bad bad tendonitis

[Noam Elron]

I have been having on and off bouts of tendonitis in both wrists in the past year. It was never really bad - sometimes I needed a day away from the bass, but it was managable.
About two weeks ago I started having serious pain in my bowing/pizz wrist. I haven't practiced since, but I have an important gig with a piano trio next week, and I was foolish enough to go to rehersal - I had such a ball playing (after ten days away from the bass) that I did not notice any pain, until about two hours into the rehersal when I said "no more".
Since then, the pain has moved to the tendons at the back of the hand (the wrist is doing better) which is really scary and painful. Right now I'm having trouble doing simple tasks (e.g. opening jars).
I'm going to call off our next rehersals for the gig and I am thinking of calling off the gig (I probably won't).

I understand that rest is the main cure. What else can be done? How can this be avoided in the future? How will I know when I can start playing again without risking further injury and longer recovery time?

I am currently "in between jobs" which would have been a perfect season to play all day long. Now all I can do is look at the bass...

[Chris Fitzgerald]

I would get with your teacher (or another) about this pronto. When I experience tendonitis (in my case it's "tennis elbow", although I had wrist problems when I was still self taught) it's always because I am using a small muscle group too much when I should be letting the burden fall on a larger one. In my case, the cure is always "relearning the dance" while focusing on bringing the source of power away from the hands and forearms and closer to the torso and hips. The outward and visible signs of this are a fluidity and looseness of the hands, wrists, and arms while playing. I recently put a practice mirror in my music room, and have since caught all sorts of little bad habits before they became serious issues. Good luck!

[Snakewood]

Originally Posted by Noam Elron

I have been having on and off bouts of tendonitis in both wrists in the past year. It was never really bad - sometimes I needed a day away from the bass, but it was managable.
About two weeks ago I started having serious pain in my bowing/pizz wrist. I haven't practiced since, but I have an important gig with a piano trio next week, and I was foolish enough to go to rehersal - I had such a ball playing (after ten days away from the bass) that I did not notice any pain, until about two hours into the rehersal when I said "no more".
Since then, the pain has moved to the tendons at the back of the hand (the wrist is doing better) which is really scary and painful. Right now I'm having trouble doing simple tasks (e.g. opening jars).
I'm going to call off our next rehersals for the gig and I am thinking of calling off the gig (I probably won't).

I understand that rest is the main cure. What else can be done? How can this be avoided in the future? How will I know when I can start playing again without risking further injury and longer recovery time?

I am currently "in between jobs" which would have been a perfect season to play all day long. Now all I can do is look at the bass...

I had the EXACT same case as you. For me it was because I was tense in my bowing hand when I played. Whenver I saw a FFF passage I would grip the bow and apply pressure to the string. Infact, I learned that if you apply no pressure and allow the natural weight of your arm to go INTO the string you can produce a much louder sound with no pain. It took me a week away from the French bow, several days rest, then i used a German bow for 2 weeks. After about 3 weeks the swelling and pain went.

[Tbeers]

For the gig, just crank your amp and brush the strings with your fingers. If you pluck using two or three fingers, maybe try just one for a while.

You'll almost definitely have to reinvent your right hand technique. It will be a slow and annoying process.... And you may never be at a point where you are physically capable of digging in.

I am a little puzzled that your right hand is the one giving you trouble, especially with pizz. I know tons of string players who have had terrible tendonitis in their left hand/arm from applying too much pressure on the string. But I don't really know anyone who has had pain from playing pizz.

[Kam]

There are lots of things that could be done, and yes, rest is the best medicine.

Relearning your right hand technique will also help.

How often did you stretch before and after playing/practicing?
If you did stretch, did you work both large and small muscle groups?

Avoiding coffee, soda, smoking, and sodium will help the recovery.

Drinking green tea, eating foods with B12 vitamins like blueberries, and raising your heart rate (excersize) for at least 15 minutes a day will also help. Look into seeing a physical therapist/sports medicine clinic. Most larger cities will have at least one therapist with experience regarding musicians, not sure how it is in Isreal though.

