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RSI for 2 years? It needs to go away...

GUEST,Mr. Dime 28 Dec 07 - 09:38 PM
Beer 28 Dec 07 - 09:59 PM
GUEST,Guest 28 Dec 07 - 10:07 PM
Richard Bridge 28 Dec 07 - 10:20 PM
GUEST,pattyClink 28 Dec 07 - 10:35 PM
wysiwyg 28 Dec 07 - 10:44 PM
GUEST,Louise 28 Dec 07 - 11:45 PM
GUEST 29 Dec 07 - 01:58 AM
chazkratz 29 Dec 07 - 04:11 AM
Richard Bridge 29 Dec 07 - 04:12 AM
autolycus 29 Dec 07 - 04:47 AM
peregrina 29 Dec 07 - 05:14 AM
Linda Kelly 29 Dec 07 - 05:27 AM
Jeri 29 Dec 07 - 10:23 AM
jacqui.c 29 Dec 07 - 10:42 AM
Beer 29 Dec 07 - 11:59 AM
JohnInKansas 29 Dec 07 - 02:45 PM
Stringsinger 29 Dec 07 - 03:08 PM
Waddon Pete 29 Dec 07 - 03:19 PM
Bonecruncher 29 Dec 07 - 09:15 PM
MrDime 29 Dec 07 - 11:42 PM
Bonnie Shaljean 30 Dec 07 - 06:57 AM
The Fooles Troupe 30 Dec 07 - 09:32 AM
Richard Bridge 30 Dec 07 - 12:06 PM
Lowden Jameswright 30 Dec 07 - 01:34 PM
Bonnie Shaljean 30 Dec 07 - 01:48 PM
MrDime 30 Dec 07 - 11:47 PM
Bonecruncher 31 Dec 07 - 12:09 AM
Rumncoke 31 Dec 07 - 05:39 PM
wysiwyg 31 Dec 07 - 05:50 PM
MrDime 31 Dec 07 - 08:42 PM
MrDime 09 Jan 08 - 06:10 PM
Richard Bridge 09 Jan 08 - 09:02 PM
Bonecruncher 11 Jan 08 - 08:21 PM
Bonecruncher 11 Jan 08 - 08:50 PM
Waddon Pete 20 Feb 08 - 06:20 AM
Bonnie Shaljean 20 Feb 08 - 07:04 AM
Bat Goddess 20 Feb 08 - 11:21 AM
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Subject: Tendinitis for 2 years? It needs to go away...
From: GUEST,Mr. Dime
Date: 28 Dec 07 - 09:38 PM

My questions come from 2 years of having to deal with general daily limitations due to tendinitis/RSI. I am now 20 years old, but my initial diagnosis of tendinitis happened when I was 18. I used to be a very active guitar player throughout high school, playing in bands both in school and outside of school at parties and such. I was proficient with the instrument and played A LOT. A lot meaning 8+ hours a day, every day. I had to give up playing after the pain in my forearms and elbows became too much. In each arm I experienced sharp pains in the tendons that extend down from the palm side of my hands and pain in my elbows also. It got to the point where I drove my car mostly by holding the wheel steady with my knees and I couldn't extend my arms fully.

To remedy this I took ibuprofen and wore tennis elbow straps on my elbows almost all the time. I iced my forearms three or four times a day.

After 3 months I was cleared to start playing again by a physical therpist and he said to play through whatever pain I experienced, to a point at least, and to start slow.

After my injuries 'healed,' noticeable scar tissue built up in places on tendons in the form of somewhat-hard bumps and my right elbow (picking hand side, lots of up and down motions) does not extend straight very comfortably. The elbow often pops and feels like its rolling over a bunch of, well, junk. I played guitar on an off for awhile, but never anything close to what I did in high school.

For the first time in 2 years, last month I made an effort to fully start playing again. So I started practicing again, only for about an hour a day, but the last time I played I had to stop because of discomfort in my right elbow and painful contractions in my left forearms on the palm side. This was probably my tenth time playing in 2 weeks time. I had felt just fine all the other times I'd played before, and I was told by a doctor to work back into it slowly, so I Iimited myself to about an hour at a time playing wise. But the pain came back anyways!

I have been careful to not play through the pain like I did before, but I want to know what I can do to make it go away for good. I recently saw a doctor who said there is nothing surgically that can be done, but if I rest, it will go away. I rested for two years! So he gave me two braces to wear at night that keep my wrists straight, and I also use the tennis elbow strap for my right elbow. He said to take 600mg of Ibuprofen twice a day. I've been using an excercise device called a 'dyna-flex' that provides gyro propelled, low resistence forearm workout. I've also been working another thing called 'therapuddy' or something close to that, and I just work it with my hands, trying to build up the strength in those muscles again. The other thing I use to excercise my fingers with is one of the old school, black handled things you just squeeze together. (Looks like two handle bars, hard to explain though sorry) These workouts rarely yield any pain at all which is a good sign, but playing guitar is a different story. It's important to mention that I started to do these workouts AFTER I felt I needed to stop playing again last week.

