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Ruth Kuefler

A time to heal

September 7, 2008 at 9:25 PM

"Ruth appears to have some tendonitis of the wrists related to violin playing. I recommend 1 week rest (i.e., off orchestra), anti-inflammatories, & physical therapy."

And a lot of patience and hope.

I haven't written here for a couple months, partly because I was away at Aspen, and partly because of the tendonitis I developed at the end of the summer. I was having some wrist pain towards the end of the festival, which I thought was just due to some over-playing. I've never had arm problems before, and didn't see this coming. It shouldn't come as a shock I suppose. At 5'3 and 105 lb, I'm not the most 'beefy' person, as the doctor put it. I'm relatively healthy, but never exercised very regularly. Besides violin, I use my hands a lot in life: typing for school and recreation, writing, handcrafts. Add tension in my playing, and you have a recipe for injury to develop. As they say, hindsight is 20/20.

After two doctor visits and many conversations with my teachers and friends, I have a basic plan for healing. First, no playing at all this week, including orchestra. The doctor gave me an anti-inflammatory prescription, and I'm trying to eat well and drink lots of water. I just took up swimming, and am looking into Feldankrais coachings for the future. In the meantime, I need to get in with a physical therapist this week. One of my friends is certified in Reiki, so I may try that as well. I'm trying to avoid excess typing and writing (I wouldn't be typing this at all, except for the fact that I need all the advice I can get for how best to heal).

Bottom line, the most important thing moving forward is evaluating tension in my playing. I've noticed some raising and hunching of my left shoulder. I also need to focus on relaxing my bowstroke all the way from my back muscles through my shoulder and down to my hand. My motions have to work with my body, not against it. If you notice anything else in my playing that I should be fixing, please don't hesitate to tell me. I have several YouTube videos — the Mozart or Bach are probably the best view.

Honestly, the hardest thing this week will be not playing. Even the couple weekends I took off, it was very frustrating being away from my instrument. I didn't realize just how stimulating practicing can be. That mental-aural-physical connection is so important to my daily routine. Of course, I'll try and keep up some mental practicing, and I'll be sitting in on orchestra rehearsals when I can't play. But of course, its just not the same.

As frustrating as this process is right now, I'm glad it's happening sooner rather than later. This is giving me a wake up call to the long-term changes I need to make, both health-wise and technique-wise. I think in the end it will give me an ever greater appreciation of my ability to play. I don't think I'll take practicing for granted any time soon.

