Forearm pain caused by bad movements and cold hands?

[vetenar]

During a practice session today I sensed some pain in my right forearm. I filmed a bit of myself playing and would like to ask for your advice.

Mostly I practice on a digital piano at home. This week is the first that I got access to a practice room with a grand piano. I occasionally felt some *discomfort* in my wrist after practice at home, and it usually would be gone the next day or two. But today it is more than mere discomfort or tiredness (still there as I type..)

I wonder if it is caused by my cold hands + some unnecessary movements. There is definitely tension when I play thirds. Still, I am surprised by the pain as I did not play particularly fast or for very long today. Could it be that cold hands make you more injury-prone? Would love to hear your thoughts or suggestions, thanks in advance!

[lelle]

While I don't think you should diagnose stuff like this on a forum (better to see someone knowledgeable in person) I'll offer some thoughts.

First of all, tension and forceful/uncoordinated movements can absolutely cause pain or discomfort, even if you don't play quickly or for a long time. It's your body's way of saying "hold up buddy, something is not right here, this is dangerous, you need to change something you are doing".

I have also experienced that cold hands can be caused by tension/stress (stress creates tension and redirects blood flow to where it's most needed when you need to fight tigers, which is not out in your fingers). So there might be a correlation between you doing something with tension (which can cause injury) and your hands being cold, though the coldness is not what's causing the pain. Correlation but not causation and all that.

Thirdly, tension in the neck/shoulder area, which can cause cold hands, can also create referred pain lower down in the arms/hands.

But it's not unreasonable to expect that if you can get help developing a more relaxed technique your pain problem might improve/go away.

[vetenar]

Thank you for your reply, lelle!
I have been doing some research on injury and a post mentions "static muscular activity" as one of the causes. I then realize indeed when I practice, I often forget to release after pressing the keys, as you say, "forceful movements". I find playing soft passages very difficult and requires a lot of *efforts*.

Thank you for sharing your experience about cold hands and tension. This is something I overlooked. "Correlation but not causation" is important! I actually arrive with warm hands, but after some time my hands turn cold. The room is pretty cold, too. Feeling uncomfortable with cold hands most likely also contributed to the tension I had in the arm and neck.

Yes, I would very much like to develop a more relaxed technique. I am looking for a teacher and hope to start taking lessons soon. Was a bit too excited once I had the chance to practice on a grand piano .

[victor66]

Thank you for your reply, lelle!
I have been doing some research on injury and a post mentions "static muscular activity" as one of the causes. I then realize indeed when I practice, I often forget to release after pressing the keys, as you say, "forceful movements". I find playing soft passages very difficult and requires a lot of *efforts*.

If you mean keybedding, it's a big no-no in piano. But also moving from digital piano (depending on a type of action you have on digital) to a grand is not an easy process. Took me a couple of months to get a good feel of my grand after MP11SE (which is considered pretty close to a real piano). Just be patient. Check this video with Graham Fitch:

He specifically talks about keybedding and useful exercises. Meanwhile he has other vides on Youtube which helped me a lot.

[vetenar]

The video is really helpful and points out precisely my issues. Also thanks for introducing the term "keybedding", victor!

I have watched his videos from Pianist Magazine but was not aware of this one. The exercise of "holding and playing" is great mental work. The tip of "moving the forearm and not stretching the fingers" is also very useful. 

I have a Roland FP-30. Fortunately it is with weighted keys. With the grand piano I am able to *feel* the lever and watch the hammer while touching the key and hear the dampers as I release. The visualization and sounds are not only amusing but also help with control. A huge difference is the pedaling. My pedaling is really not good. Yes, need to be patient!

[skypert]

I have a Roland FP-30. Fortunately it is with weighted keys. With the grand piano I am able to *feel* the lever and watch the hammer while touching the key and hear the dampers as I release. The visualization and sounds are not only amusing but also help with control. A huge difference is the pedaling. My pedaling is really not good. Yes, need to be patient!

Just out of interest, I have been playing for a few months on my fp30.  Never touched a real piano.  I was wondering what your experience of suddenly playing a grand was. Was it difficult and overwhelming or did you feel well prepared?

[swede1]

Right wrist seems low and hand too colapsed, think of and arch, holding a ball in your hand. Try higher wrist and get more power from arm/shoulder, and then you relax fingers more inbetween notes, more hanging hand. I can see the hand tense up. How are your seat position, posture, we dont se that from the video? Relaxed neck/shoulder not?
Play something slower so you have time relaxing between notes. Make more movements circular to get rid of tension. My very amateurish suggestions. Sit and relax with hands hanging down and fingers just touching keys, then strike key with arm/shoulder movement. If you get pain you should stop immedietely and do something else, massage your arms/fingers/shoulders. Josh may have some points in this video.

Maybe Josh solve your problem in this video:

And Josh third video, which pinpoint your fingerjoint is curved, the one closest to the fingertip! Josh got me there too!  Do his tips.

