How can I prevent carpal tunnel syndrome?

[janice]

I'm sure that this has been addressed before, but does anyone know any tips for preventing carpal-tunnel syndrome?  I was just reading a post by Daniel-piano, and he was quoting a book.  I am very interested in reading the section on this.  Thanks!

[Daniel_piano]

I'm sure that this has been addressed before, but does anyone know any tips for preventing carpal-tunnel syndrome?  I was just reading a post by Daniel-piano, and he was quoting a book.  I am very interested in reading the section on this.  Thanks!

The best book I've read on hands injuries prevention is "What Every Pianist Needs to Know About the Body" by Thomas Mark
Howard Richman also is a wonderful teacher with many suggestions about pain prevention, suffice is to say that his teaching method is very similar to Bernhard one
He wrote a wonderful book on sightreading called "Super Sight-Reading Secret" and a book on Key Recognition, Perfect Pitch Training and Pan Prevention while typing
He has not yet written a book about hands injuries prevention at the piano but you can email me or pay for a session with him on line

Daniel

[Daniel_piano]

As for preventing carpal tunnel syndrome tips, here's what I've found with my experience (both my father, my sister and my mother suffer from chronic carpal tunnel syndrome so it's kind of genetic in my family, but genes can't espress themselved without an external factor)
Here's some general suggestions and tips that work for me

1) Keep you hands warm and never play with cold hands: I do this by playing with a pair of fingerless gloves

2) Never do a long session; you're more likely to prevent injuries if every 5 minutes you sit up nd go for a walk in the room, listen to music, talk with a friend or drink something
Except when performing or at lesson I never play without breaks for more than 5 minutes

3) Anytime you play something stressful make a rest of a couple of minutes
This is similar to weight lifting rest time to let the body repair the micro-tears you create by exortation
Spent more of your time practicing short passages and only 5% or 10% of your time practicing long pasages of the whole piece

4) Focus on sitting at the right distance from the keyboard and at the right height
This is very important I developed CTS by playing almost glued at the keyboard

5) Use the time of your breaks to relax
Feel the difference between the state of tension and the one of relaxation and relax
If you have a passage that is tensful and stressful instead of playing it slower playing it a higher speed even if you're not relaxed (the passage should be short) when you come back to the before stressful speed it should be now relaxing and you should feel yourself relaxed

6) Sit in the correct position
Never sit with you back curved upon your tail bone but sit on your sit bone instead

7) Never sleep with you hand under your pillow
Put your arms by your side so that the blood flow is not relented

8.) As soon as you feel pain stop playing

9) As soon as you feel pain put some camphor on the aching zone (you can use natural camphor gel) camphor prevent the sinoval liquid from flooding in the membrana while taking care of the tendons inflamation

10) CTS is worsened by magnesium deficiency, so if you have CTS symptoms ask your physician about prescribing you magnesium supplements

Daniel

[xvimbi]

I'm sure that this has been addressed before, but does anyone know any tips for preventing carpal-tunnel syndrome?  I was just reading a post by Daniel-piano, and he was quoting a book.  I am very interested in reading the section on this.  Thanks!

Daniel's elaborations are good advice. I just want to add something more general:

The best way to avoid CTS is to understand what causes CTS. CTS ultimately comes from constantly restricting the Carpal tunnel that runs through the wrist. This causes stress in the tendons, which rub against the surrounding tissue, which then leads to a swelling of that tissue, which leads to the pinching of the nerves running through the CT. CTS is dramatically sped up by repetitively moving the fingers while the CT is constricted. Apart from genetic predispositions and metabolic deficiencies, the major cause of CTS in pianists is simply bad technique.

Therefore, avoiding the constriction of the CT is the key! This means, always try to keep the hand aligned with the forearm as much as possible, in both directions, i.e. horizontally and vertically. It is as simple as that yet it appears that this is very difficult to achieve in practice. However, with this knowledge and an awareness for situations that constrict the CT it is in the end surprisingly easy to avoid it.

[lagin]

A break every five minutes, wow!  I would not have the patience for that.  Though I see your point, I have one question.  How do you build endurance-strength-that way.  I've been having an ongoing mini battle with the after affects of tendonitis, and I've found that gradually increasing my playing time builds my strength, and helps me to do more and have numb feelings less.  You do have to watch that you don't overdue it.  Everything takes time.  If only I could convince myself of that and stop learning the hard way!

