Cellists: Repetitive Strain Injury in Bow Hand?
Cori
I'm interested in others' experience with carpal tunnel/rsi
problems and how you have coped with them.
I've been taking cello for about two years and have
experienced pain and numbness in my right hand (especially
when I'm practicing on the C string a lot).
Unfortunately I also use a computer quite a bit so I'm trying
to determine how much of the problem is cello-related.
Thanks in advance.
Cori
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Frazer Worley, #909980 DAD
I've been playing for 18 or so months now and too have had some trouble,
starting with my left and but also in my right too. I work as a software
engineer so do quite some keyboarding. I didn't have problems till I moved
to the States and started cello - and I think one of the main problems was
with my desk/seating position. Now that its corrected maybe I'll have less
trouble. I try to take regular breaks away from the keybaord - and maintain
a good "neutral" position too.
I couldn't say what proportion if any is caused by the cello. One way to find
out would be to stop playing altogether fir a while, say 4/6 weeks and see if
the symptoms remaineir not. This is a bit drastic I know - especially for a novice
like me - I need all the practise I can get afterall.
What have you tried/are considering to alleviate the problem ?
Just out of interest - do you own a cello or rent one ? Anif you own one
did you buy it new or used ? Mines old and beat up. I'd like a new one but
aren't sure that my playing justifies the expense at this point in time,
maybe someday though.
Regards,
Frazer
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Cheryl Hanson
Hi Cori,
I'm not a cellist - I'm a violinist/violist, but my best
friend had a similar sort of injury a couple of years ago. I'm
not sure of all of the details, but I do know that she almost
never used a computer, so her injury was definitely
cello-related. She eventually ended up going for bio-feedback
treatments which helped her tremendously - she is now pain-free
as far as I know. It got so bad before she went for treatment
that she was scared she would have to give up cello playing,
which is her life.
Hope that helps!
Cheryl Hanson
e-mail: cha...@acs.ucalgary.ca
DeanTurley
forward aggravates carpal tunnel so eliminate any bending in that
direction that you can, no matter how insignificant. Also, don't sit on
your hands by which I mean laying your head on the heel of your hand while
sitting at a table. Pressure on the heel of your hand is not good in
general for this condition.
Second, buy a wrist brace that has a rigid insert to keep your hand in its
"neutral" position which is when it's bent slightly backward. Use it to
help you through the periods when numbness is distracting or during times
when you're doing something that aggravates your wrist alot. I use mine
when I'm driving or typing and even when I practice violin at times
although it's clumsy.
Thirdly, use ibuprofen to keep inflammation down when it is BEGINNING to
be a problem, if it's a cyclical problem. Mine is, so that's what I do.
I do not know what to advise if you find out it's chronic. You will not
know until you try a few things to stop the aggravation though. I
certainly wouldn't advise taking ibuprofen all of the time.
Finally, do not let your wrist get weak. I've taken up tennis and to my
surprise my wrist has improved. So try not to use a brace all of the
time. I also build up my wrist's tolerance to stress by working out with
8 lb. weights. This last advise may be controversial.
Dean
Hsiao-wen Chung
: Hi -- I've been lurking for a while and I think I have finally gotten the
: hang of this editor. I am an amateur cellist, started playing as a
: third-grader and continued til college. I back to it a few years ago
: when I moved to Pittsburgh.
: I have a teacher here who is great when it comes to the cello and
: the player's body -- she says she got it from Starker, who was her
: teacher during her BFA. The times my bow arm and wrist became painful, I
: was not using my bow arm properly -- particularly, there was much too
: much tension in my wrist. Since I do a lot of my work on the computer as
: well, I have found that since Mary has helped with the mechanics of my
: bow arm, my wrist becomes painful only when I am on the computer for
: hours trying to beat a deadline!
: So, some amateur advice, check for tension in your bow hand, and
: use the weight of your arm to pull more sound from the cello.
: Roberta
I agree with Roberta. I used to play the cello quite a lot and had
no problems. Then I stopped for many years when pursuing my PhD in
Engineering. When I picked up my cello again (but this time without
going to a teacher), I found that I have bad pain and just can't
finish Bach's Suite No.1! I think it's cello-related rather than
computer, but typing the keyboard could have made one use the bow
arm/hand improperly. As another amateur advice, I, too, suggest
checking for tension in the bow hand and use as little tension as
possible to get the sound you want. Best wishes to all us cellists.
Hsiao-Wen Chung, Ph.D.
MRI/S Laboratory
Institute of Biomedical Sciences
Academia Sinica
Taipei, Taiwan, R.O.C.
