to a great delay and decay of what I thought might be a career in music. The worst thing anyone can do is to keep putting off serious consultation and experiment with every remedy that comes down the road. Family and friends, all well intentioned, will have many things to offer in the way of remedies, but beware. Your total costs over time and can well exceed the copayment you might have to make by thousands of dollars.

All four of my Trigger fingers resulted in needing surgery. Unfortunately, some of us are just prone to certain illnesses and injuries. There are lots of things to consider so I am not offering this as something you have to do. Each time I had symptoms, I tried everything I could to avoid surgery, mostly treating the pain. Just treating the pain is not going to be the answer. The cause is the problem. If the cause is actual physical Trigger finger, then anything you do to ease the pain is only temporary. The pain will come back sooner or later and maybe even worse. I don't know what levels of pain you have experienced, but Trigger finger can be very excruciating in its severity. I agree with Randy that surgery probably should not be plan A or B, but one must always be aware that surgery may be the only answer to a problem that is dragging on and on. Now if one does not have medical insurance coverage, options are limited. Do what one has to do. Just please be aware that Trigger finger can be a very very serious condition.

BruceW

jamesshipp Sun, 04/05/2009 - 23:54

Thank you all so very much. In hearing what you've all gone through, I feel a bit embarrassed for posting about what is, in reality, a pretty mild amount of pain that's only really bothered me over the last week or so. (Before that it was just a bit peculiar.) However, I'm glad that I've drawn out a number of these helpful cautionary tales and testimonies about solutions-- hopefully other members will read this thread and take preventative measures that keep them from even getting in MY situation. STRETCH! HYDRATE! WARM UP!

Acupuncture eh? Always seemed like smoke and mirrors to me, but Patty's the THIRD very down-to-earth person recovering from tendonitis who has recommended it to me. Might be something to think about.

I DO plan to consult an MD, or at least a licensed physical therapist. It may be a bit complicated this week, as I've got a family emergency, but it's in my plan.

Thank you all, and please, keep the advice coming. I guess I have intellectually appreciated that this is a community in the past, but I am really feeling it at this moment, and I feel deeply grateful to one and all.

JAmes

tmackay Mon, 04/06/2009 - 02:55

hey james .. i must say as i type this reply .. my hands are killing me .. time to warm down from the day of work.

like i said in my article and such ... ive been dealing, adapting, ect with the seriousness of tendonitis and carpul tunnel.. since 1987.. ive done ALL the physical therapy. ive seen many doctors, both MD's and naturalpathic docs. we have talked of surgury but have ruled it out, because of the fast the surgery, ADD's scare tissue which in turn diminishes range of motion. so my life goal is to take as best care as i can. make sure i watch EVERY motion i do. musically and through life... somedays i cant hold a glass of water .. other days its ok .. also depends on the weather .. if its humid or if its dry .. if its cold or hott.

i can only give my first hand, no pun intended, experience on this matter.. im my condition i MUST reside in myself that ONE day i will not be able to play .... until that day i will and must FIGHT, and by the grace of God ... am allowed to continue to play music ....

jah bless

T

Patty Mon, 04/06/2009 - 11:02

Hi Bruce,

First of all, I am really glad to find someone that had trigger finger. Even though is a common injury, I haven't found someone to share my experience and specially musician. When I went to see the hand specialist back in October, he did mentioned the possibility of surgery. He said that if with the shot the trigger was not gone, I had to do the surgery. Fortunately, the trigger was gone with the shot but then by not moving the hand for 8 weeks I developed tendinitis. I have heard that people that gets the shot keeps moving their hand after they get. I kept it still. Anyway, the trigger did come back on January only one morning and then again in March, but it was not a painful one it was just a click. I still have surgery in the back of my mind but last time I went to the doctor he said he could not do the surgery unless my finger was completely locked. I have heard cases of trigger finger being treated with acupuncture even at severe stages. I actually started doing acupuncture just for the pain of tendinitis but I haven't had clicking problems since then. I agree with you that it is a serious condition and I know that the pain is aweful but everything seems to be working out with the acupuncture so far.
Anyway, but I agree with you, surgery is an option that can't be ignored.

tmackay Sun, 04/05/2009 - 14:02

hi james .. i have been battling a bout with hand problems since 1987. However this has not kept me from playing..

a couple months ago i wrote a blog on this site called 1 part musician 2 parts athlete. this discusses my battle to this day.

