Lets be careful.

[JeffD]

This book has been recommended to me by someone I trust and respect in these matters. I have not as yet gotten a copy, but its on order.

I thought I would at least make you all aware of its existence. It seems worth checking out.

[Petrus]

I like that clown cello but it doesn't seem to have much to do with the title. They should've gone with a busted-up instrument, preferably a mandolin of course.

[Mike001]

Between arthritis and racing motocross when I was young, getting comfortable with an instrument is something I struggle with more and more the older I get. When I started playing fiddle the pain was so bad I thought I was going to have to quit but after a lot of experimentation with position, chinrest, and shoulder rest it got better. I still have to take a short break after about 30 minutes. I don't think I'll ever be pain free but playing less hurt is definite something that interest me. Thank you for the recommendation.

[Ivan Kelsall]

Obviously,i've never read the book,but i'd expect it to contain 'words of wisdom' regarding helping to prevent pain induced by playing an instrument. However,there's nothing that can be done to prevent the onset of pain that we're genetically predisposed towards ie. Arthritis etc. I seem to be predisposed towards 'trigger finger' & tendonitis,whether that's the result of playing an instrument for over 50 years i don't really know,but i strongly suspect that it might be. 2 friends of mine have had TF & have had treatment for it,& another friend of mine & a fellow UK Cafe member, has just been 'struck down' with it. Hopefully,the steroid injection he had will sort it out.
I don't think that there's anything that can be done to prevent long term damage. It's something that creeps up on us slowly. One day it's not there,the next day it is. We waggle our fingers around for hours for years & years,& never feel any pain,until one day it hits,by then it's too late. I can imagine this book being of more use to anybody who plays Violin / Viola,where the arms,shoulders,fingers & back are all involved in playing,but i'd think it could well be worth reading,as there maybe some 'general' points applicable to all of us,
Ivan

[Bertram Henze]

The one thing I recommend is not going down the slippery slope of unneccessary medication.
My wife is currently suffering from damaged fasciae in her left leg, having stood mainly on that leg for long hours of rehearsal of the choir she sings in on five subsequent days. She might have shifted weight, had pain given her feedback in time, but one of the singers is a pharmacist who gave Ibuprofen to everybody in advance...

Have your body warn you, and listen to that warning.

[Beanzy]

I'm another arthritic player (osteoarthritis both hands), but there are mitigation strategies I've developed to avoid aggravating things or accelerating the decline. I won't list them now or the thread would derail to specifics. However I think an approach that looks at getting the music impact minimised is useful as long as you don't just look at that one area. Looking to your everyday approach to chores, DIY, shopping, travelling, sleeping positions, use of tools etc. can all help to avoid accelerating the decline. Minimising impacts, strains and maintaining muscle tone to support the skeleton all help. A book about an area of activity at which we spend a good deal of time seems like a good tool to have in the bag.

[darylcrisp]

yoga, yoga, yoga

all these instruments we play are not really natural for our body shapes to adapt too. we fight, we figure, we learn if we are wise, the best trade offs to acquire as best ability in playing our choice of music. we practice, abuse our fingers, hands, wrists, necks, upper backs, legs, feet, etc
time, age, repeated abuse takes its toll for sure. add in all the other non natural conditions we place ourselves in and we have a steady daily stream of abuse to our daily older bodies. the modern advancement of medicine gives us pill, liquid, or injections in an attempt to mask the pain. the pain being our natural onboard system of warning that something is wrong.

if we were wise, we would acknowledge what our body is telling us-its talking to us. but we don't have time for that, we want what we want now.

some of the first things that leave humans after the teen years are flexibility and balance of the bodies muscular system. we get jobs, family, responsibility, and we try to find easier ways to make it thru the day. no longer youthful, we are not interested in stressing our bodies in a good way like using our complete muscle systems which in turn would effect our nervous and cardio systems in a good way, instead we look for the softest way out. we go home worn out from sitting most of the day, our minds bottled up in stress and too much bad nervous energy. our ways destroy our youthfulness.

yoga works ones entire system-mind/body/spirit. yoga balances the skeletal and muscular system, which in turn effects the nervous and cardio systems in a positive way. yoga works not just the front, but the complete backside, the tops and bottoms of our body parts. areas that we take for granted(our feet for example)over and over for years, then wonder why they deform and hurt.

yoga works, and it can turn the clock back-how far back is based upon ones genetics and habits, and dedication.

