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Carpal Tunnel Syndrome ( CTS ) Info

Discussion in 'Technique [BG]' started by Fergie Fulton, Oct 6, 2012.


  1. TomB

    TomB Supporting Member

    Aug 24, 2007
    Vermont
    Jimmy, I'll add my +1 to Sweets comments. I had both hands done (the "release" is in the lower palm, not the wrist for CTS). I'm 2 years healed on 1 side and 1 on the other. ...full strength, full healing, no after effects of any kind. As long as you can confirm the diagnosis, I wouldn't hesitate. Fergie's right, it's a nerve response test that is definitive. It actually sucks worse than the surgery, but don't be discouraged. If it's not bad enough for surgery yet, then a wrist splint to hold your hand in the right position while you sleep is a good thing, I found. Good luck with this!
     
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  2. Fergie Fulton

    Fergie Fulton Gold Supporting Member

    Nov 22, 2008
    London-NewYork-Paris-Munich-Braintree
    Retrovibe Artist rota
    A brace or support helps keep the palm flat....ish so helps stop the sides of the Carpal Tunnel inhibiting the nerve.
    I have written and spoken before of the crease that appears on the palm when the thumb moves over to meet the fingers and the valley it forms. So what follows is a 'laymen's " idea in terms of what is going on in the hand as far a bass playing is concerned.

    At the base of the thumb the pad moves laterally to support the movement as the thumb comes over to oppose the fingers and creates a crease in the palm, depending on how far over the thumb moves will determine the depth of the valley the crease turns in to.
    When the crease is formed it brings the edges of the Carpal tunnel in, this is not an issue, the tunnel is designed to deform and re-form its shape to deal with the complex hand movements we have.
    The Carpal Tunnel is access route, so muscles, nerve, blood vessels, etc share this 'highway' as they do though he wrist. The wrist is the bottle neck for many of these services as they all try and get past the complex system of bones and joints to service movement.

    The issue is over time is the valley is formed and finger use is maintained during the time it is formed then there is a motion that is rubbing against the sides of the Carpal Tunnel, in a sense.... wearing it away a such. When the sides cannot de-form and re-form they cannot resist the action of the muscle running over the top that is part of the roof, so the roof in effect caves in, pulls the walls in and the nerve within the Carpal Tunnel is trapped, so we get the symptoms as a permanent feeling.

    The extent of the collapse depends on the hand use and the physiology of the person, not everyone has the same hand use and not everyone has a perfect healthy hand.
    Add to this the length of time and intensity of use and the problem becomes complicated to correctly say what has caused the symptoms when the appear, we can pinpoint where they are originating and the cause, by why the cause happened is in understanding the persons hand and how they have used it in their life.

    Sometimes this is "the straw that broke the camels back" situation, in that damage occurred earlier in life and it only needed a more intense use in later life to expose it, as playing bass would do
    So bass playing was not what caused it as such, the intense use of the hands, with the increase in use we would use in learning has exposed what was there.
    If the person never played bass the injury may never have been exposed by it, if they took up tennis or golf and put in the time and effort to that, then that intense use may have exposed it, even an intense use on computers will expose a weakness.

    But as far a bass playing is concerned it is that thumb position i talk about, the putting of the thumb up-right on the neck means it has to move laterally into this position, so the pad comes over and forms the crease, and the Carpal Tunnel area is now being deformed (deforming is not a bad thing it is just a term to describe the change of shape) and the valley in the palm is formed.
    The action of using the fingers means that the muscles that also use the Carpal Tunnel are forming and deforming within the tunnel to make the fingers move.

    What i say is do not move the thumb over, do not put it up-right on the neck in such a way that you form the crease and so form the valley.
    If you have to move the thumb over, then make it a function to support use.....then let it move back to a neutral position.
    So in effect you de-form and re-form the hand within the use of the motion of the fingers.
    In holding that thumb up-right behind the fingers in the middle of the neck is keeping the Carpal Tunnel deformed throughout the finger use, so making it more susceptible to wear and tear, so weakening the sides of the Carpal Tunnel and making it easy to de-form and stay de-formed.

    Part of the Bass Guitarist problems is they relate to Double Bass Pedagogy.
    This is a flawed idea and only came into use because the instruments were seen as doing the same job back when the Electric Bass Guitar was introduced
    But the reality is they have a completely different impact on the body and on the hands.

