difficult-to-pin-down injury / physical problems

[daithi]

Hello everyone,

I would like some advice if possible. I have been playing piano for over 10 years, and taught myself, with all the bad habits that can lead to. I managed to reach a relatively high level on my own, with some unavoidable blanks in my technique.

To give you an idea of what I could play (in the good old days), some pieces I've learnt over the years include:
-Chopin ballades 1 and 4, some movts from the concertos
-Rachmaninoff preludes (from both sets)
-Bortkiewicz preludes and other pieces
-Schumann sonatas, fantasiestuke
-Brahms rhapsodies
Etc, the list is a little long...!

Without the help of a teacher, I've had to find solutions to technical problems through pure experiment and long hours at the piano.

For quite a number of years I kept improving and making leaps forward. About 5ish years ago I started noticing some discomfort at the piano and after playing for a while. Over the years it has progressively worsened, and now includes weakness in the wrists, arms and fingers. A complete list of (current) symptoms is:

-chronic weakness as listed above, in fingers, hands, wrists, and arms.
-pain both when arms and hands are in use, and more worryingly, while at rest.
-sometimes I experience numbness along the 5th finger and up the hand after I finish playing.

To complicate matters, I've been 'diagnosed' with osteoarthritis in my thumbs and wrists (the diagnosis was made by simply observing and palpating my hands, so I doubt the accuracy of diagnosis).

What really worries me is that these problems have come to have a big effect in my daily life. I experience these symptoms every day, even when I don't play for a while (It's been 2 months and my hands are aching!)
Simple everyday actions have become difficult such as opening a jar that's shut tight, lifting heavy bags/ pots in the kitchen, even holding my phone to write this is causing me pain. Every aspect of daily life seems to be affected

The physiotherapist told me that it is caused by the piano, that I have played with incorrect posture, positions, weight for so long that I've caused a lot of damage.

What I'd like to know (after a very long essay. Sorry!) Is whether anyone has ever heard of such chronic injuries being caused by the piano, that cause problems even when you don't play for months, and whether there is a solution.

If someone has suffered with similar problems, do they have a name for the condition/s? Are there cures/ways to solve the problems? Is it possible to reverse the damage?

I would hate to have to give up playing!! The piano is very important to me.

Sorry for the length of this post,
Thanks in advance,
Daithi

[kalirren]

You can definitely give yourself chronic injury from piano.  About a year and a half ago, I almost gave myself tennis elbow practicing the Waldstein, and only stopped because I had some vague idea about what tennis elbow is, and what it might feel like to get it.  If I hadn't, I probably would have continued, and hurt myself more severely.

You mention "numbness along the 5th finger and up the hand after I finish playing" - this suggests to me some chronic inflammation in your elbow, and the act of playing aggravates it and causes it to swell and push on your ulnar nerve, causing numbness.

The other symptoms are just as serious, but I can't speak to them.  I think there's at least one doctor on this board, so as a layman I'll avoid giving any further diagnosis.

My advice to you,as a pianist and as a musician, (i.e., not as a physician) is to set aside the piano for a year and pick up a different instrument.  Go join a choir, for instance - it'll give experience in both cooperative music and in an instrument where the sound production is a continuous effort of the body, something that my chamber coach in university recommended.

If that doesn't work out for you, then pretend you've lost your right arm at the piano for a year.  Work only on LH repertoire during that year, and at the end of it, see if your right arm feels better, and by how much.  This will still give you some indication of your body's response to the rest, but not deprive you of progress.

[daithi]

Thank you for your response Kalirren,

2 years ago I did just that, and stopped playing for 9 months (luckily I didn't have a choice as I had moved country and was without a piano).

While my hands improved, they have deteriorated again. I have begun to search for a teacher here who knows what they are talking about. I am aware that many will tell me they can help when in fact they probably don't have a clue.

But seeing as how doctors and physiotherapists have been so vague (the physio examined me, showed me five exercises to do, gave me a tub of a playdough-like substance and ushered me out all within the space of 5 mins, without a follow up) I am hoping to understand and solve the problems pianistically.

Another thing I've read about is Cetyl Myristoleate, which is purported to improve arthritis and hand problems. Anyone ever heard of it and its efficacy?

[drazh]

Hi
I think the main problem is tension.
Find a teacher as soon as possible
at least that worked for me

[kalirren]

2 years ago I did just that, and stopped playing for 9 months (luckily I didn't have a choice as I had moved country and was without a piano).

While my hands improved, they have deteriorated again.