as the body reacts and rebuilds and straightens and gets long again and opens again, the mind also begins to rebuild, straighten, and open, the nervous pathways unblock and react smoother and quicker and with less energy and less hurt, the air passages clear and become large again and efficient as when they were youthful. blood pressure decreases, desire for a healthy food intake becomes natural, and ones outlook on life in general takes a turn for the better.

yoga, the daily dose for what ails you.

the book looks good, I will get a copy, the more we know of what not to do, the better off we will be when we are 85 years old.

d

[Michael Bridges]

Ivan, I've recently developed "trigger finger" in my left middle finger. Really has put a damper on my playing, I have to "flick" my hand to pop it loose. If you, or anybody, has any treatment, remedy, etc. to recommend, I'd be deeply in your debt!

[Tobin]

Buncha sissies. Ain't you ever heard "no pain, no gain"? Just rub some dirt on it and keep playing.

Just kidding, of course. Pain and injury from playing musical instruments is a serious thing, and it still surprises me just how much wear and tear it can put on the human body. There is not nearly enough attention paid to it because people tend to think that playing an instrument is a very benign activity. Not like playing football or rough sports where "real" injury occurs. Complaining about getting hurt while playing a mandolin can be a source of teasing from people who don't understand, so people tend to just grin and bear it. Which is, of course, a mistake.

I have suffered through some serious wrist issues and tendon issues in my left hand from playing too aggressively on the mandolin. My recent side-track to banjo has actually helped, since the banjo requires much less fretting force. It has actually helped me to lighten my touch on the mandolin.

And my poor wife has osteoarthritis - her finger joints get larger and knobbier every year just like her mother's did. It limits her ability to bend her fingers to play certain chords or double-stops. The doctors tell her there's nothing they can do, and that she should just keep using her fingers as much as possible to keep them flexible, but I wonder if playing the mandolin and mandola are making her condition worse. It's primarily her left (fretting) hand that is getting worse. And we will not go down the road of prescription medications with all their side-effects and long-term health risks.

[Bertram Henze]

I think playing an instrument is just another hormetic medicine. A little of it is good, too much is bad. And the right dose must be found individually.
A classic is callus formation - you have to play to grow calluses, but you don't want to have raw bone sticking out of your bleeding fingertips.

[Denny Gies]

One underlying theme here is that getting old, and playing an instrument is not for wimps.

[Johnny60]

@ Michael Bridges. I was on the verge of getting trigger finger in the middle finger of my fretting hand about 4 years ago.

It felt like there was a small "ball" that moved under the skin on the underside of the big knuckle that attaches the finger to the hand, and it hurt like hell every time I did something like sliding my hand on a stair rail.

Went to see my physio (who does a monthly tweak on my back) and she told me it was a nodule that had formed. She explained that once the nodule gets too large it gets stuck in a tendon sheath and that's when the finger gets stuck (or something along those lines).

She got me to regularly rub across it with my right thumb, left to right (that is across the hand, rather than up and down from fingers to wrist direction) and said that doing this regularly would break the nodule down. It hurt at first, but it disappeared after a couple of weeks and has never returned. Left unabated, it would have become trigger finger.

Disclaimer - this worked for me, and was prescribed to me by my physiotherapist. It may be different for others.

[Beanzy]

And my poor wife has osteoarthritis - her finger joints get larger and knobbier every year just like her mother's did. It limits her ability to bend her fingers to play certain chords or double-stops. The doctors tell her there's nothing they can do, and that she should just keep using her fingers as much as possible to keep them flexible, but I wonder if playing the mandolin and mandola are making her condition worse. It's primarily her left (fretting) hand that is getting worse. And we will not go down the road of prescription medications with all their side-effects and long-term health risks.

You're right to give the prescription stuff a swerve as they haven't got anything yet. No harm in using the ibuprofen gel to rub in directly when they flare up, it helps to re wet the hands a few times while rubbing it into the joints. I'd have her look to limiting things like chopping food, lifting heavy loads such as bags with skinny handles, not doing stuff like putting a hand on anything with a running motor (drills, food processors, strimmers etc) relaxing the grip on the steering wheel and similar mundane things can avoid causing flare ups. Then there's trying to minimise the strength used to grip and avoiding hard repeated impacts of fretting fingers. Irish music can be my worst there, as it's hard not to get over enthusiastic with the fretting hand when smacking out all those triplets & trills during a set in full flight. Personally I think I'm better off playing as it gives the hands strength, but I do like to move off the mandolin to the mandoloncello or violoncello to avoid always playing with such a closed up hand.

