Is finger pain arthritis, overuse or tension?

August 22, 2007 at 03:40 AM · Help! I am a beginning (1 year)student who probably practiced too much for my first recital. Ever since, the first and second fingers of my left hand are all tightened up at the second joint from the fingertip. Is it just overuse and tension that has caused this or is it arthritis? I'm 50. I tried resting it completely for a few days and it got better but when I resumed playing, the swelling and pain returned too. Maybe I'm pushing back with my thumb? Someone suggested I try playing with my thumb tucked under and of couse that sounds lousy... Any suggestions?

Replies (24)

August 22, 2007 at 03:57 AM · Mary, for us older but better students, it's all about tension free playing. I only the past month and a half got myself off the Aleve. A story I won't repeat here and now.

It is sooooooo important to get everything on your left side completely relaxed when playing, and in this case I suspect you are right about gripping if that's what you meant. Also, it sounds like you might be over anxious in general with your left hand articulation so:

Try violinmasterclasses finger dropping exercises, and explore exactly how lightly one really has to press to make a note. And pay special attention to backing off a string bringing it to a harmonic--if you persist you'll see this later.

And strengthen your left hand without your instrument with small nerf balls at the same time.

Stretch and warm up faithfully, and stretch after getting your pain to subside without the instrument and throughout the day.

Strengthen your wrist without the instrument, but visualize that the increased strength and dexterity from stretching are not to further force things, but to allow you to dance lightly with your left, actually everything.

Other may give you better solutions and see more what is going on--I'm a beginner too.

My first teacher told me upper-body strengthening in general, with which I now agree--but it's not for strength, but for stamina and fluidity.

Good luck.

August 22, 2007 at 12:51 PM · Hi,Mary, Could be overuse, arthritis or misuse, and only your doctor can probably really tell that. Al is on to the right course as far as your playing. You know you have a persistent injury, so you need to treat it first, and then find out how to play w/o re-aggravating it. I would suggest a longer rest period of some days. I do the dishes by hand with very warm water as part of my hand care, but you can do warm soaks, too. When you commence playing again , start slowly with just a few minutes' playing and never start right in aggressively. Make sure your hands and arms are temperature-warm enough and warm up by stretching and flexing gently. If you don't use a shoulder rest or don't feel comfy and secure with your chinrest/shoulder rest combo, please work on that. In my opinion, folks with hand problems should use rests to help remove any inclination to hold up the vln.weight with the hand. Think about other activities you do which may use or aggravate the same painful areas, and think of ways to modify them, too. Sue

August 22, 2007 at 01:40 PM · A friend of mine here on Vcom named Bill WOlcott gave me a great piece of advice when it comes to hand tension. In football--the best receivers have the softest hands. Keeping your hand soft and easily pliable helps to eliminate a lot of the tension that you are talking about. And sometimes when habit takes over you have to be able to stop and step back from what you're doing and let go of the hand tension. My 2 cents.

August 22, 2007 at 04:18 PM · Sue, your advice is really good, but there's one small point I want to take issue with:

"In my opinion, folks with hand problems should use [shoulder] rests to help remove any inclination to hold up the vln.weight with the hand. "

Hand problems can just as easily be caused by problems in the neck or shoulders. Improper use of big muscles inhibits the use of smaller ones. A shoulder rest can mask as many problems as it can help. I'd be really careful about this advice, as it's not a one-size-fits-all solution. From reading your posts, I'm sure you're well aware of this, but these things can so easily get lost in print. I thought the advice about working on posture if one is uncomfortable was great - just wanted to clarify this one point.

Can of worms, I know. Let's hope I didn't hijack this thread into dangerous waters...

August 22, 2007 at 05:59 PM · Megan,

I thought you had some important comments, and I hope the ones I am about to make do not hijack this good thread either as the point I want to make is with respect to tension, NOT shoulder rests! However, for me personally I lost A LOT of tension when I dropped my shoulder rest. At the same time I realized a great loss of pain in my left wrist. No, it was likely not because of a missing shoulder rest so much as it was a loss of rigidity. Without the shoulder rest the whole of my body is a great deal more fluid, and when playing the violin the whole body needs to be fluid (or at least it should). I am not advising that one should get rid of their shoulder rest, only that all need to learn to rid tension in all aspects of their form or technique, and that this does require the entire body in participation. So, give it some thought, and be ever mindful of the sources of tension, no matter how seemingly insignificant.

I am guessing that the condition sited is an overuse injury, but these can become serious if not dealt with and treated properly. An overuse injury put an end to my playing of the classical guitar. The older we are, the more dilligent we must become. When you're young you can get away with a lot, but not so when you're old. This is especially true for adults who are just getting underway. Opportunities for injury in this situation abound. So take care, and be careful!