To me that confirms that there is a problem with your technique.  I think you are right to look for a pianistic solution.  There are ways of playing piano without hurting yourself, and you need to learn them if you want to be able to enjoy the use of your body.

I would recommend looking pianistaw's thread on the Liszt technical exercises that's also on the 1st page of this subforum - dima_oghorodnikov's advice there is very, very, good.  Finding proper balance in the hand is very important, because force without balance is excessive, and excessive force causes injury.

But seeing as how doctors and physiotherapists have been so vague (the physio examined me, showed me five exercises to do, gave me a tub of a playdough-like substance and ushered me out all within the space of 5 mins, without a follow up) I am hoping to understand and solve the problems pianistically.

Oh, I'm so sorry.  My housemate is dealing with carpal tunnel tendinitis and other elbow issues from his bad keyboard posture, and that's all they did for him as well.  We have yet to see if it's working.

Another thing I've read about is Cetyl Myristoleate, which is purported to improve arthritis and hand problems. Anyone ever heard of it and its efficacy?

Perhaps I am too cautious, but I am very skeptical of trying to solve repetitive stress injuries while on painkillers or medications.  Even if there is improvement, there's no honest way to know whether it's the pharmaceutical or your revised technique that is causing that improvement.

For what it's worth, WebMD claims that "taking a specific blend of cetylated fatty acids (Celadrin, Proprietary Nutritionals, Inc.) combined with soy lecithin and fish oil by mouth seems to decrease pain and improve knee range of motion and function in people with knee osteoarthritis".  A relatively narrow claim, and no citation given.

[dirkpretorius]

Hi Daithi
I'm a cardiologist and not a rheumatologist or orthopod  - but here are some of my thoughts.
I think you need professional help  - and a neurologist or orthopedic specialist would be the best options.
The weakness in the hands - constant aching ect ect may be attributed to carpal tunnel syndrome  - this however wont really explain the pain in the arms.
they should do nerve conduction studies and also investigate you cervical spine - the cervical plexus as a compression in this area can cause the same
 sort of symptom complex.
I've been playing for years and also love the Rach preludes as well as chopin etudes - i stopped playing actively for a number of years and took up bodybuilding ( yeah no comment on that one ! )  - earlier this year i was asked to give a concert  - i decided to play the Rach Csharp min and Gmin preludes as well as the Chopin  Ocean etude and C min Valse. Guess what ?  ( besides being stupid to attemt such a programme after being lazy for a long time ) i got the most horrific pain in my forearms - to such an extend that i can only manage half of the Ocean Etude at speed -

[dima_76557]

I've been playing for years and also love the Rach preludes as well as chopin etudes - i stopped playing actively for a number of years and took up bodybuilding ( yeah no comment on that one ! )  - earlier this year i was asked to give a concert  - i decided to play the Rach Csharp min and Gmin preludes as well as the Chopin  Ocean etude and C min Valse. Guess what ?  ( besides being stupid to attemt such a programme after being lazy for a long time ) i got the most horrific pain in my forearms - to such an extend that i can only manage half of the Ocean Etude at speed -

Thank you for that post! It illustrates how misguided ideas of physical strength are in relation to piano playing. For piano playing, one doesn't need much physical strength really. It's expert timing into the point of sound (not key or keybed beating!) that counts with a kind of concentrated kinetic energy karateka's break bricks with, a power that is not really physical. Even 5-year olds can do that because it is willpower more than anything else. Any attempt at making piano playing a sports event (even if the power is a coordinated effort with the stronger muscles, and even if one manages to "relax" immediately after having applied brute force to attack the keys) will lead to (temporary) pain sensations and eventually to "professional" disability.
P.S.: All good pianists without exception do have very strong, muscular hands, but that strength is concentrated for other purposes, and it is never used to hit the keys with violence.

[andrewkoay]

Post a video and everybody would be able to help you better!

[mcarrtunes]

Hello everyone,

I would like some advice if possible. I have been playing piano for over 10 years, and taught myself, with all the bad habits that can lead to. I managed to reach a relatively high level on my own, with some unavoidable blanks in my technique.

To give you an idea of what I could play (in the good old days), some pieces I've learnt over the years include:
-Chopin ballades 1 and 4, some movts from the concertos
-Rachmaninoff preludes (from both sets)
-Bortkiewicz preludes and other pieces
-Schumann sonatas, fantasiestuke
-Brahms rhapsodies
Etc, the list is a little long...!

Without the help of a teacher, I've had to find solutions to technical problems through pure experiment and long hours at the piano.

