She plays the violin. Back in the summer/fall of her sophomore undergrad year, her diagnosis was tenosynovitis. Her current situation is somewhat different, more related to her flexor (forearm) muscle, fascia and tendons, and her initial doc didn’t give it a name beyond overuse and instructions not to play at all. Her school/teacher was very accommodating – it’s unfortunately fairly common. Since the first injury, she’s been attuned to her body and red flags; she’s also pretty aware when a therapy is helping and isn’t, and – at least in her experience – traditional OT and resting/not playing for week after week has never seemed to heal her – it was always just another anxiously anticipated weekly visit where the advice was inevitably a reflexive “give it another week, and then we’ll see where you’re at.” I’m certainly not saying that advice may not be the best thing in certain situations (or even the only thing), but just that she had to do a lot of leg work herself to eventually find what worked best for her. You’re right, there are multiple approaches to these things (on these boards, glassharmonica recently mentioned that the McKenzie method was proving effective for her daughter, for instance), and probably each has its proponents and detractors. I’m certainly no expert. Anyway, I’m hoping your son learns more about his situation and gets what he needs at the clinic. Please keep us posted.
@AsMother Sorry to hear of your son’s continued injury. I hope the Performing Arts Clinic will be able to see him soon and provide some relief. Meanwhile kindly PM me as I might have some other ideas (will share other PT contacts) that might help get your son in that clinic faster. I don’t yet have 15 posts so I am not able to PM you myself. Sorry for the inconvenience.
@HereWeGoAgain2018 , I think I just pm’d you, but it seems that my message was sent to 23 people (???!!!). Please let me know if you were one of the lucky 23!
@Stringpop mentions myofascial release–one of my daughters (a musician, but she’s now in a different field professionally, but similar issues) did that for years. It was expensive and time-consuming, but it didn’t really help/cure her. She also did a lot of Graston. Now she’s having more success with the McKenzie therapist (but it may be more because of the individual therapist, who is also helping her sister, the musician, a lot.) One of the takeaways we have after many years of work with the “top therapists for musicians” in NYC and Philadelphia, is that the traditional approach of rest isn’t always the right thing. The very active retraining of muscles (I’m under-explaining it here) is the only thing (for them) that has produced results.
That doesn’t mean that traditional methods won’t work for your son, but just encouragement, if you hit a brick wall, to keep looking. Also, it sounds that, reading between the lines, some of his techniques may be contributing to the injury, so retraining from his teachers is a critical part of the puzzle.
@AsMother I’m sorry but I’m not one of the lucky 23! this is my 13th post so worst case and if folks don’t mind I will make 2 extra posts on this thread to get to 15 and try to PM you myself…
Referencing the question above from @StringPop, the clinic is a small one staffed by two neurologists who are very experienced working with musicians. Initial consultation lasts a couple hours and they want the musician to bring his/her instrument so they can observe any posture issues while playing. I’m not a healthcare professional and have no clue about the various treatment options. Just a happy dad knowing his daughter is in good hands.
Wishing all the very best to all our children. It is a very daunting prospect to invest so much time and energy into one’s craft knowing the fragility of human body and chances of injury over the long course of a musical career.
@glassharmonica , I have to admit that it’s a bit overwhelming to see that there are so many POSSIBLE solutions, and having no idea which one will actually work for my son. We’re willing to try anything, but I’m so worried about “running out of time.” I still don’t know what Berklee will do if he’s not able to participate in lessons or ensembles for a while. He’s working very hard at his other classes, but I just want to know that they won’t simply send him home or something–that would be horrible.
And I think you’re correct about the form issues, and his classical guitar teacher has been great about working with him on that. But I’m just worried about how long he can skirt around serious playing while he learns and heals…
@HereWeGoAgain2018 , sorry about that–not sure what I did wrong! Basically I wrote that I got him an appointment for 11/3 (first available, but that seems like an eternity!–they will call if they get a cancellation). In the meantime…!!!
@AsMother Great to hear that you managed to get an appointment. Appointments at this clinic are only over the weekends so they are quite limited. I hope your son can rest his hands in the meanwhile and not feel too stressed out.
@glassharmonica – for two years, my daughter thought she was receiving myofascial release (not sure why) in Nashville; when she very recently found someone in NYC who actually does MFR, she realized that wasn’t it at all – and a text to her Nashville PT clarified that it was active release technique all along. Interestingly, as with the McKenzie method (and this may be the only thing it shares with ART; I know nothing about the method – yet – but am intrigued), the ART therapist had her back on the instrument immediately (just as the Nashville PT had done with her previously). He said rest would not address the problem.
@AsMother, I agree. The hardest thing for child (and parent) is the sense that critical time is running out, new skills aren’t being learned, and old skills are disappearing. I don’t know any solution to that feeling, unfortunately, except to endure it and keep focused on the long view – which is to avoid a career-ending injury. One of her undergrad classmates had to sit out for an entire academic year, and then resumed playing with agonizing slowness (another extremely difficult but critical thing), but he turned out just fine in the end and is still playing.