Chris

August 23, 2007 at 05:27 PM · Thanks so much to all of you for your advice.

I'm on day three of a self-imposed one-week rest from playing, which is so hard with my violin in its case, mocking me. But at least I'm reading an interesting old book from my teacher's archive, "Principles of Violin Playing & Teaching" by Ivan Galamian of the Juilliard School.

From reading some of the other discussions on this site, I've thought that maybe some lessons in the Alexander Technique might help me to relax all over, so next week I'll have my first session.

What I'm learning, albeit the hard way with discomfort, is that overpracticing and especially practicing tense because I soooo want to play decently, is counterproductive. A friend of mine in the LA Phil said something to me that hit the mark: "Mary, you can only be where you are." Silly me, I thought if I practiced three or four hours a day I could fast track from being a second-year student to a third-year student! Another one I like is "You can't push a string..."

Thanks again, you all! Stay cool (meant both ways, of course)

August 23, 2007 at 05:56 PM · Mary,

I started the violin just 6 months or so ago, and I spent a good portion of the first 2 or 3 months injured and unable to practice much at all. Then I thought, I still have a good right arm and right hand, so I began to spend a lot of time doing open string exercises. It felt great to be doing something, anything.

You cannot have too good a bow arm, so I would use this time to work on your bow arm. It will pay you a great return in the long run. Incidentally, I am now working out of the Auer Method Books, and Book 1 is 100% open-string bow arm exercises. I am working out of Books 1 and 2 right now, but I still spend the majority of my time in Book 1.

Like I said, you cannot have too good a bow arm. In my opinion, the bow arm does the majority of the work involved in making music. The left hand gives the bow arm all the notes, but the bow arm has to turn them into music.

Take care.

Chris

August 24, 2007 at 04:13 AM · I'm so sorry that you have to face pain in your hands, I know how hard that is; I have 2 types of tendinitis and arthritis, so I can sympathize. It doesn't SOUND like arthritis, but it's NOT tendintitis. Possibly get a book by Dounis on playing with less tension. Also if you happen to have a viola, GREAT! Playing viola is like a deep tissue massage b/c it stretches out your hands and can remove some tension. Also look into introducing elements of Alexander technique to your playing. If it persists for more than a couple weeks, get the name of a hand therapist and of a hand specific physical therapist. For temporary relief take an anti-inflammatory like Advil (ibuprofin) or Aleve (Nuprin). You usually can take 3 or even 4 if you are at adult body weight. (usually...consult a doctor maybe...) I hope this helps, and much sympathy again.

September 10, 2007 at 03:00 PM · Mary and all,

I was looking for a response to Mary that might include supplements you take for joints/arthritis. I am 46 and have been playing professionally for 25+ years. I successfully overcame a neck/arm injury (repetitive stress) through Thai acupressure massage this past summer and now my fingers are hurting all the time. I don't attribute it to tension. I am not tense when I play. Mary, it could be our age. I don't know. What else can we address besides tension that would help our fingers/joints?

September 11, 2007 at 01:20 AM · Greetings,

Cathy, alot of this can be delat with workign with a doctor who understandfs how pracittioner sin orinetal medicine use food to heal.

You need to make a determined effort to get your body back into a slightly alkaline state by gently elminiating extremes from your diet. The most acidifying foods are : coffee, sugar, medicine. The alkaline extremes are salt, eggs meat and dairy products. The most well balanced diet to help this condition is vegan but you don`t have to go that far. Within all types of food group ther eare sub categories so for example, swirching from beef to chicken would reduce your the alkaline extreme. Switching from banana consiumption (ver yin/acid) to strawbeeries, apples and cherries would be of great help and so on.

Trying tp eat a lot more grains will help in bringing your body back into balance. But, brown rice not white.

To explore these categorizations of food I suggets you take a look at a macrobiotic food /lifestyle book. Those by Michio Kushi are pretty much the best. I wouldn`t recommed a macrobiotic diet per se. Tends too have too much salt and be boring.

In the meantime, a very powerful supplement that will radically inprve your overhealth and joint s is organic omega 3 flax oil. Take at least two desert spoons a day.

I recnetly had a cellist coe to me with swollen athritic looking finger tips. After she followee dmy suggesiton of cutitng out coffee and eggs and using this oil she has experienced radical improvement.

Cheers,

Buri

Just a small codicil. It is not always understood that the reference to medicine in orientla medicine also refers to the p0esticides, chemicals and additives found in most of the food we eat. That`s why coffee is a double whammy. It`s an extreme drug that is farmed with masive use of pesticides . (Even organic coffee is significantly healthier for the joints than the regular.)The lesson is `go organic.` It may be the best thing you ever do.

