<p>Well, a few years back I would have laugh at the idea of someone injuring himself/herself by playing the piano (or other musical instruments, for that matter). Appparently, however, it's more common than I would ever suppose - I guess most just play through the pain and a few (maybe more?) have to drop out - just that I'm not aware. Now that I'm on the track to it (thank goodness no acute tendonitis, etc....yet, but still have to give up a summer camp on the last minute...), I wonder if the wise parents here will give some advices (or some stories?) on how to handle this frustrating situation?</p>
<p>I can give you my own personal experience. My sophomore year of high school I experieced a lot of pain in my right wrist, especially when I played fast stuff. I went to the orthopedist and was told that it was most likely tendonitis. The doctor mentioned on several occasions that my body might just not be meant to play this instrument, I didn't listen. I went to physical therapy for a couple of months, and learned a lot of excersises that I still have to do. The tendonitis never went away, it got better, but there are still days where it hurts too much to write or play. I've gotten through it by practicing a lot when it isn't hurting. And it will always be frustrating, but I think looking back on it, the thing that would most get me through it is my parents not listening to that doctor telling me that I shouldn't be playing and supporting me. I still find it all frustrating, but I'm sure anyone who loves playing knows that it is worth it.</p>
<p>There are a number of things that you can do to prevent permanent injuries. Never omit warming up before and cooling down after a practice session or performance. Learn to use your body in such a way as to avoid tension, tightness and pressure. If you play an instrument, learn to let it do most of the work. Don't try to push your limits too quickly; it takes a while to build your muscles up to peak condition. Learn to read the signals your body sends when it has had enough and respect those signals. Build some break time into practice sessions. Structure rehearsals to avoid prolonged overuse of the same body parts. Don't try to perform physically demanding pieces before you are ready for them. Don't schedule performances of those pieces too closely together once you are ready for them. Consider taking classes in Alexander Technique and yoga. Get enough sleep (he says at 2:15 AM.)</p>
<p>My husband is a self-taught pianist, started at 10 and is now 49. He suffers from what has been diagnosed as carpal tunnel syndrome. Night-time splints on his hands/wrists seem to help -- and when he doesn't use those, his pain flares up again. </p>
<p>His pain also comes with numbness and tingling, and it's predominantly in his middle fingers, so I think that's why CTS was diagnosed.</p>
<p>My S (a violinist) developed a ganglion cyst. This is a bump on or near the wrist bone usually caused by overuse. He was unable to practise for about 6-8 weeks and it was a nightmare. I understand now that it is a not uncommon string player's nemesis as it can come and go and can cause great pain. It can be removed surgically if all else fails, but there is always a risk of permanent damage to the ligaments of the wrist so surgery is to be avoided at all cost.
He was lucky - it appears to have disappeared (almost a year now).</p>
<p>The main reason I share this is that it now appears that it was brought on by the use (probably coupled with violin playing) of one of those teeny handheld video games which forced his thumb into an unnatural position. He played it a lot at camp last summer at a time when he also was practising 5-6 hours a day and the bump appeared. While he was dealing with the problem he was not playing the game and then, when in school, he had little time for it. But during the winter break, he started using the game again, he noticed that the bump (and some pain) reappeared. As soon as he gave up the game (which he no longer even owns), the bump left again. </p>
<p>So be sure to be paying attention to other activities which could be causing or worsening your problems!</p>
<p>My S, too, had to give up his summer program and severly curtail year-end practicing/concerts (senior year!!)due to diagnosis of tendonitis. Fortunately, it was diagnosed early and we found a neurologist and PT team that specialize in working with professional musicians. (Boston has such resources, fortunately). </p>
<p>The assessment/diagnosis by this team required that he bring his instrument so that they could evaluate his technique, posture, breathing etc. to determine possible contributing factors. They also asked about computer use, keyboard/mouse placement, chair/desk height hours etc. They recommended changes in the computer/keyboard/chair/desk positioning, and initially severely curtailed his practicing to two ten minute session with a minimum hour break in between. They found no technical, posture, breathing problems and concluded that the tendonitis resulted from overuse and a practice schedule that did not include the following elements also articulated by Bassdad: warm up and cool down prior to and following practices; practice time broken down into 25 min segments divided by 5 minute breaks; strengthening excersises targeting specific muscle groups surrounding key tendon areas often impacted by his instrument. </p>
<p>These were recommendations for a lifetime of future injury-free playing once his tendonitis healed, not just during the period following recuperation. We hear stories from many of his music performance friends that by the end of the year, many string players (at Peabody, Julliard, Manhattan, NEC, etc,) have to stop or highly curtail practicing playing following the run up of practicing in late winter early spring for recitial, juries, etc). We're hoping that S' newly designed practice regimen will prevent futher injury and the enormous frustration for him that accompanies the restrictions on his playing time, especially as he heads off to as double degree performance student (both classical and jazz studies) next fall.</p>
<p>Our orchestra director had to have surgery on her shoulder because she has been playing violin/viola for so long.</p>
<p>You have received some great advice. Warmup and rest periods are very important. Frequent rests are very helpful in preventing tendonitis and other overuse injuries. Experience with computer use and sports has shown that even very short rest periods are helpful. There is one factor that is even more important than warmups and rests and that is exercise. You could always use the exercise room at Peabody or join the JHU athletic center. I think you will find some vigorous, aerobic exercises are a magic cure for tendonitis.</p>
