Pianist's Injuries (outside of piano playing)

[piano6888]

Hey guys, I thought I bring up a topic that I feel isn't very throughly covered in the pianostreet forums and I have a few concerns regarding it.  It is regarding injuries that the pianist sustains in everyday life, or at least the common activities.  To my best understanding is that any physical injury that results in limiting the range of motion of the pianist. Also, any injury that is debilitating enough (lots of pain in the wound area) to where the pianist is unable to execute a certain technique necessary to play the piece well.  

Some of these other injuries are usually from everyday activities or are more common than one may realize.  From non-daily injuries this could include: getting bitten, scratched, or pecked by any animal (dog, cat, bird, etc.), getting into an accident, getting hurt from certain sports, culinary accidents such as cutting oneself while cutting meat/vegetables, accidentally burning oneself while cooking on a grill, stove, etc.  A brief list of daily activities for physical injury would be one who is working with weights, boxing, doing any sports with direct impact (football, karate, boxing, etc.), moving heavy objects (labor), and more.


While there are some pieces that are not as technically demanding, most of the more advance pieces require tremendous amounts of techniques to execute, such as many of Liszt's pieces, Beethoven's sonatas, Chopin's etudes, nocturnes, scherzos, and more.  Moreso, it also depends on where the injury occured and the severity.  For example, if one were to get a cut on the tip of the finger near/at the fleshy part of the finger, then that would impact playing as the cut would be painful enough to compromise the full use of the finger or at least be too painful to execute the proper, appropriate technique... However, other injuries like getting a cut on the forearm, or leg would have a lesser affect on performance, assuming the cut is not deep and the wound area is taken care of.  

Any suggestions regarding situations like this other than just "being careful". (I'm looking for things like how to mitigate and how to adjust playing so that the injury does not severely hamper the quality of performance, both musically and technically.)  

Note: This is not about injuries sustained from piano practicing or performing, but rather away from the piano.  Also, keep in mind that I'm not advocating for not living daily life, but rather avoiding injuries from many activities in life.  It's still good to live life and do everyday things, but just with more caution than the average person.

[j_menz]

Of these injuries, cuts to the fingers are probably most common - certainly for me. They heal reasonably quickly (week or two) but the injury or the bandaging prevent or limit use of the mostly one finger involved.

Recently I gave myself a nasty cut on the tip of my middle LH finger with a pair of garden secateurs which put it out of order for a fortnight. I spent the time working on some Chopin etudes which did not require (or which could fudge without problem) the use of that finger. There seems to be quite a bit of LH alone repertoire, not so much the right.

For other fingers there may also be such pieces available, or you could play simpler pieces where it is easier to fudge a workaround. Worst case, a little time off, or just working with the other hand on technical drills/exercises will not hurt.

For more serious injuries, I'll leave suggestions to others.

[iansinclair]

Patience.  And a willingness to work like blazes and relearn half your fingerings.

I'm referring to very significant injuries.  As some of you may recall, I got in a fight with a piece of farm machinery last fall.  No surprise; I lost.  The middle joints of the second and third fingers on my right hand were completely smashed (5 pieces in 2 and 6 in 3) and both the extensor and flexor tendons going to the tips of those fingers cut.  I have recovered some flexion in both fingers, but not in the tips (no curl at all) and I will never touch the heel of my hand with those fingers again.

I am a concert pianist and retired organist and choir master.

I'm still working on relearning much of my right hand fingering (for example: any 2/3 trill is hopeless.  The span of the hand is shortened.  The span between fingers is shortened.  Etc.).  However, with patience and a willingness to work very hard indeed, even an injury of this magnitude and permanence can be overcome, but it is not easy, and it will take time.

My best advice is to pick stuff you already know which really works on the problem fingers (for example: Schubert Op.90 #3 is great for finger independence and flexibility.  Even the dear old first movement of the Beethoven Moonlight is good for span -- as is Schubert Op.90 #1)(and so on!).  Then work and get it back to where you want it to be.

It can be done.  It's not easy.  I'm pleased to say that my first concert after the injury will be at the end of June, and I will be ready for it (Schubert Op. 90 -- all 4, then an intermission, then 4 Chopin Nocturnes).

For the more trivial -- any cut near a finger joint has the potential for catastrophe.  Keep it cleaned.  Use an antibiotic ointment on it.  Keep it bandaged.

[ted]

It can be done.  It's not easy.  I'm pleased to say that my first concert after the injury will be at the end of June, and I will be ready for it (Schubert Op. 90 -- all 4, then an intermission, then 4 Chopin Nocturnes).

Good on you, Ian, your progress is an example for us all.