    In all Double Bass Pedagogy that accumulated over the centuries, none that developed it and used it could ever imagine a Bass Guitar and the designs, sizes and ergonomics the design would offer, or the genres and techniques that would accompany it.
    Double bass had one design and two techniques Pizzicato and Arco, although Arco had two schools of thought on use of a bow, overhand or underhand (French and German respectively).

    We as bass guitarists have to look at what it is we do....we play guitar, not Double Bass, it may be a bass guitar but the focus for technique is on the guitar part not the bass part.
    Playing bass Trombone is based on Trombone, playing bass Sax is based on Sax etc...none of them use Double Bass techniques as such.

    So look at your own technique and decide is your hand use relevant to what you play and of you can use safer positions such as neutral thumb, straight wrists, thumb over the top etc...then use them all the do is relieve the un-needed stress and strain on the hand.
    Because we have become accustomed to stress and strain does not mean it is not there, it just means we have learned not to notice it or associate any issues with it within a use.

    I am not saying anyone has to change, or anyone is right or wrong in how they use their hands, all i am saying is there are reasons why problems occur and to be aware of how you use your technique. This applies to a lot of activities and the forums they have on the web have the same issues with CTS that we have with it.

    Thanks to all for sharing their experiences, CTS is not the end of the world, neither is surgery, in fact for many, surgery it is a new start and asks the question " why did i suffer rather than do something sooner" and that is the object of this thread to let anyone with doubts realise you are not alone in this, talk to others and decide what is best for you.

    If you have had surgery, good or bad then please share your experience, what sufferers need to see is a way forward and the fact that there is light at the end of the tunnel.
    In my case (it was a broken neck) that caused all, and still does, my hand problems, i changed my bass, my amp, my strings my set up, my practice, my diet, my mattress, my pillows, my car and more..... to alleviate my problems.
    I still after five and a half years manage my injuries, there are no time limits on anything i do, it will take as long as it takes.

    Getting your mind and thought process sorted out is the big step, accepting there is a problem and being prepared to take it on.
    Its not about regaining or maintaining what you once had, its about making the best of what you now have, and how to best move forward and play. :)
     
  3. Stumbo

    Stumbo Wherever you go, there you are.

    Feb 11, 2008
    So. Cal.
    Thank you for the post! Great info and comments.
     
  4. JimmyM

    JimmyM Supporting Member

    Apr 11, 2005
    Apopka, FL
    Endorsing: Ampeg Amps, EMG Pickups
    Welp, good news for me...my wrist pains are about 99% gone. Just a very dull ache I only notice when I focus in on it. Shoulder's a bit sore but that's been going on for years. I figure as long as the hands are working, it's all good.
     
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  5. Fergie Fulton

    Fergie Fulton Gold Supporting Member

    Nov 22, 2008
    London-NewYork-Paris-Munich-Braintree
    Retrovibe Artist rota
    Great new Jimmy.
    The "only when i focus on it" part is what I talk about when a pain Centre is moved and heightend by emotion. In other words, what you think about your mind helps reinforce, so the idea you should have pain, becomes pain in reality.
    The same applies when you are not thinking of it, you are distracted so any emotion about the expectation of pain is not heightend.
    In life, heightend emotions can affect our physical state, if we are high emotions they will reflect onto other aspects of our lives we give little thought to.

    Some great Tinitus treatments work In a similar way, in as much as they help the player to ignore the noise in their hearing by being 'permantly distracted' from it. They learn to take the emotion of what they expect,and believe, how Tinitus will effect and not focus or dwell on it.

    Stay fit and best wishes for the future. :)
     
  6. I've been playing for almost 10 years and in the past week I have developed pain in both wrists and palms, along with the top of my fretting hand around the knuckles. More pain/discomfort in my fretting hand than my picking/plucking hand. I'm worried. I recently started playing with a new gp and we're making killer progress. I suspect I may have overdone it lately. I'm taking it easy and keeping an eye on it. I hope it is just a passing thing.
     
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  7. mrb327

    mrb327 Supporting Member

    Mar 6, 2013
    Colorado
    Nobody Knows
    Jimmy, thats good news



    Denver Max, definitely let em rest and try some of Fergie`s exercises. We wish you the best
     
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  8. JimmyM

    JimmyM Supporting Member

    Apr 11, 2005
    Apopka, FL
    Endorsing: Ampeg Amps, EMG Pickups
    Max, now would be the time to examine your technique. Playing should be pain free, and if it isn't, it could very well be a technique issue. Might not be a bad idea to take a few lessons with a technique maven who can examine your style and give you some pointers to make it pain free. And don't worry...using good technique doesn't mean you can't still look cool ;)

    Fergie, you are probably right...I expect pain, so when I focus on it, I feel it. Mind and body connection...very important, often overlooked.