<p>My son had wrist pain his freshman year at Eastman. He dealt with it before he developed tendonitis. He finds stretching to be very helpful before playing. He also stops frequently when practicing to stretch out his hands, arms and shoulders. Also, when he started having pain he would ice his wrists in the evening after he was done playing for the day. He said the icing helped quite a bit.</p>
<p>This past year he has learned some about Feldenkrais</p>
<p>He has found that using some of the techniques helps him play much more relaxed and with more confidence. Many musicians find the techniques helpful. Son's teacher had to stop playing for over year due to a nerve injury. He thought he would have to quit forever until he discovered Feldenkrais. He now plays again and is helping his students learn to play pain free.</p>
<p>For piano, the technique developed by Dorothy Taubman (and now also Edna Golandsky) has helped a lot of performers learn how to avoid tendonitis. My kid actually began his studies with a Taubman trained teacher, so I am pretty familiar with it (I've also adopted some of the principals to avoid repetitive stress injury from typing, which I do a lot of at work) -- some teachers are dismissive of it as a kind of "cult" thing, but it is really a practical method of avoiding repetitive stress injury, and some top piano professors, including Veda Kaplinsky at Juilliard and Robert Shannon at Oberlin, studied with Dorothy Taubman. One student I know has had to withdraw from his conservatory for a term because of tendonitis, and has been studying with Edna Golandsky in New York. If you are starting to have pain you should act immediately to address it before it becomes a bigger problem. Here is a link: <a href="http://www.golandskyinstitute.org%5B/url%5D">www.golandskyinstitute.org</a></p>
<p>Lots of similar experiences and good advice here -- my D also suffered from right wrist tendonitis (violinist). One suspected culprit not yet mentioned is the incredibly heavy backpacks / shoulder packs that high school students carry around. The restriction of blood flow at the right shoulder caused by her school bag was likely a contributing factor to her wrist tendons' inability to recover from the strain of practice.</p>
<p>DD had a pinched nerve this year from playing her English horn. She has very small hands, and between that and the weight of the instrument, she somehow injured herself (she's played it for four years, but not as intensely as this winter). Luckily, her teacher is excellent and advised her well....the doctor she saw put her hand in a splint for a while, and the teacher ordered a "peg" for the E.H. to bear the weight. DD is fine now...took about four weeks to mend. She also has some hand exercises to do.</p>
<p>My girlfriend is a pianist at NEC and has this to contribute:
"I have had experience with injuries since I was diagnosed at the age of eight with Thoracic Outlet Syndrome (a very common injury in violinists and other musiciacns) I have had more than ten years dealing with other injuries as well, including tendonitis. Although for me TOS is semi-permanent it is aggravated and brought on by the fact that I play piano at a professional level. For someone with tendonitis I reccomend basic Rest and Relaxation. 99 percent of the time tendonitis never gets better because the patient never really takes a break from ALL of the aggravating activities. This past september I was diagnosed with Tennis elbow (tendonitis in the elbow) I stopped playing piano for months, wore an arm brace, went to physical therapy up to three times a week, took private feldenkrais lessons and pilates. All of these things have helped A LOT! (I have cured my elbow tendonitis, but still have problems with TOS) especially feldenkrais: I reccomend it for any musician, it is a technique which teaches you how to move your body in a natural way which, over the years, we naturally deviate from because of bad posture, overuse etc. (it's very relaxing)</p>
<p>my last piece of advice to any musician with injury problems is: don't just settle on one doctor's opinion and try to find doctors who have "musician clinics"
a lot of doctors mis-diagnose musician injuries because they don't fully understand the stress a musician's body goes through daily. I saw one neurologist (not at a musicians clinic) who told me that I would never play again and that I should get surgery now or else, but I have also been seeing a neurologist in boston who holds a musician's clinic every saturday JUST for musicians and he has helped me so much! No thanks to the other doctor I saw, I am gradually beginning to practice again :) doctor's who have musician clinics have more experience with the variety of injuries that we get. If anyone needs reccomendations for doctors in boston I would be glad to provide more information."</p>
<p>I would only add this to what she said: take the time to fix these problems NOW, while you're young and have the time. Six months might seem like a long time to deal with an injury, but it really isn't in the grand scheme of things. It's also a hell of a lot better than never being able to play again.</p>
<p>I'm really grateful for all the advices here! I did not have any kind of continous and serious pain, which I take as a sign that if I have any problems, at least they are not too bad yet. I'm coping with finding out what exactly are the problems and how to fix and recover from them so that they won't happen again. </p>
<p>Just a warning for others: be careful with any kind of drastic schedule change - I'm most certain that my problems came directly from the change from a ultra-busy double degree schedule to a having-nothing-else-to-do summer schedule, which involves some 16 hours of almost non-stop piano practicing/computer programming combo. Oops! :)</p>
<p>If you are using a computer, especially a laptop, be sure that you are typing with your arms at a 45 degree angle to the keyboard and that your wrists are free (don't anchor them to a "wrist rest").</p>
<p>There are occupational therapists who specialize in musicians' injuries who work with hand/arm issues especially with professional and conservatory musicians. A thorough therapist with have musician bring instrument and demonstrate technique....finds physiological efficiency and alignment issues. For a singer, voice therapy approach augments issues of vocal hygiene and technique.</p>
<p>Overuse is abuse, regardless of efficiency and technical approach. This can be the dividing line between those who can do what it takes to accomplish professional level technique and those who cannot. Obviously the more easily and naturally technique is developed, the less damage and potentential for injury there will be.</p>