Carpal Tunnel Syndrome

Ergonomics and Posture for Classical Guitarists, Aches and Pains, Injuries, etc...
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Tonyyyyy
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Location: Sussex, UK

Post by Tonyyyyy » Mon Jan 22, 2007 1:58 pm

goodtone wrote: I wouldn't have a problem with adopting a begginers mind. Though I'm quite and experienced player I never have a closed mind when it comes to learning.

cheers
GT
Its a challenge - so many fixed ideas and physical patterns after those countless hours of playing.

I am really careful to only play about 10 minutes withut a break

I do some mental practice and do quite a bit of work on minimum pressure on the strings, and spreading rather than stretching into a chord. The gitano support seems to help.

The recent thread on hand exercises was useful
Robert Cross spruce 1986
Manuel Rodriguez model C, 7 string

goodtone
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Location: Surrey, England

Post by goodtone » Mon Jan 22, 2007 2:20 pm

thanks Tony. :)
I'm not saying I have a problem with tension particularly and already have a fairly good relaxed technique. But I keep reading about injurys and am careful not to overdo things. I'm just looking to go that extra mile and am looking for a structured way to improve my playing both musically and technically to see how far I can take it. I haven't decided what to do yet. All I know is I want a good teacher to help give me a bit of focus.
I'm and old dog but I'm sure I can learn some new tricks :)
cheers
GT

Mcat

yoga for carpal tunnel

Post by Mcat » Wed Jan 24, 2007 4:54 am

Before you get surgery look into yoga for cts. I found an article online about a year ago specifically related to cts. I have suffered from pinched nerves and numbness in my fingers and toes only to realize that my bad posture was pinching the nerves. With massage, stretching, and practicing better posture, I have eliminated these symptoms. Whenever I feel achy, I use a recording of Classical Stretch, which is on PBS. A combination of yoga, Tai Chi, classical ballet type movements are the basis of the exercise routines. The teacher is a former ballet dancer and she helps Olympic athletes in their training to remain limber and strong. You can look it up online to see if you have access to it on t.v.. I have avoided recommended surgery for t.m.j. by massaging my jaw muscles and tendons. (A chiropractor taught me how to do it a long time ago and I do it whenever I start gritting my teeth) I even avoided knee surgery once with proper conditioning. Good Luck. :D

Simon Booton-Mander

Post by Simon Booton-Mander » Wed Jan 24, 2007 1:06 pm

Drew;

I know this might sound too simple but you may help the situation by trying a guitar with a different neck profile. I have just posted a thread about this.

With my old guitar I was having quite severe pain in my left hand, wrist and elbow, and I thought I was going to have to knock it on the head because I could not play for more than 15 minutes at a time, now with a different profile of my CG neck, I am pain free.

My old CG had a very shallow profile which meant my hands were always cramped, now with a deeper profile they are always in a better position and I put less pressure on the fingerboard and back of the neck with my thumb.

Obviously this might be just good for me but it might just; (if nothing else) ease your pain.

NapalmCG

Post by NapalmCG » Wed Jan 24, 2007 9:25 pm

simple injection and its gone

Cheshire

Post by Cheshire » Wed Jan 24, 2007 11:52 pm

I've been managing carpal tunnel for about 5 years. Like others, I would recommend you avoid surgery if possible. I've known several people who have gotten the surgery. Only one has had completely positive results. The others all complained about permanent loss of strength -- one very extreme, the others less so. The pain went away for all of them, but I didn't want to sacrifice my strength and potentially my playing ability, personally.

My feeling is that if you pay constant attention to how your wrists are positioned and how they feel, then you will be able to adapt your behavior. I don't just mean when playing guitar, I mean all the time. For example, I remember seeing an interview with an old professional violin player once. In the middle of the interview the camera briefly focused on one of his hands because he was holding it perfectly straight, suspending in the air just an inch above the arm of the chair. In other words, he had trained himself to constantly keep his wrist straight and never put pressure on the bottom (the palm side), even to rest it.

The rubber band exercises on this page really helped me :

http://www.wellness.ma/health-condition ... ndrome.htm

The logic behind the rubber band exercise is that as you develop strength in the flexor muscles of your forearms (which control your fingers), they become bigger and push the bundle of nerves leading into your hand (your carpel tunnel) into a position that puts excess pressure on it. The solution in this case is to develop the opposing muscles of your forearms, your extensors. The rubber band exercise does this. Reverse curls using free weights do not really help, though, because when you do them you'll notice that you also use your flexor muscles to hold the weight.

You could also view this as an excellent opportunity to review and improve your playing style. Adapting your playing to reduce strain and minimize the amount of strength required can only be a good thing.

Also, I found that my sleeping positions were aggravating my condition. I had a tendency to rest my head on my wrist, or to tuck one of my hands underneath my chest. Putting pressure on your wrists is a no-no, so this was obviously something I had to remedy.

I hope you're laying off the guitar and/or keyboard completely for at least a few weeks. Doing just about anything will aggravate the pain when the insides of your wrists are still swollen.

Anyway, regardless of what you end up doing, good luck.

JQ.

Post by JQ. » Thu Jan 25, 2007 12:02 am

NapalmCG wrote:simple injection and its gone
Cortisone injections? They gave me one and I would never do it again. I immediately lost most of the strength in my hand and it took weeks for it to come back.

Azalais

Post by Azalais » Thu Jan 25, 2007 12:10 am

cortisone injections can also alter your perception of pain... which can lead to more damage... pain is a signal that something is wrong... never ignore it...

