Advice for Dealing with Tendinitis

[patrickbcox]

Hello,
I have been dealing with Tendinitis in my left elbow/forearm for several months now and I am getting a bit frustrated. (I am right hand dominant.)  I don't believe it was brought on by my piano playing but I do believe that my piano playing is now exacerbating it.  I am seeing a doctor and plan to do what is recommended to allow my elbow/forearm to heal; but from there my path is not so clear.  So I am looking for advice on how I can restart playing the piano again without flaring up my tendinitis.

Just for a bit more background, I played piano for quite a few years as a younger person and then did not play for probably 15-20 years.  Then at the beginning of this year, I decided to play again.  And even though my mind and muscle memory feel like 20 years ago, it seems that my arm and hand muscles are not in the condition to play at the level of intensity that I could 20 years ago or that I would like to today.

So any advice on conditioning and preparation for 1-2 hours per day of practice and playing will be much appreciated.  At this point in my life, I really want to play again and I would be very disappointed if I could not get there.

Many thanks!
Patrick

[pianoplayer002]

The good news is that playing piano with a healthy technique will not exacerbate tendonitis, but be likely to help it heal. However, explaining how to work to make your playing technique healthier is hard to do in only a few words, especially without knowing what types of tensions you currently have in your technique.

In short, I would say, work on being able to hold the keys firmly down in the keybed while keeping all joints of the shoulders, arm, hand, and fingers loose. (playing with dead spaghetti fingers that don't pull the keys to the bottom will not work).

A good but very very tricky exercise for developing this is: press down a cluster of notes, for example C D E F G using fingers 1 2 3 4 5 with each hand. While holding all these keys down and not allowing the to rise, and maintaining the fingertips' original position on the key, move your wrists around, up and down and left to right, in an as large circle as possible, while trying to make it feel as easy and effortless as possible. If this is too hard, start out with holding down anything between a second and a seventh using either fingers 12, 13, 14, or 15, and try to move your wrist up and down as much as possible while making it feel easy and effortless. You'll have to relax your thumb as well as your entire arm to be successfull at this. Also the shoulder will make this difficult if you tense it.

[louispodesta]

Hello,
I have been dealing with Tendinitis in my left elbow/forearm for several months now and I am getting a bit frustrated. (I am right hand dominant.)  I don't believe it was brought on by my piano playing but I do believe that my piano playing is now exacerbating it.  I am seeing a doctor and plan to do what is recommended to allow my elbow/forearm to heal; but from there my path is not so clear.  So I am looking for advice on how I can restart playing the piano again without flaring up my tendinitis.

Just for a bit more background, I played piano for quite a few years as a younger person and then did not play for probably 15-20 years.  Then at the beginning of this year, I decided to play again.  And even though my mind and muscle memory feel like 20 years ago, it seems that my arm and hand muscles are not in the condition to play at the level of intensity that I could 20 years ago or that I would like to today.

So any advice on conditioning and preparation for 1-2 hours per day of practice and playing will be much appreciated.  At this point in my life, I really want to play again and I would be very disappointed if I could not get there.

Many thanks!
Patrick

Thanks, for your insightful, and brave post.  However, as known to most who post here, there are new schools of piano technique which deal with these very problems.

I will not go down that road of inquiry with you (as a philosopher, not a behaviorist) unless you so desire.  Your problem (not issue) is easy to solve.

Nevertheless, you have to make the decision to open your mind to a new pathway.  You decide.

All the best.

[indianajo]

I rebuilt my strength & flexibility after a 27 year gap without a piano, by playing mostly Scott Joplin rags.  Much less boring than exercises.  I was floppy & weak in the beginning.  The notes played with fingers 4 & 5 were softer.
I'm fighting tendonitis this summer, mostly because IMHO my bicycle since last year causes me to push my thumb on a lever 2 to 6 times every time I stop for an intersection or go up a grade.  I've just spent over a week & $285 modifying the bike to have different shifter and gearing mechanism.  There was a $3000 electric shifter available, but it was controlled with the same right thumb, one button push per gear level change, and had 11 gears instead of 7, so I didn't waste the money.  The new system has a twist handle powered by the wrist.  The force today on check ride was comparitively light.
Finding the cause of your tendonitis and eliminating it is the priority goal.  Piano playing with proper technique & posture didn't cause my tendonitis, and I'm age 67. 