I've researched a little bit and I've heard good things about glucosamine with chondroitin and MSM for things like this.

So, given this information, with the wrist braces, the tennis elbow straps, the forearm/finger workouts, the ibuprofen, the other supplements, and general rest, what else can I do to help to heal my forearms, elbows, and tendons? Playing guitar is a huge passion in my life I don't want to give up, but I feel like I may have to sometimes.

The thing that keeps my head up is that the Doctor I saw said that it will go away, but what else can I do?


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Subject: RE: RSI for 2 years? It needs to go away...
From: Beer
Date: 28 Dec 07 - 09:59 PM

This thread may be a bit slow as a lot of folks are out doing their festive thing but have no fear you will get some great responses.
I'm no Doctor and I'm not sure that is what you need anyway. The 600 mg twice a day is a lot but being only 20 (and I don't mean that in any derogatory way)I guess your body can take it. However watch out for nose bleeds. But man at your age you need some real good advice and in what I'm reading I don't think your getting it.
I would try and get to a specialist in Neurology (I think). Your to young to get the wrong treatment. Good luck and hopefully some of our great Catters will be on soon to help you out.
Beer (adrien)


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Subject: RE: RSI for 2 years? It needs to go away...
From: GUEST,Guest
Date: 28 Dec 07 - 10:07 PM

I had very bad tendonitus in my elbow. I could not pick up a cup of coffee without pain. I tried the braces, creme, heat etc. Then the Dr. gave me a cortisone shot in the elbow joint. It was very uncomfortable and it hurt like the dickens that night. But inside of a month I had no more pain. That was 20 years ago. It sure worked for me. Maybe it will work for you.


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Subject: RE: RSI for 2 years? It needs to go away...
From: Richard Bridge
Date: 28 Dec 07 - 10:20 PM

I'm suspicious about the advice you are getting. I would expect it to be causing further damage. But I am not a doctor, much less one expert in this field. I have however had "tennis elbow" which is a form of tendonitus, and I needed expertly located steroid injections, and rest, and I also need to take constant care and NEVER ignore warning twinges.

You may need to alter your technique to put less stress on the affected parts. The "low-slung" guitar positioning favoured by electric guitarists results in chord-work being played more from the right elbow than by side-to-side sweeps of the right wrist, and excesive flexure of the left wrist. Try a guitar position more like a classical guitarist, and try "thumby" barre chords, although if you are a speed metal player they will slow your changes down. If you want to play metal power chords, dropD tuning may with a bit of re-arranging assist in taking pressure off the left wrist.

I infer you are in the USA, so getting affordable expert advice may be difficult, but you NEED to see a real medical expert, in a perfect world one who understands the guitar and how it is played.

I'm sure we used to have some players on here who had sufered RSI in the right shoulder and elbow and wrist, and actually had special-shaped guitars made to reduce the stress on those parts - but this was because they had been reaching round deep dreadnaughts, which won't be your problem.

If you can live with the types of music to which it will take you (largely folk and country) try mandolin in stead of guitar.


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Subject: RE: RSI for 2 years? It needs to go away...
From: GUEST,pattyClink
Date: 28 Dec 07 - 10:35 PM

Since you've literally developed bumps and scar tissue, and have pains when you play, it's very possible you hold your hands in positions that knock your bones slightly out of alignment.   I've had two episodes where I let a knee or ankle get a few degrees out of alignment and suffered miserable pain for months, despite medical 'care' which did not realize it was out of alignment. Coaxing it back into proper alignment and keeping it trained to stay there fixed it. I have heard there are specialists who can analyze you and tell you what's out of whack and what's got to be done, but I haven't the slightest idea what they call them. You might wind up having to relearn your technique altogether.

I can't agree with the mandolin option, I've suffered with a lot of finger inflammation from the tremendous force you have to exert on those little strings, and besides, you're still wrapping your wrist around something in a fairly unnatural manner.
Any interest in the keyboards or other more playable instruments?


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Subject: RE: RSI for 2 years? It needs to go away...
From: wysiwyg
Date: 28 Dec 07 - 10:44 PM

I would check in with a sports med orthopod for a second opinion.

I would do all I can to rebuild the adrenal system that has been pumping out cortisol to help try to heal this all along. If you join here, PM me and I can give you an adrenal-rebuilding program that has helped others with chronic inflammatory conditions, including myself.

I would try aquatic therapy for rehab. In a warm or cool pool as the physical therapist recommends. I can recommend an illustrated textbook that is quite affordable.

I would explore the remedies for fibromyalgia, not because you have that, but because there are some deep-sleep recovery strategies in that area that might assist you to recover more completely. The textbook mentioned in the preceding paragraph has what I consider a lengthy, and IMO the BEST section on FM explanation (and explanations of treatment strategies and how they work) anywhere.