[klaviertraum]

Hi,

I wanted to give my 5 cents to this post for sometime now. I am not a physician and could not agree more with Ielle that you should consult to a specialist, however I have suffered from chronic inflammation in both of my wrists for over 14 months, I could not use my hands for basicaly anything, like brushing my teeth, needless to say playing the piano. I felt I should share my experience in case it is helpful to anyone.

The inflammation started as a simple sore wrist due to a minor injury and got worse to a painful swollen wrist in 2 days after using the computer mouse and keyboard. Eventually my left wrist got inflammed too, because of overuse, the right wrist was immobilized so I had to use the left one at work. To make the story short, after 12 - 13 months of no signs of recovery I realized that there was an underlying issue. For some time even before the injury, I had tingling and numbness in the pinky and ring fingers during my sleep in both hands, as the symptoms were mild I just learned to live with them. I learned that these are symptoms of nerve entrapment and can cause inflammation in the arm. Inflammation in the tendons causes muscle tighness which triggers more inflamation in the same and other tendons in the arm. So I already had an inflammation process at the time of the injury and could not recover the wrists because I was not treating the underlying cause (correlation and causation  ). As soon as I started doing flossing exercises to release the entrapped nerve, I felt my wrists got better in a matter of weeks. I had to do other things too.

So identifying the cause of the injury is very important. But, what was the cause of the (ullnar) nerve entrapment?: Bad ergonomics and a bad sleepling position. Many decades of bad ergonomics sitting at the computer desk and at the piano had its toll in my arms. Posture while sitting is very important. 

A recommendation I could give you to help the healing process is the following, but please consult with a specialist:

- hot compresses in the forearm muscles (not in the wrist). The heat applied to the muscle has a huge impact in relaxing the tight muscles which will stop the vicious loop  inflammation -> tightness -> inflammation. It worked like a charm for me. Notice that this works when you are in the recovery phase, in the acute phase you rather need cold compresses in the wrist area, anti-inflammatory medication and to stop the swelling. But you really need the guide of a physician to know in which phase you are.

- Also in the recovery phase,  wrist rehabilitation exercises , I did these ones: 

 
- Tension and tightness are likely going to provoke injuries. I'd recommend to warm up fingers, wrists, elbows and shoulders before playing the piano. I do these exercises before playing:

I wish you a speedy recovery as I know how it feels.

KT

[lelle]

@klaviertraum Thanks for sharing those exercises. I enjoy doing Qigong. I currently incorporate the following routine into my daily life, and often go through it before I practise:

[vetenar]

I was wondering what your experience of suddenly playing a grand was. Was it difficult and overwhelming or did you feel well prepared?

For me, the most overwhelming part is pedalling, and another big difference is the evenness of keys.

On my FP-30, I always practice with headphone and I have a sustain pedal that supports "half pedal". But still, pedalling feels and sounds very different, and it is almost impossible to practice peadlling with my FP-30 (for later pedalling on an acoustic piano). Also, the keys on FP-30 feel and sound pretty even, but on the acoustic piano, it depends on the piano itself and the condition of it at that moment. Some keys are lighter or heavier than others, or sound louder or a bit off. We have to hear the sound it produces and adjust accordingly, if possible.

It probably depends on the grand piano, too: I feel it takes less effort to play trills on the grand piano, after getting used to it. But practicing trills on the FP-30 does improve my trills on an acoustic piano. 

[vetenar]

Right wrist seems low and hand too colapsed, think of and arch, holding a ball in your hand. Try higher wrist and get more power from arm/shoulder, and then you relax fingers more inbetween notes, more hanging hand. I can see the hand tense up. How are your seat position, posture, we dont se that from the video? Relaxed neck/shoulder not?

Thank you for the specific video references, swede! His explanation of the wrist's role (more firm or less firm) when playing louder or softer is interesting. I immediately tried this with one hand tapping on the other arm. And his examples on the balance of arm weight and finger work are really great!
 
I feel more comfortable sitting higher (elbow greater than 90°), which is due to the height of my digital piano at home. By the grand piano, I was sitting a little bit lower than what I am used to. My posture indeed needs to be checked by a teacher. My right shoulder was a bit tense, but it is something I do when I am seated. Recently, I have been consciously reminded myself to relax the shoulder.

[vetenar]

klaviertraum, thank you so much for sharing your experience and your solution in such detail. It is great to learn that you found the cause and have recovered!

After I posted, I had rested my right hand and arm for about two weeks. I did wonder during that time if it ever would get better. Turing the doorknob, holding something or even tying was unbearable. I have been learning some arm anatomy and figuring out which muscles were responsible for which motions. It is incredible how complicated it is and how many arm muscles were attached together! Also, I got a massage ball and tried to identify the pain spots and to release tension.
 
I realize my right side is more tense in general. It gets me into a habit of relaxing and balancing. Thanks for the videos! I am adding the exercises and warm-ups to my routine.