Playing clarinet with wrist tendonitis or thumb tendonitis

by Rebecca
(Chicago, IL, US)


I am a senior in highschool and play clarinet in the band.

I've been playing it for, well... a really long time.

I believe I have wrist tendonitis (haven't had it diagnosed, but my symptoms match the description).

I first noticed an issue last year when I picked my clarinet up before school started, after a long summer's rest. I played a long time and noticed a slight pain at the very base of my thumb, with a slight jab when I stopped, which then went away.

I thought nothing of it, until our Christmas concert was approaching and I was practicing a lot, which brought the ache back. Then, a day or two before the concert we played badminton in gym (Bad. Bad bad bad. No doubt I wasn't playing properly). I couldn't hold up my clarinet. The pressure of the thumbrest both hurt and caused my thumb to shake uncontrollably.

After that the problem seemed to disappear except for an occasional spasm along my thumb and wrist when I play for a long period of time.

The weakness surfaced again only once, right before a competition (though that I got through fine- I have a feeling it had as much to do with nerves as the tendonitis).

However, this year I have noticed that same spasm, which again happens as soon as I remove the pressure from the thumbrest, shoots once, and is gone, and generally after prolonged playing.

It is nowhere near as bad, but I don't want the problem I had last year coming back.

So I guess the questions would be these:

First, that this really is tendonitis and not something else. The pain originates from where my thumb connects with my wrist, and I seem to have the other symptoms... but I may very well be wrong.

Second, I know I need to try that bone broth thing, but what else can I do to alleviate/ reverse this? Should I try doing things with my thumbrest?

I do have something to improve my finger and wrist strength, but when and how often should I use it? (whether or not it helps this- I need to improve that anyway)



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Joshua Answers:


Hi Rebecca.

1. Do you think that you have Wrist Tendonitis, or Thumb Tendonitis?

2. Do you have pain in your wrist, or just pain at the base of your thumb? Or is it at your wrist under your thumb?

3. Describe the symptoms in more detail, please.


Answer those questions to give me a better idea of what's going on.

I don't know if you have Tendonitis, but you definitely have a tendonitis dynamic.

Meaning, muscles that are getting tighter, connective tissue that is getting more constrictive, Process of Inflammation, and a nervous system that is freaking out about it and going overboard trying to protect you....with more tightness and pain sensation.


Probably we just need to deal with the inflammation and spasm. I bet you're just in a dynamic where the nervous system is going bonkers and -thinks- that you are getting hurt. This is consistent with spasm and shooting pain.

Probably we'll look at some Magnesium supplementation, and do get a crock pot and get some Bone Broth going.

My main curiosity is what exactly is going on with the pain. Constant, or more shooting and then is gone?

(Also, you're under 18, so please make sure you have a parent type take a look at this.)




Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com
















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Playing clarinet with wrist tendonitis or thumb tendonitis

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Oct 06, 2009
Rating
starstarstarstarstar 		PART 2 - Answering the questions - Playing clarinet with wrist tendonitis or thumb tendonitis
by: Rebecca

Thanks!

I have had people look at it and my parents do know about it.

The pain is mostly in my wrist under the thumb, where that bone connects with my wrist, continuing through some of it. Mainly in that one spot, though.

Now that I'm asked I'm not really sure which it might be, or be like, or if it is actually tendonitis.

It starts as a general ache that I hardly notice. It's when I finally relax my hand that I get a really bad shooting pain, which almost seems to 'reset' it, though sometimes it still aches a bit afterwards.

Sometimes with that slight ache my hand gets tired, though I've not had the weakness for some time.

So no, the pain isn't really constant.








Oct 06, 2009
Rating
starstarstarstarstar 		PART 3 - Playing clarinet with wrist tendonitis or thumb tendonitis
by: The Tendonitis Expert

Joshua Comments:

Hey Rebecca.

Check out this page on two different ways to think about Tendonitis. There Are Two Tendonitis Types

In short, you can have pain and actual tendon wear and tear damage, or you can just have pain. They both feel essentially the same.