I would consult with a really experienced guitar teacher-- the best you can find and afford-- to see whether you can modify your playing technique adequately to continue using guitar for your main instrument. People here with MS have gone the whole 9 yards in playing in a different way as their MS advanced. For some, slide guitar has proven satisfying. Others have not been able to continue fingerstyle and have gone to strumming. In addition, member Don Meixner has played through injuries, consulted with others playing despite injuries/permanent diabilities, and on modifying instruments to allow people to continue playing music.

I would start on another instrument ASAP that does NOT aggravate the RSI at all so that you can continue healing the RSI and still be making music.

I would explore-- and this will hurt like a sonofabitch-- whether you may need to put the guitar away for good because you love music SO MUCH that you cannot stop making it, even if that means making it with a different instrument for the rest of your life.

Best of luck!

~Susan


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Subject: RE: RSI for 2 years? It needs to go away...
From: GUEST,Louise
Date: 28 Dec 07 - 11:45 PM

Putting together my 38 years of nursing experience and common sense, I suggest that avoiding repetitive strain injuries means avoiding the *repetitive* strain. I believe that an occupational therapist or physical therapist who is willing to watch how you position your hands and arms to play your guitar might be able to suggest alternate ways to hold the instrument or position your hands and arms to decrease the strain. You may need to shift your hand/arm positions around, that is, not use exactly the same positions for the same chords all the time, use different guitars, learn to relax muscles and joints when you're not actively using them, and do your playing in short sessions with stretching and relaxing exercises in between. Best of luck.


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Subject: RE: RSI for 2 years? It needs to go away...
From: GUEST
Date: 29 Dec 07 - 01:58 AM

Wow I had no idea I would get this kind of information right away. You all are by far the most helpful bunch I've run across so far.

Anyways, to elaborate more based off of what you've all said...

So I sat down with my guitar just to see how I've come to hold it out of habit while playing. My left wrist while fretting, depending on where on the neck I was, varied greatly in it's inclination. Unless I was up on the 15+ frets on the lighter strings (G B & E) my wrist in conjunction to my arm usually formed anywhere from a 45 degree angle to a near 90 degree angle depending on how low on the neck I was.

I watched some videos on youtube of some prominent guitarists and NONE of them held their guitars like this. For a reason? Obviously. Upon further review, I noticed that many of them held their picks with their thumb and the SIDE of their index finger, not point of finger to thumb like I do. The picking motion is dramatically different as well as the way professional musicians that I studied hold their fretting hands. I hope I'm on to something and nearly all of you mentioned analyzing my technique. Maybe I shouldn't have skipped the teacher when I first started :)

More specifics on me. I'm in college and still under my dad's medical insurance so afforable medical treatment isn't an issue. I am from the US though, you are right. I play mostly metal type music though the acoustic works for the girlfriend so I usually spend time with lighter music too :) I use heavy picks, ones that don't give at all. Do you you think it would do me some good to play with thinner ones that flex a little? Funny thing about the piano/keys is that my mom moved a keyboard into my room for storage between the time I left for school in july and now when I've come home for break. I disregarded it because of my current state but I'll check it out tonight. Must have been a sign I guess.

As for cortisone shots...I'll have to look into it I've heard good things many times.

On january 2nd I'll be seeing a chiropractor that specializes in sports medicine. He treated me before with ultrasound and these electric pulse things. He's the one who said to play through the pain gently. I'll have to ask him about cortisone shots and see if he can examine if the bones in my wrists are alligned properlly.

No one commented on glucosamine and company, any thoughts on that?


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Subject: RE: RSI for 2 years? It needs to go away...
From: chazkratz
Date: 29 Dec 07 - 04:11 AM

I've been taking glucosamine/MSM or for several years--I suffered from an arthritic hip and started the glucosamine when my veterinarian recommended it for my old labrador--when he passed, I started using what was left of his glucosamine and what was near-crippling pain subsided almost totally. Most of the time I have no pain at all, but sometimes I still have a bit--kind of a ghost pain seeming to tell me I have to keep taking the stuff. I started taking it when I was almost 70; I'm now 75 and walk without pain, except sometimes in my feet.

I don't recall hearing of glucosamine being recommended for repetitive stress, but it's probably worth a try and is relatively inexpensive.

Charles


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Subject: RE: RSI for 2 years? It needs to go away...
From: Richard Bridge
Date: 29 Dec 07 - 04:12 AM

I believe glucosamine can alleviate arthritic pain - but at the moment you need to address the problem not alleviate the pain because if you alleviate the pain and play on you are probably doing more damage. It may be good if you can resist the urge to play!

I have had ultrasound and electric pulse thingies both for back problems and for the tennis elbow. I don't think they did any good for those, although they may be useful for muscular problems.

Get your doctor to refer you to an appropriate and expert specialist ASAP. Do not let the GP give you the hydrocortisone (or other steroids, I think there are new ones now, too)injections. Go to the real expert straight away, you can only have so many steroid injections into a tendon without weakening the tendon - although the better experts can find ways to give more injections than the less expert. The man who came close to fixing my elbow (I still have to take care of it) was a Dr Goodwill just off Harley Street but luckily I was insured.