After my bout with tendonitis, I changed my lifestyle, and now I'm more healthy (in general) and concious of the dangers of repetetive stress.

I also need to do my obligatory plug for Janet Horvath's book, Playing Less Hurt:
http://www.playinglesshurt.com/

[armybass]

Avoiding coffee, soda, smoking, and sodium will help the recovery.

Really, why....does caffine have a negative effect? I would not be surprised.

I have had very bad tendonitis in my left hand over the past few weeks as I have just gotten back into the URB this year and already have 30 gigs in the bag so far and litle rest between gigs.

I have switched to Corelli's, a lighter string to help but will take any advice that can help me through this.

[MicheleJ]

My children both play URB ( girl 11 and boy 14). Their chiropractor gave them exercise instructions meant to help avoid injury when they were sore as they first learned to play. I don't know if it would help in recovery.My explanation is lacking in correct terminology, I'm sure.

The downward and grasping motion of typing or playing can disproportionately strengthen the grasping arm muscles, thereby causing symptoms related to imbalance of strength against the flexing muscles (symptoms being: tennis elbow, carpal tunnel syndrome and sometimes other numbness, pain, or tingling and pain, stress on tendons).

The chiropractor told the kids to take rubber bands and touching all the straightened fingers and thumb together at the pads (not bending so the tips touch together like in a circle) place the rubber bands around the closed fingers at about the second joint. Then stretch the fingers wide open against the resistance of the rubber bands until too tired to continue- the number or strength of rubber bands is to be determined by how many it takes to reach tiredness in less than thirty seconds. Repeat three times a day for about two weeks or until strength feels balanced (or absence of symptoms) and at least once a day thereafter. OK those were his instructions- I'm no doctor, but it did end my own numbness and tingling when typing.

[Mark Moss]

This guitar player friend of mine turned me on to what is called a "Cat's Paw" when I was having some real bad tendonitis in my wrist and elbows. Once I got past the initial pain phase I started using one and have found it really helped keep my problem under control.

Don't know if it would help your situation, but for a few bucks what do you have to loose.

You can find them on the internet pretty easily. Just Goggle cats claw. If you want to try one and can't get one in Israel let me know and I will get one to you.

[ctxbass]

Originally Posted by MicheleJ

The chiropractor told the kids to take rubber bands and touching all the straightened fingers and thumb together at the pads (not bending so the tips touch together like in a circle) place the rubber bands around the closed fingers at about the second joint. Then stretch the fingers wide open against the resistance of the rubber bands until too tired to continue- the number or strength of rubber bands is to be determined by how many it takes to reach tiredness in less than thirty seconds. Repeat three times a day for about two weeks or until strength feels balanced (or absence of symptoms) and at least once a day thereafter.

That is very similar to an exercise prescribed for me by an occupational therapist. It was very helpful. The "Cat's Paw" seems to work on the same principle.

Ice packs applied during breaks and after the gig will help to reduce inflammation of the tendons.

[Kam]

Originally Posted by armybass

Really, why....does caffine have a negative effect? I would not be surprised.

Yes, it dehydrates. The way I think of it is, do everything you can to promote bloodflow and hydration because thats what your extremeties really need to work properly and especially to heal.

[mikemulcahy]

It does dehydrate to some degree, but the amount that it would take to effect peripheral vascular flow would also have you so tachycardic that you wouldn't notice. In small amounts, the positive ionotropic effects would actally enhance peripheral flow due to the increased cardiac output (rate x stroke volume). Unless you have a 2 pot a day coffee habit, i wouldn't worry much about caffeine dehydrating you.

thats my 2 cents


Mike

[mje]

Welll... caffine is an adenosine receptor antagonist, and reduction of adenosine levels is associated with decreased muscular transport ... so yeah, maybe a lot of caffine could slow recovery.

[Chris Fitzgerald]

Originally Posted by mikemulcahy

Unless you have a 2 pot a day coffee habit, i wouldn't worry much about caffeine dehydrating you.