[stevedenver]

Ivan, I've recently developed "trigger finger" in my left middle finger. Really has put a damper on my playing, I have to "flick" my hand to pop it loose. If you, or anybody, has any treatment, remedy, etc. to recommend, I'd be deeply in your debt!

I had it twice within two years. Gigging and heavy practice. First was my lh ring, then a year later, the pinky, likely from doing double duty.

I saw a surgeon, and I didn't want surgery. Cortisone shot was worthless, and 1600 dollars if you can believe it. A ten minute consult and a shot.

Both times, and to date, it completely disappeared but only after 7 to 9 months rest each time. At first I avoided using the injured finger, using open and 3 finger chords. I could play lightly, guitar, and things would loosen , then get worse. Eventually my grip was so weak, I could barely lift a gallon of milk. I well recall rough mornings with a very uncomfortable hand.

Immediate and total rest is the inconvenient solution short of surgery. It is indeed the swelling of the tendon inside the sheath, and blocked from movement by the fishing line like support ring which supports the sheath. Like passing a pea through a straw.

Music and playing are hugely important to me. During these times, I tried piano and harmonica.

I can say, it can become irreversible if it lasts too long and isn't rested.
Please take this seriously.

One thing now, I make myself rest and sit out and stretch my hand a long sessions and jams. Never had issues for forty years of guitar. I do yoga too. I can only say, once you get inflammation like this, or in your joints, it is debilitating. When you can't tolerate weight on a joint or hand, you simply are stopped dead. I never understood disability until I dealt with this, and arthritis. You wear out and change with use and age, despite physical fitness and healthy diet.

Listen to your body. Rest!

[JFDilmando]

I sent a message to Michael, but thought that I would place the message here for others that might benefit from my experience. This is after full blown trigger finger has developed, and reduction of the node by massage has ceased to be an option.
"Michael;
I was afflicted with this in the ring finger of my fretting hand... that seems to be statistically the most likely finger to experience this, but can happen to others as you know...

I went to some high powered docs to see what could be done...really the only two viable approaches boil down to steroid injections, and/or surgery. The problem occurs from an inflammation of the tendon interfering with a "ring" through which the tendon passes in the finger. The "ring" is vestigial. which presumably means that it doesn't serve much actual function anymore, and is something left over from our evolutionary past. The tendon inflammation could occur from something of a small tear, or nodule that under normal circumstances can pass through the ring, with no issue, but when inflamed, it catches either going through one way or the other....

First thing to try is injection into the finger. I went that route... let me say right up front, THAT WAS A PAINFUL process. I have been through alot of pain over the years, and thought "how bad could it be?" Doc said that some have said that it feels like their finger is going to explode.... yes, it does.... and it lifted me right off the chair. It is probably the way to go though, considering that it can work. It did for me....for about a month. Then right back to square one.

upon revisiting Doc, was informed that a second injection sometimes can solve the problem.... and I said, fat chance, and what else are we going to try. That was surgery. Really a simple, fast, out patient surgery, where they just go in and cut that ring, which then relieves the catching, and presto, no trigger finger anymore.

It has been ten years since I had that done, and no issues since... fast healing time, and minimal discomfort. I am a fan.... but I think I would suffer with the injection, as a first step, but you won't like it.

Good luck"

[Capt. Quicksteel]

Johnny 60 has the right idea. Everyone is different of course. But about 5 years ago, I started getting pain and limitation of movement in my left hand. I went to a physical therapist who specializes in hand therapy. Two sessions and she showed me some exercises that I now do very gently every day. The problem went away and stayed away! Avoid meds, for the most part, and get expert advise and you can accomplish a lot. Home remedies are not nearly as reliable.

[JeffD]

I also suggest getting a general checkup. I had severe left hand problems, shooting pains in the fingers, hand and wrist. I had to limit my playing to half an hour. It was driving me nuts. The pain was so great in my index finger I taught myself to play everything one finger over, figuring I was going to lose that finger anyway. Dark times in mandoland.

Then, in an entirely unrelated checkup, I was diagnosed with diabetes. Once my blood sugar was corrected, the pain went away, entirely. And to this day I can play for many many hours without a problem.



Sometimes the problem you are having is not the problem you are having.