You need to get to that expert while your insurance can still cover you for at least a couple of years, it will probably not be a "one shot" cure.

If and when he says you can play, get the neck of the guitar up like a classical guitarist and reduce that left wrist angle (which is why I suggested the mandolin in that the neck is so narrow that you don't have to reach right round like on a guitar). Try the "Bert Weedon" plectrum grip and aim to play larger plectrum movements moving the right wrist side to side and the smaller ones by rotating it - avoiding many of the tendon movements for the right hand fingers - but don't sweep from the elbow or you will put the problem back into the elbow joint.


You could also try singing - it gets very satisfying sometimes - but again avoid overstressing the voice (and about the worst overstress for the voice is the "old-school" metal growl)


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Subject: RE: RSI for 2 years? It needs to go away...
From: autolycus
Date: 29 Dec 07 - 04:47 AM

Another approach from a very different direction is the psychological one.

We do live in societies that treat body and mind as tho' rhey were totally separate from each other - that's an assumption.

Then the mind treats the body like a machine to be fixed - the assumption continues.

If that approach appeals to you, have a look at something like Debbie Shapiro's "You Body Speaks Your Mind, Understand How Your Thoughts and Emotions Affect your Health".(There are no doubt others).


Another non-drug route that's more bodily is via diet. For all forms of inflammation, like tendonitis, oily fish, fresh fruir-'n'-ved (i.e. not cooked), and plenty of liquids, especially water neat, are all recommended, in books like The Daily Telegraph.s Food Medicine by Suzannah Olivier, a nutritional therapist.


Those two approaches are liable not to have dubious side-effects, as can be got from drugs.

Best wishes


   Ivor


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Subject: RE: RSI for 2 years? It needs to go away...
From: peregrina
Date: 29 Dec 07 - 05:14 AM

It might be worth trying some Alexander technique lessons when you are trying to find a way to play without causing the RSI.

Although you can read about it, my experience has been that what you gain from having a teacher cannot be put into words (or acquired from reading).


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Subject: RE: RSI for 2 years? It needs to go away...
From: Linda Kelly
Date: 29 Dec 07 - 05:27 AM

I have the same symptoms you describe in my right elbow, and sadly the only way I alleviate them is by having a special keyboard at work which allows me to use my right arm a little less and by strapping it up when it becomes too bad - I am not able to straighten it at all - rest is best as far as I have been concerned.


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Subject: RE: RSI for 2 years? It needs to go away...
From: Jeri
Date: 29 Dec 07 - 10:23 AM

If you do something that causes pain is going to cause more pain if you keep doing it. 'Playing through the pain' works if your pain is in muscles and they have a chance to heal. Bones and joints don't get better though, just worse.

Find out what motion causes the irritation. Constant flexion usually is the culprit, but it seems you've figured that out. Keep joints as straight but relaxed as possible and move economically. Consulting a sports medicine specialist or another professional knowledgeable about medical ergonomics is a good idea.


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Subject: RE: RSI for 2 years? It needs to go away...
From: jacqui.c
Date: 29 Dec 07 - 10:42 AM

Be aware that glucosamine can, for a small number of people, have rather serious side effects.

I started using it and, within 3-4 days was freezing cold and suicidally depressed. Stopped the medication - it all went away. Tried again some month's later and back came the symptoms. I've never found this mentioned on the packs so, as with all new meds, try to be aware of any physical or mental changes when you start taking something.


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Subject: RE: RSI for 2 years? It needs to go away...
From: Beer
Date: 29 Dec 07 - 11:59 AM

I used glucosamine for about 10 months and found it to be a complete waste of money. However, others have great results.


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Subject: RE: RSI for 2 years? It needs to go away...
From: JohnInKansas
Date: 29 Dec 07 - 02:45 PM

There have been a few places who have specifically specialized in "occupational injuries suffered by musicians." These can be very difficult to dig out, but a sparse few public reports have indicated some successes, and at least a place of this kind would recognize the relationships between your injuries and your music.

You may be able to find something with Google, but if your town - or a nearby one - has a symphony orchestra or if a local/nearby university has a fairly large music department, they might reply to a personal request for help directed to a specific person that you can identify. Deans of music departments, Concert Masters (first violins) or Conductors at symphonies, may know who in their music circles has similar problems and has found good/helpful therapy.

Be BOLD (but be polite). Find out who might know something specific to your problem, and ask them directly. The worst they can do is ignore you.

John


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Subject: RE: RSI for 2 years? It needs to go away...
From: Stringsinger
Date: 29 Dec 07 - 03:08 PM

Lifestyle and eating habits may play an important role. Also an appropriate type of excercise helps the muscles loosen and the blood flow to the right places.

This is often ignored even by doctors who will sometimes favor a drug-route. For some,
dairy products produce a negative effect. I doubt that a regimen of chemical intake will do much good over a period of time.

Alexander Technique stresses relaxation and coordination as Peregrina has so wisely advised.