For quite a number of years I kept improving and making leaps forward. About 5ish years ago I started noticing some discomfort at the piano and after playing for a while. Over the years it has progressively worsened, and now includes weakness in the wrists, arms and fingers. A complete list of (current) symptoms is:

-chronic weakness as listed above, in fingers, hands, wrists, and arms.
-pain both when arms and hands are in use, and more worryingly, while at rest.
-sometimes I experience numbness along the 5th finger and up the hand after I finish playing.

To complicate matters, I've been 'diagnosed' with osteoarthritis in my thumbs and wrists (the diagnosis was made by simply observing and palpating my hands, so I doubt the accuracy of diagnosis).

What really worries me is that these problems have come to have a big effect in my daily life. I experience these symptoms every day, even when I don't play for a while (It's been 2 months and my hands are aching!)
Simple everyday actions have become difficult such as opening a jar that's shut tight, lifting heavy bags/ pots in the kitchen, even holding my phone to write this is causing me pain. Every aspect of daily life seems to be affected

The physiotherapist told me that it is caused by the piano, that I have played with incorrect posture, positions, weight for so long that I've caused a lot of damage.

What I'd like to know (after a very long essay. Sorry!) Is whether anyone has ever heard of such chronic injuries being caused by the piano, that cause problems even when you don't play for months, and whether there is a solution.

If someone has suffered with similar problems, do they have a name for the condition/s? Are there cures/ways to solve the problems? Is it possible to reverse the damage?

I would hate to have to give up playing!! The piano is very important to me.

Sorry for the length of this post,
Thanks in advance,
Daithi

Hi Daithi,

I've been playing piano for close to 30 years.  I wouldn't say I have reached your technical level but I did go through a period of physical problems just like you describe here.  It took a long time to heal everything but everything is functioning now and I have zero pain while playing or at rest.

So here is what I did.  I did take a long  break from playing.  Maybe I would play some easy pieces but if it I felt any pain I'd stop.   I then got the Taubman Techinique video series (very expensive but has a wealth of great technique advice that goes very deep on how to play properly).

Then I started looking into getting into better physical shape. I did things like starting a regular daily excersise routine like walking - nothing too strenous.  Just enought to get the blood flowing.  I also started taking Tai Chi which is a great way to improve overall posture and teaches you how to properly move your body.  It is real important to learn how to move efficiently - especially with the fine motor control of the hands and fingers.  For expample if you are playing with your pinky extended away from your hand (not aligned) then you risk damaging those muscles and ending up with numbness as descriped in your post here.  The main point is to not force anything.  Hope this advice helps and wish you a speedy recovery.  Sounds like you love music so we want you better.

Mike

[cometear]

My advice to you,as a pianist and as a musician, (i.e., not as a physician) is to set aside the piano for a year and pick up a different instrument. 

Your advice is stupid. Why do you think giving up the piano will fix the issue with the piano? Will the habits just disappear? No they won't. I met someone who gave up the piano for 3 years and as soon as they played their first note the pain instantly returned.

The Taubman Approach is what I recommend. I'm not saying it's the only way to do it, but I believe that it has a 100% success rate in treating motion-related injuries specifically on the piano. It also will build a great new technique. Mccartunes just mentioned this as well. It really works daithi, trust us and give it a try. Search up the Golandsky Institute. People are going to respond calling it a cult but I don't care. It works.

[dima_76557]

People are going to respond calling it a cult but I don't care. It works.

There are sides to the problem that you may not have thought about, so calling somebody else's advice "stupid" is at least premature.

Kalirren's advice is certainly not as "stupid" as you think it is. A piano method/system can only retrain; it cannot cure/treat already incurred injuries; that's a task for either physicians or nature itself. If in doubt, ask your Taubman teacher.

A one-year break would also be good for retrospection, because strictly speaking, there is no good reason to hurt oneself at the instrument.

[cometear]

There are sides to the problem that you may not have thought about, so calling somebody else's advice "stupid" is at least premature.

Kalirren's advice is certainly not as "stupid" as you think it is. A piano method/system can only retrain; it cannot cure/treat already incurred injuries; that's a task for either physicians or nature itself. If in doubt, ask your Taubman teacher.

A one-year break would also be good for retrospection, because strictly speaking, there is no good reason to hurt oneself at the instrument.

Taking a year off is just nonsense. It may be necessary for mental or psychological reorientation but most definitely not physical. I admit their advice was not "stupid" just silly and unsupported. If the injuries actually caused damage to muscles or nerves than yes, the Taubman Approach will not help. I doubt physicians will do much good either (but I can't say for sure about that). I agree there is no reason to hurt yourself at the piano but there is no reason to delay the retraining unless you suffer from, as I said before, mental or psychological ailments.