[hardy_practice]

In short, I would say, work on being able to hold the keys firmly down in the keybed while keeping all joints of the shoulders, arm, hand, and fingers loose. (playing with dead spaghetti fingers that don't pull the keys to the bottom will not work).

Certainly not!  It's firmness that gave you the problem.  You need to switch from fingers to arm, rest between every note, wear a support bandage and get a thera-band.

[patrickbcox]

Thanks, for your insightful, and brave post.  However, as known to most who post here, there are new schools of piano technique which deal with these very problems.

I will not go down that road of inquiry with you (as a philosopher, not a behaviorist) unless you so desire.  Your problem (not issue) is easy to solve.

Nevertheless, you have to make the decision to open your mind to a new pathway.  You decide.

All the best.

Hi,
Thanks for your reply.  I am certainly open creative suggestions for improving my technique.  If you would like to refer me to a book or article as well, that would be great.  I don't want to take up too much of your time.

Many thanks!
Patrick

[patrickbcox]

I rebuilt my strength & flexibility after a 27 year gap without a piano, by playing mostly Scott Joplin rags.  Much less boring than exercises.  I was floppy & weak in the beginning.  The notes played with fingers 4 & 5 were softer.
I'm fighting tendonitis this summer, mostly because IMHO my bicycle since last year causes me to push my thumb on a lever 2 to 6 times every time I stop for an intersection or go up a grade.  I've just spent over a week & $285 modifying the bike to have different shifter and gearing mechanism.  There was a $3000 electric shifter available, but it was controlled with the same right thumb, one button push per gear level change, and had 11 gears instead of 7, so I didn't waste the money.  The new system has a twist handle powered by the wrist.  The force today on check ride was comparitively light.
Finding the cause of your tendonitis and eliminating it is the priority goal.  Piano playing with proper technique & posture didn't cause my tendonitis, and I'm age 67. 

Thanks for your reply.  It's an interesting story for me.  Without boring everyone here with too many details, I believe that the initial onset of my tendinitis was related to golf and long bike rides and then I believe it was prolonged by more piano practice than my arm could handle.  I guess I needed to come to the realization that I am not in my 30s (or even 40s) anymore and I need to ease into things.  I have a habit of going 110% on new activities right out of the gate.  But I have now accepted that once I am back practicing the piano, I will need to ease back into it.  And I do intend to find a teacher to guide me but that is another challenge - finding a qualified teacher to help with my situation.

Thanks again for your reply.  And my age is 51 BTW.

Patrick

[patrickbcox]

The good news is that playing piano with a healthy technique will not exacerbate tendonitis, but be likely to help it heal. However, explaining how to work to make your playing technique healthier is hard to do in only a few words, especially without knowing what types of tensions you currently have in your technique.

In short, I would say, work on being able to hold the keys firmly down in the keybed while keeping all joints of the shoulders, arm, hand, and fingers loose. (playing with dead spaghetti fingers that don't pull the keys to the bottom will not work).

A good but very very tricky exercise for developing this is: press down a cluster of notes, for example C D E F G using fingers 1 2 3 4 5 with each hand. While holding all these keys down and not allowing the to rise, and maintaining the fingertips' original position on the key, move your wrists around, up and down and left to right, in an as large circle as possible, while trying to make it feel as easy and effortless as possible. If this is too hard, start out with holding down anything between a second and a seventh using either fingers 12, 13, 14, or 15, and try to move your wrist up and down as much as possible while making it feel easy and effortless. You'll have to relax your thumb as well as your entire arm to be successfull at this. Also the shoulder will make this difficult if you tense it.

Thanks for your encouragement and suggestions.  They are much appreciated.  Maybe there is a book you could refer me to that elaborates on your suggestions?  All the best.

[patrickbcox]

Certainly not!  It's firmness that gave you the problem.  You need to switch from fingers to arm, rest between every note, wear a support bandage and get a thera-band.

Thanks for your suggestion on the thera band.  I will talk with my doctor next week about exercise.  I am currently wearing a compression sleeve and that helps with discomfort.  Best Regards.

[hardy_practice]

If they are straight handlebars then there's your culprit!  I refuse to use them.

[patrickbcox]

If they are straight handlebars then there's your culprit!  I refuse to use them.

Thanks but no, they are drop bars.  I ride mostly in the hoods.  But I think I was riding longer than I was ready to ride and even though I got fitted to my bike, I think they put me in a more aggressive riding position than I was ready for.  I have taken a break from riding though until I heal and I also don't think I will play golf anymore as that puts too much force on my left forearm and my priority is the piano.  Thanks!