A balance of all the above factors is better than trying to find a specific cure-all.

Frank Hamilton


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Subject: RE: RSI for 2 years? It needs to go away...
From: Waddon Pete
Date: 29 Dec 07 - 03:19 PM

Hello,

Just two additions for you.

I realise you are in the US of A, but others with a similar problem may come accross this thread, and find it useful as well. Have a look at www.bapam.org.uk. It may be some help.

Glucosamine is fine but don't bother with the additions some firms mix with it (e.g. chondroitin) says my osteopath!

Good kuck,

Best wishes,

Peter


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Subject: RE: RSI for 2 years? It needs to go away...
From: Bonecruncher
Date: 29 Dec 07 - 09:15 PM

Hello Guest
I am an Osteopath in the UK, the same as your Chiropractors, and as part of my work I treat injuries which occur at a number of Folk Festivals. The major part of the diagnosis is to understand WHAT causes the injury.

Much of the advice given above is excellent.

In particular, Richard Bridge has made comment that is particularly relevant, about the style of music you play and the "fashion" for holding a guitar in a particular manner.
Just because Joe Soap, who has very lax ligaments in his joints, holds an instrument in a peculiar way does not mean that the same method will work for others.

Glucosamine, a sugar amino-acid, helps form the "network" of strands covering the joint surfaces of bones. Chondroitin is the cartilage itself, which is then laid down upon that network. The two substances are symbiotic and must be used together, which is why manufacturers package them together. To take one without the other is tantamount to useless. As Jacqui c. states above, a very few people may have side-effects, but not as many as have gastric bleeding from the use of Ibuprofen and other over-the-counter non-steroidal anti-inflammatory drugs and other analgaesics.

I have to admit that I know little about the type of music you play and the terminology that Richard Bridge uses is foreign to me.
However, any patient that came to me with a condition such as you describe would be told to lock his guitar away for a few weeks while I found for him a practitioner with the expertise to help them.

While a Chiropractor specialising in sports therapy might have given you instructions within his own knowledge, I would suggest that you hunt around for another practitioner with knowledge more pertinent to your own problem - a guitar-playing Osteopath or Chiropractor.

In all cases, rehabilitation includes rest, then gently repeating the movements causing the pain, just up to where pain can be felt. Then put away the instrument for several hours, at least. From what you say inyour posts I would suggest that one hour is far too long for a single session. Several sessions per day of no more than 30 minutes each, with a three-hour rest between, would be my recommendation. As time passes and provided there is no further pain the sessions could be extended for fifteen minutes each.

Pain is the body's warning system that something is wrong or is in danger of being damaged. "No pain, no gain" is a saying that says much about the lack of knowledge of the individual uttering it.

I would also suggest that you take lessons from another guitarist, concentrating on your technique, where you state that your own observations show that it could, perhaps, be improved so that you are holding the instrument in a more relaxed manner.

Hope that I have helped in your quest to heal yourself. If you have any comments please come back to me.

Colyn.


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Subject: RE: RSI for 2 years? It needs to go away...
From: MrDime
Date: 29 Dec 07 - 11:42 PM

I have made some notes to take to my doctor based on the information you all have taken the time to provide me with. I appreciate the input. Nothing too dire, yet stern in it's own right which is something that I've been needing to hear. Something more than "It'll go away eventually," anyways.

So thank you all, I wish you luck in the new year.


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Subject: RE: RSI for 2 years? It needs to go away...
From: Bonnie Shaljean
Date: 30 Dec 07 - 06:57 AM

I'm so glad to see you've joined us as a member, Mr Dime - welcome to Mudcat! I can't say anything that hasn't already been said above, but one thing bears repeating, even shouting:

Do not, DO NOT, DO NOT "PLAY THROUGH THE PAIN". Not with tendons. EVER.

Your condition has been caused by wear. The only thing that will help is to refrain from doing the thing that is causing (i.e. aggravating) the wear, and give the affected areas TIME to heal. You need to ease yourself back into it, but only when your body is ready to. And please alter your wrist position! I'm a harpist and pianist, not a doctor or a guitarist, but I know that with harp and keyboard technique (and a classical violinist in the music school where I teach said a similar thing applies to her instrument) you keep the wrist AS LEVEL AND STRAIGHT AS POSSIBLE.

I dabble a bit in guitar and bought some classical-technique books, and all the how-to-do-it-properly pictures & diagrams show the fingerboard being held at a higher, more oblique angle to the floor (far less parallel, instrument propped on the raised left knee) and the thumb NOT wrapped around the fingerboard but supporting the back of it - allowing the wrist to remain as straight as it can. (See blue link below)

When you use fingers with a severely bent wrist, you are making the tendons pass over a constrained stress point which is causing them to wear against the casing. It's no co-incidence that all the instrumental techniques I know of emphasise the level wrist as an important part of playing position. You have to adjust the way you hold your instrument - and also sitting height - to give your arms maximum freedom and relaxation. (Computer use is an awful RSI-culprit too, and again one reason is wrist angle. Re-examine how you use its keyboard, in case you are unwittingly aggravating this problem, and change your method of typing if need be - there are by now a lot of computer-ergonomics websites and books out there. Sitting at a qwerty keyboard isn't that different from sitting at a piano keyboard - again lower arm and wrist must stay pretty level.) You can see from all this that, basically, anything that bends you into an angle is going to give your body more wear (aggravated by moving the individual fingers) and the more extreme the angle the worse it gets.