Uh oh.

Speaking purely hypothetically, of course, how much water would one need to dring to offset this purely hypothetical amount of coffee?

[mikemulcahy]

Not to worry Durrl, you probably have developed a tolerance. The LD50 for coffee is about 150-200 cups in a short period. I am a coffe man as well, no HTN, tachy or related issues. Certainly not ever dehydrated.


Mike

[ToR-Tu-Ra]

"Nicotine is so obscene
and caffeine only makes me mean" . . . Asylum Street Spankers

[Thwop]

I have a problem with tendonitis as well. My doctor was very confused by the fact it was extenders on the right hand. I basically was practicing pull offs for articulation in bowed slurs with too much gusto. I also switched from sitting to standing to change the angle of my arm in the lower positions. This helped quite a bit. I then got a lesson with a different teacher and he altered my bow grip. (this was about a month and a half ago) I have just had a huge flare up in my bow arm wrist this past week(which I never have had a problem with before). The change in grip has put the weight on different muscles so should I just ride it out and hope the muscles just need time to adapt to this change or should I go back to my old grip. I notice better control with the new one but I don't want to risk destroying my wrist in the process.

[Sippy]

Originally Posted by mikemulcahy

Not to worry Durrl, you probably have developed a tolerance. The LD50 for coffee is about 150-200 cups in a short period. I am a coffe man as well, no HTN, tachy or related issues. Certainly not ever dehydrated.


Mike

yea... coffee just makes my urine smell weird... I drink 9 esperesso shots per day... 3 at 10:00 am... 3 at 3:00 pm and 3 ay 7:00 pm

working a full time job, having a girlfriend, and being a music major... Yes I need 9 shots every day.

[Chris Fitzgerald]

Originally Posted by mikemulcahy

Not to worry Durrl, you probably have developed a tolerance. The LD50 for coffee is about 150-200 cups in a short period. I am a coffe man as well, no HTN, tachy or related issues. Certainly not ever dehydrated.

That's good to know. I try to dring at least a half gallon of water a day to compensate, but I've always wondered if that was enough.

Dammit, where's my catheter?

[mdurell]

Another thing to consider is that coffee is basically a diuretic (sp?) and, I've heard, basically water neutral. To me this seems to be pretty good to flush toxins out of the body by offsetting any coffee consumption with an equal amount of water.

It's probably not the best thing in the world to help with healing but probably not all that bad either. I would guess in 500 years doctors will finally realize that coffee is probably pretty neutral overall in the body... that all of it's negative effects are offset with positive effects.

Of course everyone's body is different and responds differently to different stimuli (and even that changes from year to year, hour to hour). The best thing to do is to pay attention to how your body responds and change accordingly. This goes for technique as well as beverage consumption.

[Noam Elron]

Thanks for all the input, everybody. Things are starting to improve, although I'm still away from the bass (I miss it dearly ).

I started playing upright about three years ago, and have been taking lessons with a classical teacher who has instilled very tidy habits in my "fretting" hand and my bowing (which are both very light), but my pizz work is bassically a carry over from the slab.
I even noticed that when I pizz, my fretting becomes sloppy (I use more thumb than necessary).
I think I'll take Chris and Tbeer's advise and take some lessons from a jazz player to rework my pizz.
Another issue is that because I play left-handed on a right-strung bass (this is why I avoid using the terms left and right hands), I do a lot more work - where a normal player would use one pluck for a three string drop, I can't do that, because the E string is on the far side - I tried doing it with the thumb but it doesn't work.

I'll try out the rubber band excercise starting about a week from now. I'll also make sure I have an ice pack for the gig.

The trouble with coffee is that it not only dehydrates in a fashion where you can simply take in water to compensate. It encourages urination so that if you drink coffee and a glass of water immediately after, you'll just lose the water (can you say pee on talkbass?) You need to wait until the urination effect is gone and then compensate (drink water).

How is green tea good for you?