[louispodesta]

Did anyone notice how amenable the OP is to everyone's reply except mine?  Every answer is a right answer to any and all replies..

This post regards a specific injury, which every pianist who has posted here, has expericenced.

Therefore, I once again take umbrage to a "website generated" phony post.

Once again, Tobias Matthay, Dorothy Taubman, Edna Golandsky, and Thomas Mark have spent decades researching a commenting on this most common type of injury.

Therefore, I call on the OP to comment once again, where every reply to any reply is an answer is a right answer.

Afterall, in terms of linear causality, the resultant desired is supposed to be from getting from Point A to Point B, is it not?

I have tendonitis, therefore how do I fix it?
 

[dogperson]

Louis,
 You're paranoid personality is showing.   You really should have your post read by somebody else before you post them as you're losing credibility every time you post something like this

[patrickbcox]

Did anyone notice how amenable the OP is to everyone's reply except mine?  Every answer is a right answer to any and all replies..

This post regards a specific injury, which every pianist who has posted here, has expericenced.

Therefore, I once again take umbrage to a "website generated" phony post.

Once again, Tobias Matthay, Dorothy Taubman, Edna Golandsky, and Thomas Mark have spent decades researching a commenting on this most common type of injury.

Therefore, I call on the OP to comment once again, where every reply to any reply is an answer is a right answer.

Afterall, in terms of linear causality, the resultant desired is supposed to be from getting from Point A to Point B, is it not?

I have tendonitis, therefore how do I fix it?
 

Hi,
I apologize if something I said or did not say offended you.  I actually replied to your post before any other of my replies and in that post I encouraged you to elaborate on your comments or refer me to other writings that might make your point.  Maybe you didn't see my "reply #5"?  Or maybe I didn't say the right thing?  I am not sure.

As far as the rest of your comments, unfortunately I don't really follow what you are saying.  Again, I am here looking for guidance on a plan to move forward with my practice and playing with the best chance to avoid future problems with tendinitis.  And I very much appreciate every comment to my inquiry as I know time is precious and people don't have to give me their time.  It's out of their kindness.

And since I am writing you I will digress for a moment...

I have wanted to say for a while that I have appreciated your posts in the past about Inderal.  I have dealt with a Neurologist's diagnosis of "Essential Tremor" (benign hand tremor) for many years.  It is actually the reason I stopped playing piano many years back.  Because even a bit of nervousness can make it much worse.  So this medicine is something I am going to look into to.

So back to my original topic, if you have further comments on avoiding future problems with tendinitis, I would be very glad to read your thoughts and comments.

Regards,
Patrick

[louispodesta]

I apologize for missing your first reply to my comment.  It was lost among the other replies.

Therefore, especially regarding your addition of a diagnosis of ETS, I will reply by PM.  And, in that it will be detailed in nature (especially with my new Concerto memorization schedule), it will take me some time.

Thank you for your honesty, and once again, your problem is anything but insurmountable.  If I could and can continue to do it, so can you.

Parenthetically, the word is properly spelled tendonitis, with only two i's.  Its etymology is derived from the word tendon.

All the best.

[patrickbcox]

I thought I would add to this post.  I have been soaking and icing my forearm and elbow and I have my doctor's appointment on Wednesday.  But I have also been trying to very gently and briefly play the piano just a bit with my left hand.  ( I am mostly just practicing with my right hand but I thought I would just try some of the techniques I have been reading about with the left hand.)  And in the process of doing this, I believe I figured out what the primary irritant has been for my left arm.  I have been playing some jazz and trying to play some large chords and some of them are really more than I can comfortably stretch.  (mainly 10ths with some inner notes as well.)  So, I know now that I won't try that anymore - at least until I get some trusted instruction.  But any comments or thoughts on this would be appreciated.

Just a side note, I have been investigating the Taubman Technique and this sounds like the type of instruction that would be helpful to me.  So any comments on this as well would be appreciated.

Thanks!

