Tendonitis? sprain? what to do?

[NoNickel]

Yesterday after a long practice session I noticed some unusual pain in my fret hand index finger (beginning right at the second joint and radiating towards the knuckle). I haven't played today (of course) and I put some heat on it and immobilized it with tape. Also took some Ibuprofen and it feels pretty good now.

I don't know if I sprained it or it is some tendonitis starting -- not sure if it matters. Any suggestions on treatments and how not to reinjure it would be appreciated.

[steelbuddha]

You would do well to have a Rolfer work on you. The repetitive motions musicians engage in cause connective tissue to shorten and adhesions to develop. Rolfing is very effective for this stuff, as I have learned from extensive experience. (Just recommended the same thing yesterday to a harpist friend who was complaining of the same problem.) You can find a Rolfer at www.rolf.org.

[Darren Kern]

I have had hand and wrist pain off and on for years, and fortunately it's been under control for some time. To prevent it, I stretch regulary. When I get some pain/inflammation, I use a combination of a gel-type ice pack, and Ibuprofen. One thing my docs have told me is to take Ibu for a week straight when I'm having pain, don't stop taking it after a day or two just because it starts feeling better. It's a really good anti-inflammitory, and taking 800mg twice a day won't hurt you for a short period of time. Also, you did right by stopping playing. It's not smart to 'play through the pain' or anything like that. Hand/wrist pain is nothing to take lightly. Best of luck to you, hope this helps.

[August Watters]

Interesting. Looks like rolfing is similar to myofascial release (http://www.myofascialrelease.com/mfr/mfr_what.asp), which I credit for enabling me to maintain an ambitious practice routine at this advanced age. #http://www.mandolincafe.net/iB_html/non-cgi/emoticons/smile.gif

A large percentage of us face these problems. When I ask my fourth-semester music students, usually half the class reports hand problems related to practice. Most of us haven't had injury avoidance as part of our training, so we're susceptible to these injuries.

Remember the music teacher who used to yell at you in music lessons when you didn't hold your hands just right? This is why!

[Marcus CA]

I feel your pain. A key part of the body gives out just as the heart and mind are getting warmed up. As Neil Young said, "Helpless, helpless."

I have had chronic elbow tendinitis for years, resulting from occupational overuse that was misdiagnosed. So, using a flatpick is really bad news for me, because the act of tightly gripping pulls on the forearm muscle which pulls on the inner elbow tendon. (It's called "golfer's elbow" or "writer's elbow," as opposed to "tennis elbow," which affects the outer tendon.)

I used to use a basic wraparound tendon-isolating elbow brace, which enabled me to play for about a half an hour (instead of ten minutes) without needing ibuprofen and/or ice. About a year ago, a fellow mandoman told me about an improved version of the design, which has a thick oval pressure pad inside the brace. It is fantastic! No matter how long I play for, I don't need any meds or ice.

[markd]

Marcus CA

Can you tell us where you got that improved version of the brace with the pad inside ? Many thanks

Mark

[Jon Hall]

I have more success with a cold pak than heat. If it persists you should probably see a physician. A few years back I procrastinated seeing one and paid the price.

[Curtis]

Well a few years back I didn't procrastinate but went straight to the Dr. A surgery, 4 scars, 6 weeks in a cast 6 in a brace and 2 months of OT, and 3 years later and I still have pain. I had given up but now my interest in the mando (which ALSO gives me problems--before it was mainly keyboard and hand percussion) and I'm giving the Orth one last chance. Appt on Tues. . .

[woodwizard]

I have tennis elbow as well on my fretting arm & useing IBU along with that tennis elbow strap, the one with the cicular bubble pad works very well for me. I got my strap from Wal-Mart for about $8 bucks. It's worth every penny.

[billkilpatrick]

once the pain has passed and your hands are back on their feet (so to speak) simply remember to shake them out every now and then. this is hard to do when learning a new tune (my hand looks and feels like a claw) but it works.

