Path: crcnis3.unl.edu!news.mid.net!newsfeed.internetmci.com!solaris.cc.vt.edu!news.bluesky.net!news.sprintlink.net!howland.reston.ans.net!news-e1a.megaweb.com!newstf01.news.aol.com!newsbf02.news.aol.com!not-for-mail From: dickschnei@aol.com (DickSchnei) Newsgroups: rec.music.makers.guitar.acoustic Subject: Re: Tendonitis strikes! (and sucks!) Date: 28 Jul 1995 20:57:33 -0400 Organization: America Online, Inc. (1-800-827-6364) Lines: 172 Sender: root@newsbf02.news.aol.com Message-ID: <3vc11t$58s@newsbf02.news.aol.com> Reply-To: dickschnei@aol.com (DickSchnei) There are many varieties of repetitive stress injury (RSI) of which tendonitis is one. The ultimate treatment(s) may differ depending upon what type of RSI a person suffers from. Knowing that, I will relate my experience and (knock on wood) somewhat successful recovery from a very painful bout with RSI about 18 months ago. I don't use a computer keyboard very much, so my injury was totally the result of playing the guitar. After not playing any guitar for more than 10 years, suddenly in 1993 I was stricken (once again) by the desire to become the next guitar great. I threw myself into the endeavor completely and just about every spare moment was spent practicing the fingerstyle ragtime and country blues that I love. I would play every day, usually for 2 - 3 hours and much more than that on weekends. That in itself isn't necessarily the cause of my problem, even coupled with the inevitable poor hand positions. I believe now that the most likely cause was my work ethic, which had me repeating over and over any difficult positions, stretches, etc. that I couldn't perform cleanly. Also, I know that I, like many players, tend to use far more pressure on the fingerboard than it actually necessary. After a couple of months I noticed that I had a frequent sharp pain in my left wrist, just below where the thumb joins the hand. I figured it was simply some strain from not using this part of my hand this way for so long, and that it would go away *once I had played long enough to toughen up the area*! Of course it slowly got worse, much worse, but I still felt that it would stop when I had played enough. Finally, when it had gotten so bad that I couldn't use that hand to turn a doorknob or brush my teeth or just about anything else (except play the guitar - for some reason I still was able to maintain my practice schedule, through the pain), I decided that I may have injured myself and went to see a doctor. Since this doctor is not a musician, the first thing I told him was that I was NOT going to stop playing the guitar, no matter how serious the problem. Once I get my interest up on something, I simply won't let anything interfere. Unfortunately, as this doctor is not a specialist in RSI, he went along with me and simply prescribed an anti-inflammatory to relieve the problem. The medicine seemed to alleviate the problem some, so I felt that I had solved the problem. However, as soon as the medicine ran out, the pain was even worse. I then decided that I needed to do some research on RSI. I read everything I could find on the subject, and finally went to a local specialist. I also told him that the guitar was my one passion and that I would not quit, for any length of time. He told me if I continued on the pattern that I had established, I could lose the normal use of my left hand and that it might not be reversible! This scared me, and as I felt that he really did understand my love for the guitar, I decided to do as he suggested. This has been a long lead-up to the actual remedies I used (and continue to use), but I feel that how I got into this situation may be as helpful as the information describing how I am now overcoming it. This doctor also prescribed an anti-inflammatory, but told me that it would not be very useful unless I quit playing the guitar (and doing anything else) with that hand for some time. He didn't know how long, but said that it would probably be at least 3-4 weeks before I noticed ANY improvement. He told me not to do anything with the hand that caused pain - that just about left everything out! He also wanted me to soak the hand many times every day. What he told me to do was use two water basins - the kitchen sink, if it is a dual basin sink is perfect. In one basin put very warm water, not hot enough to cause pain, but close. In the other basin put very cold water, using ice, as cold as I could stand. Then alternate soaking my wrist/hand in the two basins of water - first the cold, then the warm. He said to leave my hand in each basin for several minutes before switching, and to repeat this 5 or 6 times before stopping. He also said that it was important to use the warm basin last. He told me to do this as many times as possible during the day. As you can see, this can lead to a large investment in time, but as I was not able to play the guitar, I had plenty of spare time available :-). He also told me to VERY gently flex and stretch my hand while it was in the water, by closing my hand into a fist and then extending the fingers. He cautioned me to not over extend so that it caused pain. He told me to come back and see him when I felt that there was some noticeable improvement. I tried one other remedy, on my own, during the next several weeks. I went to the various computer stores and bought a brace (actually, I think that they are called splints). I looked until I found one that gave the injured area lots of support, but would still enable me to use the hand to play the guitar. I wore the brace almost the entire day, except for when I was soaking my hand. I have since found out that is not always a good idea, and a person should check with the doctor before using these. After about five weeks of total abstinence (from my guitar :-)), I went back to the doctor. He agreed that