The MOST IMPORTANT thing to keep in mind is relaxing. if the pain is in the thumb then watch in a mirror your grip. it may be that your puttin to much pressure on the stick grasping it as certain times.. For me as years have gone by i have 50% grip in my left hand and about 20% grip in my right. ive had to change the way i practice, load in and out. making sure i wear wrist braces if im loading in and out. ect ect ect ...

hope this helps .. i could go on and on ...

t

Patty Sun, 04/05/2009 - 19:30

Hi James,

As you know, I injured my hand last fall and I'm still dealing with it. I had a condition that is called "trigger finger" which is some sort of "mini" carpo tunnel type of injury but just on one finger. Basically the tendon of your finger can move smoothly and it gets stuck on the way causing your finger to "click". When I started to get the symptoms, i didn't really know what was going on and my mistake was to ignore the situation until it got severe. The option of treatment according to my stage was to get an steroid shot and rest for 6 weeks to 8 weeks. I did it and after that my finger was ok my hand was not! I started to have severe pains every morning when I try to open my hand eventually as the day went through it would get normal. After a month an a half the clicking came back just for one morning. I noticed that keeping my hand warm at night would avoid the clicking in the morning, so I started going to bed with a glove on. I still do! But I still had the pain in my hand. I went to a hand doctor and he said I had tendinitis and he said to take naproxen so I started doing that but it only got a little better and as soon as I stop taking the pills it would get worst again. Sometimes the pain will get all the way up to my elbow. I remember talking to Tony about it and telling me that I should consider cirgury. I did research about it and my condition was not "bad enough" to get one so following the western medicine methods I had to deal with it with pills and hope!. Out of desperation I started to check out other ways to deal with it. Here is some of the stuff I've been doing, hope it helps you because it definately is helping me.

First, I found out about enzymes that are recommended for tendinitis like: bromelain and papain. I actually take one called "Repair" by enzymedica. Also cherry pure extract pills are great too. I get them at whole foods (I don't know if there is one in NY).

I totally agree about the water. Drink A LOT of water, it just helps your body to get rid of unwanted things. Also alcohol is not a good idea. I'm not a drinker but once in a while I used to enjoy a beer. I don't any alcohol now, I just think is not good for your body specially with this kind of conditions.

I started running every day, out of a recommendation of someone that had tendinitis too, and this was one of the things that definitely had some huge impact on my recovery. I strongly recommended it. You can increase the amount you run gradually so you don't get injured somewhere else! Listen to your body and it will tell you how much you can take.

Yoga is great as well, but it totally depends on how severe your pain is, when I started doing it it was tough because it was painful but now is definitely better. A combination of yoga and exercise is great.

Now the thing that I started doing that definitely made some drastic changes was acupuncture. This definitely took my pain away, I stopped the naproxen, and I just started to feel all around better. I was really scared my first time, but I had had 8 treatments now and I have no pain anymore, no more clicking and I can feel how after every session it just gets better. It is also cheap!! I am still on treatment but I don't have to wake up all scared and in pain anymore. I really think you should give it a try. It really worked for me.

One that you do have to consider is that sometimes we abuse of our body and we realize about it when is too late. The answer is all in front of us, exercising, drinking water (not soda, beer, etc), having a good and balanced diet, eating at appropriate times (having some kind of schedule).

Also giving our body the right amount of rest is indispensable. At least 7 hours of sleep, at least.

Now, every disease has some mental side of too, that needs to be addressed. Our mind is really powerful, and has a lot to do in our recovery. Having a positive attitude about it it does make a huge difference, and I think in general, having a positive attitude about life just makes a huge difference. Just by the thinking every day that you are getting better, it's something. I start my my days with some breathing exercises and meditation and just being grateful of the things you have at this moment, because I'll the end that's all it is. I spent so much time feeling bad about myself, and thinking how it was before I injured my hand and just a bunch of negative stuff. It is not helpful!

Hope this helps, and if you have more questions, I am more than glad to help.

Patty

Randy_Sutin Sun, 04/05/2009 - 21:50

If I had been asked about this in a vacuum, I would have said, yoga, exercise, lots of water, rest, meditation, no drugs (including alcohol, caffiene and nicotine), etc. But Patty already pretty much said that stuff so... I will just say, listen to Patty. I think she is on point on this one.

