From Karen Johnson
Posted March 18, 2007 at 07:09 PM
He couldn't play 4th finger for close to a month, but he is essentially fully recovered.
Two weeks ago, he fractured the ring finger outermost phalange. So now, he has pain with the 3rd finger. It bothered him too much at one week to play more than a few minutes, but today he played about an hour and had only minor pain.
In both caes, we wasted $250 for the "surgical procdure" of the doctor bending a splint, and another $120 each time for x-rays. We also followed up the 1st break at 6 weeks.
By the way, it has been very difficult keeping him wearing the splint. Maybe that's a good thing in his case--kept his soft tissues strong. Perhaps the severity or extent of the fracture dictates this aspect.
There hasn't been a need for therapy.
The thing about fingers is that they get fractured quite frequently and usually heal themselves. Unless it is a crushed mess or a tendon insertion torn off or something else gruesome, it seems that they just get better from usage.
My wife broke her pinky just doing daily stuff (10 years ago) and it points slightly differently but has had no ill effects on usage. She didn't do anything for it at the time and only later during a routine visit did a doctor say, "yeah, looks like you broke it. No big deal."
I'm pretty sure I fractured my pinky toe last year walking by the the foot of a blanket chest. I lost the toenail too. It hurt like ^^%y h%ll for a couple weeks but doesn't bother me at all any more.
one potential concern is that of muscle atrophy due to the lack of use while in splint. (not sure about your pinkie muscle condition, but a study done in the past showed that if you pay starving med students to lie still in bed for a week, they lose about 1-2% of strength PER DAY.) thus, to be properly reconditioned or conditioned during this recovery phase is important for injury prevention once you get back into your routine,,hard and fast.
i would consult with an occupational therapist (thus hand therapist), and NOT physical therapist (who is not really trained for hand as much as occupational therapist and the latter has nothing to do with helping one with getting a job:)
voice your concern as a musician early and ask for a taylored program to MAINTAIN some level of muscle use while in splint.
as tolerated (pain wise, i would assume couple weeks) start some isometric exercises while in splint (the OT can show you). then progress from there. once your fracture is diagnosed and properly evaled, your best friend is the occupational therapist.
the whole ordeal should take less than 3 months assuming the fracture is simple like a chip off.
in the foreseeable future, try leaving the lawnmower repair to the boys,,,
ps. i was in your beautiful state over the weekend...wintergreen,,,a blast.
So it really all depends on the injury. I did 'a lot' of manual strength training and dexterity training the first six months, and now just do Sevcik and other 4th finger exercises faithfully.
This too shall pass.
On the bright side, that focus on my left hand for so long will one day benefit me. Already it allows me to understand more complex discussions of southpaw technique if not really excel at them yet.
I received about four years ago, in my mid-thirties, a small avulsion fracture (ligament ripping a chunk of bone off its end at a joint) at the middle knuckle of my third finger of bow hand. It was of course the night before opening night of a musical directed by Julie Andrews (in her directorial debut). Valiant Viking violinist that I am (actually, poor and needy and unwilling to forego the work for any reason), I carried on with the month of the show. That was fine. Playing violin was the most comfortable, painless thing I did during any day for months! Besides the uniqueness of injury, I was subject to an astonishing host of aggravating circumstances before, during, and for at least months after the injury,
which surely impeded healing and make my timelines unusually long.
If you look up info on avulsion fractures, 90+% heal with no loss of function. I'm in the unlucky 10% or so, with finger unable to straighten by about 30 degrees (!!) even to this day, and apparently til death. I can almost curl it all the way. I've been interested to see over a long time, the first year or year and a half, the base knuckle gain compensating flexibility compared with the other fingers, so that mostly the fingers line up together anyway and make a hand. ANY other finger, and it would have been I think a career-ending disaster and/or grueling debt for very dubious surgical interventions.
Ring finger of bow hand is, I think, the most passive of a violinist's fingers. My life now is a unique accidental experiment looking into this idea. As it is, I was conscious for the better part of a year or so of slightly adjusting angles and balance in my right hand (and wrist and arm) and of actually re-learning to some extent all colle and spiccato and sautille in some tempi and characters, but I feel successful at that, really don't notice anymore, play fine, won audition into contract with minor local orchestra, type fine, etc..., all since the injury.
