Piano World Home Page Forums Our Most Popular Forums Digital Pianos - Electronic Pianos - Synths & Keyboards Thoracic outlet syndrome and digital pianos?

Hey everyone, I'm new here. Some of you might know me from Keyboard Corner. Anyway, I thought this forum would be a great place to ask about this topic. I've searched the forum and found some discussion of thoracic outlet syndrome (TOS) but not quite with this emphasis. I hope you can forgive the long post that follows ...

Many years ago I was diagnosed with TOS (1996). It took 5 years for me to recover. Five years with no music in my life; at the time, TOS was not very well known, it seems, and I kept getting diagnoses of carpal tunnel, which I KNEW was wrong; I was not having the right symptoms! I was going through a worker's comp system at the time because the pain was not caused by playing piano, but computer use (I had stopped playing in 96 but continued to have pain that was unsuccessfully treated for years after), and the bureacracy was ridiculous. Finally, after 3-1/2 years of suffering and getting worse, I got the right diagnosis. But I had been damaged for so long I was also diagnosed as a "chronic pain patient" for the rest of my life.

I am pleased to say that with job change and therapy I have been largely symptom-free for years, bucking the common prognosis for me of probably never being able to play again, and even going on to play piano semi-professionally. I am able to play acoustic pianos just fine.

However, here I am leading my jazz-piano trio, about to record a CD, and having flare-ups. The problem I am having is because when I play venues, much of the time I have to play digital pianos. Up until recently I had been playing a Kurzweil PC2, the semi-weighted one. Didn't hurt my hands, but doesn't feel like a piano. When I was more of an ensemble player, this was no big deal. But now that I'm out front leading a trio, I really want to feel like I'm playing piano as much as possible ... so I decided to update my rig with a more appropriately weighted stage piano. I found one I thought would be great, after trying many, so I bought one a couple weeks ago -- the Roland FP4 (the old one, not the new FP4F).

But after a few practice sessions with it, my "old" self, the TOS sufferer, is back again.

I'm thinking there must be something I'm doing differently on digital weighted keyboards to cause the pain, since playing acoustics doesn't cause the symptoms and oftentimes relieves them. But I was wondering, is there anyone else here who is a TOS sufferer (either dormant or active condition) who experiences problems playing DPs but not acoustics? And if so, which digital offerings have been the kindest to you? I realize everyone is different, and what triggers my entrapments might not be the same as yours, but it still might be helpful information.

I will be researching and starting either Taubman or Alexander-based therapy/lessons for digital piano evaluation soon, but I am still interested to hear what DPs have been easiest for others to tolerate.

Thanks for reading!

There may be coincidental factors which are contributing to this problem. For example, at your gigs, if you are moving/setting up all your gear that might put additional strain on your body. You wouldn't get this when playing acoustic pianos because you aren't having to move or set them up. Even loading things into and out of a car will cause strain - it's heavy gear. It could also be that your posture when using your live rig is not totally ideal in relation to keyboard/stool/pedal height. If any of these things is not identical to your normal posture at the acoustic (including keybed angle), I think it can cause tension and exacerbate your problem. It may be that you tend to play harder on your DP. Perhaps you feel you have to when doing a live gig. Maybe you feel you have to push harder to cut through the mix. I think the DP action is unlikely to be the root or sole cause of this flare up. If you consider all the factors and still think it's your DP, you might have to look into trying some different DPs to compare actions. For me though, provided the action isn't excessively heavy, I think the cause will be some other combination of co-factors.

Thanks for the reply, Ando. One thing I should have mentioned is, so far I have not gigged this new keyboard out, so I can rule out physical strain of schlepping the gear. Also I've loaded the Kurzweil PC2 in and out of several gigs for years and played out on that with no problems, so live playing in general doesn't seem to be the differentiator. But since you mention it, it could be something with angles and heights, despite my best efforts thus far of compensating for different keyboard thickness. Argh. Anyone else experience this changing from one digital to another?

GG, just wanted to say hi and welcome. Good to see you here.

Sorry to hear about your hand problems, I wish I could chime in with something useful but fortunately I haven't had any hand or finger issues---except when I played the Roland RD700GX for extended periods of time a few years ago...