[louispodesta]

I thought I would add to this post.  I have been soaking and icing my forearm and elbow and I have my doctor's appointment on Wednesday.  But I have also been trying to very gently and briefly play the piano just a bit with my left hand.  ( I am mostly just practicing with my right hand but I thought I would just try some of the techniques I have been reading about with the left hand.)  And in the process of doing this, I believe I figured out what the primary irritant has been for my left arm.  I have been playing some jazz and trying to play some large chords and some of them are really more than I can comfortably stretch.  (mainly 10ths with some inner notes as well.)  So, I know now that I won't try that anymore - at least until I get some trusted instruction.  But any comments or thoughts on this would be appreciated.

Just a side note, I have been investigating the Taubman Technique and this sounds like the type of instruction that would be helpful to me.  So any comments on this as well would be appreciated.

Thanks!

Thank you so much for your brave post.  It takes guts to bare ones soul in regards how they actually play.

1)  Dorothy Taubman based her entire teaching career (Leon Feisher, student) on playing without stress and pain.  Her niggard stepchild Edna Golandsky has attempted to continue her legacy through her own Institute.

2)  Dr. Thomas Mark (www.pianomap.com) who was a Taubman practice coach and also a student of Golandsky, has taken it to a further level with his widely academically accepted book, "What Every Pianist Needs To Know About The Body."

3)  Now, that I have finally found a Concerto Coach who has magnificent scale passage technique, I am now re-assessing Taubman/Golandsky/Mark.  THAT DOES NOT MEAN that everything that I learned from them was even remotely wrong/incorrect.

4)  What it has directed me to is pressing, pushing, stretching, and especially holding on to a note and groups/chords of notes.  None of the aforesaid is a natural hand/wrist/arm/shoulder/whole body interaction.

5)  Therefore, I am currently re-assessing all of my pieces, especially the Rach 2nd Concerto.  And, therefore I want to weigh in at this point of the conversation.

If you want more, (and there is a final analysis) I can respond, if you guys want me to.

Otherwise, thanks for listening.

[patrickbcox]

Thank you so much for your brave post.  It takes guts to bare ones soul in regards how they actually play.

1)  Dorothy Taubman based her entire teaching career (Leon Feisher, student) on playing without stress and pain.  Her niggard stepchild Edna Golandsky has attempted to continue her legacy through her own Institute.

2)  Dr. Thomas Mark (www.pianomap.com) who was a Taubman practice coach and also a student of Golandsky, has taken it to a further level with his widely academically accepted book, "What Every Pianist Needs To Know About The Body."

3)  Now, that I have finally found a Concerto Coach who has magnificent scale passage technique, I am now re-assessing Taubman/Golandsky/Mark.  THAT DOES NOT MEAN that everything that I learned from them was even remotely wrong/incorrect.

4)  What it has directed me to is pressing, pushing, stretching, and especially holding on to a note and groups/chords of notes.  None of the aforesaid is a natural hand/wrist/arm/shoulder/whole body interaction.

5)  Therefore, I am currently re-assessing all of my pieces, especially the Rach 2nd Concerto.  And, therefore I want to weigh in at this point of the conversation.

If you want more, (and there is a final analysis) I can respond, if you guys want me to.

Otherwise, thanks for listening.

Thanks for your reply.  Can you expand on point #4 please?

Regards,
Patrick

[patrickbcox]

Well, I had my appointment today with the orthopedic doctor.  They took X-rays that looked fine but I do still have some swelling in my elbow.  He diagnosed it as "lateral epicondylitis"  (aka-Tennis Elbow.)  I think that is just irritation and/or overuse or injury of/to the outer tendons of the forearm.  So he gave me a Cortisone shot and referred me to Physical Therapy.  In addition I will try to find a teacher in my area who can help me with my piano technique.

And as a side note, as I am becoming more attune to my issue, I have discovered that typing on my computer keyboard at work is actually more bothersome to my arm than playing the piano.  So I need to improve my computer setup at work as well.

Thanks for everyone's help.

[patrickbcox]

Hi all,
Well, I thought I would report back on my condition and progress.  I have been going to physical therapy for a couple of weeks and it seems to be helping.  When I leave physical therapy, my arm actually feels better.  But then it does become sore again the next day.  I think the main thing that is helping is the massage treatment they are doing and maybe the ultrasound treatment as well.  I am also stretching my forearms and hands throughout the day and then some light strengthening when I am in physical therapy.  So even though it is a slow process, I am hopeful that my arm will eventually heal.

And then also, I am very excited to say I have found two teachers who are willing to help me.  One is a local university professor and then the other is a teacher who used to live in my city but has moved, however she returns to the area periodically and she studied with Edna Golandsky for 11 years.  And while she does not teach the Taubman technique per se, she does teach a kind of tension free playing technique.  So I am excited to get started!

