From Jonna Fitzgerald
Posted August 2, 2010 at 09:02 PM
Need to find a doctor with experience dealing with violinists and left wrist problems. I've been told my volar radioulnar ligament is 'blown' and needs reconstruction - which would also leave me unable to play. !!! Need to find an 'expert' in the field - preferably in Texas. But will travel wherever I need to in order to save my music career.
Long story short, I've played for more than 40 years. More than a year ago, began experiencing pain in my left wrist while playing. The movement of even lifting the violin and rotating my wrist is VERY painful. Local hand 'specialist' said there was a TFC tear, so did a debradement. In subsequent physical therapy, my arm 'popped' one day and everything went downhill. Another MRI indicated the ligament on of my arm had 'given way' and caused the wrist joint to become unstable. Apparently the ligament was 'frayed' in the first MRI, but because it is apparently a rare injury, nobody thought to look at that.
Who is the 'go to' person in the US for wrist injuries on violinists? I am heartbroken that I've missed a year of playing already, and may not play again. I've been told a ligament reconstruction (which one doc recommended) would leave me with only 40-50% rotation, and that I'd never play again. Help!!!!!!!!!!!!!!!!!
I know a great physical therapist that deals only with musicians. She is awesome and saved my shoulders. She's a published author, her name is Coralie Cousin. Unfortunately, she lives in Paris, France. I live not too far from her. I know it's very far from Texas, but she is a miracle worker.
I'm not a doctor. I'm a runner, so I can't guarantee anything I say here, but 40-50% mobility doesn't necessarily mean you wouldn't be able to play. It would be hard to find a surgeon willing to do things "wrong", but it may be possible to leave you with the mobility for violin at the expense of "standard" mechanics.
It may be possible for you to go into surgery planning to reattach the ligaments too long. This would mean your wrist would be permanently twisted. You would then where an orthotic brace during the recovery stage after your surgery and probably for the rest of your life. But maybe you could still play.
Looking at the wikipedia article for "orthotic" it says the word is derived from greek "ortho", to straiten. But what you would be wanting, is a brace that would unstraiten...
list of hand surgeons in your area
If you have a physiotherapist ,you can ask them "who would they go to " .They deal with local patients and may have insite into this.
As a supplemental therapy, I cannot recommend Alexander Technique highly enough. It doesn't pretend to be a substitute for surgery, but can greatly assist in recovery (and sometimes prevention if you aren't sure you need surgery, but that doesn't sound like your situation). If your injury is at all related to the way you use your body, AT can help you to avoid repeating the problem and/or making it worse.
Here's a page listing teachers in your state: www.alexandertech.org/teachers/TX.php It's probably not complete, it's just the teachers who belong to one of the main professional associations; but it will give you someplace to start.
I have some idea how scary this can be. Best wishes,
Not sure about this because of potential fraying, but there is also a treatment called "prolotherapy" that might be helpful. It enabled my Dad to play soccer seriously again after blowing his ACL 15 years before and 3 surgeries later... I'm not sure I understood exactly what's wrong though, to know if this would help or not...
and I agree with the comment that the wrist doesn't twist much, hence part of my confusion.
Talk with hand therapists! They specialize in this stuff!
Thank you for the replies!! I have contacted someone regarding AT, so that will at least get me going in some direction. Regarding the wrist rotation, my fourth finger is significantly shorter than normal due to a birth defect - so I must rotate and reach much more than most people do. When I first began playing, my teachers weren't even sure I would ever be able to use the fourth finger. I believe so much stretching through the years may have contributed significantly to my current problems.
I think both a Physiatrist (MD) AND a hand surgeon who deal with sports injuries (at least), if you cannot find a Physiatrist who specializes in problems with playing instruments. I know, in CT there is a Physiatrist who does this, and he is associated with UCON medical school. His waiting list, I believe, is about three months. There are doctors who have no idea what it takes to play the violin, believe me, I've been to one (hand surgeon), and I simply couldn't believe it. However, you can demonstrate to them on your violin and they can study your movements, so bring your violin with you.
Interesting you mention a cutaway, as I'm actually commissioned one which is being made now. Not sure what the tone will be like until it is finished, however. Will also be making modifications to the neck circumference, and possible the angle of the fingerboard. Most of my difficulty with the fourth finger is reaching double stops on 3rd and 4th strings. Have toyed with a 3/4 size instrument, but that really doesn't seem to make a significant difference.
You mentioned much stretching to use your 4th finger over the years may be a contributor. I am just a hair over 5 feet tall, and I have found this to be true with multiple body parts, doing many normal day-to-day activities, because most of the furniture, cars, and other equipment is designed for bigger people.
I have switched to a 3/4. Although I still can't reach to do some double stops, and a can't make a 1st finger to 4th finger stretch, I think the overall smaller size of the instrument has both shoulders, both arms, and my left hand doing much less stretching. Over time, over many repetitions, that excess stretching with the full size, and even the 7/8 had been bad news.
You may find that over time, a smaller instrument does relieve some of the strain.
I'd love to see a picture or even a sketch of your design, John.
Wow, I'd love to see a sketch or something,too - sounds like a novel idea, John. Will keep you folk posted on my commissioned instrument. Am anxiously awaiting its delivery, and will let you know what type tone it has, post pics, etc. I do plan to have some adjustments made to it once it arrives by a skilled luthier friend, so hopefully that will help a little with the volume and tone issues we are anticipating.
Also, some of you may already be aware that Methodist Hospital in Houston has an entire program devoted to medical care for performing artists. It's called the Center for Performing Arts Medicine. I was directed to that group by some wonderful people connected to the Houston Symphony. Will be seeing two surgeons in Houston this week, so am anxious to hear what their diagnosis and treatment protocol will be.
Violinist.com Editor Laurie Niles is in New York to cover the biennial event at The Juilliard School, including classes by Brian Lewis and Sarah Chang.
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