I've used DPs, I will continue to use them for making money on gigs, I'm glad that they are now at a level which sometimes can surpass a crummy, beat up acoustic. But overall, I have serious doubts and concerns about anyone putting mega hours in on a DP over a period of years---especially on anything more technically challenging like Classical or Jazz.

I also think that players with a harder touch are more at risk too. Just an observation from watching many different kind of players throughout the years.

.

Welcome geekgurl. I wonder if it's not the DP keyboard but something subtle about your posture with a DP. The FP4 is a stage piano I think - what height have you set it up to, and what position in relation to the keys have you put the pedal? Also where is the music stand and sheets in relation to hands, shoulders, eyes hence head position? Finally what about the bench? Just thoughts.

Maybe it is the keyboard, there's been another discussion on the way most DP keys push back on the fingers after a key press.

geekgirl, I also want to add my best wishes to you and welcome you here. (I was banished from my previous residence where we got to know each other and took up accommodations here.)

Regarding pain\tension\whatever and playing, I always refer to my fly-away-wrist test for a quick overview.

It's been brought quite many times, that some Roland actions bottom out hard, which possibly passes stronger shock to your arm, than with acoustic pianos. One should look for softer action if suffering from carpal tunnel or thoraic outlet or similar syndrome, although I don't know much about the nature of TOS. I also don't know if FP4's action is like this, only know that PHA II is.

Hi Dave,

Please do give more detail regarding the "fly-away-wrist test," and, does this apply to all problems at the keyboard in general, or, does it target only one specific issue?

As I didn't see any information about this test on your website, can you post that here?

Extra note:

Would certainly appreciate your comments, as I currently have some unresolved issues in my own playing (regarding pain / bad habits formed over years of playing / strained tendons), and so forth. I have sustained long term stress related injury to my hands / forearm tendons, due to excessive piano pounding (in my younger days) and proper re-training to correct these habits is probably the only solution, I have been told. I have to monitor my own playing very carefully, or, these issues tend to re-surface.

pv88

pv88, if while playing, someone (or your other hand) flips the playing hand up and away from the keyboard in one swift movement, the playing hand should effortlessly fly away.

This doesn't address all aspects of proper techniques, but does address what I call gross technique, using the correct set of muscles.

If the playing hand does not fly away, you are probably using much more effort than is necessary. If you're playing just from your hand, and not playing using the weight from your entire arm, you'll also have pain\tension\whatever in your top forearm muscles.

Long story short, I learned how to correctly approach the keyboard at the age of 28 (from studying with a concert pianist). I had played incorrectly for 15 years or so before I learned how to play effortlessly. Since I played so many years incorrectly, I can easily spot this issue.

This fly-away-wrist test is a quick way to determine if the individual is playing using the weight of the entire arm (some call this playing from the shoulder) or if the individual is playing just from the hand (which will result in a locked hand to the keyboard when doing this test and the resultant pain\tension\whatever in the top forearm muscles).

@ Dave,

Thanks for your comments above, as I would hope that they might be helpful (for others) in resolving issues with general aspects of one's playing, and, technique.

I believe that with many problems of actual injury (as I have had, and, in order to achieve a playing technique that can be called effortless and pain free), one must seek professional re-training with a qualified professional, so that the ingrained habits formed over the years can be properly corrected.

This usually requires a lot of time (and money), although it has apparently provided results for many pianists who have had long term injuries, and, to help with regaining a natural playing technique.

I can't affirm that I have taken my own advice as of yet (regarding my own injuries), since it really is a matter of expense with finding the right qualified instructor, although I can share some of this information with others.

pv88

That's a good test, Dave. I'll keep that one in mind.

That concert pianist explained concretely in a matter of a few minutes how to correctly approach the piano regarding gross technique (large muscle groups) and fine technique (hand position, thumb position, etc.). He explained this in probably under ten minutes.

I was a highly motivated student and it was an eye opener just how wrong I had approached the piano. My private organ teacher during high school said nothing about technique, my teachers from college (Temple College of Music, Philadelphia, now the Boyer College of Music and Dance) also said nothing about technique.