[Ken Sager]

Well a few years back I didn't procrastinate but went straight to the Dr. A surgery, 4 scars, 6 weeks in a cast 6 in a brace and 2 months of OT, and 3 years later and I still have pain. I had given up but now my interest in the mando (which ALSO gives me problems--before it was mainly keyboard and hand percussion) and I'm giving the Orth one last chance. Appt on Tues. . .
This is the most depressing and disturbing post I've read on this board. Curtis, you have my deepest sympathy. I hope you find relief soon and can keep playing.

I've had my share of hand/wrist problems (tendonitis and neuroma) lately, too. I went months trying to manage it with ibuprofin, ice, and deep massage. After about an hour of play I couldn't use my ring and middle fingers no matter how much stretching I did or ibuprofin I took.

I'm doing everything I can to avoid surgery of any type. It sure gets depressing when I simply lose the ability to shape a 4-finger chord after playing for an hour or so.

One overlooked cause of hand/wrist problems is simply the physical shape of an instrument's neck. If you have problems of any type try playing another instrument for awhile to see if the issue could (in part) be attributed to that.

Best to all,
Ken

[Steve Scott]

Here is an excellent site devoted to musician's health issues. http://www.shape.bc.ca/resources/pdf/msi.pdf

[Alex Orr]

Wow! #I was just going to post on this topic.

I do editing work, so I spend many hours a day with a mouse and a keyboard. #I play guitar/mando about two hours a day, sometimes less, usually not more. #For about a month now, I've noticed a slight discomfort in my knuckles and to some degree wrist...but mostly knuckles. #It's more noticable on my left (fretting) hand. It doesn't affect my playing, and actually, when I play I don't feel any pain. #I was worried that it was early carpal tunnel, but I'm somewhat doubtful about that because there is no numbness, I don't feel it in the morning, and it doesn't extend to my forearms. #I'm thinking it may just be some mild tendonitis.

Next week I'll be on vacation, and will be avoiding the computer, so I'll see if that helps. #I'll also do a week of ibuprofen. #I'm not very consistent on stretching regularly throughout the workday, but I'll start trying harder.

Anyone ever have similar pain in the knuckles, sort've a very mild sense of burning and slight ache?

[Chris Biorkman]

Check out this thread. I recommended a routine that worked for my brother and wife and the original poster too.


Old Thread (http://www.mandolincafe.net/cgi-bin/ikonboard.cgi?act=ST;f=12;t=45265;hl=homeslice)

[sailaway]

re; tennis elbow/tendinitis/ radiating pain down the arm form playing mando 4 hrs at a stretch: my physical therapist recommended a s tretching exercise for both wrists which goes as follows: place hands flat on a wall or table. now bend your wrists trying to bend them PAST a 90 degree angle in both directions (oops, obviously removing your hand from wall or table as you reverse your wrist from 90 degrees 'up' to 90 degrees down...) . this stretches a particular tendon that helps control fine motor movement in the wrists. you can also use 1 hand to bend the other wrist back and forth. this exercise made it possible for me to paly for 3 -4 hrs at a time. now if he could only fix my 4th degree tear left rotator cuff......:p

[Fretbear]

You can always switch mouse hands as well by just moving it to the other side of the keyboard.

[scgc.om]

I've played mandolin for about 4 or 5 years now. For about the 1st half of that time, I would get significant wrist pain in my left hand - I can recall posting here about it. Many suggestions were offered. THE BEST advice was "Buy a better mandolin".

Shortly after this post, I started buying batter mandolins - some were considerably better, a few were WAY BETTER, and one or 2 were DRAMATICALLY B E T T E R . I haven't had wrist pain for years now . . . .

[Also, back pain resulting from carrying a too-heavy wallet has also gone away ;~) !! ]

[mrbook]

For the last year or so I have been suffering from what I thought (and still think) is carpal tunnel syndrome, which got so bad for a while last year the fingers on my left hand would sometimes go numb during a break. I cut back my playing, did some stretching, everything someone advised to avoid surgery.

