Tendonitis! It's a word we bass player fear nexted to carpel tunnel syndrome(spelling?). I went to the Chiropracter on Tuesday and after looking at me he said that I have the dreaded T word(Tendonitis). Now I honestly don't beleive him because he said I had the "t word" before he even checked out my arms and hands and wrists. He told me I have a extremely small case of tendonitis and wanted me to stop playing bass completly telling me it will never go away! AHHHHHHHHHHHH, I recently read in this bass player article found below, that tendonitis can be cured! So now I'm refering to physiotherapist they seem to have a deifferent education for that kind of stuff. The article down below. Healing Your Hands BY ARLO GORDIN, D.C. A Note From The Editor This article was written by Dr. Arlo Gordin, a chiropractor who has treated many musicians, including Billy Sheehan and Stuart Hamm. As he notes, many career-threatening hand and wrist injuries can be successfully overcome. Chiropractic is one method for treating these injuries, but it is not the only method. Below, there is an account by Greg Mooter, an Assistant Professor at Berklee College, of his experience with playing-related pain and its subsequent cure. Steve Rodbys column in May/June 92 described his positive experience with yet another type of therapy. (If you dont have that issue, send me a self-addressed, stamped envelope and Ill mail you a copy of the column.) BASS PLAYER does not endorse any method of treatment. If you are having a problem with pain when youre playing, we encourage you to investigate all possible remedies, including conventional medicine, physical therapy, chiropractic, and even such alternative means as acupuncture and holistic medicine. The only "correct" program of treatment is the one that works for you. And, if youve been treated successfully for playing-related problems, please let us know so we can pass along the information to your fellow bassists. Jim Roberts, BASS PLAYER Editor, 199097 Pain seems to go with the territory of playing bass. The slapping, tapping, and rapid-fire playing demanded by modern music can aggravate problems that can cause pain, numbness, weakness, or lack of control. These symptoms commonly occur in your wrist, hand, fingers, thumb, arm, elbow, shoulder, or neck. The heavy strings and wide neck of a bass can make these problems even more intense than the ones faced by guitarists. Based on the large numbers of players coming to me for treatment and attending my seminars, it appears bass-playing pain is reaching epidemic proportions. Many of my patients report that even a few minutes of playing causes symptoms, and these symptoms range from annoying to crippling. Many labels have been applied to these problems, including "tendinitis" and "carpal tunnel syndrome." Medically, these conditions are treated with drugs (painkillers and anti-inflammatories), braces, instructions to lay off playing, and even surgery. I avoid drugs and surgery for myself, and I dont recommend them for my patients. As a chiropractor, I have sought a natural method to correct and cure the underlying causes of musicians pain, not just a way to cover them up. Whats Really Happening These problems are basically electrical and functional. The electrical wiring system of the human body is the nerve system. It controls the functioning of muscles and joints. The cure for a players pain is based on fixing the electrical failure and restoring the proper functioning of the joints. When these jobs are done, the pain is gone. The main problem of nerve-system malfunction is known as subluxation. This means the bones in joints have moved slightly out of normal position, so they interfere with the normal pain-free motion of the joint. These bones put pressure on the nearby nerves, interfering with their electrical function. The challenge with a bass player in pain is simple: track the wiring diagram of the nerves, find the short circuits, and fix them! To put it in more technical chiropractic terms: Find the subluxations and adjust them; that is, move them back into normal position and normal motion. This means locating and correcting whatever is interfering with the proper nerve flow to and from the arms and hands. The wiring diagram that requires inspection involves the nerve pathways from the (1) lower neck; (2) shoulder-area joints; (3) elbow joints; (4) wrist joints, especially the carpal tunnel; and (5) thumb and finger joints. All must be checked for subluxation; any problems found must be adjusted and fixed. What Caused The Short Circuits? Tracing back the current problem a bassist is having with his hands, Ill often find old injuries to the neck. They could be whiplash, football, surfing, or skateboarding injuries. In other cases, the problem is traced to repetitive impact, perhaps caused by hammering or heavy lifting at work. Sometimes the player subluxated himself lifting weights. On top of this, bassists put additional mechanical stress on their bodies by hanging heavy instruments over their shoulders (some problems can be resolved simply by changing the way the bass is strapped) and by the onstage posturing they do. The subluxations have often been caused by something other than playing bass. Then, when the musician