[Ivan Kelsall]

Hi Michael - I developed TF in my left ring finger,that's where my first severe bout of TF hit me,i also had it in my left thumb as well. I literally had to open my left hand middle finger with my right hand when i was playing banjo.
There are 2 main treatments for both of which need medical consultation. 1) You can have a Steroid injection at the TF site.This helps to reduce the swelling in the tendon,to allow it to pass through the tendon sheath that holds it in place. 2) An operation during which,the tendon sheath is simply 'nicked' to allow it to open up with the same result.
I had the operation & my finger & thumb are fine. The only downside to the op.,is the recovery time. From having the op.to full recovery was around 3 months,& IMHO,it was well worth it - TF will never come back in those 'digits'.
A couple of years ago,i began to develop TF in my left middle finger. I use an ''anti-inflamatory gel'' on my back to treat severe lower back pain. I decided to try it out on my finger by rubbing it into the site of the TF & after a few weeks,the symptoms had gone - & they haven't come back. In that case i'd caught it before it became too severe. I've developed quite severe TF in my right middle finger,but the gel hasn't worked on that because i left it too late. I have an agreement with my Doc.about a steroid injection,but as long as it doesn't stop me playing mandolin or banjo,i'll leave it.
Here's some info on TF :- http://www.nhs.uk/conditions/trigger...roduction.aspx But do consult your MD & if all he offers you is an op.,go for it,it's usually 100% effective,but i'd opt for the Steroid injection first if it's an option.
John Dillon's post is interesting,but the pre-op.injection i had was pretty up-lifting as well. However,the anaesthetic eased it's own pain - praise the good Lord !.


One thing that i've advised several times on here,was part of the Physio. i had on my left hand after my op. Soak your hand in water as warm as you can stand, & soak a face cloth in it at the same time. After a few minutes,take the facecloth & wring it out as hard as you can several tiumes. The tension & release really eases up your fingers & it's someting i do every morning. Five minutes is all it takes to get any stiffness that might be there gone & i'm set for the day,
Ivan

[montana]

Jeff, when you get the book please give us a review in a new post.

[JeffD]

Jeff, when you get the book please give us a review in a new post.

Will do. It looks useful.

[Mike001]

Jeff are you or anyone else familiar with the Alexander technique? I've never had any experience with it but I've seen it discussed on other music forums and a lot of people had success with it.

[darylcrisp]

excellent thread here, with many folks offering up many experiences and treatment methods. the more we know, the better equipped we will be at handling times like this.

i work in modern medicine, i look for a naturalpathic/holistic or Ayurvedic path before first-always. sometimes it works, sometimes it doesn't. even with modern medical treatments, i look for the method that will give me a jumpstart towards healing and then be able to remove the treatment(pills, injections, etc) as soon as possible. every method whether more organic or synthetic, will not effect each person in the same way. our personal physiology, habits, thoughts processes tend to work with or against us at times.

chiropractic, yoga, acupuncture, and working with a real ayurvedic practitioner can offer many times a healing pathway towards a more healthy life.

i've had excellent results with acupuncture on some hand and back injuries/issues.

d

[Beanzy]

Jeff are you or anyone else familiar with the Alexander technique? I've never had any experience with it but I've seen it discussed on other music forums and a lot of people had success with it.

Yep one of our local cellists does a course for us every year as an add on to a cello weekend which I do. It could be useful for people who need things packaged up as a distinct exercise regime, but I'm more of an 'incorporate it into your everyday moves and routines or it won't happen' type so I've never taken to it as a packaged discipline in itself. Some people are positively evangelical in their assertion of it as the way, but it's really just another approach that will work for people who roll that way. It's been so commodified as a commercial proposition that for me it has little appeal beyond familiarising myself with the core approach then ignoring the hype and pseudoscience that often gets tagged on to what is essentially a sensible self appraisal method.

[Bill Clements]

I just ordered the Kindle version via Amazon. Only $16.19
Thanks, Jeff!

[JeffD]

Jeff, when you get the book please give us a review in a new post.

Got the book and finally had a chance to go through it.

I highly recommend it. It is focused primarily on the professional orchestral musician, but the lessons and advice apply to anyone who plays a lot.

The first third of the book is bent on convincing one with statistics, experience, and anecdotes, just how physically taxing musicianship is. Especially for the gigging professional. Its a freaking marathon a day. So a lot of the message seems to be that general health, physical conditioning, rest, pacing, etc., are as important if not more important to the musician.

I did not find any magic bullet, but lots of good common sense stuff that will help, all in one place, and really good explanations.

Hope that helps. I think it is valuable to have on the shelf and I will be referencing it as needed.