If it doesn't get better, I would recommend that you seek out a traditional accupuncturist/herbalist trained in TCM prior to a surgeon or MD. You might eventually find that surgery or drugs are the only answer and they may work fine for you, but I just would not make them Plan "A". I would make them Plan "C" or "D".

A good body worker can also do wonders for these sorts of problems. In particular, somebody trained in accupressure, myotherapy, or myofascial release therapy can be excellent resources.

Best of luck.
Peace
randy

Patty Mon, 04/06/2009 - 11:10

One thing I didn't mentioned in my post before, is that I have changed the way I play and practice. I do 90% of my practice on the piano and mental/aural. I think that specially for jazz you figure things out in your head/ear. At the end, you play what you "hear", right? I think that Gary Burton talks about this way of practicing. For me it was not a huge change because I always used to do a lot of mental practice for my classical playing. So I am used to it, but I recommended it because you develop other senses more than the muscle/visual one. I also have been playing 2 mallets only. Maybe if I want to play a classical piece that requires 4 mallets that might be an issue but I have been doing more jazz now so it has not affected me. I know there is a lot of emphasis on the site to play 4 mallets but at the same time lots of great vibes players were 2 mallet guys but I don't really care if it is 2, 3, 4, 5 or 6 mallets and I don't think that one is better or worst, I'm just doing what works for me at the time.

vibeman27 Mon, 04/06/2009 - 13:13

Just a little bit more info. Please find three photos, one pic and two documents regarding Trigger finger. The picture is of my fourth and hopefully last Trigger finger. The documents should give some more concrete advice and suggestions about Trigger finger.

I might add that my first two Trigger finger incidents were the worse because I did not even know about Trigger finger and allowed the condition to worsen before surgery. Also I always had an office day job (or evenings or graveyard shift) and did a lot of keyboarding on computers. Those two Trigger finger episodes and various other incidents, heart attacks, undiagnosed foot and leg cramps, three heart stent operations and my subsequent prostate cancer derailed my career completely. I hope none of you experience any of that.

Incidentally Patty, I am a 2 mallet player so don't be disillusioned that changing from 4 to 2 is a great help in preventing this malady.

My advice: if you are young (under 45 years), get it fixed somehow and keep charging on. :-)

BruceW

jamesshipp Mon, 04/06/2009 - 14:28

Actually, this has been an interesting little break for me, because I'm doing a week-long workshop with Zakir Hussain next week @ Carnegie, and since I didn't use my left hand for a few days, I was focusing as best I could on Indian syllable singing, which is helping me get my brain around the simplest level of the stuff I'll be delving into next week.

I'm not one to practice harmonic improvising on vibes a lot either... rather do it with piano where I can play bass for myself.

Well, I'm freshly back from a physical therapist, and feel much less desperate about my condition. He worked on me for a bout 45 minutes, showed me my problem areas and how I can work on them myself, and basically said what I've got is unpleasant, but not yet severe or chronic. He suggested a DVD made by an ex-accupuncturist who has translated a lot of those traditional Japanese techniques to massage, which he backs up with a good knowledge of anatomy. Apparently this is a very good video of exercises for keeping limber... will post info when I get my hands on it.

thanks again for all your support, and let's all keep this thread going for the good of everyone's wrists, arms, and fingers!

JAmes

bware59 Mon, 05/04/2009 - 13:22

hey james and all,

I had a similar problem with my wrist and I changed the angle of my wrist to the instrument by raising the instrument( vibraphone) on blocks. I recently had a tumor in my spine that caused nerve damage (I had it removed).Warming up properly along with the water/dietal advice by others can help.Also, taking a special vitamin B commonly called methyl B12 can help tremendously with nerve problems try http://www.realfoodnutrients.com/ to order it. It's really helped me.I now sit while playing the vibes which has led to using both feet, one on the damper bar the other on my Zoom G9tt triple guitar effects pedal.There are also a host of natural cures for this.You my try castor oil soaks.hot shower,hot castor oil soaked cloth wrapped around the injured area covered with plastic (to keep the oil on the skin).It's an amazing cure for many problems...good luck
bill ware

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