starts playing, he demands more power, more speed, and more accuracy from his hands and armsand the system thats already damaged becomes inflamed. Of course, there are other factors that can contribute to the health problems of musicians: drugs (even if just nicotine and alcohol), too little sleep, too little nutritious food. All of these can damage the body and reduce its resistance to stress. How To Check The Wiring Diagram The first step is my examination of the neck, spine, and extremities involved, which often locates signs such as weakness, swelling, subluxated joints, spasms in muscles, and areas of tenderness. The player sometimes requires a set of X-rays to locate physical damage to the spine and to show structure and misalignments. Often subluxation of the neck or back vertebrae shows up as pain not in those areas but in the shoulder, arm, or hand. The tool I have found most useful with musicians is a set of super-precise techniques developed by Dr. Ray Zindler of Vancouver, Canada, and first applied by him to sports medicine. These techniques are an extension of the chiropractic specialty called Applied Kinesiology. (Kinesiology is the study of the motion of the body.) Over the past 14 years, I have been able to adapt and fine-tune their application to helping musicians. To test a player for the cause of his symptoms, the hand and arm are held in a series of different positions, each of which brings different nerves and muscles into play and can show where nerves are being put under abnormal pressure by the bones. I then do a series of strength tests on the fingers, hand, and arm in these different positions; these tests show instantly where the nerve messages to the hand and arm are being blocked. With the real problem located precisely, I then do specialized chiropractic adjustments to relieve the pressure and restore nerve function. The results are immediate and dramatic. Almost all the joint problems of the musicians I see can be rapidly handled in a series of adjustments over the succeeding days or weeks, as the bones of the skeleton go back into alignment, the nerves normalize, and the muscles readjust. The Problems Youve Heard About Carpal tunnel syndrome is a specialized example of subluxation. The nerves that travel out of the hand go through a tunnel of bones forming the wrist; these bones are called the carpals. The system is very delicate in some ways, and if the bones are even slightly out of alignment, the nerves become entrapped, compressed, pinched. Instead of surgically cutting, we recommend adjustment of the carpal bones to stop the nerve compression. Tendinitis as a diagnosis of a musicians hand problems is really a description of the symptom, not the cause. Tendinitis is an inflammation, but we find it is best cured by finding the nerve blockage and/or the nutritional problems causing it. If youve read this far, youre aware that I am firmly dedicated to the non-surgery, non-drug approach, because I find it most effective. I have had to cure many musicians "Whats The Deal, Doc?" I had been playing through severe left-shoulder pain for several months, and my family doctor had no solutions. She recommended that I see Dr. Dechecko, an orthopedic surgeon. I had heard about this fellow Dechecko: His fingers could penetrate your muscles like a dagger. He had a knack for finding pain and rubbing it out. Sometimes, his means werent pleasantbut he was efficient. I met Dr. Dechecko on a cold, rainy evening in April. His eyes were like ice as he sized up my body. He used his fingers to examine every inch of my arm. He inspected and prodded and probed. Then he squeezed and pinched and twisted. He found every ache and amplified each one with his maneuvers. Finally he sat down and began to write. He didnt look up or speak for five minutes. The silence made me edgy, and I felt my knees begin to tremble. Then Dechecko began to ask me questions. He wanted to know about my fathers medical history, and I blurted out, "But I came here to get answers about my arm. Its tendinitis, isnt it?" He peered over his glasses and said, "No, you dont have tendinitis. Now, tell me about your physical activity before the pain started." I detailed a typical weeks program: I swim a mile four times. I attend two symphony rehearsals and play two or three gigs. I have about 25 bass students and teach four or five classes, all of which require playing. I practice at home for about two hours a day. I noted that I had only recently joined the symphony, and that I had also just begun to play an extra-long-scale 6-string bass. Dechecko asked me if I had done anything unusual just before the pain came on. I remembered that Monday had been a holiday, so I had spent the entire day hanging at my house, playing bass. When I woke up Tuesday morning, I felt a knife in my shoulder. To complicate things even more, Dechecko wanted to know about my sleeping habits. I figured he was way off the track, but I showed him how I usually sleep: on my stomach, with my head on my left arm. Dechecko began writing again. Suddenly he stood up, walked over to me, and began probing my shoulder again. Ouch! "You might need some cortisone to fix this," he said. "Cortisone can help to relieve the inflammation." I was relieved he