It took longer for my psyche to heal, in a way: I spent so long (even just a couple months forced into acting weird can be rough on my introverted self!) unable to shake hands in greeting or meeting, and felt SO BAD or ashamed, even though I knew I shouldn't feel that way, just at being a violinist with a broken finger.... It was surprising to me how much of our violinistic beauty is visual in the fingers! I felt probably worst meeting new students. Also, I'm one of those who talk with my hands-- very gestural communication. I had a very hard time for a while communicating or being with people, just unable to endure seeing the twisted finger in front of my face. Perhaps I still keep it out of sight (and out of harm's way!) a little more than I would without the break-- again, even though I don't believe I should behave that way. Interesting learning experience about the primal, visceral, central relation I have with myself and with others through the function and appearance of my fingers...
Well-- I'm not earning karma or getting paid to tell stories, but to teach your kids violin! Just trying to do what I should! Lessons are so dang short!
And, really, you're right: I was very prolix last night on at least a couple threads, but I think it's true that I've never told the story-- in print or in person anywhere so thoroughly before. Related to the general insecurity, fear, mis-placed shame I've felt over the finger.
Very kind words-- thank you, Bill. And also same thanks for your partly similar comments in other discussion threads lately, which I only found so late that a reply seemed too distant and out-of-place-- but I saw: thanks.
And, lest we be accused of hijacking the thread, let's recall that all of this verbiage is testimony and encouragement, and a result of sympathy and best hopes and wishes for the health and healing of everyone's fingers, especially Karen Johnson's.
See, Karen? Healing! :-) I'm really the only one who knows, and I forget often enough now, and my extenuating and exacerbating circumstances were outrageous and irreproducible (untold stories!), and I still bet you'll be completely fine soon!! :-)
And, oddly overlooked by most, bones are great collagen network repositories of both calcium AND phosphate salts-- all the calcium in the world won't help a bone without a similar bulk of phosphorus / phosphates. Need both.
Hello, I just joined. First I wanted to say that it's great to be here with so many other violinists.:) I've played since I was a child and I'm now in my 50's. Recently, I had what turned out to be a serious injury to my left hand.
In October of 2007, I tripped as I was crossing the street and sustained an intraarticular (the break crossed the joint line) displaced fracture to the top joint of my left ring finger. The first doctor put a pin in to hold the joint in place while it healed but the pin fell out. I was referred to a hand specialist who performed surgery on the joint to put it back in place. The surgery also involved remobilizing my extensor tendon on my middle joint as well as freeing the tendons on the top joint that had become embedded in the scar tissue.
Since the surgery was done 4 weeks after the fracture, it was impossible to reconstruct the original anatomy but the doctor told me it was very successful and everything looked good. The splints were removed on December 22nd and I began hand therapy on the 31st. The therapist has told me that since the fracture crossed the joint line, I will not be able to regain full motion in that joint, probably less than 50%, possibly only 30%. Right now I can barely move it. Both joints are very stiff from being immobilized for so long. However, she said I should be able to get closer to normal mobility on the middle joint.
As you can imagine, I'm pretty worried about how this will affect my playing or if I will even be able to come close to playing again with the skill I once had. I won't know what the final recovery will be until I complete 3 months of hand therapy. I was wondering if anyone here has ever had a similary injury and how it worked out for you. Any suggestions, help or encouragement would be very much appreciated! Thanks!
i suffered a fracture to my right middle finger in late August from a bike accident. It was an avusion fracture involving the dorsum of the distal phalanx, with intraarticular extension. i had it in a splint (constantly) for 11 weeks and the fracture still has not fully healed. Now there's no pain but i'm still working on getting full mobility. I probably won't be able to fully straighten the finger but i should be able flex the finger reasonably well after more therapy. i feel lucky because i can still hold a bow and manage to play, and even perform. I think it would be quite different if it were my left hand.
I just wanted to make several comments, as a medical professional. 1. kids heal much much better than adults when it comes to fractures. 2. intra-articular fractures (those that extend into the joint surface of the bone) are worse than fractures through the main body of the bone. 3. There are almost always accompanying non-bony injuries you need to pay attention to as well (tendons and ligaments). 4. Work with an orthopedic or plastic surgeon who specializes in hands and with a good therapist who also specializes in hand injuries. 5. Believe in the power of the body to heal. it may just take a little longer than you expect.