Putting on my music-teacher hat for one last time: Don't practice for 8-hour stretches. It's just too much. A lot of students are having to be told this these days, as competition and the demands of the pro world push the standards higher and higher, because over-practice is actually counter-productive. Also, it's too big a chunk of your day, which then gets deprived of other mental stimulation and physical exercise. (I sound just like my mother. But it's true.)

In addition, though it seems a bit fanciful & new-agey, you can help keep in trim with mental practicing. Not just daydream images, but actually go through all the playing motions in your mind, imagining every individual movement in clear tactile detail - i.e. how it feels - as though you're actually playing. This visualisation run-through is more effective than you might think, and there is some scientific evidence for it, along the lines of how the brain-patterns relate to and impact upon the muscles, with some very real physical manifestations (for instance, that old example of telling a hypnotised person you are about to drop a red-hot coin on the back of their hand, actually dropping a cold one, and watching the skin redden & blister - not a pleasant little story, but it speaks volumes about the mind-body relationship). I can't explain it better than that, but there's plenty of info on this subject if you research it. These techniques are known in the sports world too, and a lot of top athletes do mental work-outs. Don't worry too much about muscles atrophying - it doesn't happen that fast, and you can always keep them moving in non-painful ways. If you've developed a strong finger technique on your instrument, you'll be able to get it back more quickly than you might imagine - it provides a strong foundation for playing, which is why music teachers make such a fuss about it.

If you've already experienced RSI to this degree, it may flare up from time to time so you have to remember NOT to try and fight with it. Make whatever physical adjustments you can to your playing/working habits and try whatever anti-inflammatories & treatment your SPECIALIST suggests. (GP's & general physios are often just not clued up enough in this area: I've been horrified at seeing students here - not mine! - told to "exercise" when what they should be doing is the the exact opposite.)

Keep your spirits up, and develop ways of dealing with flare-ups as they periodically occur, because they may (and I think your current one has been made worse by what I can only see as bad advice). It will probably be a matter of management rather than outright cure. And whatever you do, DON'T jump straight in at the deep end the minute you feel better. Ease in, build it up step by step, and give yourself time. With intelligent care and a few alterations of habit, and the fact that you are young, there are plenty of grounds to be optimistic.   

Very best of luck to you, good wishes for the new year, and be sure to let us know how you get on.

http://www.tuneup.com.au/biomx/wrist.html


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Subject: RE: RSI for 2 years? It needs to go away...
From: The Fooles Troupe
Date: 30 Dec 07 - 09:32 AM

"Glucosamine is fine but don't bother with the additions some firms mix with it (e.g. chondroitin) says my osteopath!"
"Glucosamine, a sugar amino-acid, helps form the "network" of strands covering the joint surfaces of bones. Chondroitin is the cartilage itself, which is then laid down upon that network. The two substances are symbiotic and must be used together, which is why manufacturers package them together. To take one without the other is tantamount to useless."


Well, a little knowledge is a dangerous thing...

Both such chemicals are useful, Some 'counter self medications' also include many other things including omega 3&6, various minerals, etc.

There is an old saw... "moderation in all things except moderation itself". This applies to both the taking of 'drugs' and physical exercise.


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Subject: RE: RSI for 2 years? It needs to go away...
From: Richard Bridge
Date: 30 Dec 07 - 12:06 PM

The point about playing thumby barre chords is that it gives your wrist a chance to go from flexure into extension occasionally, so providing a relief from the constant pressure of the tendons in the inside part of the wrist.

If fact, putting the thumb in the middle of the back of the guitar neck, classical style, does not give the tendons any rest because the wrist is then ALWAYS arched. It is done to provide the best angle of attack for the fingertips on the fretboard, and that involves arching the wrist: not as much as playing in the phallic position, but some. "Lazy" positioning actually keeps the wrist more straight, and "thumby" chords provide a positive relief from the arch - like stretching your back when sitting up from the computer keyboard.

This is also why mandolin is less dangerous - you don't need to stretch round the neck, so you don't need to arch the left wrist: the strings are so close you pretty well never need to chord from the right elbow, and the body is small so you don't have to arch the right arm round it and get frozen shoulder. If a mandolin is correctly set up with 10s not 11s it should be light and easy to play, not bruise your fingertips, too, and the fact that there are two strings to a course also spreads the point-load on the fingertips.

I do repeat - get to a specialist doctor as soon as humanly possible. If it turns out that you are going to need surgery, (and it does happen with tendonitis, sometimes) you want it while you are insured...