wasnt recommending surgery, but I was mystified. "Whats the problem?" I asked. "You have bursitis, and you got it from your father." I was confused. I had heard of people complain about a "touch of bursitis," but they werent in constant pain. And I knew this lady who had bursitis in her kneebut she was old. "Whats the deal, Doc?" Dechecko explained that I had inherited the tendency to develop bursitis. This tendency had finally manifested itself because of my age, my occupation, my exercise activities, and my sleeping habits. The cure? Cortisone, rest, ice, gradual rehab, and some behavior modification. It worked. After this experience, Id suggest the following to all of my fellow bass players: If you experience performance pain or discomfort anywherewhether its your fingers or your lower backsee a doctor. Dont wait until a minor problem becomes crippling. Change your performance habits slowly, especially if you are set in your ways. Your body is a delicate mechanism. Learn your family history. It could have a direct effect on your performance ability some day. You may have inherited more than your mothers nose! Analyze your physical activities, giving special consideration to your hands and arms. Too much strain on one spot can cause serious problems. As a bassist, your most valuable physical assets are your hands, arms, and back. Take care of them! Greg Mooter of hand and wrist pain after failed surgeries. Drugs like cortisone that are used to treat tendinitis and carpal tunnel syndrome have side effects on the human glandular system. Healthy adrenal glands are supposed to be producing cortisonewhich brings me to another aspect of musicians health. Stress, Your Adrenals, And Nutrition It may be better to burn out than to fade away, but I see my purpose as helping musicians to avoid both. Musicians live in a world of stimulation and stress. Such stresswhether its mental, emotional, physical, or biochemicalwill first make the adrenal glands overactive. (The adrenals are two little glands that sit on top of the kidneys; they produce a powerful chemical called adrenaline in times of stress.) But eventually stress wears them down to where they cant keep up. The wearing-down of the adrenals is connected with B-vitamin deficiencies. A bass player may live on snack food and soda, play under high pressure, and get little sleep. He is very liable to deplete the body of the B vitamins, and this alone can produce carpal tunnel in some cases. Well often recommend vitamins B5 (pantothenic acid) and B6 together. Studies have shown that B6 helps the carpal tunnel, and the pantothenic acid helps the adrenal glands to fight inflammation. Like many other nutrition-minded practitioners, I have had a lot of success using glandular materials to treat adrenal burnout. They are made to contain the raw materials to rebuild your worn-down glands, without the hormones. They are drug-free and safe. They help the body to rebuild its own glandular system, which permits it to deal properly with stress. On The Road Or On The Stage I have expectations that our new techniques of diagnosis and adjustment will become much more widely available, and I have been asked to do a series of seminars to like-minded physicians to help them treat musicians. Meanwhile, let me urge youbefore you let anyone perform surgery or prescribe drugsto check out the natural alternatives available in your area. There are also some useful things you can do by way of prevention: Dont force your wrist into a bent-back position (e.g., by doing regular push-ups). This can cause carpal-tunnel nerve compression. If youre in a car accident, suffer a fall, or sustain a sports injury to your neck or arms, get checked promptly by a competent chiropractor for subluxation. Eat quality foods. Take a good B-vitamin supplement, vitamin C, and a good multiple vitamin/mineral supplement. If you try to run your body on burgers, coffee, and candy bars, it will sooner or later give you trouble. Take steps to avoid injuring your back. When lifting something heavy (like your amp), dont bend forward at the waist; instead, bend your legs and let them do the lifting, with your back straight. If something is too heavy to safely lift alone, get help. Check out the way your instrument hangs on your neck and shoulders. A number of my patients have experienced marked improvement by the use of a strap extender, or by switching to a strap wide and soft enough to better disperse the weight. Pay attention to your physical condition. Even if you jam far into the night in smoke-filled rooms, sleeping in a good bed, sitting and standing with good posture, following a fitness program, and doing "crunch" exercises to strengthen your abdominal muscles will all help to maintain a spine healthy enough to support your playing. Warm up properly. A short stretching routine for your hands and wrists before playing can keep them limber and make them less prone to subluxations and inflammation. Dont Be In Pain In summary, let me say that musicians are very important peoplethey are the heartbeat of the dreams of our cultureand there is no reason why you should be in pain. You need only to find someone in your area who is competent at treating musicians problems and take advantage of what is known.