From Jim W. Miller
Posted on September 7, 2008 at 11:17 PM
Warm up slowly, and if at any time you feel numbness, pain, any strange sensation at all, go away for a half-hour and come back. For this week do whatever you'd do if you never had to practice. It's a vacation. See a baseball game, go to movies, run around the block with your dog. I myself would be wary of walking very deeply into the jaws of the medical profession, but if you go and you get advice, then follow the advice of course.
From Stephen Brivati
Posted on September 7, 2008 at 11:17 PM
firts of all tyr and se ethis as a great opportuinty for tehcncila development. I mean this really sicnerley although it sounds crazy. As you know, tehcnique depends on the clarity of one`s intent and the link between mind and hands. By working really strenuously on creaitng mental images of yourself playing certain peices you will not only find out where yu actually don`t know a work IE the mind has no clear, automatic image, but also strengthen the mind miuscle response. The imgae must be so clear that one feels a marked reaction in the hands and arms. Anythign less will not do!;) You may be amazed how much you can improve.
There is a book on mental practice around that I can`t remeber the name of I will tyr and track down for you unles sanyone can come up with it quicker.
In the meantime Feldenkreis is an excellent idea. Reiki probably won`t do that much for the problem although it is a fine healing art in general.
I strongly reocmmed taking one specific supplemet (for the rets of your life actually): organic omega 3 flax oil. You can order it from a Canadian company on the web. Fantastic for joints. All violnists should keep it a sa daily ritual.
An exericse you migth find useful is crawling. This strengthens the hands and arms very effectively as well as having huge health beneifts. Poeple mayy think you are a litlt elooney though...
From Stephen Brivati
Posted on September 7, 2008 at 11:25 PM
re youtube. Perosnally, I think your violin is held a little low. I would prefer to the the rest end lowered somewhat and the scroll raised slightly. This lets the weight of the isntrument drop towards oyu and reduces tres son the left hand.
You have the violnists disease ;) of dropping the instrument evenmore when you wish to play expresivley on a particalr note which puts stress on the whole set up especially the bow arm which is focrced to control the bow more and more prevent it slipping away from you.
Clealry youare a highlymusicla person and some of that is expressed a sa violnist who moves around a little. However, the moveemtn actually contributes nothing to the sound or overall musicla expression it is simply a habit. I cannot count the number of times I have seen Aleaxnder teahcers in seminras stop a player form moving more than necessary and then have the player complain that their playing sounded lacklustre and inexpressive. This then provokes laughter form the audience who point out that it sounds more expressive.
Soe of the moveemnt does not get in the way but some of what you do seems to stem from inner tension somewhere in yur body. AsMimi Zweig points out, it may well be in somewhere as abstruse as the toes. Indees, toes are a major storage point of tension for violnists!
I might suggest you check out the exericse I have written about in my blogs many times of integrating the whole body before playign. It only tales a few minurtes. Also it is a good idea to strok all parts of the body you never actually see bfore you play. I will leave you to work out what those are,
From Jim W. Miller
Posted on September 8, 2008 at 1:08 AM
I didn't notice before where you mentioned the videos, so I watched the Mozart #4 movement 1 just now. You're about ready to enter the QE competition or start touring :) Honestly, so much energy and ideas and facility. Everybody should listen to it. I remember hearing you a couple of years ago or less and my impression was just alright/needs work. I've only seen progress like that one time before. Plus...well I already raved about the Sisters video. Really great.
From Charlie Caldwell
Posted on September 8, 2008 at 3:29 AM
I have one stupid question. Is this tendinitis in one wrist or both?
From Pauline Lerner
Posted on September 8, 2008 at 3:23 AM
I'm sorry you're having so many problems, but I'm very glad you have a positive attitude towards fixing them. Give each thing you try enough time to see whether it really works. The answer for you will almost certainly be several techniques used together. When the body gets uptight, so does the mind, and you need to relax both of them. I don't want to sound like a faith healer, but any technique that gives deep rest and peace will help you. I do yoga and take long walks. I wish you godspeed in unraveling your problems and playing to your full potential.
From Douglas Marples
Posted on September 8, 2008 at 11:57 AM

Sorry about your discomfort. I'm a retired physician and professional violin maker. It seems unlikely to me that violin playing would cause simultaneous tendonitis in both wrists (if that's actually the case) since the physical movements of the two are quite different in violin playing. I would ask you to be sure of a correct diagnosis before embarking on any lengthy treatments or technical changes. There are specialists in this area available to you and it might be worth a second opinion if there's any doubt in your mind.

From Tom Holzman
Posted on September 8, 2008 at 8:09 PM
Sorry to hear about your tendinitis. It is frustrating and hard to be away from your instrument. I agree with the previous post that you would do well to get another opinion. However, doing the exercises recommended by a physical therapist will strengthen your wrists and help protect against tendinitis in the future. Good luck!
From Ray Randall
Posted on September 8, 2008 at 8:38 PM
Our Veterinarian cured my tendonitis
when the human MD's were not doing that well. Yes, you read that right, our Vet. cured it. When he saw me gingerly leading our Golden retriever in on a leash he asked what my problem was. I said the wrist has tendonitis from practicing violin. The animal sawbones said he'd fix me up after the dog.
After administering to our Golden he disappeared for minute and came back with a horse syringe. I have a super high pain threshhold, but a horse syringe in my small wrist? OMG. He just laughed and tossed away the needle and handed me the syringe which was filled with medical grade DMSO.
They use it for horse tendonitis. He said rub a little on my sore area of the wrist with a q-Tip a few times a day with the emphasis on little. Dang, in a few days the pain was down, a few more and zero pain that has never come back.
You can buy DMSO over the counter from health stores, but it's not the super high pure medical grade.
A side effect is you smell garlicky for awhile.
Make an appointment with a Vet, go in on all fours if you have to, hold up your paw, I mean wrist, bark or meow and ask for some DMSO.
From Stephen Brivati
Posted on September 8, 2008 at 10:10 PM
is that cool, or what?
From Ruth Kuefler
Posted on September 9, 2008 at 12:27 AM
Thank you all for the advice and support. I've seen two doctors, and their diagnosis seems consistent with what I've heard/read. I had a couple different teachers check out my technique this week, and they confirmed some of Buri's observations Again, thanks to all, and I'll keep you posted how this process goes.

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