[Disarmedpianist]

A break every five minutes, wow!  I would not have the patience for that.  Though I see your point, I have one question.  How do you build endurance-strength-that way.  I've been having an ongoing mini battle with the after affects of tendonitis, and I've found that gradually increasing my playing time builds my strength, and helps me to do more and have numb feelings less.  You do have to watch that you don't overdue it.  Everything takes time.  If only I could convince myself of that and stop learning the hard way!

Are you learning with a teacher? I can totally understand where you're coming from because when i first started playing piano when i was really young i spent about 5 years of my life just holding my wrists in pain after 1-2 hours of playing piano almost non-stop. Talk to your teacher about the tension in your wrists, with a proper technique of playing you shouldn't have a problem or even feel any pain in your hands or wrist for about a good 30 minutes of playing. But I do agree with Daniel though, do take a break once in a while between practices, it's good for ya

[Brian Healey]

Breaks are good. Every 5 minutes is a little excessive I think, although that depends on what you mean by "break." I consider a break to be something lasting longer than a minute or so.

Anyhoo, in agreeance with what xvimbi said, the best prevention is understanding. If you play with harmful technique, all the breaks in the world won't prevent injury. Read up on technique books such as "Indispensables of Piano Playing" and Berstein's "Keyboard Choreography." If you have teacher, make sure he/she is knowledgable about these things and be sure that you are being monitored for posture during your lessons. If you play ergonomically, not only will you not get CT, but playing the piano will actually be theraputic.

Peace,
Bri

[rlefebvr]

Great thread. This is going into my scrapebook.

[Egghead]

Hi, I am easily convinced that (in addition to all other things mentioned) breaks every 5 min or so will reduce the chance of developing CTS.

Just a thought going in the opposite direction though: my only real test for whether some movement/technique is ergonomic, efficient, physically not detrimental is to repeat that movement (in context) quite a few times and as fast as (or faster than) required in the actual piece.
If the movement is right: can go on for ever. If there is any pain/discomfort/unpleasant tension (whether in wrist or wherever) developing: movement is not good  . Then I take a closer look why, and vary the movement.

Since I am still learning technique, this is my approach for identifying and eliminating harmful movements before they become habitual. Otherwise, with frequent breaks, they might go unnoticed and I would still be using suboptimal technique for the rest of my life.

Most of the time, I need v. frequent breaks because of mental strain rather than physical strain though.

Any thoughts or advice on this approach?
Egghead

p.s. Most important though: let others do the hoovering/cleaning of your place. Vacuum cleaners can be deadly for wrists.

[xvimbi]

There is one thng that hasn't been mentioned yet. CTS in pianists does not always come from piano playing! It could be caused by something completely different, such as

- using computers in a non-ergonomic way
- doing some athletic activity (tennis comes to mind)
- sleeping habits (hands tucked under the chin)

Those are just a few. Piano playing will then bring out the symptoms very rapidly. Therefore, one should not only investigate one's piano technique, but pretty much everything that one does. Playing the piano is a high-impact (athletic) activity. As such, it will sooner or later bring out every flaw in posture and movements, whether they are caused by playing the piano or something else. Piano playing cannot be separated from the other daily activities. Healthy piano playing is only possible if every other type of movement is healthy too, from pushing a button, opening a door, watching a movie (no slouching!) to getting in and out of a car.

[pianowelsh]

The best way to avoid carpal tunnel is not to play any keyboard instruments at all. Develop your singing voice instead

[pianowelsh]

Sorry! Seriously the best way is not to keep in any one position too long so look for opportunities in the pieces you play to make alterations to your hand and wrist position. Dont over do it or start waggling frantically (like some pianists) but just be sensible when you start getting a bit of tension being in one place move it.

[goose]

I agree with Xvimbi. Piano playing may be seen as the cause of CTS, when in fact it simply aggravates stressful movements from other activities.

Here's two simple tips for computer users which worked for me:

1) if you use are right-handed, switch your mouse over to the left side of your keyboard and use your left hand for a while. You may be surprised how weird it feels at first, but persevere. We're pianists, right? We can cope with using the left hand! I now use my mouse left-handed all the time which seems to balance out my slight right-hand dominance in my typing.

2) Learn more shortcuts and use the mouse less, period. MS Word and Explorer both have lots of shortcuts which minimise how often you need to use the mouse.