The TRUE cause of tension and injuries

[Daniel_piano]

I would like to share this info with all of you who have suffered with mild tendonitis or chronic tendonitis or carpal tunnel syndrome or other injuries or problems related to playing with tension.
I think I have found the 1 TRUE cause (and solution) to injuries but I would like to know what the opinion of the experts of the forum is ...

I've suffered with severe tendonitis, synovitis, epicondylitis and carpal tunnel inflamation.
I've perused and tried everything I could get my hand on to try to heal from injuries: from Thomas Mark anatomical book, Aschbrenner method, weight of the arm school, Taubman (not as in detail as I would have liked) to Alexander Technique.

The reasons why 1) playing the piano (dynamic, volume, speed ...) ends up to be so enervating 2) the sound is not good and the pieces take years to be mastered and eventually 3) injuries and pain develop are easily summarized in the four points both Marks, Taubman and Lister-Sink make

1) awkard position
this including thumb orientation/twisting, raised shoulders, hunching, jutting elbows, locked elbows and so on

2) dual muscular pull or co-contraction
tightening a set of muscles before an opposite set of muscles has been released

3) static muscular activity
contracting only for the split second of impact just to release the muscular quickly creates a dynamic muscular activity of contraction/shortening and releasing/lengthening that is lacked in its opposite static muscular activity

4) excessive force
contracting the muscles when pushing the keys down instead of letting the gravity do the work

Too many things and hard to reprogram.
But I've (I believe) found out just "one thing" to correct that "takes care of all the others"
That is: collapsed wrist

I've seen that those people who suffer injuries because of the 4 points above all play with a collapsed wrist and if they fix the collapsed wrist problem all the other problems are fixed by themselves.

It means that raised shoulders, twisting, jutting elbows and so on can persist only if the wrist is collapsed but as soon as the position of the wrist is corrected the hand will align itself making thumb orientation impossible, the shoulders align themselves making raised shoulder and jutting elbows impossible.
It also means that co-contration doesn't occur when the wrist is not collapsed because when the hand, wrist and arm are aligned the contraction is transferred back to the torso without effort but the transfer is compromised by a collapsed wrist.
It also means that it's impossible to use excessive force when the wrist is not collapsed because the force is transferred back to the torso and the hand natural shape is maintained without muscles tension.

I've looked for people in my school and private lessons who suffer with tendonitis, carpal tunnel inflamation or other injuries and I asked them to show me how they play and they all had in common a collpased wrist.
I told them to play with at mirror at their side and make sure that each bar is played without collapsing the wrist. As I theorized this advice took care of all the other problem as well and now they can play faster, with evenness of the sound and without pain or tension.

A collapsed wrist makes playing at speed very hard, makes scales passages blurred, thirds uneven and fakes fingers heavy and hard to move. When the students make sure not to collapse their wrist all of this takes care of itself in few days ...
the movements become smaller and speed faster without tension, thirds and scales becomes even and trills becomes easy.

I don't know if my "theory" is valid or if it isn't but I observed the same pattern in several students: those who suffered from tendonitis and hand injuries played with a collapsed wrist and had different combination of the 4 causes of injuries, as soon as they made sure not to collapse their wrist all the 4 causes disappeared as well and their pain and injuries improved in few days.

What I'm suggesting is that probably all the four causes of injuries are caused by the same problem and taking care of it, takes care of all the other causes by itself.

Why should a collapsed wrist be such an important cause that have an impact over all the rest?
I could attempt an explanation by telling you to read Thomas Mark chapter 5 of his book where he explains how the arm works like a bridge that transmit weight from the torso to the tips of the fingers to send it back to the torso (dynamic muscular activity)

It can be compared to a bridge where cars keep coming and returning ... if the bridge collapses all the cars get jammed  and can't move anymore.
So when you interrupt the dynamic muscular activity by collapsing the wrist (hence a chain rection of awkard positions of the thumbs, elbows and the shoulders)
you create a static muscular activity, hence the contracted muscles don't release themselves after the moment of impact with the keys and hence you have a co-contration which we subconsciously try to fix by using excessive force.

