RSI's

[Jazz]

Repetitive Stress Injuries. I got em. No one told me to be careful and now I'm all about spreading awareness.

I have been unable to play for about 6 months now. I still have to be careful how much I type. I finally have med insurance and am now in physical therapy. The way I injured myself was by practicing 8 hours a day with horrible technique, while my teacher was telling me I was being overly paranoid about the pain...

So, what encounters have you had with this problem? How did you deal with it? Are there any warm-ups or stretches that you do before playing, or is it not a problem? Is there any awareness among the musicians you know to be careful? I would really like to hear other people's perspective.

[Joe G]

Since I don't have time to practice 8 hours a day, that never becomes an issue. There are times that I get fairly obsessed with a new piece of music, and end up playing the same phrases for a couple of hours on end without much of a break. That gets my fingers, hands, and wrists pretty sore. I practice a form of chi-gong that works all the joints and muscles pretty well to keep things loosened up.

I don't want to turn this into another Effortless Mastery thread, but it does tie in. Our first instinct when picking up the instrument should be to breath and relax. There should be no strain whatsoever. It's easy to get lost in the music (and perhaps our fears about not being good enough) and before you know it, you're all tensed up again. That's when we need to stop, put the thing down, stretch, breath, relax and start again. Keep sending the message to the body that it's all about being relaxed and having an experience of pleasure, not pain. I've gotten much better at catching myself in the last couple of years when it comes to this.

Musicians are athletes of the fine muscles. Taking care of our bodies as other athletes do should be a top priority. I think your teacher did you a huge disservice by telling you to ignore the pain you were having. I sure hope you can bring about a recovery and get back to playing again. Thanks for sharing your story.

[Joe G]

So Jazz, are the PT's you are working with confindent that you will be able to play again?

[Jim Alfredson]

Jazz, so sorry to hear about your condition. I hope your road to recovery is a quick and (relatively speaking) painless one. My sister is a PT and she's been helping me with my back. Hauling that organ around has done wonders for it (I know, Joe... you try to help and I'm a dumbass macho fool).

I hardly ever get pain unless I play a lot of nights in a row. I have a little soreness in my hands tonight after playing my fourth gig in three days, but I played a little hard tonight. I played with an extremely loud R&B band and wore my ears and my wrists out. I gotta make sure I have earplugs in my organ bench.

There was a great article on Keith Emerson (the keyboardist for Emerson, Lake and Palmer) about 6 or 7 years ago in Keyboard. He had CP so bad the docs said he might not ever play again. But with the right physical therapy, he's playing great. Again, it was a matter of poor technique.

I hope you get well, man.

[Guest Mnytime]

I posted this over on the JC over two years ago when someone posted asking about CTS. Please keep in mind RSI & CTS are not anywhere close to my specialty. Though this is some basics.

If your having pains in your wrists, both numbness and tingling of the hand in the thumb, index, middle, and part of the fourth fingers you most likely have Carpal Tunnel Syndrome. A majority of the time these conditions occur while sleeping at night. This is caused by a flexed wrist while sleeping as well as fluid buidling up in the hand and wrist from laying down.

If you want to check to see if you have CTS examine the wrist for swelling, warmth, tenderness, deformity, & discoloration. Sometimes tapping the front of the wrist can reproduce tingling of the hand, and is referred to as Tinel's sign of CTS. Symptoms can also at times be reproduced by bending the wrist forward, and is referred to as Phalen's maneuver.

From the things I have seen described I would suggest going to a Orthopedic Hand Specilist normally, but if you get a postive result from either of the above tests, I would suggest going to one immediatly.

Also, start taking Vitamin B6 (pyridoxine), which has been found to be helpful in relievin some symptoms of CTS.

Most people that have CTS improve with conservative measures and medications. Occasionally chronic pressure on the median nerve can result in persistent numbness and weakness. In order to avoid serious and permanent nerve and muscle damage, surgical treatment is performed. This involves severing the band of tissue around the wrist to reduce pressure on the median nerve. This is called a Carpal Tunnel Release and usually provides almost instantaneous relief from arm and hand pain and tingling.

As the wound heals, new tissue will bridge the severed ligament in about six weeks, making the ligament long enough to create additional space inside the tunnel and prevent recurrence of symptoms in most cases.

When going to the Doctor I would also highly reccommend getting tested your thyroid hormone levels, complete blood counts, and blood sugar and protein analysis. This is to find other medical conditions associated with CTS. Such as Amyloidosis, Rheumatoid Arthritis, and Hypothyroidism.

The Doctor will use a Electromyogram to test you for CTS. By the way if any of you have Diabetes or any infections make sure not to allow the Doctor to prescribe any Corticosteroids.

So do not delay in getting a proper check up. The longer you wait to go see a Doctor the more chance of having to end up needing surgery or a crippling of the hand and other serious health problems.

Some basic symptoms:

It's frequently accompanied by sharp pains radiating through the arm or shoulder. Muscle weakness of index and middle fingers and thumb. Aching in one or both hands. Lack of feeling in your hand may cause you to drop objects. Activities requiring fine hand motor skills may prove difficult if not impossible.

