Repetitive strain injujury

Subject: Repetitive strain injujury
From: Les in Chorlton
Date: 22 May 13 - 09:42 AM

Given the nature of tune playing and maybe tune players, I am surprised that RSI is not more common than it is.

It seems to be lurking in my left hand. I play tenor banjo and whilst I welcome original and new banjo jokes I urge friends to leave the old ones out.

What causes RSI, yes I know repetition is part of the problem, and what prevents or cures it?

Subject: RE: Repetitive strain injujury
From: Leadfingers
Date: 22 May 13 - 10:17 AM

Could it be a dodgy hand / wrist position causing the problem ?

Subject: RE: Repetitive strain injujury
From: Highlandman
Date: 22 May 13 - 10:22 AM

You could try a regimen of exercises that utilize a greater range and variety of motion than what you normally use on the banjo. Start carefully, and if you can, limit your playing to give it a head start on healing. You may need a serious period of rest to begin.
I had a tendonitis in my left shoulder that kept me from holding bagpipes properly for a good six months. And it's so easy to let the frustration lead you to reinjure it.
Above all get after it now, before it becomes severe enough to need surgery.
Good luck
-Glenn

Subject: RE: Repetitive strain injujury
From: Les in Chorlton
Date: 22 May 13 - 10:40 AM

Thanks Glen, I am off to play snooker - does that count as alternative excersise?

Subject: RE: Repetitive strain injujury
From: Richard Bridge
Date: 22 May 13 - 11:18 AM

The repetitive "juju" cracked me up!

Subject: RE: Repetitive strain injujury
From: GUEST,alex s no cookie
Date: 22 May 13 - 11:48 AM

Glenn's advice is good. I had RSI from too much hammering on on the G banjo and had to learn to curb my natural tendency to do so. Ok now.

Subject: RE: Repetitive strain injujury
From: Bat Goddess
Date: 22 May 13 - 03:54 PM

What causes repetitive stress is when your playing posture or hand position(s) used in playing are forcing the body to do something it wasn't designed to do: poor posture, poor technique and overuse.

And repetitive stress was being diagnosed in musicians long time before in computer users. I first read about it -- and what was being done to treat it -- in Smithsonian magazine about 25 years ago.

A REALLY good book on the subject is Repetitive Strain Injury by Dr. Emil Pascarelli and Deborah Quilter. He was the subject of the Smithsonian article and the work he was doing was for musicians.

I've been through forearm tendonitis...not caused by poor posture (I was well taught) but by misplacement of the computer mouse which majorly stressed my right wrist. BTW, surgery usually leaves scar tissue which means therapy after surgery generally doesn't work. Also if you misuse your wrist (or whatever) after surgery, there's less likelihood of recovery from the strain.

Linn

Linn

Subject: RE: Repetitive strain injujury
From: Highlandman
Date: 22 May 13 - 05:17 PM

Agreed, like Bat says, you should have a look at your ergonomics too. But another common cause of RSI is too much working of a small portion of the range of motion, which was why I suggested range-extending exercises.
Les, you really do want to get this knocked without surgery -- necessary sometimes but the ultimate outcome is never as good as if you can avoid it. Like Bat Goddess said.
Richard! LOL! but the J and U keys are under his right hand.
-Glenn

Subject: RE: Repetitive strain injujury
From: GUEST
Date: 22 May 13 - 05:46 PM

http://www.rsi-therapy.com/statistics.htm

Subject: RE: Repetitive strain injujury
From: GUEST,leeneia
Date: 23 May 13 - 10:16 AM

"what prevents or cures it?"

I took a dance/exercise class from a nurse once. She used to holler, "If it hurts, quit!"

Is your banjo set up right, or do you have press hard to play it? If so, get it adjusted.

Don't get hypnotized. Switch instruments, take a rest.

See a doctor and get the right anti-inflammatory medicine for you. Could be as simple as an over-the-counter drug, but it needs to be the right one.

Subject: RE: Repetitive strain injujury
From: GUEST
Date: 23 May 13 - 11:45 AM

Better see a physiotherapist than a doctor, and take your instrument with you, and show them how you play! As Highlandman says, your ergonomics need to be looked at! I have met a couple of mandolin players who have had left-hand problems, and there is a tendency for some of them to sit hunched, even hump-backed, over the instrument, which leads to other stresses in the neck and shoulders, which in turn can lead to "referred pain" - I.e. pain felt in the more distant part of the nerve pathway, so although perhaps the cause us up in your neck somewhere, you actually feel it in your fingers. Also learn to be as relaxed as possible when playing as "strain" arises when muscles are consistently tense.

Subject: RE: Repetitive strain injujury
From: JohnInKansas
Date: 24 May 13 - 04:40 AM

Quite often what feels like a muscle strain, especially in the wrist and hand, is really due to a nerve problem. The best known "syndrome" is probably carpal tunnel syndrome, where there is a stress on the carpal nerve that controls finger movement.