Take care of the collapsed wrist that caused the chain reaction and everything will take care of itself. The collapsed wrist is like the trigger without which all the other causes can't exist.
Any thought?
What do you think about this?

Whatever your opinion is I hope this info will help other pianists who are suffering needlessly

Best Wishes
Dany

[i_m_robot]

What is meant by collapsed wrist?


this   ___/    or this ^-------\

[Daniel_piano]

What is meant by collapsed wrist?


this   ___/    or this ^-------\

More like the first one
The wrist is not collapsed when it is the center of the forearm-wrist-hand bridge
When your forearm-wrist-hand doesn't look like a bridge anymore the center of the bridge (the wrist) has collapsed ...

These are bad images but should clarify what I mean:






Dany

[xvimbi]

It is very valuable advice to pay attention to a collapsed wrist, and in fact, to collapsed joints in general. Though I am not convinced that a collapsed wrist is behind all the problems you listed, it does make a big contribution.

There are a couple more ways to look at this. Force gets transmitted along bones. So, when the wrist is collapsed, force gets transmitted below the hand, which collapses the wrist even further. In addition, getting the appropriate force to the fingers to play will require even more force along the forearm, thus compounding the problem. The same is true for a "hanging" thumb. When the fingers play, the thumb must not be left hanging in front and below the keys, because this diverts force from the forearm and directs it below the keys, not into the keys where it should go.

However, it's not that simple. Many techniques require a slightly collapsed or raised wrist for sound production. Although those positions are bad for the above reasons, I think as long as one doesn't deviate too much from the optimal positions of the joints, one should be OK. One must also minimize the duration of such positions, i.e. get rid of unnecessary dwelling in the keybed or stretching and reaching for notes.

[ted]

For what the fact is worth I have always tended to play with my arms and wrists held somewhat higher than most players and I have never had any sort of injury from the piano in fifty years. This doesn't prove anything and may not imply much in itself, but it is consistent with the collapsed wrist theory.

[torchygirl]

Dany-

I have really noticed this too in my working with my computer.  Computer + piano = (in my case) soreness/dystonia.  Since I work with a notebook that is just a bit too high up on my kitchen table or counter, my wrists were almost always "broken."  Stopping this habit has helped so much!

Karen

[Rez]

Daniel,

Excellent thread.  I'm suffering from wrist/hand problems and have noticed that my wrist collapses when typing and playing. I'll watch this thread closely.

Just curious.  How did you "cure" this?  Did the change in hand position alone alleviate the problems or did this also involve other methods: anti-inflammatory drugs, physical therapy, surgery, etc.?

Joe

[shoshin]

I can explain why you get wrist problems with the collapsed wrist.  Your tendons go through a hole in your wrist. When your wrist is collapsed it is like rope at an angle scraping against an edge of a table. When your wrist is in the correct position the tendons or "ropes" are straight and dont scrape against the bone.  Just having your wrists collapsed does not cause the problem. Your fingers have to be moving as well.  The finger movement causes the tendons to scrape and cause inflamation. The inflamation causes swelling which makes the hole that the tendons and arteries go through become tight. You will feel a numbness in your index finger. I think the pinky and ring finger wont feel numb because their blood supply doesnt go through that hole in the wrist.  Same thing can happen with typing on a keyboard.  I'm not a doctor but I think the anatomy I described is mostly correct. If someone could check it with an anatomy book that would be great. I have none at home.

[CalKat]

Thank you for your wonderful and informative post, Dany. I've been seriously starting up on the piano again recently and I think that this is something I definitely need to keep in mind. It would probably help my playing in addition to preventing injuries. 

[abell88]

When your wrist is collapsed it is like rope at an angle scraping against an edge of a table. When your wrist is in the correct position the tendons or "ropes" are straight and dont scrape against the bone.  Just having your wrists collapsed does not cause the problem. Your fingers have to be moving as well.  The finger movement causes the tendons to scrape and cause inflamation. The inflamation causes swelling which makes the hole that the tendons and arteries go through become tight.

Shoshin, this is a great explanation that I can pass on to my students. Thank you!