Members davd_indigo Posted October 10, 2015 Members Posted October 10, 2015 I just returned from a road trip. I drove about 3,000 miles and was gone about 12 days. The highlight for me was walking around the tiny town of Clarksdale Mississippi enjoying their remnants of the blues scene from days past. Heard a great performer there who calls himself "Watermelon Slim". Plays electric dobro. But during my first 3 days I did all interstate driving. I came to realize I was gripping the steering wheel too tightly, especially when passing tractor trailers. I developed the tell tale tingling numbness in my 3rd and 4th fingers. Carpel tunnel symptoms. I loosened my grip after realizing the error of my ways. After I got back home, I got back to my piano regimen of roughly 4 hrs per day (I'm retired two months now) being mindful of keeping my wrists loose. Last night I woke up (for one of those calls of nature) with my right 3rd and 4th fingers tingling and numb. I had this roughly 23 years ago when I was doing COBOL programming and entering a lot of data for testing. Back then I changed my wrist position when typing at the computer keyboard AND stopped playing piano for about 1 month. This morning I ordered a wrist support splint from amazon. Took an Aleve. And I guess I'll take a break from playing piano (after just having taken a break while driving on my trip). Does anyone have any advice from their experiences ? The splint I ordered:http://www.amazon.com/gp/product/B00...ilpage_o00_s00
Members Anderton Posted October 10, 2015 Members Posted October 10, 2015 I don't have any medical advice, but given how much computer work I do, I've always been concerned about the possibility of getting CTS. So I alternate between using a mouse and trackball, and type on different keyboards (laptop, two different keyboards for my Mac and Windows desktops). Whether that's effective or not I don't know, but I haven't had issues so maybe it helps.
Members nat whilk II Posted October 10, 2015 Members Posted October 10, 2015 Four hours a day is one heck of a lot of piano practice on a regular basis for someone with enough years on them to retire. Personally, I've never found practice to do much good after a couple of hours, max. But everyone's different. Rules of thumb I've heard, for what they're worth, is that 4-6 hours is what it takes to develop advanced technique for difficult repertoire. But to maintain technique, an hour or two. I've known probably a dozen people with serious carpal tunnel - they all seem to have conquered it. Solutions differed depending - the drummer had multiple surgeries, but the jewelry maker just had to wear some stuff and limit his time doing the stuff that really stresses the hands. But once you get it, you remain at risk even after remission, so changes have to be made. My advice? Asking around is fine, but see a neurologist who specializes in this. Best of.... nat whilk ii
Members onelife Posted October 10, 2015 Members Posted October 10, 2015 In a word… Yoga. Everything is connected to everything else. When I had a serious run in with tendonitis the doctors wanted to cut my wrist but the problem, as it turned out, originated in my shoulders. Yoga keeps everything open by creating space in the body - I highly recommend it for aging musicians.
Members davd_indigo Posted October 11, 2015 Author Members Posted October 11, 2015 Well thinking back to the start of my trip. Sunday (9/27) I had hours of rain (sometimes really heavy) on I-10 going west in the Florida panhandle, Alabama and Mississippi. I'm sure I was gripping the wheel tightly for hours. It was pretty nerve wracking. There was some flash flooding in that region. The second day I noticed the tingling. I played the 4 hour routine for about 6 weeks before beginning the road trip. And the 4 hours is an estimate. It's woven into my day between maybe 10 am and 10 pm. So first I'll try backing off. I'll do some reading (very slowly) thru some 4 part Bach Chorales. Keep my head in some music. And wear a wrap or splint. I did read something about people often bending their wrist while sleeping and aggravating the condition. So the wrap/splint should help correct the middle of night numbness. I'll see how things progress. By the way, I do exercise - walk, bike. swim. I mention this because yoga was mentioned. Thanks for your input.