The usual assumption is that the problem is that the nerve is pinched in or near the wrist, but the real cause can be clear back at the elbow or even further up. The tendons that "move the fingers" and wrist actually anchor near the elbow and that's where the "signals" get into the path to the fingers.

The carpal nerve gets past the elbow in the "notch" near the inside of the arm (close to the body) and a second very similar nerve called the "cubital nerve" goes through the smaller notch on the other side of the joint. It's not heard much, but you can have "cubital nerve syndrome" that's very similar to carpal syndrome.

Either of these nerves can be "stressed" in a number of ways that reduce the effectiveness of the nerve conduction, without producing much in the way of symptoms until you try to use the fingers they control a little more than usual. "Leaning on your elbow" at the computer can stress either nerve so that when you actually use the fingers to play, the fingers hurt, even though the elbow doesn't.

The carpal nerve mostly controls the thumb and first two fingers, while the cubital nerve controls the two little fingers and lateral motions of all the fingers, so "where it hurts" might give a clue where to try to apply remedies. (If you can't do the Vulcan salute, it's very likely due to a cubital nerve problem.)

There are lots of things that can cause a whole bunch of things that look like RSI. Many people find that fairly deep muscle massage is helpful, and massaging the muscles that hurt is probably a good idea. Extending the massage to the "whole arm" also sometimes helps, concentrating on where the tendons that move what hurts are connected, at least up to the elbow and maybe clear into the armpit.

In my case of a diagnosed cubital nerve problem I found a "massage vibrator" applied at elbow and armpit actually produced more significant effects than what I could do to relax the wrist and hand, but I must say this is NOT SOMETHING THE DOCTORS RECOMMENDED. A problem is that most "consumer vibrators" don't actually vibrate. The may "hum" but are pretty much worthless for actually affecting deep muscle tension. You can get similar results with manual massage, but it takes a lot more of it.

The whole point here is that the problem may not be just where the pain is, and there may be no pain at all where the real problem is. Explore all the attached parts and see if getting them all in good shape (relaxed and happy) helps your personal situation.

It's entirely possible that your pain is just from overuse of a few muscles, but a good massage makes everything feel better anyway.

John

Subject: RE: Repetitive strain injujury
From: gnu
Date: 24 May 13 - 06:21 AM

Good info all round. Mine was caused by an hour and a half of shovelling heavy (wet) snow immediately followed by an hour of Bodhran practice.

My cubital and carpal tunnel first "happened" at 16 when I worked in construction labour. Carrying and piling 22' long fresh sawn 2X14s, a concrete block in each hand, shovelling concrete in footing forms and so on. That went away after I returned to school.

My present cubital and carpel tunnel are a combination of too much time at the PC and the fact that my elbows are below the desktop and my keyboard are above it. JiK described my problems almost spot on but here's the odd part... I had no problems when I was 285# as the fat padded the nerves in the forearms and elbows. Losing over 100# meant the loss of my "protection". I was rather taken aback when I sought professional help and was told never to use an arm rest. Not even when sitting in my Lazy-Boy armchair. And, never to cross my legs... not even at the ankles.

The REAL eyeopener was when I was told by an ENT that RSI of the vocal cords, especially for an untrained singer who doesn't treat their voice properly, can lead to cancer. I was more than taken aback by that. Still sounds odd to me today but the doc oughta know eh?

Subject: RE: Repetitive strain injujury
From: GUEST,Lavengro
Date: 24 May 13 - 12:05 PM

I'm with John on this, you do need to get carpal tunnel syndrome etc. ruled out. I had some problems with fingers-tightening, numbness, pins and needles etc. turned out to be a nerve problem in my neck! You never know?

Hope you get it sorted soon.

Subject: RE: Repetitive strain injujury
From: gnu
Date: 24 May 13 - 04:35 PM

Indeed! I have often thought that the problems in my limbs were in the upper spine due to the distribution of the problems but such a diagnosis seems to elude even the most astute neurologists because, I assume, it's simply so difficult to pinpoint. Know what I mean, Verne?

BTW, if you have ever been thru the diagnostics... I think they get paid by the shock! SO MANY electrode stick ons and then electrode needles and they start off with very slight shocks and eventually get to "I think my foot is gonna fly off!" voltage. In about an hour, I was zapped at least four hundred times. I didn't even get a cut.

Subject: RE: Repetitive strain injujury
From: JohnInKansas
Date: 24 May 13 - 05:05 PM

The common tests can vary a lot depending on how good the equipment is. In my case, for the nerve conduction tests, the doc used a little bitty cattle prod that produced a shock that was a little startling at first, but not painful at all. He had "sensitive" pickups that didn't require a very big jolt.

Some others (different times, different docs) have had quite different descriptions. Tales they had told gave me some concern going into the test, but it wasn't a big deal when I got there.

If anything the X-Rays were more painful, since the doc ordered "all angles" and the techie twisted things around like she didn't know there was a body on the other end of the limb she was slinging around.

John