    Thanks for the advice, guys! And I hope those of you with pains can recover and get back out there playing pain free.
     
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  9. I think a lot of it may have to do with my acoustic bass I play at home. Its really bulky and I have to bend my wrist strangely to pick or pluck. I played for a few minutes today and there's no pain while I play. Just discomfort afterwards.

    I also recently started a new part time job that requires me to be on a smartphone a lot, and I'm taking online classes. My hands need a vacation.
     
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  10. catcauphonic

    catcauphonic High Freak of the Low Frequencies Supporting Member

    Mar 30, 2012
    Seattle WA
    Question for past sufferers of CTS in the hands: What were the symptoms that led you towards getting a diagnosis? I ask because on occasion in the past few weeks when I'm laying in bed or driving, I feel one or both of my hands starting to curl into a lobster claw position, and I can't really uncurl it until it subsides on it's own (usually in a minute or two.) The shape my hand takes is best described as if you were making a 'C' with your thumb and first finger, with all of the fingers pressed together.

    It's not painful. More like an uncontrollable curl with a tiny bit of numbness if anything. I thought it might be from the fingerless gloves (more like mittens that are cut off at the middle knuckle) that I've been wearing most days over the winter, as they are kind of snug around the fingers up to that knuckle.

    I'm 44, haven't been playing but a few years, and I don't do a lot of typing on a keyboard or anything else that puts the fingers to work doing repetitive things. I'm going back to warm up stretches before playing ... I just need to remember to make it a habit.

    Thanks Fergie for (as usual) being full of information. Great topic for musicians!
     
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  11. N.F.A.

    N.F.A.

    Jun 25, 2009
    In a blue funk
    CTS is certainly a serious issue. I've been a licensed massage therapist for nearly 10 years now. The 4 year stint I did in a doctor's office brought me many CTS cases. I can tell you that everyone should try massage to relieve things before they get surgery. Many of my clients were able to postpone or avoid surgery altogether with a regular program of massage and stretches that I would teach them. Naturally, some cases are too far advanced for this option. I'm certainly not trying to diagnose or advise, because I'm not a doctor. I am an extremely experienced L.M.T. though and just sharing my experiences with CTS
    Don't wait and ignore symptoms. You have options when it's treated early, not so many when you wait too long.
     
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  12. I think that's the start of it. Mine started like that in my left hand with my index finger just curling up on its own and I could pull it back to straight. Now when I get it really bad I have a muscle or tendon that pinches in my forearm and it closes my index finger really tight where it takes me a few to pry it back open.

    Definitely go see a doctor to make sure it's CTS and not arthritis. I've not had surgery on it yet since the worst that happens to my arm doesn't happen that often like once a year. When I feel an onset I'll put my brace on and try not to do anything repetitive and take it easy for a day or two.
     
    Fergie Fulton likes this.
  13. TomB

    TomB Supporting Member

    Aug 24, 2007
    Vermont
    I've had CTS surgically released in both hands. The symptoms were extreme tingling and numbness and mild aching. A nerve response test is painful but definitive. Please check in with a hand specialist.
     
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  14. TomB is giving good advice.
    There are many health concerns that can cause symptons similar to CTS. In fact, many of them can be quite serious. I would also recommend a hand specialist. But make sure that the problem is accurately diagnosed. I had three opinions on mine. The first surgeon, I was convinced that he simply says "surgery" to any patient that comes to see him. In the end, he was correct.

    For me, and I suspect for most. Non surgical treatments are only very temporary for true CTS. Once the nerves are damaged or severly irritated, it takes much longer to heal than most people would be able to or willing to rest. We are talking months and years.
     
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  15. Just had my right hand released two weeks ago, playing better already. EMG is the only true way to diagnose it. Hand specialist is the way to go.
     
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  16. joebar

    joebar

    Jan 10, 2010
    it has been about 18 months since I had both my hands surgically repaired.
    10 weeks after the surgeries-April 2013, worksafe sent me back to work. I worked for a year in tremendous pain and difficulty; my quality of life didn't exist for me.
    in march of this year I had to stop working all together. I had to quit my band and playing bass for awhile. I have been resting for 4 months and recovering quite well.
    I am still not out of the woods; riding a bicycle puts my right hand to sleep in ten minutes. my wrists are still not strong.
    worksafe hung me out to dry and I am partially disabled in the natural.
    my only hope is for God's miracle working power. it is all I have.
     