[dima_76557]

@ cometear

The physical problem may be more serious than anybody here suspects. Nobody can diagnose that correctly online; it's simply "difficult to pin down".

Here is a post on another piano forum that may be of interest to you, the more so since it was written by a Taubman authority. It may help to give you a broader perspective upon the physical side of the problem: Piano Injuries-First Aid.
His other posts will also be very interesting to you because that person knows very well what he is talking about.

P.S.: Ultimately, people hurt themselves because they tend to go beyond what the hand can do naturally, and the motivation for doing that may have different sources. Retraining is therefore inevitable, but nobody in this thread actually denied that.

[electrodoc]

Hi

I agree with Dirkpretorius. This sounds as though it may not be entirely due to playing the piano although good posture is important. From the description of problems in the arms I suspect a problem with the upper cervical ganglia. Have a consultant check this out. If it were carpal tunnel or elbow related then it would be unlikely to cause problems in the upper arm. It is quite possible that there may be a problem with the cervical vertebrae.

[cometear]

@ cometear

The physical problem may be more serious than anybody here suspects. Nobody can diagnose that correctly online; it's simply "difficult to pin down".

Here is a post on another piano forum that may be of interest to you, the more so since it was written by a Taubman authority. It may help to give you a broader perspective upon the physical side of the problem: Piano Injuries-First Aid.
His other posts will also be very interesting to you because that person knows very well what he is talking about.

P.S.: Ultimately, people hurt themselves because they tend to go beyond what the hand can do naturally, and the motivation for doing that may have different sources. Retraining is therefore inevitable, but nobody in this thread actually denied that.

I agree that daithi has gone above what their technique is capable of. I do not believe the post you sent me was written by a certified Taubman/Golandsky teacher. It is somewhat contrary to what is taught by the certified teacher. They may be an authority from studying with Dorothy Taubman until they believed they have learned enough. A certified teacher has requirements to meet in order to stay a certified teacher such as bringing their students to a master teacher and workshops for evaluations.

Great posts though! Everyone has some great ideas. This is just my opinion!

[lamadoo]

Don't lose hope, this is curable. It may take you 1-3 months depending on your severity but you should see results in your first day if you listen to me. This happens when you work your muscles for an extended period of time to gain that 'technique' in a fast span of time.

What has happened is that your muscles have gotten too tight from repetitive motions over the years, known as RSI.Once your muscles are too tight and cramped they start pulling on your tendons causing pain in your hand (tendonitis), thumb and forearm. Resting will do nothing, because it will rip open once you use your muscles again causing pain because it is too short.

You must deep massage. Deep massage. Take no other advice, trust me on this. Massage your whole forearm deeply. Any sore spots means that your doing the correct thing. Sore muscles mean tight muscles. Massaging it will lengthen your muscles back to its proper length and provide good blood flow.

Look at this image

https://imbuebody.com/wp-content/uploads/2012/05/ForearmPain.png

Use your elbow or even knee to apply pressure and massage all the X to release the cramped muscles. Use lots of pressure. Do this twice a day for 10mins

Heres a great video. Also going to an experience hand therapist would help alot to find the tricky trigger points causing you pain

[cometear]

Don't lose hope, this is curable. It may take you 1-3 months depending on your severity but you should see results in your first day if you listen to me. This happens when you work your muscles for an extended period of time to gain that 'technique' in a fast span of time.

What has happened is that your muscles have gotten too tight from repetitive motions over the years, known as RSI.Once your muscles are too tight and cramped they start pulling on your tendons causing pain in your hand (tendonitis), thumb and forearm. Resting will do nothing, because it will rip open once you use your muscles again causing pain because it is too short.

You must deep massage. Deep massage. Take no other advice, trust me on this. Massage your whole forearm deeply. Any sore spots means that your doing the correct thing. Sore muscles mean tight muscles. Massaging it will lengthen your muscles back to its proper length and provide good blood flow.

Look at this image

https://imbuebody.com/wp-content/uploads/2012/05/ForearmPain.png

Use your elbow or even knee to apply pressure and massage all the X to release the cramped muscles. Use lots of pressure. Do this twice a day for 10mins

Heres a great video. Also going to an experience hand therapist would help alot to find the tricky trigger points causing you pain

I agree rest will do you no good but deep tissue massage? Really? Especially to yourself? The problem lies within the technique.

[lamadoo]

I agree rest will do you no good but deep tissue massage? Really? Especially to yourself? The problem lies within the technique.