One thing – and I know this may sound kind of fluffy/ridiculous at first blush but really isn’t – that my daughter has taken to in a big way during this period is incredibly intense mental practice. It’s one of the many imports from the world of sports, I guess, and it involves visualization – incredibly vivid, specific and detailed visualization and assessments. (She worked with a professor, Noah Kageyama, and he also has a website, Bulletproof Musician; others discuss this as well.) It’s a rigorous method of mental and physical playing – it went to 100% mental when she was told to lay off, then 90% mental/10% physical, 85%/15, etc. It’s hard at the beginning, but easier over time, and it made her feel (legitimately, I think) that she was still making meaningful gains. Right now, for instance, she can play her entire concerto and other audition pieces note-for-note mentally. She’s a total convert and will continue using it, she says, after she’s fully healed. It certainly doesn’t make practice sessions shorter – she’s been doing this six hours a day, and it’s mentally exhausting. The idea is that combining mental and physical run throughs of a section or piece or whatever will not only cause more rapid gains but also protect her arm from additional overuse injury in the future. Among other things, it leads to intense focus and a razor-sharp, detailed conception of each piece musically and technically. I am not explaining this thoroughly, but that’s the gist. Could be something to consider.
@StringPop , the “mental practice” actually sounds like something my son would take to. He’s really interested in theory and the structure (I guess you’d call it that?) of the music he plays–hence the additional interest in composition, I guess.
Just a question–when you said that your daughter had to “sit out” for a year, do you mean she had to leave school altogether?
@StringPop Thank you very much for the information on mental practice. My daughter’s teachers have always encouraged learning pieces away from the instrument but so far she did not have much traction on this front. I will ask her to take a look at the website, Bulletproof Musician. Appreciated.
@AsMother , that was a classmate of my daughter who had to sit out, but he didn’t have to leave school or anything.
Sorry, @stringpop! I need to slow down and read things more carefully-I guess I’m just a little scattered at the moment! But thanks for the clarification.
As Mother I would think your son, with his interest in theory and composition, would have plenty to do, more than enough to justify his staying at Berklee 
For others (I have mentioned this to AsMother), when PT doesn’t work, there is a procedure called PRP, platelet rich plasma, a form of prolotherapy, that can do wonders for tendons that need tightening and regeneration.
I would be curious how much use and what type of use these various therapies suggest, since absolute rest is never good and leads to atrophy. No doubt he will be given exercises to prevent this and advice on what “use” to continue.
I am curious: for performers, is it helpful to also look at the ergonomics of computer use while recovering?
@StringPop writes:
Yes! I don’t know why I didn’t think to mention Noa Kageyama and his work! My daughter even took a class with him at undergrad, and she uses these techniques all the time. Even in the best possible circumstances (not injured, lots of time to prep for whatever audition and performance is coming down the pike) these are enormously helpful techniques. Noa lives in NY, but a good place to start would be his website, as lots of this work can be done remotely. I get his free newsletter every Sunday.
It’s really interesting to hear the proposition from @compmom and others that total rest may NOT be the way to go. I have so much to learn about all of this!
We got a seriously lucky break yesterday–I’d taken the first available appt. at the Performing Arts clinic, which wasn’t until 11/3. But later in the afternoon they called to say they’d had a cancellation for this Saturday morning! You’ve all offered awesome suggestions, but I’m hoping that the clinic can give him a much better idea of what his specific issue is, so that we can proceed with a clue (they will observe his playing, do nerve tests, etc., apparently). It feels good to know that he’s doing SOMETHING about it, sooner rather than later. I’m optimistic.
As I mentioned in another thread, he also told me yesterday that he bought himself a beginner’s clarinet (go figure! ) and intends to learn to play, just so he has additional musical options. I also suggested he look into vocal ensembles at Berklee, as he sings very well. We’ll see… I’m just happy that he’s taking positive steps, rather than just being despondent.
I’m also going to look up Bulletproof Musician!
Thanks again to all.
Also, @compmom , I agree that there is a lot he can find to do beyond playing (thank God). But he is required to take 4 semesters of private instruction on his instrument, and I assume there’s an ensemble requirement as well. I’m just not sure if it all has to be done in consecutive semesters.
Your son really is an awesome young person, so constructive in a difficult situation.
Thank you, @ compmom . To be honest, I was really afraid that he would just despair and feel cosmically “singled out” or something! But I’m learning that he’s really developed some resilience over the past few years (probably more than I have!). It’s another reason why I feel glad (in retrospect) that he wasn’t admitted to Berklee the first time around. This time he’s ready (he’ll be more ready, of course, when his #%*! hands work properly again!).
I never thought I’d be so happy to hear someone say he wants to learn to play clarinet!