Carpal tunnel Syndrome

Ergonomics and Posture for Classical Guitarists, Aches and Pains, Injuries, etc...
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Tomzooki
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Carpal tunnel Syndrome

Postby Tomzooki » Sat Jan 07, 2012 11:41 pm

I realized this afternoon I am developping carpal tunnel syndrome.... For several months I woke up at night with half my right or left hand completely numb, and this afternoon the thumb, the index and middle fingers of my RH got a little bit numb after 2-3 hours of practice ended by 30 minutes of tremolo........ :(

So I am asking your advices so that it does not worsen. First of all I must precise my RH is not tensed when I play, and I am currently working to get it even more relaxed. I never feel pain in my right hand or arm, even when playing tremolo. I understood I must take pauses when practicing (that will be hard...) and do stetches. I will buy wrist splints to wear at night; I tend to sleep with my wrists bended, and that is bad. I will apply Voltaren Emulgel 4 times a day (anti-inflammatory)

So now I am looking for some exercises and stretching program. Any ideas??
Benoît Raby, Engelmann sp/Ziricote
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Tomzooki
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Re: Carpal tunnel Syndrome

Postby Tomzooki » Mon Jan 09, 2012 2:06 am

Any ideas?? Last night I woke up twice because of my left hand being numb, and I noticed that my wrist was not bent.. :( . Today I bought splints to wear at night; I hope it will help
Benoît Raby, Engelmann sp/Ziricote
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Jose-Guitarra8a
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Re: Carpal tunnel Syndrome

Postby Jose-Guitarra8a » Mon Jan 09, 2012 2:18 am

Please, I suggest you see a doctor asap.
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Olarte
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Re: Carpal tunnel Syndrome

Postby Olarte » Mon Jan 09, 2012 2:26 am

Besides seeing a doctor ASAP, you should make sure you take frequent breaks during practice, no more than every 20 or 30 minutes. Get up walk around, shake your hands a bit, stretch etc.... Then after 5 minutes or more resume.

You will find that this will help you in the long run both physically, but also mentally and you will make better progress as you will concentrate more after each break.

Hoping for a speedy recovery,
Ivan
Instead of anticipating the goal, learn to enjoy the Journey for this is where we spend 99.9% of our time.
The Journey is the reward...

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Tomzooki
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Re: Carpal tunnel Syndrome

Postby Tomzooki » Mon Jan 09, 2012 2:41 pm

No need to see a doctor yet. I am currently studying in health science (pharmacy), so I have some medical notions and I have access to medical litterature. I am sure of my auto-diagnosis because the symptoms of carpial tunnel syndrome (CTS) are very typical: mostly nocturnal, numbness of the thumb, index, middle fingers, and the inner side of the fourth finger. At my stage most people would never think to see a doctor, thinking they simply cut the circulation of their hand while sleeping. And the first line treatment is to use splints at night.

I did some research, and found that CTS is a common trouble associated to hypothyroidism. Up to 30% of newly diagnosed hypothyroidic have CTS. I was diagnosed with hypothyroidism last fall........... I just hope that treating hypothyroidism will help to improve CTS..... Until now it does not seem so....
Benoît Raby, Engelmann sp/Ziricote
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Re: Carpal tunnel Syndrome

Postby lagartija » Mon Jan 09, 2012 2:55 pm

If you have access to health information, then you know that besides the night splints, doctors often treat the inflammation with NSAIDs. My husband is an avid white water kayaker and has a tendency to have carpal tunnel problems. He wears the night splints when he feels that numbness (indicating inflammation and resulting pressure on the nerves going through the tunnel) and that helps a lot. He has a reaction to the NSAIDs and does not use them. He uses DMSO ..... which never did a thing for me when I tried it for an elbow injury. :roll:
You can also use ice to reduce inflammation after you have played.

Visiting a doctor is a good idea rather than diagnosing yourself. They can give you the most recent information on ways to deal with it. The more things you can try, the more likely you will find something or a combination of things that will work for you.
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Tomzooki
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Re: Carpal tunnel Syndrome

Postby Tomzooki » Mon Jan 09, 2012 3:32 pm

lagartija wrote:If you have access to health information, then you know that besides the night splints, doctors often treat the inflammation with NSAIDs. My husband is an avid white water kayaker and has a tendency to have carpal tunnel problems. He wears the night splints when he feels that numbness (indicating inflammation and resulting pressure on the nerves going through the tunnel) and that helps a lot. He has a reaction to the NSAIDs and does not use them. He uses DMSO ..... which never did a thing for me when I tried it for an elbow injury. :roll:
You can also use ice to reduce inflammation after you have played.

Visiting a doctor is a good idea rather than diagnosing yourself. They can give you the most recent information on ways to deal with it. The more things you can try, the more likely you will find something or a combination of things that will work for you.


