I've just completed my third week of physical therapy, and have one week to go!!
My right arm/elbow/tendon is getting stronger (although I'm no where near full strength), and I have my left arm tendinitis back under control. I was released to play about 5 minutes at a time this week, and it felt great. I am sticking to four string only for the foreseeable future, so my two remaining 5ers will probably go on the block soon - they are way too nice to sit unplayed, and if someone else can benefit from them, all the better! In terms of playing, I need to very carefully monitor my technique, lighten up on my touch, and be certain that my wrists are as straight as I can keep them.
Next week is my final week of PT, and then I will be back to my surgeon on March 26th. At that point, I should be ready to build up my endurance and strength further. I don't think that I will ever let myself get to the point that I was at with pain ever again, and I know that I will be utilizing the exercises, stretches, and strengthening methods that I am now using for the rest of my playing life.
Fergie Fulton and I have been having a private e mail dialog about tendinitis, and I wanted to share a part of our ongoing discussion here:
Hi Ed,
hope i find you in good spirits and with no complications or difficulties?
Just a check in to see how your getting on. A few questions on your experience if your up to it?
Have you noticed and improvement?
Was it immediate or graduale?
Has it made a difference?
What advice where you given to avoid such injuries in future? (if any)
Has it been worth it in your situation.
Please add any other info you may think may be relevent
Thanks Ed and here's hoping your well into your recovery?
Fergie
Fergie –
Nothing happens in a straight line, that’s for sure!
I was in a cast for about I ½ weeks, and now I’m in the middle of my third week of physical therapy. Surprisingly, PT has not been one bit painful. Following removal of the cast and getting my arm straightened out, the pain relief was immediate, but not complete. This is due to the tendon needing to be re stretched, and letting what really is a pretty traumatic wound begin and go through the healing process. I was given Oxycondone for pain. I took this for a week, and haven’t touched it since. I would rather have any pain that’s left let me know what I’m doing wrong and right. It is a very reliable gauge!
I still have a very large mass of scar tissue directly on the bone where the tendon needed to be reattached. I don’t get pain as much as I still get simple irritation at that spot. This is because I need to re develop muscle there! It took 48 years to develop that muscle the first time, and an hour to cut it out. I’m doing my exercises and stretching every day as recommended, and using counterclockwise ice massage in the morning and at night. What really needs to happen is for me to build up my endurance in that arm again, and this will take time. I can play, but I need to be very mindful of my technique and pressure. No more digging in; a light touch, low action, and letting the amp do the work is now in order. Also, no more 5 string basses for the foreseeable future, and I’m using lighter strings as well – no more .135 B strings!
The best advice I can give to anyone is to simply LISTEN TO YOUR BODY. If you are experiencing even a little pain, it is there for a reason and you need to take immediate steps to alleviate it and to correct the root cause. Being macho or tough about it is the absolute height of stupidity (and I speak from experience!) Use proper technique. We as bassists need to treat our elbows the same way that a long distance runner or a soccer (football to you!) player treats their knees, or a pitcher in baseball treats their throwing shoulder. We all should take steps to warm up properly and get those muscles moving to get bloodflow and fresh oxygen into those critical areas. We need to constantly stretch and do strengthening exercises away from the instrument. We need to be cognizant of our posture. We all need to breathe correctly when we play, and not get tense. When we’re done with the gig, we need to ice those elbows down for a few minutes, whether you feel any pain or not!
Would I go through the surgery again? As of now, yes, but time will tell. In my case, the tendon was off the bone, and completely decayed. Surgery turned out to be my only course of action. Had I addressed it properly earlier, things may have turned out differently for me. Right now, I’m doing everything I can so that the next 30+ years of my playing career can happen!
I hope that this was helpful for you. Stay in touch!
Ed
Hi Ed, great stuff, one more set of questions about you comment
Had I addressed it properly earlier, things may have turned out differently for me
Do you now truly believe that statement?
Can you pinpoint a time in your past when you should have done something but did not?
If so how did you reason that "it would sort itself out, or its not that much of a problem if you know what i mean?
Great to hear your warming up and down and using ice. The exercises away from the bass are important as are hand positions. I have found a neutral position in all my research, that led me to the conclusion for having the thumbs of both hands pointing at the head stock when ever possible. In this position if you look at the palms the carpel tunnel area is flat and the "carpel tunnel" that is created by having your thumbs in front of the fingers is gone. Try it yourself with your Physio. Hold your hands up in front of you, palms facing you and touch your thumb off each of your fingers starting with the little one. notice how the carpel tunnel reduces as you get to the forefinger and completely dissapears when you point both thumbs out. If you now turn your picking hand over in the position you will notice that your thumbs do indeed point toward the head stock. It is having an opposible thumb that is the problem, and a lot of the research suggests, sort the thumb position rather than the hand positon for carpel tunnel related problems.
Something to think about as you begin to play again and please ask your physio for an opinion i would like to hear it.
take care and speedy recovery
Fergie
________________________________________
Fergie –
I truly believe that statement. Had I addressed the problem while it was small, it would have saved me all of this grief! My whole goal in letting everyone else in on my experience is so that maybe I can help others avoid my mistakes.
I probably ignored the problem for about a year while it got progressively worse gig by gig. I finally broke down and got the first of three cortisone shots, and this turned out to be a temporary solution at best. Following the first shot, my arm was fine for a number of months. Believe it or not, I reinjured the arm lifting a trash can outside of my house. I felt a “pop” at the joint, and got immediate pain. That is probably when the tendon pulled off of the bone. I then went through two more rounds of shots, to no avail, over the next 1 ½ to 2 years. My overall recommendation on cortisone is that if the first round doesn’t work, don’t bother with the other two, unless they are a condition of your insurance coverage to get to the next step. At best, cortisone is a cover up, not a cure, and can only fool you into thinking that you are OK. You still need to take the other precautions (ice, stretching, strengthening, warming up the right way, proper technique, etc.), which I did not do. My attitude was that I was tougher than the problem, and that it would sort itself out. Big mistake!!
Next week is my final week of physical therapy. This is going well, and they have given me plenty to think about and do on a daily basis. Following PT, I won’t have access to either the ultrasound treatments or the electronic “tens” stimulation, but the ice, stretching, and strengthening exercises that I’m doing should be enough until I meet with my surgeon again on March 26th.
I’ve started playing on a limited basis again, and I’m building this back up slowly. I won’t be back into full gig mode until May or June, but I will be able to finish the recording project that was started prior to my surgery commencing in March.
Thanks for the advice on hand positions. I’m going to try it out!
Stay in touch.
Ed
The reason that I have kept this thread alive is that tendinitis is a very real occupational hazard for musicians, and can be career ending in some instances. I simply want to share my experience with everyone here as a precaution as to what can happen to any of us if you let this problem go on too long without addressing it (are you listening, Bikeplate??) When you are younger, you heal a lot more quickly. When you are a little older, regardless of how you choose to fool yourself, your body loses a lot of its' former elasticity, and you become more prone to these injuries. Consequently, healing takes longer!
I will continue to post updates, as I believe that everyone here can benefit from my saga!
You too! I couldn't imagine playing any other position. Being me was a bit of a novelty, since there aren't a ton of lefties around in general and since I was very comfortable with both feet. My difficulty has always been that I wasn't a consistent player. (It wasn't a matter of will either.) But when I was on? Oh man. 