Simon Booton-Mander

Post by Simon Booton-Mander » Sat Jan 27, 2007 10:33 am

Here is a pic of the elastic band exercise for anyone who is not sure what to do. I use this for the only bit of slight pain I have left, which is in my left hand after practicing things with a lot of bar chords, like Sor's Op 35 No 22 in Bm study. It works wonders after only 2-3 minutes of gentle stretching, remember not to be too forceful.
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okdaysdays
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Joined: Tue Oct 17, 2006 3:12 am

Post by okdaysdays » Sun Jan 28, 2007 4:20 pm

time heals all wounds

Bentkey

Post by Bentkey » Sun Jan 28, 2007 4:57 pm

I'm just curious. In all the years I've played CG I've never experience any pain. But since I'm trying to get things back after a very long absense from the instrument and I'm a very impatient person by nature, I tend to push pretty hard. It's frustrating to not be able to do what you used to be able to do easily. So, since I'm not a youngster anymore I leave open the possibility that I COULD experience pain. So, my question for those that have experienced it is: How did your pain of CTS first manifest and if one experiences it, is it already too late? Or did you ignore it at first and therefore suffer the real injury of CTS? I guess I'm asking for warning signs.

Cheshire

Post by Cheshire » Sun Jan 28, 2007 6:31 pm

Bentkey wrote:I'm just curious. In all the years I've played CG I've never experience any pain. But since I'm trying to get things back after a very long absense from the instrument and I'm a very impatient person by nature, I tend to push pretty hard. It's frustrating to not be able to do what you used to be able to do easily. So, since I'm not a youngster anymore I leave open the possibility that I COULD experience pain. So, my question for those that have experienced it is: How did your pain of CTS first manifest and if one experiences it, is it already too late? Or did you ignore it at first and therefore suffer the real injury of CTS? I guess I'm asking for warning signs.
This page lists the warning signs : http://www.arthritis.ca/types%20of%20ar ... lt.asp?s=1

For myself the first symptom was tingly numbness at night. The tingly numbness gradually became more frequent. I started to use the rubber band technique and that held it at bay for years. Sometimes I would slack off and the numbness would return, and then I would do the rubber band thing and it would go away. At some point, when I was playing a lot and typing most of the day, I started getting some very serious pain any time I would play. It would linger afterwards. I would always wake up with numb hands. The rubber band thing didn't help any more. This is when I really started to re-evaluate my posture both at the keyboard and at the guitar. But first I had to stop playing for at least a month and only use my right hand at work. The posture adjustment made all the difference. In the same way that you might always be making slight changes to the way you play a piece, constantly making it better, I do the same thing now with my posture/hand positioning. It's always getting better.

Um. So, short answer : tingly numbness, never too late.

kfisherx

Post by kfisherx » Sun Jan 28, 2007 7:47 pm

Cheshire.... Your post is right on and shows of yet another person who is cured of this as opposed to managing it with all the "bandaid-type" answers. Perf, you and I all cured this once and for all by evaluting the root cause of the problem and fixing it. I actually know many others who have done the same thing. In all of our cases the root cause is really about how you are playing and using your body. I've no doubt that Vitamin B, rubber bands, exercise, and a number of other things all help or mask the problem but without dealing with the root cause this issue will continue to plague anyone who comes upon it. Once you deal with the root cause of this issue then you can play without pain for as long as you want. From what I can tell in communicating with people over the past 4 years this is a pretty prevelant issue in CG with very little understanding of how to root cause and fix it. It is especially prevelant in adult beginners who are fairly motivated and jumping in with both feet (so to speak). :)

Bentkey

Post by Bentkey » Sun Jan 28, 2007 8:05 pm

Thanks Cheshire, that is good info. Now I can stay alert for the symtoms should they ever start to rear their ugly little heads.

JQ.

Post by JQ. » Sun Jan 28, 2007 8:37 pm

Bentkey wrote:So, my question for those that have experienced it is: How did your pain of CTS first manifest and if one experiences it, is it already too late?
There were little things not related to playing guitar, like spilling tea because my hand was too weak to hold the cup (I thought I was just a klutz) and using a stapler in my hand and having a shooting pain go down from my elbow. But the clincher that made me decide to see a doctor was when I was introduced to a bodybuilder type and he gave me one of those firm, macho man type handshakes. I nearly screamed in pain.

I have heard of some CGers who refuse to shake hands. It may seem rude, but I really don't blame them. There is a way to shake hands daintily by grabbing only the other person's fingers and not allowing them to get a grip on your hand itself. It's rather wussy, and you can get away with it if you're a woman. When I would have to go to meetings where I knew I'd be expected to shake hands with a lot of people, I would wear a brace on my right hand. Most people know better than to give you a death grip if they see your hand is in a brace.

I believe my CTS/RSI was a result of too many 12 hour days spent doing nothing but desktop publishing and not from playing guitar (heck, I rarely had any time to play then). Computer keyboards can be dangerous. I've learned to use as light a touch as is necessary to depress the keys, to not be a speed demon and to take lots of breaks. Nothing makes me cringe like seeing someone really "pound" a keyboard.

I also found that a trackball is much easier on my hands than a regular mouse. Been using a 4-button Kensington for years, currently using their optical "Expert Mouse". Not cheap, but well worth it IMO. The ball is large... you just place your fingers on it with no gripping and you use your thumb for the main click. The buttons are programmable and chordable. Mine are set for left click, right click, double click and drag lock. If you have pets, beware. Trackballs contain powerful cat hair magnets and need to be cleaned now and then. :shock:

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