Roberta J Astroff
Cori
>
>What have you tried/are considering to alleviate the problem ?
I have, but not very consistently, done exercises involving stretching the hand back and
down. They came from a very good book with "RSI" in the title--one of the authors' names
is Deborah Quilter I believe.
I have avoided going to a doctor so far because I haven't talked to anyone who seems to
know about the battery of tests they can do to determine various types of damage (tissue,
muscular, nerve etc). I would not consider surgery whatever the outcome of the tests. My
understanding is that it does not really work in most cases.
There is some evidence that B vitamins (B6 I think) helps. This I've also done
inconsistently.
Also I've heard that keeping the wrists warm while working or playing (there are some
special fingerless gloves available) helps. I'm considering getting some.
I'm afraid that I do sleep on my hand, and I'd like to come up with a solution for that.
Right now the hand is numb, however, I haven't played the cello very much for 4 months,
nor have I been at the keyboard for long this morning.
My experience with wrist support with the metal flange is that it made my hand numb.
>
>Just out of interest - do you own a cello or rent one ? Anif you own one
>did you buy it new or used ? Mines old and beat up. I'd like a new one but
>aren't sure that my playing justifies the expense at this point in time,
>maybe someday though.
I own a cello. It's very definitely a student instrument. I spent a year, however, on
one that was even more difficult to get a good sound out of, so in a way I'm grateful for
this one.
I'm sure that I'm doing something wrong, especially on the C string, when my perception is
that not enough sound is coming out. Also, in that position, I tend to bend my hand back
a lot. My former teacher did not respond to my complaints that I was feeling pain in my
right hand, although we did concentrate quite a bit on what was proper bowing technique.
I'm sure I'm applying more tension to the hand than is necessary.
As for better equipment...I have also felt that buying a better cello was unjustified, on
one hand. But after having the opportunity to play a couple of VERY expensive cellos, I
realize that a good instrument can help prevent so much strain by being wonderfully
responsive. I was amazed at how the sound seemed to leap out of the C string with little
effort!
But back to reality...an instrument in my price range ($5,000-7,000) may not make that
much of a difference. For now I'm going to concentrate on better technique and taking
care of the wrist. Though I do support the idea of getting a better instrument when you
can afford it. (life is short).
Thanks everyone for your responses! I'd really like to continue to read about your
experiences with this.
Brian Sandle
: Distribution:
Did she have a weighty bow? A few grams makes much difference when rapid
movements are required.
Anyone used biofeedback machines attached to various muscles while playing?
It's interesting finding muscles pulling unnecessarily against each other.
Ronald M. Schmidt
a unique thing that has to be in balance. Try Alexander Technique to become aware of
bad attitudes that may influence your posture while playing. Take playing - and
keying - as easy as you can, do not force sound out of your instrument. Do not apply
antirheumatics without consulting a pharmacist or practitioner, because they may in
the long term aggravate cartilage breakdown!
Hope this helps,
Ronald
Steve Smith
.
Cori, without knowing anything about your build, playing style, etc.,
I will pass on the means of preventing several common causes of
bow-arm discomfort. Neither may apply to you at all.
A common problem which I've seen as a teacher, and which was first
pointed out by my old teacher, Donald Whitton, is a tendency to use
end-pins that are too long. This particularly affects taller people.
The effect of a longer endpin is that of moving the cello's bridge
closer to the cellist's chin, and causing the cellist to scrunch up
the bow arm as a result (kind of like playing 'sul tastera' all the
time) in order to keep the bow in the 'sweet spot' above the bridge.
The scrunched up arm means a more severely bent bow wrist (depending
on the bowing school to which you belong) and acute angle at the
elbow, and I feel that this must contribute to such problems as carpel
tunnel syndrom.
So, I advise students as Don advised me - to adjust their instrument
with the comfort of their bow-arm as the primary goal. It also means
that, contrary to what would naturally be assumed, taller cellist's
should probably use shorter endpin lengths (given conventionally
designed endpins and conventional playing styles).
I'm 6'3", BTW, and use no more than 14" or so of endpin.
Another common technical problem I see with students is a tendency
to 'cock' the wrist sideways - e.g. lay your right forearm flat on
desk, palm down - now slide hand to right, keeping palm against desk
and without moving forearm - feel terrible strain in wrist?
This is what students often do when they are trying to imitate what
they think they see advanced players doing. I have even seen a few pro
players doing it, but never a good soloist. They just couldn't play
like that and survive.
