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Recovering from Tendonitis:Where to begin?

November 11, 2009 at 1:44 AM

Hello everyone!

I am a undergraduate conservatory student who encountered a really bad tendontis/ulnar nerve  problem. I was diagnosed with severe tendonitis after I won a competition and was preparing to play with orchestra. I am finally getting over my tendonitis/nerve problem and I needed some of your advice. I have read Flesch/Galamian/Auer and studied many different aspects of technique. I realized that i was playing with a faulty technique for quite sometime. I understand that everyone says to "consult your teacher" about such matters, but I really could use some of your input. Where do i begin on getting back to practicing? i tried developing a nice technical practice routine to try and get back (since I can only play for about an hour a day..split up into two intervals) Where would you begin if this happened to you? I'd really appreciate your advice! =)


From Stephen Brivati
Posted on November 11, 2009 at 3:56 AM

Greetings,

I am so sorry for your plight.  First off I suggets you read a small book by a lady who suffered in the same way and almost ended her career.   The name i have virtually forgotten but it is soemthing like `The use of mental practice  in violin playing.`  Or not.... I will try and dig it out unless someone can come up with the title. Lots of great ideas in it. Okay, I got it:

Mental Practice and Imagery for Musicians by Malva Freymuth, D.M.A., ...
 

SEcond,  I would respectfully sggets that although you certainly can modify and improve your technique to an enormous extent throuhg the books you mention it is not the most efficient of helpful way back to health i the long run.   Its kind of complicated but your problems are so bound up in the art of the insturment that that in itself ceases to be the best way forward.  What you really need to do is bypass the old deep level directives to the body which were faulty and this is best done in essence by er,  by-passing the instrument in a conventional sense.  The simplest way to do this is to find a reputable Alexander Teacher and have them work on how you use your body and perhaps later on the violin playing.   This may seem strange but consider the comment by Arnold Steinhardt ` I often think one might be well advised to get advice on playing from a golf pro.`  In other words one looks objectively at what one is doing with all aspects of the body/mind and works from there.

Alexander technique is -very- expensive and you would have to have I guess, at least ten or fifteen lessons before you began to really uderstand and consciously alter the way you use your body,  not only playing the violin but in daily life.  You cannot correct one and not the other.....   Nonethelless I can think of no better investement for a talented young player in trouble .  Without doubt more valuable than a new bow or ten lessons with a famous teacher or whatever .  Incidentally, AT is so mainstream it is offere dat vrtually all music insititutes:  Julliard,  Guildhall,  Academy etc etc.   However,  beware. Although these are ofetn fre efor studnets they are also,  in the cases I`m aware of too often large groups workng in a less than effective situation,  probably through no fault of the teacher or institute.   Y'ou need ot find a good teahce rand work with them privately . 

Incidentally, I can reocmmend a superb teacher in New york.

Best of luck. I know you will find your way.

Buri


From Dimitri Adamou
Posted on November 11, 2009 at 11:37 AM

As well as AT, you will NEED to do stretchs.

Before playing, stretch your WHOLE body (Yes whole) from head to toe. It is all relative, after you've given yourself a good stretch, calm your mind and body down. Lay down if you have to, but please do not pick the violin up with the word tension in your mind. If you notice you are in any sort of pain, make adjustments where you have to. You shouldn';t have ANy pain, perhaps slight discomfort yes (Though, I find no discomfort with my setup).. but no pain.

Exercising is also great, you will need to build up some muscle, as my belief is tendonitis can be prevented by doing alot of light/merdium exercise.

Heck, I even do 10 ~ 15 push ups before I play violin :) It gets the juices flowing in my elbows.

 

Also perhaps you have bad setup? Or you may be holding your violin incorrect for your body.

 In fact, I recomend you visit a Physio before visiting an AT. Physio will also be able to offer invalueable advice (and help treat your tedonitis .. you might get some nice treatments :DD:D When I had my problems, I was given a really interesting mild electric current and hot towels - IT WAS SO RELAXING!! then I was put on this stretchy machine)


From Anne-Marie Proulx
Posted on November 11, 2009 at 1:06 PM

Good luck!   Anything that releases tension works to get rid of tendonidus may it be a change from rest to non-rest (worked for me since I had so many painful tendonidus with rest and the non-rest technique made me take conscience of my shoulders, neck, finger joints and thumb behind the neck. More importantly, conscience of how much they were tense...) or AT or anything else.  Menuhin surely not did yoga for nothing...  

Good luck!