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Subject: RE: RSI for 2 years? It needs to go away...
From: Lowden Jameswright
Date: 30 Dec 07 - 01:34 PM

The time you spent playing guitar probably got you to a point much quicker than many thousands of others who will undoubtedly suffer the same result eventually. I've been playing guitar for over 40 years and have been fortunate enough not to experience any RSI problems - but I do know that dropping the guitar down to my waist and playing it like a rock star soon starts to create problems.

Richard Bridge was probably spot on when he pointed to guitar technique as the most likely problem. Constant up/down movement of your right arm is superfluous. Your arm and wrist should be relaxed, and there should be only limited movement from a pivotal point - watch players like Richard Thompson, Eric Clapton and Mark Knofler for good practice.

You'll see some acoustic players resting their "pinky" on the soundboard whilst playing - they are storing up problems for later life.

Very good luck to you


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Subject: RE: RSI for 2 years? It needs to go away...
From: Bonnie Shaljean
Date: 30 Dec 07 - 01:48 PM

Wow, thanks for that "pinky" tip [guilty as charged]. I've been spending all my time thinking about the LEFT hand! But it does force your picking hand into an unnatural angle, doesn't it? Thanks also to Richard for the clarifications -


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Subject: RE: RSI for 2 years? It needs to go away...
From: MrDime
Date: 30 Dec 07 - 11:47 PM

So I've sat down and played twice today, 20 minutes each time. I feel fine except for the fact that the technique is so different I feel like I'm starting from square one. But it's better than nothing of course. I'm still planning on seeing a specialist soon, whether it be while I'm home for christmas break or after I go back to school, I'm hoping to get some diffinitive answers. I've still got open ears to whoever posts in this thread as I have been checking every day, so any anecdotal advice or anything of the sorts is appreciated as always.

Happy New Year!


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Subject: RE: RSI for 2 years? It needs to go away...
From: Bonecruncher
Date: 31 Dec 07 - 12:09 AM

Hello again, Mr. Dime
Congratulations on joining us and we all look forward to hearing your progress.

Bonnie Shaljean and Richard Bridge have given you some excellent advice ande I am pleased to see that you have reduced your practice sessions to something which most of us would consider more reasonable.

The comments about "mental practice" and visualisation are absolutely correct. I was taught this in Osteopathic College and the system certainly helped many of us to get through our exams.
Of course the changes in your method of holding your guitar will feel strange. I have just the same thing when I am learning a new technique to adjust a joint. Practice, with visualisation when no patient is available, will train the muscles into a new habit and ability to do a particular job.

Think how long it took to learn to drive smoothly, without setting off like a kangaroo! How long did it take for your brain and your muscle to learn to ride a bike?
Best wishes and keep us informed
Colyn.


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Subject: RE: RSI for 2 years? It needs to go away...
From: Rumncoke
Date: 31 Dec 07 - 05:39 PM

Although you are very young for such things - have you ever been tested for thyroid function?

I found a great improvement in my ability to play the guitar once I was diagnosed with a failed thyroid - I went from not playing at all to how it used to be. I mentioned this to someone I meet once a year, who had had painful wrists and hands for over ten years - a year later I saw her on stage playing again too. At the end of a song she waved at me, tapped her throat and wiggled her fingers - which I assumed meant that she too had thyroid problems which had been resolved.

These days - after many years of treatment with Thyroxine, I no longer have the gristly noises in the wrists which I heard for years when I tried to ease them into motion, and my hands are flexible and strong - I can crack walnuts in my bare hands.

Low thyroid function can be difficult to diagnose, I had several tests within the normal range before one day it was suddenly found to be dangerously low, but it might be worth a test just to see if anything is wrong there.


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Subject: RE: RSI for 2 years? It needs to go away...
From: wysiwyg
Date: 31 Dec 07 - 05:50 PM

Of course now that MrDime has joined, he can get PMs, too.

~S~


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Subject: RE: RSI for 2 years? It needs to go away...
From: MrDime
Date: 31 Dec 07 - 08:42 PM

The thyroid idea is interesting and I'll add that to my list.
You said you had it tested 'within the normal range' and I'm not quite sure what you meant by that...

But today I awoke with that good feeling of soreness in my forearms. That feeling one gets after a good workout from the day before kind of thing. I'm taking it easy today letting the muscles recooperate but that's a good thing in my mind. I've had less pain today than any other day so far, and am feeling optimistic. Still, I'm crawling before walking and I've got that chiropractor appointment one the 2nd so I'll post any interesting details that come from it.

And I'm still amazed how helpful how much feedback you've all provided and I really do appreciate it.

See you all in 2008

MrDime


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Subject: RE: RSI for 2 years? It needs to go away...
From: MrDime
Date: 09 Jan 08 - 06:10 PM

So I've seen my chiropractor and he was a lot less helpful than was anticipating. He recommended I start taking Omega 3 something or other. Some Fish Oil kind of thing. I figure it's worth trying because I'm running out of options.