I am taking a pause right now :wink:

I will see my doctor somewhere in April. I have to be followed because of my newly diagnosed hypothyroidism, it is easy to treat but it can take some time to find the right dose of Synthroid. That **** of health issue is easy to diagnose, extremely easy to treat with no side effects or medication interactions, but until now I have experienced all the possible problems that come with it: always tired and sleeping all the time (resolved now), dry skin (also resolved), thin and friable nails (hope it may resolve), dark spot on my hands like an old lady (they are there, they may stay...) and now CTS. TABARNAK!!!!! (I tend to say F**K in real life, but as it will be sensured I use here a colorful Quebecish swear :wink: ) Here in Quebec it is hard to see a doctor quickly except if it is an emergency, and CTS is not an emergency. Beside that I have the chance to have a good doctor that follows me, it is better to talk about that with him than with another that will never see me again. Since 2 or 3 years there is possibility to go to semi-private doctors, it would be quick, but I would have to pay, I have no cash because I have to pay my new guitar and university, and anyway I prefer to see my own doctor that I appreciate a lot (it is a great compliment to him, as I tend to despise doctors)

The Voltaren Emulgel I use is a nice little thing. It is a topical NSAID in a gel form, so you have the effect of the Voltaren (or Naprosyn or others) in oral pill without the side effects. Studies have shown that in arthritis it is as effective as an orally taken NSAID :mrgreen: And it is sold over the counter. It is not avalaible in USA :( Often american travelers come to quebec pharmacies to stock themselves. Come here to say Bye bye! :mrgreen:
Benoît Raby, Engelmann sp/Ziricote
Yamaha GC-3A
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Tomzooki
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Re: Carpal tunnel Syndrome

Postby Tomzooki » Mon Jan 09, 2012 3:41 pm

And now I pay a particular attention on my RH technique. The numbness in my RH fingers that appeared Saturday did so after a 2-3 hours of practice, 30 min tremolo, but there was something else.

I have false nails, and it is hard to get a nice tone with them. The attack angle is very important, to have the less possible of the back of the nail that rub the strings. That Saturday I had found a RH position that was effective in that way, but that also resulted in a more bent wrist...........

So I tried to find something else, to get that attack angle while keeping my wrist in the same position given by the splints. It is going well, it changed the way I hold my guitar a little bit, and in a good way. For my LH My technique seems to be OK, to date I never felt numbness or tingling after having practice. But in the night it is my worst hand... To be followed....
Benoît Raby, Engelmann sp/Ziricote
Yamaha GC-3A
11-strings alto guitar by Heikki Rousu, sp/indonesian RW

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Re: Carpal tunnel Syndrome

Postby LVR » Mon Jan 09, 2012 4:10 pm

Hi Tomzooki.
I'll PM you about this.
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Olarte
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Re: Carpal tunnel Syndrome

Postby Olarte » Mon Jan 09, 2012 7:25 pm

30 mintues of anything, especially something as demanding as Tremolo is a direct path to health issues. Please consider rethinking your practice strategy.

Best of luck,
ivan
Instead of anticipating the goal, learn to enjoy the Journey for this is where we spend 99.9% of our time.
The Journey is the reward...

2007 - Antonio Loriente "Clarita" Cedar Top\Indian Rosewood - Ergoplay Troster, Hiscox Liteflite Pro II case

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Tomzooki
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Re: Carpal tunnel Syndrome

Postby Tomzooki » Mon Jan 09, 2012 7:51 pm

Olarte wrote:30 mintues of anything, especially something as demanding as Tremolo is a direct path to health issues. Please consider rethinking your practice strategy

Best of luck,
ivan


Already done, I force myself to take 5 minutes pauses each 30 min of practice. :D It is hard..... :roll: And as I said I also reconsider my technique. I told about the RH. For the LH I will work to use more of the arm strenght to push the strings into the fingerboard. I have to say that it works extremely well, strangely my LH is then more fluid, and my tone and projection with the RH is better. My overall posture too....

It goes well with my philosophia: most of the time physical problems are almost a benediction; it forces ourself to reconsider technique and improve it; it may help to climb steps we would not have climb otherwise. I just hope now that I am myself dealing with a real and potentially serious problem that my beliefs will stay true for me :?

Olarte wrote:30 mintues of anything, especially something as demanding as Tremolo is a direct path to health issues. Please consider rethinking your practice strategy

Best of luck,
ivan


In that case it was not the tremolo per se that induced the sympoms I felt that saturday, but the RH position I was working on while doing that tremolo. Tremolo normally does not cause me problem; it is no more than a simple arpegio, I worked it so that my brain (and my subconcious...) percieves it that way, and after a couple of weeks I quite succeed in that way. So now it is easy to do and enjoyable to play. Saturday I had worked the new RH position for one hour, half an hour on tremolo, then I felt my fingers tingling and get a little bit numb....... Of course that new position was thrown immediately to the garbages. Now my new-new RH position implies a strait wrist..... I will begin to check the "straighteness" of my left wrist too....
Benoît Raby, Engelmann sp/Ziricote
Yamaha GC-3A
11-strings alto guitar by Heikki Rousu, sp/indonesian RW

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Olarte
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Re: Carpal tunnel Syndrome

Postby Olarte » Tue Jan 10, 2012 12:26 am

I don't want to be a nag so this is the last post for me on this subject.

