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Healing from Tendinitis, practice regimen? #1585370
12/27/10 11:39 PM
12/27/10 11:39 PM
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Urtext Offline OP
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Argh.

Three weeks ago, I got tendinitis from drill-practicing two cadenzas and passages for a recital the next day. I ended up over-practicing that night and my hands were 'swollen' when I performed later that day.

My teacher has told me to take a break from practicing, and to ice the pain and drink Advil. I'm a righty, so my left hand is almost fully healed, but my right hand is not so much due to writing in school and the sort.
Starting last week, I got back to the piano slowly, doing fifteen minutes of slow practice with breaks in between, doing sight reading and scales mostly with the left hand.

I'm to be back into full working condition sometime soon in January. I'm just wondering if anybody here can give me any tips on what else to do to hasten the healing.
I stretch my hands backward and hold for a couple of seconds, followed by making a slow fist and releasing.

I know that forcing anything would be absolutely detrimental to my healing, but is there any other things that I could do to get back 'in shape'?

Thank You in advance


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Re: Healing from Tendinitis, practice regimen? [Re: Urtext] #1585380
12/28/10 12:07 AM
12/28/10 12:07 AM
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Hobart, Australia
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ando Offline
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Originally Posted by Urtext
Argh.

Three weeks ago, I got tendinitis from drill-practicing two cadenzas and passages for a recital the next day. I ended up over-practicing that night and my hands were 'swollen' when I performed later that day.

My teacher has told me to take a break from practicing, and to ice the pain and drink Advil. I'm a righty, so my left hand is almost fully healed, but my right hand is not so much due to writing in school and the sort.
Starting last week, I got back to the piano slowly, doing fifteen minutes of slow practice with breaks in between, doing sight reading and scales mostly with the left hand.

I'm to be back into full working condition sometime soon in January. I'm just wondering if anybody here can give me any tips on what else to do to hasten the healing.
I stretch my hands backward and hold for a couple of seconds, followed by making a slow fist and releasing.

I know that forcing anything would be absolutely detrimental to my healing, but is there any other things that I could do to get back 'in shape'?

Thank You in advance


Ok, for starters, give up handwriting indefinitely. As somebody who had a serious case of tendinitis many years ago, handwriting is the single most detrimental action to healing a hand tendinitis injury. Especially for people who hold the pen tightly, but even light pen-holders will aggravate it enormously. You must give it up until your tendinitis is resolved. Even if it makes school work very difficult. I was in University doing a music performance major when I got my injury, and I actually found that instead of trying to write everything down, I would just listen to lectures and try to understand everything that was said. In the end, I don't think it harmed me at all. It made me listen better and understand the first time instead of writing down notes and trying to understand it all later. If you are doing maths it can be pretty tough though.

It is always better to take more time off than you think you need. Even when you feel the symptoms are gone, the healing is not complete, you are still not ready to play. Give it a bit longer and return to practice in a light-hearted way. Just play for ten minutes at first and then don't play again for another hour. you will have to build up slowly to avoid irritation. Tendinitis also becomes a psychological problem because you will be monitoring how your hand feels and this promotes tension and "testing" of the injury which exacerbates the problem. You need to extend your break until you are no longer thinking about it. It needs to leave your system in more ways than the injury itself. It very much feeds on negative thinking and worry. I ended up not playing for 1 month the first time, but it wasn't enough, the next time I took about 3-4 months off. Sounds scary, I know, but sometimes it's the only way.

The other thing you should do is investigate a low acidity diet. There are plenty of cookbooks on the subject and you can find these diets on the web. Tendinitis is an inflammatory condition and if you can reduce the acidity of your blood, it greatly reduces the inflammation of tendinitis. There are certain foods that create huge acidity in the body - you must avoid these. Look into it.

I eventually got over my problem and it has never been a problem again. I never returned to much hand-writing though. That will still bring it back for me.

Best of luck, I know what you are going through.
Regards,
Andy

Re: Healing from Tendinitis, practice regimen? [Re: Urtext] #1585492
12/28/10 03:52 AM
12/28/10 03:52 AM
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Expecting to be back to full working condition by January sounds EXTREMELY optimistic, and/or foolhardy. However, I guess I don't know your full situation.

At the top of your list of things to do is to eliminate forever the kind of practicing that caused you trouble in the first place. Frankly, you must learn how to give up and how to stop working on something that isn't finished. For some people that is very difficult.


(I'm a piano teacher.)
Re: Healing from Tendinitis, practice regimen? [Re: david_a] #1585517
12/28/10 05:27 AM
12/28/10 05:27 AM
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Here, as opposed to there
stores Offline
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Here, as opposed to there
Originally Posted by david_a

At the top of your list of things to do is to eliminate forever the kind of practicing that caused you trouble in the first place. Frankly, you must learn how to give up and how to stop working on something that isn't finished. For some people that is very difficult.