The error here is in keeping the forearm too pronated (flat - like on
the desk). If the player simply rotates the forearm towards the tip
of the bow (or if your hand is still on the desk in that uncomfortable
posture, slide your thumb under your palm as you rotate your forearm
in anti-clockwise direction while lifting elbow/upperarm so the weight
of arm transfers mostly onto your fore-finger for effect), the
'sideways' bend in wrist disappears along with the useless tension in
the wrist, and you can allow the full weight of your arm to 'stand' on
your fingers - mostly the forefinger (esp. when playing near tip).
Using this technique the downbow is very similar to the arm movement
used in the Australian crawl swim stroke - but obviously more across
the front of the body - the important point being that wrist flexation
is executed in the 'flapping' axis of the hand instead of a side-to-
-side axis - and is very much less stressful. The fewer 'kinks' in
your wrist the more easily power can be transfered to the bow from the
upper arm and back muscles.
We want to let the big muscles do the big work and use the smaller
ones for short periods or not at all. That way we stay loose and
have great stamina.
Sorry for the dumb explanation, but I have never had any problem
with my wrist, due to this technique, and I am a fairly strong player
who can put in 6 hours of heavy practice without discomfort (though
my left hand may complain). And I do understand how controversial
some may find this notion, but rest assured that I have studied
with some 'namebrand' teachers, and this is how they all do it - their
explanations just weren't so wierd.
I work on keyboards all day as well, and have found that I must avoid
using the mouse extensively with my left hand, or I begin to suffer
wrist problems when playing. I've learned to type while keeping my
wrists straight.
Can someone think of a better word for 'flapping' axis?
Steven E. Smith
val...@halcyon.com
> down. They came from a very good book with "RSI" in the title--one of the authors' names
> is Deborah Quilter I believe.
Yes, the book is "Repetitive Strain Injury" by Emil Pascarelli and Deborah Quilter. It's excellent.
Pascarelli is an MD who first began working, interestingly enough, with musicians although this book
focuses mostly on keyboarding/computer use (mouse too!)
> I have avoided going to a doctor so far because I haven't talked to anyone who seems to
> know about the battery of tests they can do to determine various types of damage (tissue,
> muscular, nerve etc). I would not consider surgery whatever the outcome of the tests. My
> understanding is that it does not really work in most cases.
Depends on exactly what the problem is; if you've read Pascarelli you know that more than one thing
can be wrong at once. And you're smart to be suspicious of doctors; I was intitally misdiagnosed &
slapped into the totally wrong kind of splint by my GP & it wasn't until I found a hand specialist that I
finally figured out what was going on. (Are you anywhere near Seattle?)
> I'm afraid that I do sleep on my hand, and I'd like to come up with a solution for that.
I find that splinting at night helps me when I have mild problems. Keeps the wrist in proper position so I
don't end up with it all scrunched in the morning. (But not if it's too tight! ;-)
> Right now the hand is numb, however, I haven't played the cello very much for 4 months,
> nor have I been at the keyboard for long this morning.
But HOW long? If you do more keyboarding than 'celloing (is that a word?) the keyboard is probably the
culprit; and because the movements are so fine and so many when you keyboard, the strain can really
add up fast. It's best to type for half an hour or less, then take a 5-10 minute break.
> My experience with wrist support with the metal flange is that it made my hand numb.
Maybe it didn't fit right. I spent 8 weeks in a custom-made splint for deQuervain's tenosynovitis about
three years ago -- got it from keyboarding. Sounds like your splint was too tight.
> Thanks everyone for your responses! I'd really like to continue to read about your
> experiences with this.
Cori,if you're anywhere near Puget Sound let me know & I'll give you the name of my doctor. But try to
find one in your area who "does" hands!
Val
Valerie Schultheiss <val...@halcyon.com>
Seattle, WA
Sam Cross
a disease, he is doing something wrong. If one attempts to get sound with
muscle, two things will happen: 1) you will get pain in your bow hand by
the need to press with the first finger and counteract that pressing with
your thumb to hold the bow, and 2) the sound you get from your instrument
will be painful. I am a bass player. We have a heavier bow, so I guess we
should have more pain. I even switched to the German Bow to avoid pain.
Ultimately, the pain returned with the German Bow as well as the French
Bow. The sound through arm weight method of Francois Rabbath completely
solved the pain in my bow arm, as well as greatly improving my sound and
technique.
Roger Lebow
A resource you all should be aware of is a new book by Victor Sazer--the
exact title of which, of course, has deserted my noggin--published by Of
Note. The book treats physical problems of cellists, and is the product of
Sazer's years-long study of physiology and Alexander technique.
I'll try to get the exact title and repost!
Roger
--
Roger Lebow
slot...@cheshire.oxy.edu