Do you want the hard truth or lies?
Ok, I'm honest so I will tell you my real story. I fractured my right pinkie while playing compulsory basketball at school. I had a cast on because I said to the doctor that I was a little afraid since my hobby was music and he did the most efficient thing. After, I went in physiotherapy and it never was the same finger despite all the recovery care and exercises. It defenitively could't trill fast ennough, the reflexes are slower and for bowing, it is find but if it was the left pinky and I was a pro I wouldn't be able to play. But, I think teaching would be very possible. It is hard to tell.
THIS IS ONLY MY EXPERIENCE AND I WISH VERY VERY MUCH THAT YOU WILL BE LUCKIER THEN ME!
GOOD LUCK AND ALL THE BEST!
Thanks for your response and for your honesty. I'm trying to be positive but also realistic so I know it will never be the same again, just hoping I'll at least be able to play a little. Only time will tell. I'm pretty sure if I were a pro, my career would be over but I used to teach kids so that's something I can think about doing again some day to fill the void...Debbie
Hi, just an update. After 6 weeks of physical therapy, I'm playing again. It's going pretty well, the lack of motion in the top joint isn't affecting my playing too seriously. It's still sore and stiff, I'll be continuing hand therapy twice a week for at least a couple more months but I'm able to play for about a half hour without much pain. It took a few days of playing scales and getting my finger accustomed to moving on the strings again. My tone and intonation have not suffered to any great extent except that I need a lot of practice after not playing for so long. Considering, I thought I might never be able to play again, I'm extremely happy with my progress so far. I was able to play the Bach Celebrated Air on the G string without too much trouble this evening so it's coming along.
The best therapy for finger injuries that I have found is an old manual typewriter. If you type properly, it forces the use of all the small muscles of the fingers and helps develop/tone them. It is painful at first, but it helped me quickly regain almost full use of the injured fingers.
Stephane Grappelli suffered a fall in his Paris apartment, breaking the pinkie of his left hand.
Doctors pinned the break and when he recovered, he said his fourth finger was "better than new".
This is not an endorsement of broken fingers. Your mileage may vary.
You are a professional violinist...
Go see a performance arts doctor...don't just trust time to heal it.
IT IS YOUR LIVELIHOOD
hmm... I was just thinking of the Stephane Grappelli experience. Since my earlier responses on this thread years ago (my finger still stuck at the thirty+ degrees), I've seen a double DVD biography film of Grappelli with interviews and playing.... maybe because of the wide cultural esteem for the value of his hands and playing, or for some medical reason I don't know, it was, he said, a gold pin that was put into his right pinkie. This gold pin stayed in, never came out, and Grappelli actually said that he believed it was faster and better than before. !!!! Not to recommend injuries and gold implants, nor to recommend how his colleague Django Reinhardt lost use of two fingers of left hand in fire, but these are pretty interesting, astonishing true stories about frikkin' amazing musicians carrying on inspiringly well through outrageous circumstances...
I posted this past June about my fractured left pinky. It was a "simple break" near the knuckle with a small floating chip. The x-ray was first read by the physician on-call, and then he sent it to a hand specialist when I informed him I was a violinist (playing 35 years). It was splinted for three weeks, and was told to start using it at the end of the third week. I was satisfied with the medical care, and when the finger was declared healed at week 6, I started playing long and hard as I had lost time to make up; I had an audition the end of August. In response to the practice, my finger went into contraction- it wouldn't even open- after it was supposedly healed. In contrast to the most recent post, playing soon after the break and playing aggressively aggravated the injury. In August I started OT therapy, but my finger didn't respond to the therapy. Finally in September I was seen at the Crystal Clinic (well known in my area as the best hand care facility around) and was told my recovery would have been better if I had gotten treatment and the subsequant follow-up care from a specialist immediately. So here is the lesson: if your hands are your livelihood (or very important to you) seek the very best treatment as soon as possible. Last Friday, Oct. 21st, my finger was finally straight after months of therapy and stretching devices. Now it has to be casted for four weeks. After the cast is removed it will be a slow (their instructions) recovery to playing my instrument again. My hope is that I will play again next season.
Please consider supporting Violinist.com by becoming a sponsor, and reaching our dedicated community of violin professionals, students and fans!