On the trivial level, I find hangnails are my worst nuisance. All you can do is inspect your fingers daily and if one of the little buggers comes up, cut him off right away as low as possible. Once they get driven in and infected you've had it for a few days.

I tend to use just strong antiseptics for minor cuts and abrasions these days. If I really needed it I would see the doctor for an antibiotic, of course, but a real problem is arising, at least in this country, with people plastering antibiotic creams on indiscriminately. Strains of resistant bacteria such as MRSA have become rife here recently, and it is thought their appearance has been encouraged by the wholesale use of antibiotic creams, particularly with children. 

[piano6888]

Thanks for the good feedback everyone, and my worst injuries were a result of arm wrestling back in early high school, as well as cutting the tip of my right hand middle finger when cutting vegetables. 

LH repertoire seems like a good choice, but it might not be an option for people who injured their left hand. (I can't recall injuring my left hand to where it has compromised my playing) Maybe most pieces with a less demanding left hand, but right hand melodies would suit a pianist who injured his/her left hand instead? I think most pieces are made for RH, but maybe there exists RH exclusive repertoire?

My other daily concern (I don't work out vigorously nor really do much physical sports personally..) is simple injuries from falling or getting bit by an animal; even though I'm quite overprotective with my hands and body in general, I'm still working on finding the balance of being careful and living life as normal as the average Joe.

[indianajo]

This is an odd topic.
I'm glad to hear Ian is playing again after his massive injury. Some adjustments were to be expected.
I've been very mindful of pinch points since I had some safety training at the factory.  A pair of channl-lock pliers is my constant companion when I am working around machinery with pinch points.
In particular because I took up the piano age eight as a suggestion from a teacher to my Mother about regaining use of my third finger right hand after the end was pinched off age three.  That pinch point was on a folding chair, a gift for my third birthday.  
A couple of years of Schmitt exercises, and I was using the finger again freely, although it makes a slight click when the fingernail hits the key.  So I'll never be on the concert stage; my teacher didn't even suggest contests to me beyond the piano guild local exhibitions.  But I've gotten to be pretty good. I'm practicing pieces that I hear on Master's recitals over at the college music school.   My limitations playing piano these days are more caused by  body geometry than that finger.
As far as major accidents, playing piano helps one forget the pain for a while, if you don't have back trouble.  I don't, fortunately.  My bicycle bucked me over the handlebars on my face last year when a stick got jammed in the front brake.  Then the bike landed around and on top of my arm and shoulder, wrenching them to an odd angle.  Everything hurt for a couple of weeks: nothing was broken the nine X-rays indicated.  But practicing piano in that recovery time was still a pleasure.    
I'm very particular to care for the fingernail on the shortened finger (the pad is missing) which is necessary since it gets considerable force on it.  And despite my efforts to be careful, I bounced a machete off some dead flowers two weeks ago onto the top of the third finger, causing a laceration to the top.  But not a deep one, and piano practice was not interrupted.  
Study factory safety courses about "lock-out" and pinch point management, is.  Things as simple as a car door with electric windows, have to be watched out for.  You can't always assume a machine is going to function normally.  
The biggest risk to my hands these days is European origin men trying to prove their manliness by squeezing my hand in a "shake" until the cartledge is torn.  My right hand was injured by the pastor of my church six years ago in a "friendly" handshake.  This year is the first that it is again pain free. That pain was a major limitation on practice time for several years, despite constant NSAID use.   I hate to be completely standoffish, but **** Europeans think that because they covered the earth, everybody is a European- or should be treated like one. I have light bones and upper body muscles suitable more to chasing down deer on wet mountain rocks with an atlatl or bow, than for handling a plow, persuading an ox or mule to work,  or reefing a topsail in a gale.  By contrast it is a pity to watch many muscular retired or over 50 Europeans cripple around on their feet, when at age 64 I can still bike or walk dozens of miles without much effort.  

[therealfolkblues]

i have a bit of fear regarding my wrist. I do alot of handshaking, and Im migrating to the fist bump,. Some weird shite can happen to my wrist with a bad handshake so seeking to mitigate that.

other than that i know my hands , knuckles etc can take some abuse.
be careful?

[piano6888]

@Indianajo
Regarding people who squeeze too hard on a hand shake, I haven't really paid much attention to that and props for mentioning that.  I don't know if my bones are dense or light, but yeah I would hate it when someone does that to me; is there a way to tell them to be more gentle with the hands, fingers, etc? Or perhaps avoiding or minimizing damage from the situation? I mean, I don't want to be paranoid with things and I'm not saying to not live normally, but I just want to minimize the risk and damage.

i have a bit of fear regarding my wrist. I do alot of handshaking, and Im migrating to the fist bump,. Some weird shite can happen to my wrist with a bad handshake so seeking to mitigate that.

other than that i know my hands , knuckles etc can take some abuse.
be careful?