Anne-Marie

 I have found that the best method ever to cure tendonidus in just a few days (told by MD and physiotherapist and tested successfully by me) is to put ice with wet (absoluntly wet because dry doesn't work as well) cloth over the ice to protect your skin many times a day even if it is torture (especially in the back and shoulders...) + take anti-inflammatories as prescribed and a total break of violin so that your body can recover and forget the old moves (the more you are stuburn to practice with tendonidus, the longer it takes to cure because the dammage is bigger...) .  I'm not a drug taker at all but these really work. However, this is just a way to get rid of the pain. If you don't want it to come back, you have to solve what causes your tendonidus...

Just to say that I was shocked when an MD told me that tendonidus leave scars... You tendons comes slightly bigger at each tendonidus and this can lead one to do "chronic" tendonidus. So it's really true that the more you practice when having them, the more chances you have to make big dammage to your body and having more later one.  So take a break, cure and find solutions is the key to get rid of them forever.


From Christian Vachon
Posted on November 11, 2009 at 4:17 PM

Hi,

There are many things that you can do, but in the end, it all boils down to some simple basics and making sure that you execute good movements with good hand positions, with a good violin setup.  Pain is a sign that you need to change something in your approach to playing and that your body is out of balance.  Restoring balance is essential.

The first step is to adapt the equipment for you with a chinrest that fits for your build, and your playing geometry with a support system or none that is appropriate (i.e. rest, no rest, cushion).

The next step is to fix your errors in movements.  Flesch was big on this but only glimpses at it in the Art of Violin Playing though there is much valuable insights.  There are ways to do it that are efficient, however.  Violin in essence is simple with a few basics that govern almost everything.

The other thing is probably a change in practice that leads to the build up of correct movements, the minimization of tension and a good correlation from slow practice to fast playing.  In essence, slow practice is fast playing slowed down and fast playing is slow practice speeded up.  Finding the correct correlations and addressing all problematic issues in fast playing through slow practice is a good way to help in avoiding injury.

Consulting a teacher who teaches fundamental principles (rather than a method) may be worth doing to address the issues that are a problem for you.

I could write about this all day but giving advice is difficult without seeing you firsthand.  For now, good luck and best!


From Charles Cook
Posted on November 11, 2009 at 4:25 PM

Need more imfo . where does it hurt  most when your playing?Does it hurt more when using fourth finger?Is there pain on the back of the arm or in the hand or finger area?How high are your fingers from the finger board when not in use? Was  your teacher trying  to correct this problem with you ,but to no avail?How many min. into playing till you notice pain?Do you have a vid of your playing?

 


From Ray Randall
Posted on November 11, 2009 at 5:33 PM

I have a prescription cream that you rub on where the tendonitis is. It has Lidocaine and cortisone in it, but more importantly, it penetrates the skin. The pharmacist told me they can control how deep this stuff goes into the skin. It helps numb the pain AND helps eliminate the inflammation causing the pain.


From Tom Holzman
Posted on November 11, 2009 at 5:42 PM

As at least one person has pointed out, building up muscle is important for avoiding tendonitis.  The cause of tendonitis is doing something which strains the tendon because the attached muscle cannot handle the load.  A physical therapist who specializes in musicians (and there must be a number in NYC) could give you a series of exercises to strengthen the crucial muscles.  Call Julliard or one of the major orchs to find out which physical therapists (and orthopedists) their members, particularly violinists, use. 

That said, proper technique is also crucial.  The position in which your left hand and arm hold and move the violin is not a really relaxed, easy one.  Therefore, whatever you can do to improve your technique will lessen the strain on the important muscles and tendons.

Good luck!

 

 


From Charles Cook
Posted on November 13, 2009 at 2:54 AM

http://www.handhealthresources.com/

repetitive_injuries.htm

 

Good site for extra reading 

 

Be careful with the muscle building idea. After not being able to play violin for long periods of time ,I took up guitar to strengthen my finger muscles.After a short period of time I could pick out melodies on  the guitar for hours ,but still couldn't play the violin for more then 15 min.It's mostly about technique.Keep your fingers low to the finger board, use your elbow to get to lower strings,don't bang your fingers on the finger board,lift your 1st or 2nd fingers when using 4th.

I teach all my students rock violin, not for the funny sound but purely as a technical exercise Paying a two octave scale in this mode has help my heaviest finger players.

http://www.youtube.com/watch?v=cktCx54EyZ0&feature=related

 

If your going to strengthen muscle, you need to work with the opposite motion, the weak muscle.

 

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