But I'm a barefoot runner, I log about 20-25 miles on road surfaces all barefoot. It sounds crazy right. Well There is a term in running TMTS (Too much too soon) and that's when you start barefoot running and do say a mile before you are ready. Well you end up injured. It took me a 6 months to go up to 2-3 miles and then within a year I went up to 10-15 mile runs then a full marathon within 2 years. In barefoot running you start with 100 yards at a time, and increase that weekly and in time you can run as long as you want.

My point is that even 30 minutes might be TMTS for you at this point. And the initial tingling is a clear sign that spells DANGER DANGER! At this point you need to back off completely until your right hand feels 100% ok, then slowly go back in very small increments.

The other point about a 30 minute practice session is that it becomes counter productive. Your mind\focus\body works like the standard bell curve. as you warm up, you focus, you learn you develop good technique but at some point you reach the top of the curve and the curve starts sliding back down. When this happens you start getting sloppy, unfocused, and injured. And worst than that you end up reinforcing bad technique and everything that is associated with the descent of the bell curve.

The trick is to learn where that apex of the curve is for you and then stop while all systems are working at their prime, before the eventual decay. For each person that apex will be different, and it will also change over time.

For me with music the apex seems to be between 20-30 minutes in general and for something like a difficult technique it might be as little as 10 or 15 minutes.

In any case, like barefoot running, playing\practicing guitar should never feel like work, never hurt, or stop being fun...

I apologize if I sound like a nag but I found that this works for me, and I wanted to give a non-musical example to show that this works for much more than just music.


Now I will get off my soapbox :oops:

I wish you a speedy recovery, and a lot of success in your Journey.

Ivan
Instead of anticipating the goal, learn to enjoy the Journey for this is where we spend 99.9% of our time.
The Journey is the reward...

2007 - Antonio Loriente "Clarita" Cedar Top\Indian Rosewood - Ergoplay Troster, Hiscox Liteflite Pro II case

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JQ.
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Re: Carpal tunnel Syndrome

Postby JQ. » Tue Jan 10, 2012 1:47 am

One contributing factor to CTS is computer use. You're here and posting, so obviously you use a PC. ;)

Use as light a touch as necessary to depress the keys, no more. I cringe whenever I hear someone "pounding" a keyboard. A split keyboard can help give you a more natural angle to type from. (I have a Goldtouch. The split as well as the height are fully adjustable.) Most laptop keyboards are too cramped for my comfort. If you use a laptop as your main PC, plug in a full-sized keyboard when you can. Not always doable when you're out and about, but you can at least do it at home. Never use the "kickstand" feature on keyboards where it raises the far side and forces you to type uphill.

Learn to use keyboard shortcuts whenever possible instead of a mouse. I use a Kensington Expert Mouse trackball. If I have to use a normal mouse, my hand will start hurting in short order.

One thing I tried that really seems to help is B6. Fluid buildup within the carpal tunnel can lead to pressure and inflamation and the B6 acts like a natural diuretic. It is a water soluable vitamin, so you can't overdose on it, any extra will just be excreted in your urine. I had read about this and supposedly it could take 6 weeks or more for it to really kick in, but I noticed a difference in about 2 weeks.

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Tomzooki
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Re: Carpal tunnel Syndrome

Postby Tomzooki » Tue Jan 10, 2012 3:26 am

:lol: I use a laptop, and a netbook at school. But I don't write so much.. I did hurt myself when I did a school work last fall, but something completely different and independant from TCS or the guitar. I was keeping my LH index up in the air...

@ Olarte: you are not a nag :wink: And you could be right. It depends on the context. I chose to stop each 30 minutes because after 30 minutes I am not tired yet. Tonight I did my pause after the first 30 minutes, but did not pause after that :oops: It is a hard.... And the other detail concerning me is that I feel nothing alarming when I practice, no alarm signals beside normal tiredness at the end of a practice session, no pain; the symptoms occur only at night. The only exception was saturday. But I appreciate your "naggism" because I could be denying some important details and it is good that some people shake my naivety :mrgreen:
Benoît Raby, Engelmann sp/Ziricote
Yamaha GC-3A
11-strings alto guitar by Heikki Rousu, sp/indonesian RW

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Tomzooki
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Re: Carpal tunnel Syndrome

Postby Tomzooki » Tue Jan 10, 2012 3:35 am

Olarte wrote:The trick is to learn where that apex of the curve is for you and then stop while all systems are working at their prime, before the eventual decay. For each person that apex will be different, and it will also change over time.


That is a very wise advice, and I should follow it. I always stop practicing when I really can't do nothing good anymore. It is not very bright...

Olarte wrote:In any case, like barefoot running, playing\practicing guitar should never feel like work, never hurt, or stop being fun...


You are so right....
Benoît Raby, Engelmann sp/Ziricote
Yamaha GC-3A
11-strings alto guitar by Heikki Rousu, sp/indonesian RW


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