Repetitive Strain Injury - Questions & Advice
I've been experiencing some degree of discomfort in my left (fretting) arm/hand since early May this year. After doing a number of tests with my neurologist to rule out more severe causes, it seems that I have a repetitive strain injury. It's a "burning" and "soreness" sensation extending from my wrist into my forearm. The "ball" of the thumb and parts in the back of my hand experience some discomfort as well - some seem to be along joints/bones.
I tend to play with a very heavy-handed (pun intended) style, which is likely contributing to the issue. With that in mind:
Just trying to get a consensus on the best way to proceed - I have no one to seek advice from IRL. Quitting long-term is not an option!
For reference, I play an '08 Fender American Standard Jazz through an Aguilar TH500 and DB210 (x2). I'm a long-time lurker, so sorry if this post is in the wrong thread (or if there's a more appropriate one).
Lower your action. Refine your playing technique. Lighten up & relax! Turn up the volume at the instrument and/or the amp in order to compensate for any volume loss. Let the amp do the heavy work. It may even benefit your playing style. :hmm:
I have had carple tunnel tendonitis etc.
Light touch, lite strings, turn up your amp.
Garry Willis has a whole lot of information on the subject as well.
If your young take action soon so you can play for a long time to come.
When I was first diagnosed with RSI, they mentioned, cortisone injections, or surgery. I researched the Alexander technique and some other stuff, but my solution was to not practice for 6 months, and to change the angle that was causing me pain. That was 17 years ago and I am pain free. Investigate what works for you specifically, and stop as soon as it hurts. Good luck...
Thank you guys so much for your help! I'm going to check out the links and names you all mentioned for more info - just trying to get a feel for how I should progress.
For reference I'm 23. I started playing at 15, and have been gigging a lot more regularly since 22. Have already has some tinnitus issues (which is now under control), so I am of course very open to changing my playing habits. Without bass I'd be insane by now!
Rule of thumb: If it hurts, you're doing it wrong. If it causes numbness, you're doing it wrong. If it causes fatigue, you're doing it wrong.
Maybe there's something in the nature of the instrument that causes some players to believe that they have to "fight the bass", in order to win their sound from it. But playing the bass isn't supposed to require much physical exertion. In fact, the more that you can minimize the physical exertion required, the more able you'll be to focus on the all-important mental dimensions of it.
I played 12 string bass for a couple of years and ended up with carpal tunnel syndrome i guess because of the extra pressure required to fret 3 strings at once. Also I arpeggiate chords a lot so my hand was holding down some awkward shapes rather than just basic one note at a time basslines.
My symptoms were numbness in my index, middle and thumb. I ended up having the surgery. 2 weeks later, I was playing regulal 4 string bass again with minimal pain from the surgery. A few months after that I had built up enough strength to tackle simple stuff on the 12 string again. And one year after that I had built up my chops to beyond where they were before with no pain, discomfort or numbness no matter what bizzarre stretched out awkward chord I was fretting.
My advice. Find a good surgeon in a big city hospital that does that kind of surgery you need several times a day every day and get it done and overwith.
Don't play for the month. Sorry, it's good advice (sad trombone sound).
Everything MM says. He knows his stuff.
And if it was me, I'd be icing my wrist 20 minutes, many many times daily for at least 2 of those weeks. Repetive stress injuries (this is pretty much tendinitis) have a chronic inflammation element, and ice will bring down inflammation. This assists healing.
Go with least invasive procedures first (ice, rest, technique modification) and hold off on the most invasive procedures (surgery) until everything else has been exhausted and has clearly failed.
I suppose over time I've grown accustomed to my super high actions and felt that it was "normal" to have to exert a lot of effort in playing. Stupid - but I guess I acclimated to that as the standard. Will definitely be taking at least the next 4 weeks off from playing.
All your advice is fantastic, thank you everyone. I have an Rx to meet with a physical therapist, will schedule an appt this week to get another perspective on my healing and treatment options. Hoping this is temporary and I can make the right changes to get rid of this for good. Perhaps it will be a blessing in disguise - allowing me to protect myself long-term and play more effectively. Optimism!
You likely have a problem with your first rib being out of place. When the first rib is elevated it puts strain on the nerves/tendons/veins which run down your arm into the wrist.
Search for a good chiropractor that can adjust it for you. Doing some excersises will help the chiropractic care along.
Also look into some of the other poses to help loosen your shoulders and hands.
Do not use ice. You should use heat to loosen the muscles in your neck, specifically your scalenes, as well as your trapezius.
I'm recovering from the same problem. Although my first rib still becomes elevated it only took 2-3 adjustments to get rid of the pain in my arm.
Another thing to consider is seeing an Ocupational Therapist as they specialize in fine motor control in the upper body. Additionally get a brace for the inflicted hand. This will help reduce the strain you place on the hand and wrist during every day activities and help with recuding the swelling and inflimation that is causing the discomfort. An ocupational therapist may very well make you a coustom fit brace while you are there, perscribe you exercises to help strech and relax the effected limb, etc.
Mine did, and I followed his advice for months Icing down, minimizing playing, even tried shots. Finally we had to resort to surgery. To be quite honest after the surgery was over I was mad. Mad because I had wasted all those months dicking around with things that might help rather than going for the one thing that would fix the problem.
Yes, there is some risk in surgery, and I hear the horror stories of how someone's surgery went wrong. Of course to put that in perspective, not all patients are honest with their doctors about their symptoms and some surgeons operate in small towns and don't do these specific procedures all the time. I suspect those two things would account for a certain percentage of those whoops cases.
Now I'm not saying surgery is always the best option, and for that matter I don't even know if the OP is a candidate for surgery. I'm just saying that I ask doctors straight up from the beginning now how effective the treatment is and I prioritize according to what is going to be most effective and save the most time now.
These helped me with any pain I was having: http://www.mydailyyoga.com/yoga/rsi.html
As the name suggests, I do them everyday.
Ergonomics are essential
Because I worked in the computer industry and had carpal tunnel surgery, I was extensively trained in ergonomics. I have also read books on string player injuries. Many traditional techniques on instruments were incredibly poor ergonomically. Think how they taught guitar players to bend the wrist.
I created a page on my web site devoted to it.
www.comarow.com, I think the page is musicians and health.
Most importantly, you want to keep a neutral position in your wrists, they should not be bent or they limit the lymphatic systems ability to remove waste products and health.
Of course your lymphatic system, while more extensive than the circulatory system does not have a pump, your movement is the pump. We evolved to more so aerobics is important to your entire immune system. It helps with all the micro tears and natural repairs from repetitive stress injuries.
Warm up slowly making sure your wrists are in a neutral position.
If it hurts, stop.
You should absolutely replace your computer keyboard and mouse with an ergonomic setup. Traditional keyboards require you to bend your wrists. The ultimate keyboard is the Gold Touch Keyboard. They are expensive, but completely adjustable and I kept one keyboard through 5 computers before spilling coffee in it. I found one inexpensively on EBAY.
However, at thrift shops I often find Microsoft Ergonomic Keyboards. While not adjustable they are a huge improvement. I give the one's I find to students. I wonder about kids that are using keyboards from an early age.
An ergonomic mouse keeps your wrist straight as well.
The traditional keyboard was designed in the 1800s to slow typists down so they didn't jam the machine.
Your other activities, like computer use is related to your music playing.
Carpal Tunnel Surgery is generally very simple. If your nerve has reduced electrical activity, it will gradually die. I was keyboarding hours after surgery and it restored all electrical activity. Physical therapy is basically useless if the nerve is pinched. It will come back if you don't have great ergonomics.
Cheers man. Good luck.
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