Members philboking Posted October 11, 2015 Members Posted October 11, 2015 There are certain stretches that are extremely helpful. The tunnel syndromes (carpal, cubital, and tennis elbow) are all caused by nerve inflammation caused by the nerve sheathing being pinched as they go through narrow channels between various bones. The idea of stretching is to pull the nerve length-wise a bit, which moves the inflamed portion to another area, allowing it to recover for a bit. To start with, try the milder ones: (note there are 3 photo slides on this page)http://www.webmd.com/pain-management...unnel-syndrome Another one, that I made up, is good for driving if you can drive one handed. Put your hand on the car seat, palm down, beneath your thigh (right leg for right hand, and fingers of the right hand pointing 90 degrees to the right, and vice versa for the left hand). Bend your elbow out away from your body till you feel the stretch, then hold for 20 or 30 seconds. The most advanced one I know of is an obscure yoga pose. It is the same as shown in the WebMD link, except you do it behind your back. Start with your fingertips touching, low on your back, and slowly (over weeks or months) raise your hands in that 'prayer pose' higher and higher, eventually getting your palms flat against each other. (Don't do this one driving, it's hard to steer with your nose)
Members davd_indigo Posted October 11, 2015 Author Members Posted October 11, 2015 I'm starting with that Prayer Stretch. Thanks for that. I think I may have read something about soaking in warm water. Not sure. Will search on that.
Members thankyou Posted October 12, 2015 Members Posted October 12, 2015 If all else fails, the surgery is usually a piece of cake. The testing before, not so much. A friend, a registered nurse I see once a year at a music festival, told me to get something done about it, because the condition only gets worse, and there is a point of no return. I had CTS in my left wrist that just kept getting worse. I couldn't play a stringed instrument for more than a few minutes before my fingers would go numb. Driving was also a trigger. I was bummed. My doc sent me to a plastic surgeon who had done lots of carpal tunnel surgery. It took a day of laying around watching TV after the procedure to let the anesthetic wear off, but there was virtually no pain and the results were immediate.
Members onelife Posted October 12, 2015 Members Posted October 12, 2015 I'm glad it worked out for you. I know a few people who have had success with the surgery but the thought of it still scares me. Perhaps, when it gets to the point where the Yoga is no longer effective I may reconsider.
Members davd_indigo Posted October 12, 2015 Author Members Posted October 12, 2015 Well I'm taking 2 Aleve in the morning and wearing a velcro strap. I plan to wait a couple of weeks and see how it feels. As long as the symptoms recede I'll see this as a blessing in wolf's clothing. It'll make me hyperaware of any tingling. And if it'll help I'll keep a timer and get up after 20 minutes of playing and doing the "whatever" stretches. So it may be a good thing.
Members thankyou Posted October 13, 2015 Members Posted October 13, 2015 If all else fails, the surgery is usually a piece of cake. The testing before, not so much. A friend, a registered nurse I see once a year at a music festival, told me to get something done about it, because the condition only gets worse, and there is a point of no return. I had CTS in my left wrist that just kept getting worse. I couldn't play a stringed instrument for more than a few minutes before my fingers would go numb. Driving was also a trigger. I was bummed. My doc sent me to a plastic surgeon who had done lots of carpal tunnel surgery. It took a day of laying around watching TV after the procedure to let the anesthetic wear off, but there was virtually no pain and the results were immediate. I'm probably not as dedicated as you, but I've practiced yoga since I was twenty or so.