So in the meantime, I will keep up my PT along with some light piano practice, without overdoing it.

And finally I have a new piano arriving on Monday so I can't wait for that.  Yamaha YUS5. 

So thanks again for your support!

Regards,
Patrick

[louispodesta]

For starters, as I have alluded to before, you are not playing on a normal grand piano acoustic "action."  And, this piece of junk ($17,500) Yamaha does not even remotely have a normal "key dip" resistance.  I know because I fired my last Concerto Coach because she had this same "Brand New" junk.

That is why you keep messing up your hand, wrist and everything else.  Because, in order to get a decent level of sound/volume from this super-easy action, you have to beat on it.  This is not the normal physics associated with a quality acoustic grand piano action.

So, in my opinion, send this brand new piano back to the previous owner/dealership.  Then, get with the oldest piano tuner/technician you can find in your area.  That person will know of at least several (very cheaper) legitimate acoustic pianos, maybe even a Grand, (for sale) that can give you the actual tactile feel of a true piano.

After that, if you want further (much previously reviled) advice on how to cure your tendonitis, then contact me by PM.  Obviously, no one else is listening.

The point is, until you get a decent piano, you will only get worse, and may probably injure yourself permanently.

[patrickbcox]

For starters, as I have alluded to before, you are not playing on a normal grand piano acoustic "action."  And, this piece of junk ($17,500) Yamaha does not even remotely have a normal "key dip" resistance.  I know because I fired my last Concerto Coach because she had this same "Brand New" junk.

That is why you keep messing up your hand, wrist and everything else.  Because, in order to get a decent level of sound/volume from this super-easy action, you have to beat on it.  This is not the normal physics associated with a quality acoustic grand piano action.

So, in my opinion, send this brand new piano back to the previous owner/dealership.  Then, get with the oldest piano tuner/technician you can find in your area.  That person will know of at least several (very cheaper) legitimate acoustic pianos, maybe even a Grand, (for sale) that can give you the actual tactile feel of a true piano.

After that, if you want further (much previously reviled) advice on how to cure your tendonitis, then contact me by PM.  Obviously, no one else is listening.

The point is, until you get a decent piano, you will only get worse, and may probably injure yourself permanently.

Thank you for your kind words and advice.

Also, the correct spelling is actually Tendinitis.  Tendonitis is simply a currently accepted incorrect spelling....

https://www.webmd.com/fitness-exercise/arthritis-tendinitis#1

[louispodesta]

Once more, is this some other Pianostreet Mechanation, or are you for real?  You see, the longer the Post, the longer the potential advertisers?

Tobias Matthay was not a fraud.  Dorothy Taubman, Edna Golandsky, and Thomas Mark, were and are also not frauds.

It is time for this worthless (in terms of legitimate discussion) to be put to bed.

[keypeg]

Tobias Matthay was not a fraud.  Dorothy Taubman, Edna Golandsky, and Thomas Mark, were and are also not frauds.

I read through the discussion twice to make sure.  I could not find any post that suggested that Matthay, Taubman, Golandsky, or Mark were frauds.  Nor were there any negative comments about them unless I missed something.

The only comment I did find was where the OP says he has found a teacher who studied 11 years with Golandsky.   I can't see you taking umbrage with that.  I, for one, would be interested in knowing how that goes.

[patrickbcox]

Once more, is this some other Pianostreet Mechanation, or are you for real?  You see, the longer the Post, the longer the potential advertisers?

Tobias Matthay was not a fraud.  Dorothy Taubman, Edna Golandsky, and Thomas Mark, were and are also not frauds.

It is time for this worthless (in terms of legitimate discussion) to be put to bed.

If you are distrustful of Pianostreet, maybe you should find another forum to bully.  And I never said anyone on your list is a fraud.  But I can think of another name that could be added.

[dogperson]

If you are distrustful of Pianostreet, maybe you should find another forum to bully.  And I never said anyone on your list is a fraud.  But I can think of another name that could be added.

Indeed.   Louis, you have posted many times that you believe Piano Street and the posts are a fraud.  Maybe it is time for you to find a forum which you find credible. I believe you are no longer a member of PianoWorld,  but have you considered another forum where you believe the posts are not fraudulent?  
To continue these type of posts here is not healthy for the forum or for you.