My main message is that the damage isn't the problem so much as the dynamic that exists before and after tendonitis damage.

Which is, too tight muscles, constrictive connective tissue, and inflammation.

My guess with you, as you are young etc, is that you don't have tendonitis per se.

I bet you that what you have is:

You used your thumb too much for too long in too short a period of time. Your nervous system freaked out because it thought there was danger. The structure is thrown into an acute pain and tightness dynamic.

The benefits of youth settle it all down pretty quickly, but you're basically left with a hot button, a spot in your muscle that is too tight, and when used too much in a specific manner like playing clarinet, fires off a message to the nervous system that causes it to throw the mechanism towards pain again.

Left to it's own devices, it is predictable that it won't just go away back to normal. We can 'fix' it, though. Not that big a deal.

Like the shooting pain, it feels bad, but that's just it. It feels bad, but you're not broken or anything, your body just went a weird direction and we need to steer it back to working 'right'.

By the way, that shooting pain that feels like it resets...that's kind of what it is doing. I like to think about it like a submarine sending out a ping to get a picture of the ocean around it.

An electrical charge fires off, likely accompanied by muscle clenching in a spasm, that sends an echo through the nervous system. Possibly it's not finding much bad to report, so the nervous system tells it to settle down.

But, right there around your thumb/wrist, you have a Pain Causing Dynamic that we need to deal with.

And muscle that is too tight, for too long, fatigues VERY quickly.


So, thanks for making sure your parents have seen this, and, before we move on, does this all make sense? Any questions about any of this?
Oct 08, 2009
Rating
starstarstarstarstar 		PART 4 - I get it! - Playing clarinet with wrist tendonitis or thumb tendonitis
by: Anonymous

Yes, this does make a LOT of sense.

I must say, I really apreeciate they way you describe it, because now I think I have a much better idea of what's going on.

So no, I don't think I really have any questions about that.

Thanks again.


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Joshua Comments:

Excellent.

You're welcome. Now, no more thank yous. Get better is thanks enough.

Moving on.

I wonder if you have a trigger point.

Essentially, a trigger point is a little tiny bit of muscle stuck in spasm. This sends off information and chemical constantly, causing everything around it to get 'worse'.

Probably I should have you do what is described on the How To Reduce Inflammation page.

You can if you want. It's a good idea.

But for right now, my main suggestion is to do two things.

1. Increase your Magnesium intake. Read the Magnesium for Tendonitis page.

Then, at the bottom of that is a link to my Kerri's Magnesium Dosage which will describe what and how.



2.
Start rubbing your thumb pad muscles.

First, you are going to explore. Get in there with your other hand/thumb/knuckles, etc. See what hurts. See what is tight. See what isn't. Go exploring in all the tissue all around. Feel the bones and their angles and grooves and such.

See if you can feel where muscle turns to tendon, then where tendon connects to bone.

While you do this, you will find tight, painful bands in the muscle.

Exploring those, you will likely find hot spots.

Right now your primary form of self care is to get in there and rub all that. Circles, across the fibers, squeezing like a sponge, chipping away at hard spots, etc.

You can even to static pressure, meaning not moving/not changing pressure. If you find one of those hot spots, stick it and hold it for a minute or so.

Sometimes when you do that, it will 'explode' in a fast spasm, then release and relax. That's fun to experience.


Ultimately, you're going to get in there until you turn the 'dry, crunchy sponge' into 'soft, squishy sponge.

Towards the dry crunchy end of the spectrum, things hurt and don't work well.

Towards the soft, squishy end of the spectrum, there is no pain and things work great.

Do this 10 times a day, for 3 minutes each, for 3 days, then update me.

You can spend more time in the wrist/forearm area if you are really motivated to get out of pain. Also, it would be smart to ice dip at least several/many times a day.

Having said that, if the thumb pad muscles really don't hurt, explore elsewhere until you find what does.

Again, does that make sense? It's not a magic bullet, but it works, and I think it's your primary need at the moment.

Get to it.



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