I couple months ago I started playing in a new band. We have fun, play music I like (no bluegrass versions of Beatles songs or southern rock classics), and I'm having the best time I've had playing in a couple years. I also realized I am often now playing 4-5 hours a night without any hand problems. Am I getting the hint?

Lots of computer time also contributed to my problems, but less stress in my playing situation helped a lot, too. After all, playing music is supposed to be fun.

[homeslice]

See biorkman's link. This REALLY works! I owe a debt of some sort for this advice because it literally saved my mandolin playin life (which is one of the best parts of my life). Its doctor approved and costs nothing!

[NoNickel]

Thanks for all the help. With all of this advice my hands are back to 100%. Wish my playing was.

[man0mando]

I used to have a lot of wrist pain and it went away after i started doing a lot of mountain bike riding - i think bike riding was a form of strength training (and possibly stretching) - someone in one of these threads once said a musician is an athelete just like a ball player or runner and i think maybe some of us ignore things like strength training as an aid to continued playing - dave

[chirorehab]

Proper warm up, stretching, good posture & technique are all very important. #I utilize Active Release Technique www.activerelease.com (http://www.activerelease.com) with my patients. I get excellent results.

Best of luck,

Eric

[Harrmob]

I was in the emergency room last night until 3:00AM because in the middle of a big finish solo, my knuckle popped and my hand and index finger radiated in pain. The ER had no clue and of course I felt like an idiot. Now, my finger is swollen to the point of almost no mobility, and I have it splinted, and I have (had) 2 shows today. The original post here describes it well- sprain, torn tendon,?. What is going on here? I have an appoitment in 2 weeks with a hand specialist, and you can bet come monday they are going to get call from me to move my appointment up. I am fearing the worst as the crooks at BC/BS now make you take 2 types of anti- imflammatories for a month before you can get an MRI. Well that is BULL. What are some of the experiences and results from these previous posts?

[Jim]

Stretching full range of motion, warm-up and ibuprophen. A previous poster mentioned taking Ibuprophen max dose for days past the symptoms disappearing and I recomend this as well.I examine a great deal of patients with joint injuries and this is the most commonly successful treatment plan I see.

[MandoSquirrel]

Interesting. Looks like rolfing is similar to myofascial release (http://www.myofascialrelease.com/mfr/mfr_what.asp), which I credit for enabling me to maintain an ambitious practice routine at this advanced age. http://www.mandolincafe.net/iB_html/non-cgi/emoticons/smile.gif

A large percentage of us face these problems. When I ask my fourth-semester music students, usually half the class reports hand problems related to practice. Most of us haven't had injury avoidance as part of our training, so we're susceptible to these injuries.

Remember the music teacher who used to yell at you in music lessons when you didn't hold your hands just right? This is why!
Myofacial release is one of the less painful(to the client) ways to achieve similar results to Rolfing, which can be Very painful. My therapeutic opinion is it should not be torture for the client or the therapist. Look into Bodywork/Massage Therapy, not necessarily one individual modality.

And yes, despite what some on the forum will say, there are reasons for those centuries old traditions of technique.

[2manytendons]

My two cents for those of us tired of visiting doctors...I find success, along with the already mentioned stretching, with walking - when I take my long walks, I swing my arms. Seems the gentle sway back and forth helps to stretch them out. I also have an exercise ball, the ones used in Pilates and in PT offices. I roll out on my stomach and walk out on my hands and back five times a day. Helps keep the muscles strong in the wrists and forearms. I've had the golfers elbow tendonitis in my left arm for many years, originally from violin playing, and now have Intersection Syndrome in both forearms/wrists(it's like a combo of thumb and first finger tendonitis.)

I still deal with the pain and discomfort from time to time, but I have found ways to play with it. I wish you the best in your recovery. Please keep us all posted on your success!