Useful links

http://eeshop.unl.edu/music.html

http://www.feldenkrais.com/

http://alexandertechnique.com/

I hope this is of help!!

Edited June 2, 2003 by Mnytime

[Jazz]

Wow guys, I just wanted to say thanks for all the supportive responses! Can't type much now, but will post again in a couple of days or so. Joe, I'm pretty certain I'll play again, but it was a harrowing 5 or 6 months without med insurance and without knowing for sure! Mny thanks for the info!! B-3 thx for the encouragement! You guys really rock.

[Rooster_Ties]

I gotta make sure I have earplugs in my organ bench.

Go to the drugstore and buy a bag of those cheap foam earplugs, and stash 'em in your bench - so you always have some handy. You might also consider getting fit for some custom earplugs, which will dampen the sound equally across the entire frequency range. Most foam earplugs don't block the low bass enough, and some hearing damage can still occur. Although, the foam jobbies are 100 times better than nothing at all.

Here's a link to one brand: Musician's Earplugs (There may be other brands, maybe.)

My Mom is an audiologist (or rather 'was', she's retired now), and insisted I get some of these for going to rock concerts and such. I also used them on-stage sometimes when I sing in the chorus of big "bombastic" choral works, with full orchestra.

They consist of a custom-fit ear plug (made from molds of your own ear canals), and there are two kinds of filters you can pop in and out, one that cuts the overall sound levels by 15db, and the other cuts everything by 25db.

I'm not 100% sure if the link I provided was to the brand I have (there may be multiple brands - maybe?), but they sure look the same, since the 'black' filters are the 15db ones, and the 'light-colored' filters are the 25db ones. (The look the same as mine, is what I'm trying to say.)

They aren't cheap - I think they run around $100, maybe $150 (not sure, I got mine probably 8 years ago), but they are really worth it. I think you can be fit for them by any quality audiologist in your own area.

If you have any other questions, I'll be glad to dig for some more info about them, or ask my Mom.

[Joe G]

We're going in another direction talking about hearing protection, but it's important too. I was just wondering about the trend of in ear monitors for concert performances, and what kind of decibels are happening with those. That scares me a bit having something right in your ear that you don't have control of. I've been foolish in the past exposing myself to loud music without hearing protection, and I'm fortunate that my hearing isn't damaged more than it is. Anyone have experiences with the in ear monitors?

[Rooster_Ties]

That scares me a bit having something right in your ear that you don't have control of.

I don't play, but that would scare me too. Surely there must be some sort of protection against really loud amplification directly into the ear-piece, wouldn't you think???

Anybody ever use one of these before??

[Robert J]

Anyone have experiences with the in ear monitors?

My brother's band is now using that system. He's a guitarist. I'll ask him tonight.

I have partial hearing loss in my right ear which I attribute to stage monitors (I was always next to the guitarist), wearing out a walkman in university, and a certain My Bloody Valentine Concert about 10 years ago. I now wear plugs to most concerts and onstage when it gets out of hand. RT, thanks for the info on these plugs, perhaps my health insurance can cover them

[Guest Mnytime]

http://www.futuresonics.com/

http://www.garwood-radio.com/

I know GNR, Jane's Addiction, and AC/DC used Shure.

http://www.shure.com/psm/default.asp

[Rooster_Ties]

FYI, from one of the FAQ's, at one of the sites listed above...

Can an IEM system feedback like conventional systems?

The system cannot generate feedback because there is no open speaker which the microphone can feedback into.

Is there a limiter?

Yes - all Garwood systems incorporate a variable slope compressor / limiter system.

So what happens if the engineer makes a mistake and overloads the input?

The compressor / limiter system prevents sound levels exceeding the pre-set safety limit. This helps protect the wearer against sudden volume surges.

With speakers in my ears, won't the level be louder?

No. In fact the level will be lower. For a start, a lower listening level is possible because the audio signal is more precise. Secondly, for every user of in-ear monitoring, there is a reduction in the overall sound level generated on stage. This means that your monitor mix doesn't have to compete with the mixes of your fellow performers. Ironically, the result is a downward spiral of reducing volumes until you reach the absolute (as in the case of Rod Stewart) of no amplification whatsoever on stage.

How can I control the volume?

The discreet belt pack gives you complete control of the volume at all times.

[Joe G]

Sounds like this is the wave of the future. Interesting...

[Jim Alfredson]

Ironically, the result is a downward spiral of reducing volumes until you reach the absolute (as in the case of Rod Stewart) of no amplification whatsoever on stage.

If only there was no amplification off stage as well.

But seriously, those in-ear monitoring systems are great. The only problem for working musicians like myself is how friggin' expensive they are. We're talking $600 and up per system. So for my five-piece band the total cost to get everyone on the system would be $3000! And then you need a mixer that has enough monitor sends (or aux sends) to support all your performers.

It starts to get expensive.

[Joe G]

Cripes! I wonder if the prices will come down in the future...