there was some improvement and said that I could begin to play the guitar on a very limited basis. Only a few minutes at a time, no stretches of any kind, and no using the thumb to wrap around and play the 6th string! He told me that anything that caused me discomfort should be stopped immediately! I was to continue the soaking regimen and every time after I finished playing I was to use an ice bag or cool pack on my wrist. Initially I was very exicited to be able to play again, but the limitation of only a few minutes at a time was actually more difficult to maintain then not playing at all. I used the brace when I played, as I felt that it precluded my getting into some of the stretches that might cause me problems. Actually, the brace allowed me to do more than I thought it would - I could maybe do 75% of the positions with it on. So I still had to be careful not to stretch too much even with the brace. I purchased another guitar at this time also - a late 50's Gibson LG-2 3/4 size. I felt that with the much shorter scale and narrow fingerboard I could maybe do more things without straining my hand. Besides, it gave me an excuse to use on my wife to justify buying another guitar! The guitar did help quite a lot, but there was no way that I could play complicated fingerstyle with my fairly large fingers, at least not cleanly. I had to maintain this pattern of playing and treatments for several months before I was able to begin to approach my normal playing style. I did slowly increase the length of my playing sessions, but never exceeded 15 minutes at a time (well, maybe a few times). I remember how excited I was, about a year ago, when my hand felt good enough to again play a full sized guitar on a regular basis. At the time, all of my guitars (other than the LG-2 3/4) were standard scale, and after playing one of them for more than a few minutes, my wrist ached a little and seemed weak. I bought a 1939 Martin OO18, with the shorter scale, and that slight difference seemed to really have a significant effect on how long I could play. I wish I would have realized this sooner - just think of all the wonderful short scale guitars that I could have told my wife I needed for therapeutic reasons! I continued to soak my hand, although not as often, and ice it down after I finished. I also continued to wear the brace whenever I played, perhaps as a mental crutch more than anything. I did discover that it was important, after I stopped wearing the brace all of the time, to continue to wear it at night while I slept. When I stopped using the brace, except for when I played the guitar, I noticed that my wrist seemed to ache when I woke up in the morning. I mentioned that to someone who had worn one for overuse on a computer, and she told me that at night we have no control over the position that we put our hands and arms in. She said that we often can get into positions in our sleep that can put strain on injured joints without our knowing it. Wearing the brace during the night prevents that from happening. I will mention one other device that I used, but really have no way of proving if it helped me at all. The black, fingerless gloves that I'm sure most of you have seen advertised in the various guitar periodicals. I can't remember what they are called, but the ad claims that they provide "relief" from tendonitis, carpal tunnel, etc. I ordered a pair (you can't get just one), since they are fairly inexpensive, with the hope that they might really work. They are a fairly tight woven stretchy material that does offer some support to the wrist and hand. Probably not enough to do much good, though, since they do not prevent you from any of the stretches or positions that can cause injury. However, I do think that they help, in that they trap heat and keep your wrist and hand very warm. Anyway, I wore one of these for many months, even under the brace while I was still wearing it. I only stopped using it a few months ago, because I was almost back to 100%. I don't do the alternating soaking anymore, but I do continue to ice down the wrist after I finish playing. I also make certain that I never hold a difficult position very long or repeat attempts to play a large stretch many times in succession. I am now able to play as long as I want and can make stretches that I never could even before I was hurt. I do make sure that I stop playing frequently and flex and clench and extend my fingers. However, I am not totally cured and probably will never be. My hand does ache after I play for more than an hour or so. I know that I don't have the overall strength in that hand and wrist that I did. However, I am very happy that this injury does not prevent me from picking up one of my guitars whenever I get the urge and that I can play it for as long as I want. Going through something like this does have positives - provided of course the end result is successful. I am now much more aware of the damage we can unwittingly do to ourselves. I tend to pay more attention to what my body is telling me, whether from sickness or simply aches and pains, and don't simply ignore them as normal. I certainly appreciate (and even enjoy) playing the guitar more now - it rarely gets frustrating, even when my efforts to play something seem to continually fail. Perhaps the greatest positive of all (my wife would disagree emphatically) is my introduction to vintage guitars from purchasing the Gibson and Martin I mentioned above. I have purchased a few others, and have no intention of stopping. My wife thinks that I have simply traded RSI for a different ailment. I'm sorry about the length of this narrative, but once I got started, I couldn't get stopped. There seemed to be so much to tell. Hopefully, someone will get some ideas from it that will help them. Dick Schneiders DickSchnei@aol.com