[ELSOL102]

I had tendonitis in my ring finger last year from playing guitar. What I did was rested the hand...played less for a few weeks...doctors told me to tape the 2 fingers together and not use for 6 weeks....I did NOT do this...BUT...I limited my playing for awhile...and I got these herbs, http://www.totaltendonitisrelief.com/index2.html
I do believe these herbs plus resting helped get rid of the tendonitis.
There are exercises to do before you play. hold arm out and slowly bend fingers back one way, then go the other way stretching arm muscles keep arm straight. Also arm out straight hand up so fingers are facing sky and slowly bend each finger back one by one. Also shake hand. Play with breaks inbetween, do these exercises....
Now lately my fingers were bothering me and my fingers went NUMB so I stopped playing for 5 days...took Ibuprofen, now resumed playing, but now I do the exercises before during and after playing and shake hands and I am mindful of long sessions...I play the street for money and it's very hard on the hands.
Last year what I had was trigger finger...and it got so that I could not bend or move the finger when I woke up and I had to move it with the other hand. I could not play for awhile with this...but since I had been in a guitar class when I got this problem, I played 10 mins a day for the class and rested as best as I could...I only did the minimum to practice for the class, and no bar chords...nothing to stress the ring finger...since it's your index finger, maybe playing different chords for awhile...try the 2 finger chords and not the 4 finger chords where you are barring across...also switch to lighter strings...BUT REST is most important...there is inflammation in the tendons and this will get worse if you do not rest. REST and it will go away...play less...play lighter...take a few days off and let the hand rest. The herbs have a lot of good ingredients that help the body heal. There is something called The Alexander Technique that is supposed to help musicians. These are common problems. Listen to your body and don't let this condition get worse because you will not be able to play for a longer period. Nip it in the bud now. That's what I did this time having learned my lesson last year where the finger got stuck and I had no control.

[Randi Gormley]

I used to have some shooting pains in my left hand from my thumb joint all the way up when i played more than an hour. Went to an orthopedist and he said i had some osteo-arthritis in the joint and also recommended ibuprofen as an anti-inflammatory if things got too bad. I cut back on my practicing to every other night and apparently the rest helped the swelling go down and I haven't had any recurrence since. my husband said he thought i had injured it somehow, which is why it was swollen to begin with and the daily 90-minute practice aggravated whatever i had done to it. i noticed the aching started after i spent way too much time playing solitaire games on the computer. i type for a living and don't normally have hand issues, but then typing doesn't use a mouse ... now i'm just careful not to overdo. I spent the past week in a mando class and playing sessions for a couple hours and didn't have any problems except sore fingertips -- probably from not enough practice!

[Harrmob]

As an update to my previous post, I have "exploratory" surgery in the morning. I most likely ruptered a tendon in my left index finger and the doc says I should be fine after some "cleaning up" and a several weeks of no pickin. I can't move it let alone play right now, so there ya go. Friday night when it happened, I played the rest of the set without my left index finger. The solos were...creative but it worked. Chording was pain, but doable. I don't think anyone even noticed, then again we were in a bar!

[Marcus CA]

Good luck with the surgery. #It's never fun, and when they tell you not to play, DON'T PLAY! #It's a short-term sacrifice for a long-term gain.

Lacking any medical training whatsover, I think that whenever pain like yours happens suddenly and forcefully, it's an injury rather than an inflammation.

You might want to also look into various finger stretching and strengthening exercises to spare your other nine a similar experience. #The good news is that most finger exercises are something that you can do while doing something else (e.g., watching t.v., walking the dog, etc.), so they won't take up additional time.

[Pete Martin]

Musicians and Injuries (http://eeshop.unl.edu/music.html)

Try looking for info on this page.

[Harrmob]

Surgery is over, and no playing for several months. I tore some tendons in my index finger that would have not healed by itself. Judging by the cast and the physical therapy they have planned for me, I am in for a long recovery.

[Marcus CA]

Sorry to hear that it's months rather than weeks. However, unlike some, at least you have solved the mystery behind your ailment. May your long recovery lead to a full one!