Members davd_indigo Posted October 13, 2015 Author Members Posted October 13, 2015 No "yoga for pianists" books on amazon. I searched. But I found this stretching video. I'm going to try it. [video=youtube;zYLHJqnzpxU]
Members techristian Posted October 13, 2015 Members Posted October 13, 2015 REST is the only cure...or surgery....but I never got the surgery. Back in 91 , my CTS was so bad that I couldn't sleep more than a few hours at a time, and then stand at the bathroom sink pouring cold water on my hands until the burning tingling would go away. Even though my CTS was caused at work, from my job, I had to lay off drumming for 6 months. Then I got a bit better job and got back into daily practice. It still haunts me today whenever I try to practice insane things (which I CAN execute) with both hands...a few days practicing those things and CTS wakes me up again. When I paint a room, the motion of the paint brush also causes INSTANT tingling......but yes REST is BEST. 4 hour practice is EXTREME !! This took me years to discover this.......It is not all in the wrist, but, muscles in the shoulders will also constrict the nerves, so I find that lowering my riding toms helps a bit.....ERGONOMICS. Maybe raising your seat 3 or 4 inches will help ? And wristbands only help for awhile. When I wore a wristband ,everyday at work, the problem moved from my hands to my shoulders and elbows, because the movement moved to my shoulders, so I alternated. wristband on right wrist Mondays, Wednesdays and Fridays and left wrist Tues, Thu Sat. I was operating a spot welder at chest level during that time and every morning it would take 10-15 minutes to adjust but this system worked FOR ME. Dan
Members onelife Posted October 13, 2015 Members Posted October 13, 2015 This took me years to discover this.......It is not all in the wrist, but, muscles in the shoulders will also constrict the nerves, so I find that lowering my riding toms helps a bit.....ERGONOMICS. Maybe raising your seat 3 or 4 inches will help ? And wristbands only help for awhile. I cannot overemphasize the value of Yoga. I recommend finding a good teacher and starting a regular daily practice. It is, without a doubt, the best thing a person can do for themselves including, but not limited to, removing the obstructions that make it difficult for us to perform on our instruments. Yoga is a holistic approach to the human experience and provides us with techniques for improving and preserving mind, body and spirit without the need for surgery or pain killing drugs. In my case I had problems with my shoulder blades being stuck and damage to the sheath around some of the nerves in both wrists - I now view my experience with tendonitis and CTS as a blessing because it got me off my duff and into Yoga.
Members jazzgitter Posted October 13, 2015 Members Posted October 13, 2015 Check out cold laser therapy. I have found it incredibly helpful for healing my carpal tunnel: I use a unit for home use called the laser therapy pen.
Members davd_indigo Posted October 14, 2015 Author Members Posted October 14, 2015 Jazgitter, you brought to mind a story on cryotherapy a while back. I will check out your cold laser link. http://www.npr.org/2011/10/15/141336088/cryotherapy-why-pro-athletes-like-it-chilly
Members techristian Posted October 14, 2015 Members Posted October 14, 2015 One more thing. WARM UP FIRST. Don't start off playing 16th notes at 240 BPM. Start at 1/2 of your fastest speed and after 15 minutes or so then start gradually speeding up until you get to your most complex stuff. Dan
Members davd_indigo Posted October 14, 2015 Author Members Posted October 14, 2015 I found these "Kevin's 52 Tips" (below) that seem to me particularly good. As I type this I have a laptop sitting on my thighs as I sit on my sofa. A classic couch potato. But reading his tips made me mindful of my wrist alignment as I type. Also, I have a heating pad plugged in and have done a little wrapping with it. And a cold pack that's in the freezer right now. I did swim at the Y for 50 minutes today followed by about 50 minutes of walking. Hopefully "rest" only means the wrist. BTW, just to be clear, I don't have actual pain. I had the numbness and tingling. But I took them as warning bells. But I think these 52 tips are have some universal wisdom.... http://www.ergonomictimes.com/wrist_pain.php
Members onelife Posted October 14, 2015 Members Posted October 14, 2015 BTW' date=' just to be clear, I don't have actual pain. I had the numbness and tingling. But I took them as warning bells.[/quote'] The neurologist who looked at my problem said the numbness and tingling was caused by damage to the sheath around the nerve. He suggested wearing the wrist splint for a few weeks while sleeping and (unofficially) suggested that some people have had some success in regenerating the sheath with the aid of Vitamin E. I did both and it worked. I would again recommend Yoga as a way of restoring and maintaining the body's proper functional alignment. Take the "warning bells" seriously enough to correct what is wrong and prevent things from getting worse. I iused to be quite confident that my ability as a guitarist would allow me to work anywhere at any time. When I became debilitated, I realized the fragility and temporary nature of the whole thing. Now that I am restored and able to play again (albeit not at 100% of what it was) I am doing what I can to keep it going for as long as I can. Yoga has benefited me in many other ways as well.