I have an appointment back at the university hospital for when I go back to school, so hopefully as I work my way through the system again I am presented with a bit more action.


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Subject: RE: RSI for 2 years? It needs to go away...
From: Richard Bridge
Date: 09 Jan 08 - 09:02 PM

Goodluck, and keep us informed.


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Subject: RE: RSI for 2 years? It needs to go away...
From: Bonecruncher
Date: 11 Jan 08 - 08:21 PM

Mr Dime
I've been following your thread due to professional interest. I am an osteopath, similar to your chiropractors.

If your chiropractor could give you no recommendation other than to take Omega-3 fatty acids then I would suggest that you change your chiropractor because s/he was prescribing the wrong medicine.

Fish oils contain Omega-3 and Omega-6 fatty acids. Chemically they are Linoleate and Linolenate. These are known as "essential" fatty acids because they cannot be mady within the human body. They must be taken in diet where they are found, in particular, in oily fish such as mackerel and herring. A good quality normal diet will contain enough nutrients and vitamins for most people. Supplements are only neccessary in cases where the diet is poor, there is a problem with absorption, or a mechanical breakdown of part of the body has occurred.

You will notice that there is a considerable amount of "faddishness" about diet - what a certain newspaper columnist, or more usually an advertiser, writes or what a certain "celebrity" is taking suddenly is a "must-have" for the general populace.


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Subject: RE: RSI for 2 years? It needs to go away...
From: Bonecruncher
Date: 11 Jan 08 - 08:50 PM

Mr. Dime
Sorry, I hit the wrong button. To continue.

An example is the way that people carry about with them bottles of water. When asked why, most will say only that "it is good for you". That is all they know, due to the advertising.
In 1932 a medical report was made that we need to intake two litres of fluid per day. Most of this is taken in food, which is 70% water.
In the 1990's advertisers of bottled water quoted this report and the two litres of water, but ignored the second sentence. Hence the advertising was mischievous in that it did not paint a full picture.

As I said in an earlier post, some good advice has been given to you by Bonnie Shaljean and Richard Bridge which, if followed, will certainly help your recovery. I made some earlier comments which, again, if followed will help.

I am pleased to see that you have an appointment with the University hospital. When you attend for your appointment take your guitar! Show the medics how you stand/sit to play the instrument. Emphasise the hand/wrist position. If the particular doctor cannot understand what is causing the problem then ask for a referral to another practitioner.

YOU are the patient - the customer, if you like. The attitude of "Doctor knows best" belongs to the last century. Stamp your foot (metaphorically, of course) and insist on the type of treatment you think you need.

Please keep us informed

Colyn.


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Subject: RE: RSI for 2 years? It needs to go away...
From: Waddon Pete
Date: 20 Feb 08 - 06:20 AM

So Mr. Dime?

How's it all going?

Have you any news for us?

Best wishes,

Peter


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Subject: RE: RSI for 2 years? It needs to go away...
From: Bonnie Shaljean
Date: 20 Feb 08 - 07:04 AM

Thanks for posting that, Pete. I've been wondering the same myself, and was tempted to bring the thread back up myself. Mr. D, give us an update. Hope all's going well -

Bonnie


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Subject: RE: RSI for 2 years? It needs to go away...
From: Bat Goddess
Date: 20 Feb 08 - 11:21 AM

I posted much of this to the thread BS: deQuervain's tendonitis on 01 Feb 08 - 01:25 PM

I had regular garden variety forearm tendonitis (right arm) in 1994. The first thing I did was stop doing what caused it and start doing it the RIGHT way so as not to damage my body further. In my case it was using a computer mouse to clean up bitmapped images in Photoshop. (Got my mouse placed so my hand would be in a neutral position, relaxed the muscles in my hand, took breaks, etc.)

I also remembered an article in Smithsonian about the work of Dr. Emil Pascarelli. He started working with musicians and then found a lot of the repetitive stress injuries started coming from people using computers. His book --   Repetitive Strain Injury: A Computer User's Guide; Emil Pascarelli and Deborah Quilter (ISBN 0471595330) -- is the best I've ever run across on the subject with good advice, good exercises, etc. (And, believe me, there are some books with some very BAD advice out there.) AND he understands the problems musicians develop. Proper position and technique is everything -- if you are abusing you arm muscles, you will eventually do damage and be in pain -- and soft tissue takes a long time to heal.

I never lost any time at work (my boss worked with me on making changes). And I never actually got professional help for it. It did take a long time to heal. At one point, when I had plateaued in my recovery, I had an appointment with an osteopath (who had gotten his MD first) for something completely different. Mentioned the forearm tendonitis and he did some manipulation around my elbow and, whatever it was, it unblocked the continuation of healing. Haven't had any problems since -- and if I get the first twinges, I again straighten out how I'm abusing my arm and it goes away.

The problem with surgery is it causes scar tissue which can also cause problems. Plus, it's considerably less likely that if the condition returns, that further surgery will do any good or even be possible.

Physical therapy is by far a better solution.

Linn


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