Repetitive Stress Pain/Injury (RSI) Information:
- Dr. Mark Hendrickson wrote a great
Q/A article on Repetitive Stress Injuries. You can access it here.
- Great PDF resource full of hand
and wrist stretches Hand
Yoga PDF
- BBC article on RSI click here
- Musician specific RSI
causes/treatments click here
- IDRS article on Oboe/Bassoon
Movements Motions
- Carpal Tunnel, IDRS Doctor William Dawson; Informational
Video on Carpal Tunnel Syndrome
Performing Arts
Medicine Association: http://www.artsmed.org/relatedlinks.html
Performing arts medicine resources:
- Musician's Injuries Powerpoint: By
Dr. Kee Fedak
- Health Promotion for School's of
Music http://www.unt.edu/hpsm/summary.htm
Performing Arts Health Clinics:
- University of North Texas
Performing Arts Clinic. Denton, Texas Website
- Brigham and Women's Performing
Arts Clinic. Boston, Massachusetts Website
- Methodist Hospital. Houston, Texas Website
- Cleveland
Clinic. Cleveland, Ohio Website
- New
York Presbyterian Hospital. New York, New York Website
- Performing Arts Occupation
Therapy. Bookline, Massachusetts Website
- Musician's Clinic of Canada.
Toronto, Ontario Canada Website
- Texas Voice Center. Houston, Texas Website
- Harkness Center for Dance. New
York, New York Website
- Performing Artisits Health Center.
Arlington, Texas Website
Oboe Specific Site/Book
General Questions about my hand experience*:
- What kind of a
doctor should I see for RSI or just pain from playing?
I first went to a sports medicine doctor who was licensed to
diagnose and execute an EMG. My favorite doctor was at a Physical Medicine
and Rehabilitation facility Because I knew I had carpal tunnel,
I searched for doctors who specialized in it. I have also heard
that visiting a Rheumatologist can be a good place to start if joints are
your main issue.
- What is an EMG?
Here is the wiki page for EMG tests. Basically it's a
test where they determine how well your nerves are responding by
shocking you. It doesn't hurt at all if you don't have carpal tunnel
(didn't hurt in my good hand) and is semi painful if you do have carpal
tunnel.
- Why did you
decide to get surgery?
Unfortunately by the time I knew I had a serious issue, I was experiencing
more than just "normal hand pain." I was losing function in my
hand. Although looking back I wish I had gotten a second opinion and
researched it more, I went ahead with surgery because at that point I was
told it was the only way I could have a hope or regaining normal function.
Surgery did help my functionality, but didn't drastically improve the
pain. I am not sure that doing it right away was the best choice for me.
- What ultimately
has helped you regulate the pain?
There are 4 things I now do that I think have made the biggest difference
in my pain levels.
1. Splinting. I
often sleep in wrist braces. If you do research on RSI's, splinting is
often a suggested practice for regulating pain. I directly saw a correlation in
my pain between the times I was diligent in sleeping in braces
and when I wasn't. Now that my pain is less and I am more stable, I only
sleep in the braces when I am experiencing unusually high pain. My doctor
always stressed to me not to play while wearing the brace because it would
cause other strains on my hand. Braces are for rest.
2. ASTYM treatments.
Since I have been going to physical therapy and receiving ASTYM
treatments, my pain has reduced to a point where I can go months without
pain. ASTYM treatments work to break down scar tissue that, in my case, is
limiting the space and functionality of my nerves. You can read from the
professionals about ASTYM
here. It is sometimes called soft tissue therapy and it activates your
body's natural ability to break down scar tissue.
3. Physical
therapy/Stretching. In physical therapy my doctor has been working to
loosen up the tension in my neck/shoulders which is likely contributing to
the strain in my hands. He has me doing strength exercises to
build up those muscles and I often get deep tissue massages to work out
the knots in my neck. He also has given me several stretches to do to my
hands/wrists to help keep scar tissue from building up as I continue to
play.
4. Macro activities.
Playing and instrument and making reeds engages my muscles in tons of
micro activities. This semester as I have been in a flexibility class and
cycling class and I have found my pain to be reduced. I attended a seminar
on RSI's where the doctor discusses the need for macro activities to
counteract all of the micro activities we as musicians do. He suggests
that every week you engage in at least 3
macro physical activities. He suggested 1 session of yoga, 1
cardio (swimming or likewise) and 1 strength training. By engaging your
body in these other activities it will help stretch out the tension that
doing the same repetitive motion all day creates.
I first went to a sports medicine doctor who was licensed to diagnose and execute an EMG. My favorite doctor was at a Physical Medicine and Rehabilitation facility Because I knew I had carpal tunnel, I searched for doctors who specialized in it. I have also heard that visiting a Rheumatologist can be a good place to start if joints are your main issue.
Here is the wiki page for EMG tests. Basically it's a test where they determine how well your nerves are responding by shocking you. It doesn't hurt at all if you don't have carpal tunnel (didn't hurt in my good hand) and is semi painful if you do have carpal tunnel.
Unfortunately by the time I knew I had a serious issue, I was experiencing more than just "normal hand pain." I was losing function in my hand. Although looking back I wish I had gotten a second opinion and researched it more, I went ahead with surgery because at that point I was told it was the only way I could have a hope or regaining normal function. Surgery did help my functionality, but didn't drastically improve the pain. I am not sure that doing it right away was the best choice for me.
There are 4 things I now do that I think have made the biggest difference in my pain levels.
1. Splinting. I often sleep in wrist braces. If you do research on RSI's, splinting is often a suggested practice for regulating pain. I directly saw a correlation in my pain between the times I was diligent in sleeping in braces and when I wasn't. Now that my pain is less and I am more stable, I only sleep in the braces when I am experiencing unusually high pain. My doctor always stressed to me not to play while wearing the brace because it would cause other strains on my hand. Braces are for rest.
2. ASTYM treatments. Since I have been going to physical therapy and receiving ASTYM treatments, my pain has reduced to a point where I can go months without pain. ASTYM treatments work to break down scar tissue that, in my case, is limiting the space and functionality of my nerves. You can read from the professionals about ASTYM here. It is sometimes called soft tissue therapy and it activates your body's natural ability to break down scar tissue.
3. Physical therapy/Stretching. In physical therapy my doctor has been working to loosen up the tension in my neck/shoulders which is likely contributing to the strain in my hands. He has me doing strength exercises to build up those muscles and I often get deep tissue massages to work out the knots in my neck. He also has given me several stretches to do to my hands/wrists to help keep scar tissue from building up as I continue to play.
4. Macro activities. Playing and instrument and making reeds engages my muscles in tons of micro activities. This semester as I have been in a flexibility class and cycling class and I have found my pain to be reduced. I attended a seminar on RSI's where the doctor discusses the need for macro activities to counteract all of the micro activities we as musicians do. He suggests that every week you engage in at least 3 macro physical activities. He suggested 1 session of yoga, 1 cardio (swimming or likewise) and 1 strength training. By engaging your body in these other activities it will help stretch out the tension that doing the same repetitive motion all day creates.