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Left Hand Pinky Injury

Discussion in 'Jazz Technique [DB]' started by rftbass, Apr 27, 2008.


  1. rftbass

    rftbass

    Mar 31, 2004
    Waterford, CT
    I have just been diagnosed with a soft tissue (ligament) injury to my left hand pinky finger – the joint next to the nail (1st joint). I have played upright bass for about 48 years and have not had any left hand issues till now. My occupational therapist and I have discovered the middle joint is collapsing as I press the pinky finger to stop the note on the fingerboard. Thus I no longer have that nice curved finger. We believe this to be putting excessive pressure on the 1st joint resulting in the ligament injury and pain.

    Rest, not playing, is certainly working as the pain and inflammation is gradually going away. My OT has a ring that I can put in the finger to assist in keeping the middle joint from collapsing, but I am curious if any of you have any thoughts on how to keep the middle joint from collapsing?

    Thanks
     
  2. rftbass:

    After months of searching, I have finally located someone who is suffering from the exact same ailment as myself.

    I have been playing guitar and bass for 35 years and have never had an issue with my hands or fingers. Suddenly however, about 3 months ago, I started feeling excrutiating pain in my left hand pinky when I fretted a note. The knuckle closest to the nail started to swell and has been swollen ever since. The only thing that seems to help is heat compresses. The pain subsides slightly but the swelling remains. After only about 15 minutes of playing however, the excrutiating pain returns.

    I feel that my technique is very good (proper placement and posture of my hands).

    I have an appointment to see a doctor at the beginning of the new year. Can you please tell me what has happened with your injury since posting this? Have you had any success in repairing or minimizing the injury and it effects?

    Please let me know.
     
  3. rftbass

    rftbass

    Mar 31, 2004
    Waterford, CT
    After seeing several doctors, MRIs, etc...there appears to be no tendon or muscle issues. The best quess at this point is that the little finger middle joint has too much movement from side to side. There are ligaments that run down each side of the finger to hold the lower and mid-bone together that may have become elongated. My doctor will continue research with several specialized hand surgeons for their opinions. Sorry it is not more positive news.
     
  4. Do you have pain? What do you do to minimize it?
     
  5. powerbass

    powerbass

    Nov 2, 2006
    western MA
    i have extensive experience w/these kinds of injuries - i am a muscular therapist and bassist, not only have i treated these injuries i have injured my hands as well. the primary issue is ligaments are not meant to be stretched - they hold bones together and allow a certain amount of glide/slide to joints. once a ligament is stretched (either from an acute fall/blow or over time w/prolonged poor joint alignment) they do not return to their original state. the pain is often a result from the injured ligament and from excessive joint motion. once the joint has lost the inherent stability from the ligament the muscles that control the joint motion need to be extra strong to handle the job of joint stability. in other words if the joint is not too unstable exercising the finger muscles can help regain the joint stability. here is my routine for ligament injuries:
    1. stop taking anti inflammatory medication and stop icing, this will dufus the healing of the ligament
    2. perform deep self massage to the injured ligament rub back and forth and length wise- it should hurt but not too much. do this many times a day.
    3. use a suitable rubber band as a resistance tool - the finger motion at the tip is in only 2 directions, use the rubber band exercising in both directions - do this many times a day. keep the movement somewhat limited - you are trying to stiffen up the finger so go slow w/the exercises
    4. finger/joint alignment is the most important factor. if the finger collapses while playing that is because your finger muscles are weak and cannot control the joint properly and/or your finger aligment is poor.
    5. stop practicing if your finger collapses, do not play w/the finger bent backward - hyperextended this will prolong your injury.
    6. research prolotherapy (http://prolotherapy.com/). this is a therapeutic injection technique that can aid in the healing of ligament injuries.
     
    SmokinJazz likes this.
  6. fciscobass

    fciscobass

    Mar 11, 2010
    New Jersey
    My pinky problem is not exactly like the problems stated above but it sounds like it may also be a stretched ligament problem. It appears that when I started to adapt to the "one finger per fret" technique, I possibly overstretched the ligament in my pinky joint (my knuckle joint) that is closest to my palm. The result is that my pinky no longer has the "nice arch" it should have when pressing down on a string, instead it collapses at the knuckle joint causing my pinky to bend away from my middle finger. In other words, instead of obtaining flat contact onto the string with the tip of pinky, my pinky falls sideways away from the ring finger. I have tried to retrain the muscle by maintaining an arched finger, and sometimes it seems to be effective, but inevitably the finger gets exhausted. I have also tried using Buddy straps to retrain the pinky and to keep it closer to the ring finger, but the straps can feel uncomfortable and unnatural. Have you ever seen anyone else with this problem and do you have any exercises or therapy you can recommend??
     