I fully agree with the first sentence here, but not the second. There's no need to give up, or stop working on something. You simply LEARN THE CORRECT WAY to work. Don't feel badly...a surprising amount of pianists hurt themselves (and not just physically, but musically), because they DON'T know the correct way to work through things.



"And if we look at the works of J.S. Bach — a benevolent god to which all musicians should offer a prayer to defend themselves against mediocrity... -Debussy

"It's ok if you disagree with me. I can't force you to be right."

♪ ≠ $

Re: Healing from Tendinitis, practice regimen? [Re: Urtext] #1585523
12/28/10 06:22 AM
12/28/10 06:22 AM
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offnote Offline
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Originally Posted by Urtext
Argh.

Three weeks ago, I got tendinitis from drill-practicing two cadenzas and passages for a recital the next day. I ended up over-practicing that night and my hands were 'swollen' when I performed later that day.


you didn't get any tendinitis, you just get muscles straines
and so called trigger points. Self massage will heal your hand whithin a days.

Quote
Misdiagnosis

Pressure applied to the site of the pain is used as a test for tendinitis and bursitis. If it hurts to press there, a tendon or bursa is presumed to be “inflamed.” It’s pretty convincing unless you happen to know that trigger points typically refer pain and tenderness to muscle attachments; in other words, to their tendons and bursas.

True tendinitis is inflammation of a tendon, presumably as a result of microscopic tears in the tendon suffered through injury or overuse. Bursitis is inflammation of a bursa, the fluid filled sac that that pads a tendon.

Inflammation is indicated by pain, redness, swelling, and increased temperature in the tissue overlying an injured tendon or bursa. In the absence of these indications, inflammation does not exist. Pain alone is not an indication of inflammation, or of tendinitis, bursitis, or arthritis.


Quote
Muscle Tension
Even when inflammation is present, trigger points in muscles can still be the ultimate source of the problem. Irritation of connective tissues by the unrelieved muscle tension produced by trigger points can be the direct cause of the inflammation and degenerative changes that develop in or near a joint. When this is the case, trigger point therapy is the appropriate treatment, because it goes to the source of the trouble.


Quote
Trigger Point TherapyTrigger points should be one of the first things considered during any examination for pain that seems to be in joints and tendons. When healthcare practitioners have had adequate training and experience, trigger points are easy to locate and treat. In fact, there are ways to treat them yourself quite effectively.


http://www.triggerpointbook.com/tendinit.htm


Re: Healing from Tendinitis, practice regimen? [Re: offnote] #1585530
12/28/10 06:49 AM
12/28/10 06:49 AM
Joined: Jul 2004
Posts: 6,425
Vught, The Netherlands
Dave Horne Offline
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I took a look at that book. Does a massage therapist have the same medical standing as a medical doctor?

I've hurt my hands on occasion from doing similar things - intensive technical exercises and had to take it easy for a few weeks. I let the pain be my guide.

Since everyone here has an opinion, I'll give you mine. If it hurts, don't do it. If it continues to hurt after what you think is a reasonable amount of time, see your doctor.

Why not call your GP during his or her call in hour and ask for advice now.


website | mp3 files | Yamaha AvantGrand N3 | Roland RD 2000 | Sennheiser HD 598 headphones
Re: Healing from Tendinitis, practice regimen? [Re: Dave Horne] #1585534
12/28/10 07:02 AM
12/28/10 07:02 AM
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offnote Offline
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Originally Posted by Dave Horne
I took a look at that book. Does a massage therapist have the same medical standing as a medical doctor?


most of the time yes.

Originally Posted by Dave Horne

Since everyone here has an opinion, I'll give you mine. If it hurts, don't do it. If it continues to hurt after what you think is a reasonable amount of time, see your doctor.


exactly, if it hurts do not play but massage the spot. When it hurts you know it the right spot. Going to doctor is pointless, they have no clue about physical therapy, they can give you drugs only.


p.s.
you don't look at the book, you read it.

Re: Healing from Tendinitis, practice regimen? [Re: Urtext] #1585542
12/28/10 07:23 AM
12/28/10 07:23 AM
Joined: Jul 2004
Posts: 6,425
Vught, The Netherlands
Dave Horne Offline
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I wrote I took a look at that book. ...

and you then commented ... p.s.
you don't look at the book, you read it.


sigh ...


website | mp3 files | Yamaha AvantGrand N3 | Roland RD 2000 | Sennheiser HD 598 headphones
Re: Healing from Tendinitis, practice regimen? [Re: Urtext] #1585543
12/28/10 07:31 AM
12/28/10 07:31 AM
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Hobart, Australia
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ando Offline
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I should add to my comments above that what I wrote only applies to a genuine diagnosed case of tendinitis. If it hasn't been diagnosed as such, you may not have to wait for such a long time. For just a muscle strain, I would give it a week and see how it feels. Massage and warming up slowly will help.