The last two words.  Sorry I had to do that since I get frustrated when I don't get good advice, let alone what I specifically didn't want.  Speaking of other body parts, I could take some bruises and some abuse, but just not my fingers, wrists, hands, and arm. 

[therealfolkblues]

 [polite chuckle upon reread , or um ,read, post../at least until "be careful"
and finished OP.

i think be careful is the best advice there is.
period.
know what you are prone to.
know your body's weaknesses
a shoulder,rib whatever,any number of things can b a weakpoint n make sitting,playing a negative experience.
be careful with the application of force using your hands. i.e. working on your car

[timothy42b]

Patience.  And a willingness to work like blazes and relearn half your fingerings.

I'm referring to very significant injuries.  As some of you may recall, I got in a fight with a piece of farm machinery last fall.  No surprise; I lost.  The middle joints of the second and third fingers on my right hand were completely smashed (5 pieces in 2 and 6 in 3) and both the extensor and flexor tendons going to the tips of those fingers cut. 

I am sorry to hear of your misfortune. 

Farm machinery is deadly, with most elderly farmers I know having some missing body parts.  It's not so much any one inherent danger, it's just the necessity of maintaining concentration 24/7/365, in all sorts of weather, no matter how fatigued.  Sooner or later you have a lapse.

Had it been your other hand, I would have had the opportunity to deliver one of my stock rejoinders:  "yes, it will heal..............but it will never be right!!!!!"

[8_octaves]

Hi all,

this is a thread which reminds me of 2 incidents:

1 ) I broke the saddle-joint of my right thumb during sports years ago ( the surgeon let me choose: 8 weeks wear a plaster which SPREAD my thumb for to be "in position"  - or to have an operation. I chose the plaster... .) When the plaster was removed, playing piano again was a torture. It was, like burning needles, every time I touched a key or other things with the thumb, because the muscles and everything had down-developed to nothing, and each touch hit directly the bone and the nerves. )

The surgeon recommended remedial gymnastics, but I said to him : "No! I play piano..." - he looked at me for a long time, and then said...: "mhhh - OK."

Nowadays it's fine, and since there perhaps was new bone-material developing, the joint is very strong. No problems, but very rarely STILL a feeling of numbness.

2 ) My left thumb: Years ago, I was in an Inn with a friend, sitting at the bar. I had a glass of beer before me. I made a stupid movement with my right elbow, swept the glass from the bar, and tried to "catch" it with my left "backhand"... . But I pressed the glass against the bar (while it was falling down ), and crushed it. So I cut through the outer sinew of my left thumb down to the bone, which led to much BLOOD, and my friend had to accompany me to the emergency medical service, since it was 2 o'clock (ca. ) a.m.

They drove us to the hospital, where it got suturation, and then I got a splint for weeks.

But it's ok now fully.

But I wear the scars of both incidents until today: From Nr. 1 the scar of FIVE syringes I got in one place to deaden my hand, before the thumb was "arranged" in the spread position for the plaster, and from Nr. 2 the cut-scar, which I now see during typing, too.

Cordially, 8_octaves!

[timothy42b]

2 ) My left thumb: Years ago, I was in an Inn with a friend, sitting at the bar. But I pressed the glass against the bar (while it was falling down ), and crushed it. So I cut through the outer sinew of my left thumb down to the bone, which led to much BLOOD,

Ah ha!

Thank you, thank you.

I shall now deliver the epilogue.

Your thumb has healed.  BUT.......it will never be right!!!!!!!!

[j_menz]

it will never be right!!!!!!!!

Probably because it was the left. 

[8_octaves]

Ah ha!

Thank you, thank you.

I shall now deliver the epilogue.

Your thumb has healed.  BUT.......it will never be right!!!!!!!!

Probably because it was the left.  

LOL   - reading these comments for a while, I was already getting a little misconfused, wasn't I ?!  

But: No. What I find astonishing, is, that there aren't problems today, besides, as I said, and very rarely, a "numb" feeling in the area where the right saddle-joint is. The left thumb works fine, too: Only at the very small area in which the sinew had been sewn together, it's a little thicker maybe a millimeter, but that's hardly to notice.

Cordially, 8_octaves!

[piano6888]

Thanks again to everyone for their advice, I probably should have shortened my first post to just two or three questions:

How does one cope with the injuries when it happens(remedies, workarounds, cancelling)?

How does one prevent the injuries and/or minimize them (more than just avoiding said activity when one is relying on performing or teaching as their livelihood)?