  7. Taniv

    Taniv

    Jan 3, 2011
    Ligament injuries: Ligaments act as anchors that stabilize joints by attaching bone to bone. Ligament sprains and tears occur in the hand due to direct trauma or hyperextension/hyperflexion of a joint. A common ligament injuy in the hand involves the ulnar collateral ligament (at the base of the thumb) known as “skier’s thumb” or “gamekeepers thumb”. Ligament injury can result from “jamming” of a digit, which describes axial trauma to the end of a digit. Jam injuries most often cause stretching or partial tearing of the ligament or its bone attachment point. The IP joints are most often affected. Ligament sprains are treated with immobilization followed by physical therapy to regain normal range of motion. Tears require surgery.

    Ligament Injury
    http://www.sportsmedicineclinicdelhi.com/
     
  8. BluesMan1

    BluesMan1

    Nov 1, 2010
    Similar issue here. I've played guitar on and off, and after a long lapse I picked up the electric bass. Only a few weeks into it, but I'm experiencing a little pain (nothing too severe) in the pinky joint closest to the palm. Some swelling too in the area between the joints.

    I'm battling it by taking it a little easy on practicing my scales. I don't want to completely lay off practicing though; don't want to loose the little progress I have made in getting acquainted with the instrument.
     
  9. smcrosby

    smcrosby

    Jan 4, 2012
    Powerbass - I am sooo glad I found your post. I am a guitarist/bassist going back to 1968 and just fractured an arthritic bone spur in my left pinky tip joint by deflecting a basketball out of bounds. I am sure I stretched the tendon on top of the finger across the joint by the nail base in the process. I have been wearing a finger splint which I only take off to play (about 2 hrs. per day). The finger is only slightly bent (in its natural curling position thank God) when I remove the splint but becomes bent 40-45 degrees by the time I finish playing some jazz fusion runs on the guitar. Looks like I should abandon the splint and work the muscles attached to the top tendon with a rubber band to strengthen the finger? Can you recommend a doctor or OT in Midtown Manhattan or by New Brunswick, New Jersey? I only wish I was local to you for therapy!
     
  10. powerbass

    powerbass

    Nov 2, 2006
    western MA
    smcrosby - Arthritis is a different scenario since the joint surfaces/cartilage have deteriorated. That said it is a good idea to preserve as much mobility and range of motion you can by actively using the hand/joint and stretching the joint range (assuming the range is limited) to tolerance - everyone has varying degrees of comfort/pain tolerance, pushing the joint past comfort may/may not be beneficial (I have had clients with severely arthritic knees who do not experience significant pain, they also ride bikes and hike too). My post above spells out my approach - massage, mobility, strengthen and excellent alignment to individual joints as well as the whole extremity. Since you are dealing primarily with a specific joint you could apply these principles to yourself - or consult with your MD about such an approach. I'll work on finding someone your way
     
  11. I had a (sort of) similar problem when I first started playing in that I was placing too much sideways pressure on the first pinky joint as I was keep it too straight/flat instead of arched; ithe joint developed a little sideways movement and playing became quite painful. After a couple of month's rest, I switched to guts (from Spiro Weichs) and the lower tension meant that I could play with less pressure and hence no pain. It also meant that I could correct my technique gently. As my finger strength & technique improved over about a year of playing (not overdoing it, though), I've now been able to go back to steel strings (DA Helicore Orchestrals, even heavier than the Spiros) with no problems. Under the appropriate medical guidance, perhaps guts could similarly provide you with a suitable rehabilitation option? Good luck in your recovery!
     
  12. smcrosby

    smcrosby

    Jan 4, 2012
    Powerbass - thanks for looking for someone my way - do you know if Dr. Coyle with New Brunswick Orthopedics in NJ is a good MD to see?

    In the meantime, I play fusion-style leads every day on shred guitars that I set up myslf so the resistance (and risk of trama) is very low (LOL, part of my self-prescribed rehab).