My primary teacher at Temple had an Honorary Doctorate in Music so you can imagine what I now think of degrees at least in music. I'm not singling out organ instructors, I recently met a young girl who was studying with a top piano instructor from a local university. She was playing with bad technique and had the pain I mentioned in her top forearm muscles. What I consider the basics are not always taught and it's a shame since the basic concepts are rather simple to grasp. You don't have to sign up and spend thousands of dollars to learn special techniques (with a guru's name attached), the concepts are rather easy to learn and any good teacher should be able to explain this in a matter of minutes.

It took me a matter of several months to relearn and incorporate what he explained to me. I went on and took a total of ten lessons from him. There's a lot of nonsense to wade through regarding technique. Whether we're discussing how to swing a golf club or how to approach the keyboard, the basics can be explained in a matter of minutes though it probably takes months before those rather simple set of instructions become ingrained second nature.

One of these days I'll get around to making a video to explain this if for the only reason to combat a lot of nonsense I see on the internet.

I'm interested!

For those of you interested in playing technique, I found this site a while ago, about 40 videos (some overly long at times but still worth listening to) explaining the relationship of our mind-body to the piano, the basic technical problems and how to approach & solve them. It helped me quite a bit to become aware of how to use my whole body and particularly shoulder-arm-forearm-hand-fingers properly. As a beginner a year ago, I had no idea that playing was not just about fingers!

The site is a YouTube user's channel: http://www.youtube.com/user/pianoologist

John

I'm not sure if this can help in the long term. http://www.dynaflexpro.com/

It hasn't made me a better player but I feel stronger in all the right places for piano playing.

I've used Chinese Boading balls to great effect for hand and finger agility! Some pianists also use them.

J

Hi all, thanks for chiming in. I posted this out of desperation and realize I need to chillax and evaluate other things going on in my life, ie, why I got this flare-up and why it stuck around.

It seems I am on the mend. I have set up my Kurz PC2 once again, have the FP4 in my closet ... and I am going through my TOS and other stabilization exercises every night, as well as restarting my yoga discipline. These things seem to be helping the pain. I am playing a bit, which I need to for the few professional music obligations I do have.

I am afraid to set the FP4 up again, LOL. But I will when my flare-up appears to be totally gone. It's slow-going and taking a lot of extra time that I really don't have, but what would life be without wrenches thrown in it once in a while.

A couple specific comments:

Dave H, nice to see you here too! I didn't know you actually got banned from that other place. Sorry to hear that ... anyway, regarding the flyaway technique, I find I can't test myself on it. I had been able to do it with my piano students when teaching, and had been able to have them test ME, but unless my technique has gotten really bad in 3 years' time to where I'm not playing correctly at all, I must just get too "self-conscious" to test myself (ie, I anticipate when I'll flick my wrist away with the other hand and will interfere subconsciously). I've tried it at the acoustic as well as DP. *sigh*

Hemppa, I find that the RD700s, as well as the new RD300NX/FP-4F, bottom out too hard ... and this causes me to feel it actually in my hands, very different from TOS onset's cascade of symptoms. I think this hand fatigue with the bottoming out is what others who complain about those actions also feel. The reason I chose the previous-generation FP4 is because that bottoming-out characteristic seemed completely absent ... YMMV.

huh never knew of this condition. Though from the symptoms and how it's produced Id say it's your posture. If you were slightly slumped or bent forward a bit, maybe even used your upper arms keeping your hands positioned above the keyboard would seem to cause it.

Id make sense as with an acoustic your pretty much with perfect posture hands resting on the keys. A keyboard on the other hand could be to high, to low, especially if you were using more then one.

Hi geekgurl,

I had just learned about TOS while researching about piano-related injuries, and then I saw your post here on PW. I have the feeling I might have TOS or something related, and I am trying to schedule an appointment to see a doctor next week.

Anyway, I've been looking at digital pianos for practice and I was wondering the same thing - would the change in action/feel affect how I play and put more strain on my tendons? My pain started after playing with the practice pedal down for long periods of time on my acoustic. I know also need to go through some serious technique and posture reeducation before I restart my piano practice, so I'll probably need to wait a while before I buy a digital.

I also wanted to ask you about your treatment - what kind of therapy did you go through, what kind of doctor finally gave you the right diagnosis (orthopedic, vascular, physiatrist?). I know I need to see a doctor and get a definite diagnosis, but I have the feeling, from what I've been reading, that it might be TOS.

Thanks!