Thanks to Ian, J_menz, tim, realfolkblues  , and Indiana.  Personally, right now I'm pursuing a field other than music, but it does help to have these tips at hand for the future

[piano6888]

It's been a while, but I have a specific question about a physical injury (prevention is good only before the fact, not after.  So of course, one should NOT put all their eggs into one basket! Prevention and mitigation would be best, so I'm going to focus on mitigation/workaround and recovery.)

So here is the scenario.  Suppose one has a finger cut on one of his fingers, burned with blisters, scratched/bitten by some animal (assuming damage to nerves), or similar injuries.  This person has a recital, concert, performance (situation where he has to play the piano) coming very soon, usually within 1 week or so (so pretty soon, I used a more typical time frame.) Let's also assume that this person prepared for this performance at least a year or more in advance, the repertoire is technically demanding (trills, runs, fast tempo, requires a lot of technique as well as maybe an expressive piece but still requires delicate touch to produce the appropriate voicing, sound).

Then the question is what can the person do to mitigate the situation? What are the work-arounds if he is unable (or will not be able to) cancel/reschedule the performance?
Finally, what can he do to ensure a good recovery (hopefully a FULL recovery)


Of course, the scenario is also not considering the psychological impact of the injury, which is another can of worms in itself and I'm leaving it out for simplicity. 

[iansinclair]

Since you have popped this up again, may I assume that your have a very good (and unfortunate!) reason?

First, what is the nature of the injury (I assume that if it is anything more than really minor the victim has seen a medical professional)?  If the damage extends into a tendon -- even if it is not fully cut through -- do NOT try to play.  The finger in question is, hopefully, splinted.  Tendons take time to heal, and can rupture without warning rather easily until they do.  So -- just don't even try.  However, if that is not the case, are there stitches or sutures?  If so, is the finger flexible enough (or are they in such a location) that the victim can flex the finger as needed, even if it is painful? If that is the case, and the need is extreme, the victim can use pain medication (he or she may need to see a medical professional to get something strong enough) for the performance, but should be aware that being on pain meds will affect his or her performance.  To put it bluntly, the victim will not be able to play up to par, and possibly may not be able to remember some things or play some things at all.  So one wants to use the minimum pain medication possible.

In answer to finally -- see above about tendon injuries.  If it is a tendon injury, a good recovery, never mind a full recovery, can only be achieved by taking the time -- weeks -- to let the tendon heal.  For lesser injuries, avoid anything which may lead to re-opening the wound, as one wants to avoid scar formation or at least minimise it.  Also be sure to keep things clean and use antibiotics; for a minor injury, topical.  For a major or deep injury, probably a course of pills or even an injected antibiotic.

[piano6888]

Yeah, I've had a cut on my finger before in the past and it sucks, but despite the scenario that I presented was on the extreme end, I have on occasions had minor cuts when working or cooking (cutting meat/vegetables) so I'm not just fear mongering. 

The reason that I did pull it up again was that I didn't get a sufficient answer regarding how to mitigate with it but I hear responses (referring to realfolkblues here ) about prevention- but prevention is only good for prior to injury, not during or after the fact. Anyways, I hope I didn't stir up any hard emotions or anything, and again thanks for being clear with your answer

[michael_sayers]

Martin Berkofsky fractured one of his arms in eight places and it seems that he recovered adequately.


Mvh,
Michael

[stevensk]

The computer mouse is dangerous 

[michael_sayers]

The computer mouse is dangerous 

It is!


Mvh,
Michael

[irrational]

I managed to break the base of my right thumb in a motorcycle fall.
The annoying part is that this was not picked up until a recheck 6 weeks later due to consistent pain.

I know the injury occurred instantaneously, but I can't help thinking it may have been improved having been picked up quicker. So I would suggest any big hit to your hands. X-ray immediately!

I don't seem to have less mobility in my hand, but it feels as if I do. As if its stiffer. Like the tendon is not moving freely.
Also, its prone to some inflamation, causing a dull pain when I practice a lot. When it hurts a lot, I stop playing immediately for at least 2 days and drink an anti-infalammatory..
I went for Cortisone injections a while ago which seems to have helped a lot, but it took a week before my hand felt normal again.
Basically the injury hastened the inevitable onset of arthritis by a few years. I just hope it stays ok for the next 20-30 years. Maybe by then the medical profession can replace the damaged trapezoid bone. You never know.

Meantime I have not changed my practice schedule, but I seem to keep my hand more relaxed now. A good thing.

[piano6888]

Interesting story Irrational.  I hope you are able to make a full recovery and that the medical field advances more in the future. 

It seems the consensus of how to mitigate physical injuries (dependent on severity as well) outside of piano playing is to let the injury heal, not play while it's healing, and if one were to practice, it should be done carefully as well as stopping when the pain sets.  I'm glad that I'm not alone in my assessment and opinion about this topic.