    I have also stopped using the pinky to bend strings to ensure the bone completely heals. But I am ready to give pinky string bends a try again after I show a MD my x-rays. Hmm. Will x-rays show the tendons and ligaments on the pinky?

    The good news: my pinky is not bent out of alignment (to one side or the other). Nor is it bent out of its natural curved playing position (thank God). So I can still play and jam with others, etc.

    I also have no trouble at all fingering the notes for crazy jazz chords with the tip of my pinky and can still bar 3 strings with the affected pinky segment (e.g., barring G-C-B onthe the 5th fret with the pinky between the affected knuckle to the pinky tip while playing an F in the bass on the 6th string 1st fret with the index finger).

    Its just that, for now, the joint by the tip won't stay straight when I try to extend the entire pinky unless I leave the splint on for a few hours. As soon as I take off the splint and play for say 20 minutes, I can't straighten the last joint out all the way. But. I can move it into a straight position with no pain or crunching of the joint, etc.

    In fact, there really is no pain to speak of anymore unless I push down real hard on the strings with my pinky tip (which I try to avoid).

    So I'll start doing the extensions and contractions with a rubber band to see if that helps tighten up the connective tissue over the last joint.

    Thanks again Powerbass!
     
  13. Ross Kratter

    Ross Kratter Gold Supporting Member

    Dec 31, 2010
    New York, NY
    Artist, La Bella Strings and Phil Jones Bass Amplification
    Shoot an email over to Mike Richmond. He's been playing on a broken left pinky for over 40 years now. mike4805@aol.com
     
  14. Hi smcrosby,

    can you please tell me what splint you use for your pinky? Maybe that might help me as well. Did you buy this splint via the internet?

    I recently bought the handmaster plus in order to strengthen my fingers, hand:

    Hand Exercise & Grip Strength with Handmaster Plus - YouTube

    Thanks,

    TonyD
     
  15. powerbass

    powerbass

    Nov 2, 2006
    western MA
    THis device looks OK but when it comes to finger injuries you may need to isolate a particular joint. If the pinky is injured usually it is the last metacarpophalangeal joint ligaments. These can be strengthened with a simple rubber band placed on the bone above or below the joint then flex/extend the finger. This is effective if your finger joints collapse while playing.
     
  16. Thanks powerbass,

    I recently purchased 'Principles of Double Bass Technique' by Michael Wolf. On page 105 he writes that 'The inability of the fingers to form an arch without hyperextending the knuckles is not due to the weakness in the joints that have "collapsed", as is often mistakenly thought to be the case, but rather in the ones which are too sharply bent'.

    So I have to strengthen the first knuckle of my pinky (from nail) to prevent the second knuckle form collapsing.

    Do you agree?

    I did not quite understand the exercise you advised (sorry for my poor English). But I think that when I do the handmaster exercises firstly with the rubberband between nail and first knuckle and secondly between first and second knuckle - I may strenghten the first knuckle. Hope you agree.

    Last question: what would be a safe training program with the handmaster? Did not see any of this on their website. Perhaps 3 times a day with 30 seconds max to start with for two weeks? After that 60 seconds 3 times a day?

    Thanks for your help,

    TonyD
     
  17. powerbass

    powerbass

    Nov 2, 2006
    western MA
    Here is a picture of the exercises I was trying to describe, notice the rubber band is around the last digit of my pinky finger, you can place it above any finger joint you want to exercise. As pictured I was doing flexion exercises as in closing my hand, turn the band/resistance around and you can do extension as well. Choose a band that has a reasonable resistance. Since you are trying to increase the stability of the joint you need more muscular endurance, so your exercises should be either performed very slowly or in an isometric (holding still) fashion. Do not exercise to full range as well, move in a smaller range. If you are only having trouble with one particular joint then I would isolate it with these exercises. The device you purchased is a total hand strengthener, you could also try the isometric, single joint exercises I am doing with a band. Yes, several exercise sessions per day for not more than 1-2 minutes should be enough. Follow up these exercises with a review of your technique - you need to play without the joint hyperextending.
     

    Attached Files:

    lowendrachel likes this.
  18. That's great help - thanks!

    What about the figure-8 ring or splint to prevent to finger from collapsing? Is this an option?

    In the meanwhile ofcourse strengthening is the way to go, but the sliver ring splint might be a temporary solution to prevent any injury.
     
  19. powerbass

    powerbass

    Nov 2, 2006
    western MA