Regarding the cause of tendinitis, it is not always poor technique that causes it - although that is the major case. I actually just got it from practising too much after a long break. I hadn't played intensely at all for the years leading up to my studies at Melbourne Conservatorium, then suddenly the pressure to perform was on. I decided to practice 6 hours a day after doing very little before that. It was simply too much too soon, and I overdid it. Mine was genuine tendinitis and I handled it in the way I described above. My technique did need some refining to reduce strain, but it wasn't the main cause of my tendinitis. It's a good idea to make sure your technique is sound nevertheless - that is very good advice.

A good doctor who is experienced with these injuries will not give drugs and rest as the only advice. If they do, that is not a good doctor. Initially, rest is the the first step for any overuse injury, then you have to cautiously retest and see how it responds. Sometimes it turns out to be a strain, other times it turns out to be tendinitis. Tendinitis tends to manifest with sharper more localised pain. Muscle pain or strain tends to be less acute and less localised, but there isn't always a clear distinction. It is always a good idea to consult somebody who is experienced and well credentialed and with a good endorsement from somebody you trust.

Re: Healing from Tendinitis, practice regimen? [Re: ando] #1585643
12/28/10 10:55 AM
12/28/10 10:55 AM
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Originally Posted by ando
A good doctor who is experienced with these injuries will not give drugs and rest as the only advice.


so you guys need a doctor to tell you to rest...gush...

Re: Healing from Tendinitis, practice regimen? [Re: offnote] #1585648
12/28/10 11:11 AM
12/28/10 11:11 AM
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Hobart, Australia
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ando Offline
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Originally Posted by offnote
Originally Posted by ando
A good doctor who is experienced with these injuries will not give drugs and rest as the only advice.


so you guys need a doctor to tell you to rest...gush...


Pretty sure the quote you used says a good doctor should offer more than just advice to rest. Maybe you should read it again.

Geez, I'm really glad I defended you in your tuning thread now...You're really worth the effort.

Re: Healing from Tendinitis, practice regimen? [Re: Urtext] #1585662
12/28/10 11:37 AM
12/28/10 11:37 AM
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Urtext Offline OP
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Thank You Ando, and everyone else who contributed.

Just to follow up, the tendinitis I had was not full-blown tendinitis. Even though it's not full-blown however, I can assure you waiting for this to pass and "testing" the injury is one of the most tedious things I have ever experienced as a pianist.

If this provides any help .. I was practicing multiple sixteen-note passages in Beethoven's Sonata No.5 (Op10 No1) and the tricky areas and cadenzas in Liszt's Third Concert Etude Un Sospiro, 'mercilessly' going over them so I 'could not get them wrong' the next day. I'm sure I practiced that Friday night more than I do normally, my teacher agreed. That, and the addition of my new piano's action could play a part, since the keys resistance is on the more difficult side of piano's I've played.

I definitely try my hand at not writing during school, haha.


Music, is Language.
Re: Healing from Tendinitis, practice regimen? [Re: Urtext] #1585692
12/28/10 12:22 PM
12/28/10 12:22 PM
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Posts: 457
San Francisco Bay Area
P I A N O piano Offline
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I, too, experienced these symptoms after beginning work with my new teacher and increasing my practice time significantly. It was horrible! Swelling, numbness, etc. I did take a 3 day break from practice- and I did find relief wearing those splints for carpel tunnel. I believe that it helps maintain blood flow and inhibits awkward bending of the wrist which can exacerbate the symptoms. In fact, two years later, I still sleep with a splint on each hand so that I do not bend my wrist in such a way to result in numbness & reduced blood flow through the carpel tunnel. BTW, I am now used to this new technic and no longer feel swelling/numbness when playing anymore...and I monitor how I feel when practicing- especially with challenging passages or new material. Sometimes,breifly, I feel tingling when i work through something new. But this is fleeting and temporary and immediately resolves when I play familiar works with a more relaxed position. I think I have tension going on when I play new passages...

Urtext, good luck to you!

Re: Healing from Tendinitis, practice regimen? [Re: stores] #1585771
12/28/10 02:35 PM
12/28/10 02:35 PM
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Originally Posted by stores
Originally Posted by david_a

At the top of your list of things to do is to eliminate forever the kind of practicing that caused you trouble in the first place. Frankly, you must learn how to give up and how to stop working on something that isn't finished. For some people that is very difficult.


I fully agree with the first sentence here, but not the second. There's no need to give up, or stop working on something. You simply LEARN THE CORRECT WAY to work. Don't feel badly...a surprising amount of pianists hurt themselves (and not just physically, but musically), because they DON'T know the correct way to work through things.
I wasn't referring to giving up permanently, but to being able to say "That's all for today, even though I'm not finished; it doesn't matter if I have to have it right for tomorrow".

Injuring yourself is never worth it.


(I'm a piano teacher.)

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