Hand Injuries... how to overcome?

[janindaboo]

I know I ought to really go to a physiotherapist for this, but I thought I would maybe post something about it here too see if anyone can provide any helpful feedback...

Almost 11 years ago, I hurt my right hand when I lost my balance and landed with my hand outstretched (such that all my weight landed on my pinkie/thumb). Though initially painful, I soon was able to continue playing without issue.

Four months after the fact, I began to experience pain in my right hand after practising; at the time I was working on a number of big pieces (including Milhaud's Scaramouche, Gershwin's Rhapsody in Blue, Chopin's Ballade no. 2, among others) and preparing for festival and recital performances. I was usually okay during playing, but as soon as I stopped, I would become crippled with pain. I never told my piano teacher, though, in retrospect, I know that I should have. 

The pain would come and go, depending on what I was playing or the intensity of practise. I later completed my ARCT performer's.

But, due to the pain, I have never been able to learn some of the pieces I really want to study; pieces like Liszt's La Campanella are impossible because stretching my hand out causes intense pain that prevents me from playing altogether (and makes even holding a pencil difficult). Changes in temperature can set off the pain, as can simply allowing my hand to get a little cold (including from being in an air conditioned room).

I am almost certain that the injury from my fall is the source of the pain, since the hand pain I experience is similar to that which I experienced in the fall.

I've taken time off playing; I've avoided doing anything that can aggravate the pain (such as knitting); I've limited myself to playing pieces that do not have large chords or anything else that can trigger the pain... and yet, it is still there. I can't play without ending up with the pain.

What I wonder is: what did I injure, exactly? Is it the tendon? Is there a remedy? Will I ever be able to play large/intense pieces without experiencing debilitating pain?

Sorry for the long post... but I really hope someone may be able to shine some light on this for me...

[I suppose I should add: the pain mainly extends across the centre of my palm, from the base of my pinkie to the base of my thumb; I have never experienced swelling, redness, or anything like that; cold makes the pain worse, but heat makes it ease up a bit; simply stretching out my hand can trigger the pain.]

[iansinclair]

All that does not sound good.  I am not, however, going to venture even a little way out on a limb with an opinion on what it might be that's damaged, how repairable it is, how to repair it, or what the prospects are!

You should find yourself a really good physical therapist for starters, and it is quite possible that you may need to also see an orthopedic hand specialist as well.

And the sooner you do it, the sooner you may be able to stretch again!

[bellywelly]

i agree with iansinclair. you should definitely get it checked out, because the longer you avoid getting it examined by a professional, the higher the chance it gets worse, even to a point where it would never go back the way it was before.

[thesixthsensemusic]

It sounds not like something for a physiologist, I'd rather visit a neurologist for this matter. I myself am an ex-sufferer of carpal tunnel's syndrome, which is basically a form of hernia in the hand, with abnormal pressure on nerves going through a space that was, due to swelling or a dislocated joint, previously normal but now too narrow for the nerve to go through. These symptoms sound surprisingly familiar to me, and I had to undergo surgery for it.

However, I am not a doctor, so I'd advise you to visit your family doctor and ask him about it and get a second opinion at another doctor's, after all, it's one of the most precious parts of your body, especially since you're a good pianist and you can never be too careful about it. The operation I had was quite something risky as it could have cost me the ability to sense touching sensations with half my hand.

Whatever you end up doing, I wish you the very best in overcoming this highly frustrating problem.

[mikemiester]

janindaboo,

Hi, I'm a serious piano student, 21 years old, preparing for a performance career. I was injured while doing a solo concert series last fall, and I've been dealing with the repercussions of that for just over a year.

First thing you need to do is see a hand specialist to rule out any bone spurs, congenital defects, etc. I doubt it's any of those things though personally, all the same, rule it out. I did that, and was diagnosed with Tendinitis, did the physical therapy thing for several months to no real effect, went back, got an MRI, and then the doc overturned his diagnosis and said he simply didn't know what it was.

The solution for me has been retraining, which I've been doing for a few months now. I was playing and performing everything, Kreisleriana, Beethoven's Appasionata, beginning work on Rach's 3rd, etc etc. The problem that lead to my injury turned out to be a physically damaging technique. Things like dropping the wrist on chords/octaves/etc, stretching (even visually small stretches can be damaging, if you do them enough - there are other ways)  

What you will find eventually, is that even if this problem goes away safely and you forget about it, it is very likely to come back later in life if you don't address it. I know how impossible it seems to cancel concerts and festivals (I had to do that myself... very annoying) but your body is telling you to do something differently, via the medium of pain. PT/OT will alleviate symptoms most likely, as will time and cortisone if you go that way, but it still won't address the root cause.

Look up these people https://www.golandskyinstitute.org/., and the associated method. This is what they do. DO NOT start reading guides and forum posts on the internet and start trying to retrain yourself - it won't work, you need someone to watch and coach you, no matter how much you know. Even Olympians get injured, and they go see people who help them move past their troubles.

They're controversial in the piano community, and people are bound to get on my case for posting this but believe me. I've tried everything short of surgery, and this is the only thing that is helping me move forward. Give it a chance, it's probably your best bet. These people know what they're doing. Go to the summer symposium and find a qualified teacher of this method on the website.

I don't want to bore you with a long post, but if you have any other questions just PM me and I'd be happy to talk about injuries and solutions.

It makes me very sad to see people injured, I've been through and am continuing to find my way out of the hell that is a performance injury. I hope you get better! best of luck.

[bb-bb]

Look into TFCC injury - Triangular Fibrocartlidge Complex. They are common for hand outstretched falls as you described, and go see a physio or doctor.

I also second the Golandsky tip.

Good luck.

[jimhendricks72]

Generally speaking, it is better to not stop practicing. Instead, play lightly and take lots of breaks. Taking lots of time off can cause tendon binding, muscle guarding, and general stiffness.

Surgery is a last resort and if you know you must play in exertion, 600-800 mg of Ibuprofen will keep inflammation down.

Remember that your body is a whole entity. A whole body stretch - yep, even legs, neck, back, etc., along with good large-muscle group workouts (not strenuous, but enough to keep those muscles toned) will also do wonders.

I suffered from tendinitis, bursitis, big-time muscle tension, and a host of other problems back in the early 90's, but I've been good now for many years and I do 1-3 concerts a week year-round. But I've gotta keep in shape - whole body.

Hope this helps. Blessings to you -

[cometear]

In my opinion you should do two things.
1) See a physical therapist
2) Find a teacher certified in the Taubman Approach through the Golandsky Institute.

This way, you're covered on all your bases. This fall may have uncovered certain technical habits that are now revealing in the form of pain. I would certainly take a look at the Golandsky Institute, I have seen it heal and form great pianists.