Members philboking Posted October 14, 2015 Members Posted October 14, 2015 Tingling and numbness mean your case is acute. See a professional. Soon. Nerve damage is not reversible.
Members thankyou Posted October 22, 2015 Members Posted October 22, 2015 Tingling and numbness mean your case is acute. See a professional. Soon. Nerve damage is not reversible. That's what my nurse friend said, too. I have never regretted the surgery.
Members davd_indigo Posted October 22, 2015 Author Members Posted October 22, 2015 I have an appt with my physician tomorrow (Fri) morning. I'll see what he says and follow his advice. I expect that surgery will be the last resort. Seems they often try steroids and hand therapy first. I am anatomically predisposed because of my thin frame including thin wrists. I've taken (mostly) a break from piano since returning from my road trip (2 weeks ago today). I've been wearing a splint to sleep in. I am swimming laps at the YMCA pool. I noticed that doing my crawl stroke in the pool, my arm, wrist and hand are in a straight line. Hopefully that's ok. I'll see what the Dr says. I've also done some googling of course. There is something called the "Taubman Approach" with emphasis on proper hand/wrist/forearm/shoulder mechanics. There are disciples of Dorothy Taubman scattered around (she's dead now I believe) the country. I ordered a DVD by Barbra Lister-Sink which seem to use these principles - haven't received it yet. But I am not ignoring the issue.
Members Iamthesky Posted October 22, 2015 Members Posted October 22, 2015 I had a similar problem on a motorcycle trip back in '93. The hand levers were set too high, which meant I spent a lot of the trip with my wrists at a very bad angle, and lost feeling in my left hand for a day or two. It was not good. Since then I have taken to being consciously aware of my wrist angles (up-down and left-right) whenever I'm doing anything for more than a few minutes. My motorcycles now have levers and handlebars positioned to be in a very relaxed position when combined with my riding posture, and my keyboards are all arranged in ways that give my hands a neutral position. Like a bad back, once you've had a bad wrist problem you pretty much (in my experience) have to stay aware of how you're using that part of your body from then on. Recurrence is much easier to trigger than the problem was in the first place.
Members UstadKhanAli Posted October 23, 2015 Members Posted October 23, 2015 REST is the only cure...or surgery.... Sorry, but I disagree. Stretching, yoga, physical therapy, muscle work, doing things differently, and other approaches all help as well. Viewing things as "cures" or "all or nothing" approaches detract from approaches that can genuinely help people. There are a continuum of approaches that can aid with carpal tunnel, tennis elbow, and other forms of repetitive stress syndrome.
Members davd_indigo Posted October 24, 2015 Author Members Posted October 24, 2015 Just to update, I saw my physician (an internist) yesterday. He referred me to a hand surgeon. He said he will probably try something with steroids first. He also said that the CTS could have been developing over years. Thinking about it, I may have had subtle tingling in my hands, but never had given it a notice. Not really sure. In other words, the road trip could have provided the "straw" to break the back of the camel. I'm sure the insurance company won't be approving surgery without trying other treatment first. He said that the surgery is simple. Of course there are also risks with any surgery. Just incidentally, he said I could do a cycling class at the Y if I wear a velcro wrist splint. I received a DVD yesterday, ordered from Barbara Lister-Sink called "Freeing the Caged Bird" which is supposed to give advice on better body mechanics. It appears I'll have to get an app for Windows 10 to watch it. Have no DVD player. Haven't wanted one between Netflix and youTube.
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