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  17. h2otorched

    h2otorched

    Jun 21, 2014
    SoCal
    I'm new to Talk Bass, but, I wanted to share my personal experience with carpal tunnel. I started playing
    professionally when I was 15 years old, by the time I was 16 I was playing 5-6 nights a week.
    I have medium to small hands, mostly playing a Gibson EB3 short scale, years later a 70 P Bass, then in 78 a MusicMan Sabre Bass. I never had any problems till I turned the Sabre into a fretless. I started experiencing
    cramping on stage, painful, which led me to set the bass down.

    I broke my right elbow roller skating and was unable to play close to three years due to my arm being frozen in an angle that put my hand at an akward angle. Finally my right arm straightened out and I began concentrating on fingerstyle acoustic guitar. I became a devotee of Michael Hedges and studied his music in depth for the better part of ten years. Five hours a day, four days a week, concentrated study. Six years in I started experiencing carpal tunnel symptoms in both arms, both my right where I had broken my elbow was the more painful by far.

    My schedule changed to massaging my arms, shoulders, and hands for two hours a day. That allowed me
    to practice for a half an hour to 45 minutes a day. Depression reared it's head as my technique and all that
    I had accomplished began to backslide. Michael Hedges also experienced problems. It's a very concentrated
    style of playing.

    After Michael's passing in 1996, I promised myself that I would visit Harbin Hot Springs
    in Northern California. He visitedit frequently and talked about it in concerts.

    So, in 1997, I visited Harbin for a five day vacation. It stretched to 10 days. I loved the land and the beautiful
    water. Their Hot Pool, a meditation pool would be 117 degrees in the morning. You walk up a few stairsteps to a cold plunge. The hot/cold experience back and forth repeatly begins to smooth out the rough edges. Like a stone in a river bottom. Physically, mentally, and spiritually.
    I filled my days with great massage modalities. I decided to come back six months layer to attend a workshop
    in a aquatic modality I experienced my last day there, Watsu. It became my new passion. Filling the void that
    performing, and songwriting had.

    In the middle of the week long workshop I experienced Quantum Light Breathwork. Facilitated by one of the instructors Richard, it was like stepping through a StarGate!
    It opened my body, my chakras lit like a drag strip light, and I at first experienced extreme pain in my arms
    where my energy was blocked. As a buzzing vibration began climbing up my spine, it finally burst through
    and energy rushed from hands as if I was a superhero! Tears of joy mingled with a supreme peacefulness as
    I came to the realization that I was experiencing a Divine Healing.

    I won't go into all the details, but, every slight, or unpleasant incident in my whole life was pulled from
    me as if they were a continuous magician's scarf. An unkind word here, an offense taken there, it really was watching your life pass before you. All the while this beautiful peace had settled over me.
    I came to know myself as more than Don, the personality. I began to realize I was Spirit.
    Had been , was, and would always be, unchanging Spirit.
    I began to exist within Presence.

    Upon my return home, all my friends were blow away, they repeatly told me they felt I was changed, calmer,
    assured, not the anxious man they knew.

    I now look back at that time as a moment where I became aware.
    There was before, and what was had changed elementally.
    My interest in Chinese Energy Healing grew, and that became my focus over the next ten years.
    Studying Shiatsu and Watsu, and other forms of energy work.

    I still write, play bass, acoustic and electric guitar, but, my years as a working musician are by and large
    behind me. I no longer experience any problems with my arms, hands or shoulders, other some
    arthritis as I turned sixty last year.
    I may play again.
     
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  18. joebar

    joebar

    Jan 10, 2010
    I totally know what it is like to be consumed with your ailments. life passes you by as you focus on your pain and discomfort.
     
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  19. iblanky1

    iblanky1

    Feb 25, 2012
    Virginia
    Had the surgery on both wrist in 2013 ... successful thus far!
     
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  20. Jaco Taco

    Jaco Taco

    Jul 30, 2012
    Anyone know if a rounder or flatter radius on the fretboard is better for people dealing with CTS?
    Also, is there a better neck shape for people dealing with CTS, like C, D, etc?
    Thanks.
     
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