Its because the damage is already done. Fixing the technique won't help heal his hands nor resting will do anything. His forearm muscles have become tight and shorted from repetitive stress which pulls on the tendons of the hands causing pain. Massaging is the only way to release the muscles to its proper length, pain-free. You should research RSI: tendonitis and carpal tunnel.

[cometear]

Its because the damage is already done. Fixing the technique won't help heal his hands nor resting will do anything. His forearm muscles have become tight and shorted from repetitive stress which pulls on the tendons of the hands causing pain. Massaging is the only way to release the muscles to its proper length, pain-free. You should research RSI: tendonitis and carpal tunnel.

I'm saying the proper technique will prevent further injury. I misstated in an earlier post that it treats injury and I did not mean that. I do not believe that if the muscles are used in the correct way there will still be pain even if there is damage. The damage will only cause pain if it is irritated by an unhealthy technique. This is why injured pianists who build a healthy Taubman (or their own) technique claim that they still feel pain if they play unhealthily even many years after converting. That is because the damage has already been done. So yes, I agree that the damage cannot be repaired by technique but I do believe that pain can be eliminated solely by it. I have no opinion on how muscular injuries can be healed. Massage may or may not be the way to do it. I don't think it's necessary though.

[lamadoo]

The ops hands has gotten to the point that it hurts for daily activity. Its sad to see that people have just lose hope and lived with it for years. Tendonitis, RSI and carpal tunnel is curable, if you just leave it and try to rest.. it will never disappear and stays for life until you cure the underlying problem that is the cramped and tight muscles which sends pain down to your hands. This is not something many people are aware of.

Its very simple however.

Think of your muscles as a string, its very flexible. If you keep overworking it with repetitive motions and improper technique it will shorten and tighten up to the point that it is so short it sends pain down your hands and forearm, knots are formed in your muscles known as trigger points. Tight muscles also stops proper blood flow, and often presses into your nerves causing more pain.  Healthy muscle is muscle that is flexible. Now the only way to properly restore the imbalances is to apply deep massage techniques or active release technique (ART) to break away the ahesions which is formed from micro tears and provide blood flow back. The blood will than wash away the lactic acid and start healing itself. Stretching also aids to a small degree as that attempts to lengthen the muscle back to its proper length, but not as much as massaging does.


Its your bodies way of telling you, 'Hey I'm not okay'.

Im certain if the OP tries some deep massaging he'll be fine.

[j_menz]

Or the OP could try this..




Seriously people!

@ OP - I'd get a second opinion on the arthritis diagnosis. It may be right, but doesn't sound like it was done by someone who knows what they are doing.

[kalirren]

Taking a year off is just nonsense. It may be necessary for mental or psychological reorientation but most definitely not physical. I admit their advice was not "stupid" just silly and unsupported. If the injuries actually caused damage to muscles or nerves than yes, the Taubman Approach will not help. I doubt physicians will do much good either (but I can't say for sure about that). I agree there is no reason to hurt yourself at the piano but there is no reason to delay the retraining unless you suffer from, as I said before, mental or psychological ailments.

There is no substitute for rest in recovery from chronic injury, just as there is no substitute for a healthy and safe technique in the prevention of further injury.

Carpel tunnel tendinosis and muscle strains are not the only kinds of repetitive stress injury one can sustain at the piano.  Tennis elbow, a forum of bursitis, is possible.  Depending on the balance of the hand and the technique being used, compression stress fractures of the forearm and hand bones can't be ruled out either.  All of these take many months of rest to heal.  I simply took the maximum of the things I thought of and rounded up to a year to give a safe margin.

I admit, the advice to simply take a year off was simplistic, yes.  At the same time, as I'm not a medical professional, it's the only regimen I could in good conscience recommend.  Its purpose would simply have been to ascertain that rest from piano-playing was effective at all. It is, after all, possible, that the OP's piano technique was not in fact to blame, and their injuries were sustained primarily through some other activity, or as a consequence of some other bodily condition. The suggestion to take up a different instrument, or to restrict one's activity to single-hand practice and repertoire, was to open the OP's mind to possible ways of improving pianistically and musically, even while physically resting from the piano itself.

This advice is largely moot because as the OP explained, they were already forced to take a hiatus from piano for 9 months and from that experience we know that rest from piano is effective, but poor technique causes pain to return quickly.  Also, actual medical experts have visited this thread.  Their opinions supersede mine.

[leroy199]

 look at this video series

[cometear]

look at this video series

This is exactly what I've been sharing with everyone lol! The Taubman Approach