September 11, 2007 at 05:42 AM · Does this mean I'd be cool with an all-latte diet? Or it doesn't balance, it's just two of the worst possible foods, and combined they are just a bomb that hits on both ends of the acid/alkali spectrum?

September 11, 2007 at 06:14 AM · but doesn@t it taste great?

September 11, 2007 at 06:41 AM · Drink chicory instead. It tastes like coffee but better and you can pick your own out on the median of the interstate. It's the bluish-purple one.

September 11, 2007 at 11:37 AM · improper body mechanics (down to the fingers) can lead to joint dysfunction thus arthritis. for a violinist, no matter what you do, how you do, how intensely you do, one must consider injury prevention as priority number one. this is like that airline instruction: put oxygen mask on yourself first...

i think the mention of a "better" diet is a good consideration. we can all eat more wisely. however, there are more established do's and don'ts as well as others yet to be established. for instance, is there evidence that each person will react to certain group of food to the same degree? in other words, will 40 gram of something cause the same effect in 2 different persons and thus reach the same therapeutic level? i don't know.

i think in this case, the diet is a good direction to explore but the tension or the improper use of the left hand is an immediate issue to be addressed. to alleviate the problems, it is more mechanical than nutritional. actually more instructional because the solution is a good teacher:)

September 11, 2007 at 10:39 PM · Greetings,

al said

`i think the mention of a "better" diet is a good consideration. we can all eat more wisely. however, there are more established do's and don'ts as well as others yet to be established. `

I must say I find your comments just a little dismissive and patronizing. You are incorrect in your assertion that there are more established do`s and don`ts. Regulating diet as medicinal practice is actually the oldest and most widely established form of treatment for health problems. Even western style doctors specializing in athritis in Japan prioritize diet. I doubt if there are many more established and mainstream ideas than the one that argues the degenerative or unaturally prevalent diseases that we accept as a part of life for some reason (athritis, diabetes, heart disease, cancer etc) are primararily afunction of diet and the evidence is in irrevocably that a great deal of immediate help can be done by simply removing the cause.

>for instance, is there evidence that each person will react to certain group of food to the same degree? in other words, will 40 gram of something cause the same effect in 2 different persons and thus reach the same therapeutic level? i don't know.

That is why I pointed out the need for working with a nutritionist who knows what they are doing and can help the client modify things over time. The point made here is irrelevent.

September 12, 2007 at 01:10 AM · hello buri, i am afraid you have misunderstood the line ..."there are more established do's and don'ts as well as others yet to be established"

it was written in the context of using/choosing food with a view on health maintenance. in other words, certain groups of food are good for health. (thus, do's...decrease inflammation) and certain groups not good (thus, don'ts...increase inflammtion) and others that are not very clear yet. your explanation of the importance that food items play in the development of degenerative diseases is evidentially agreeable. we are truely what we eat. (and we don't care because it tastes good:)

nutrition as a class is not taught in US medical schools. i am not sure it is the case in japan. many practicing doctors in the west have limited understanding of nutrition as a science. they check blood sugar level, look up food for its glycemic index, recommend meals of portions of carb/protein/fat, estimate calory,,,that is about it. the effect of a single food item among thousands on the body has not been empirically studied per se extensively.

if the direction is to employ food as medicine proactively, then i feel there should be a deeper and better understanding of the whole gamut of materials used, as well as quantification of dose-effects.

i agree some nutritionists are very experienced and can offer insights without the benefit of outcomes from clinical studies (in the violin world we call them prodigies:). precisely because certain remedies are proven effective to some, the question is whether they will be equally effective to others.

ps: did i just respond to a buri imposter who obviously spells differently from the guru from the east? or did buri up the dose of omega 3 and also bump up the DHA???

:)

September 12, 2007 at 01:12 AM · Greetings,

sorry. I mistook your meaning. Coffee headache. Yor commets on US (and Europe) nurtrition training are aboslutely true although things are beginning to change.

However, I am actually referring to oriental and Indian medicinal pracitce using nutrition which are very knowledgeable in this area and uses food in very powerful ways. There are now western practitioners who combine the more `scientific` approach of the west with this huge corpus of established knowledge. Paul Pitchford is perhaps the number one in this area. A lot of the time they tend to simply confrim what is known through thousands of years of observations. Ocassionally they make the same discover and call it by a differnet name. For example the relatively recent recognition of the conncetion between lifespan, helath and enzymes in the stomach is widely knowen under other terms in Chinese and Indian medicine. It never really makes sense to me to talk in terms of finding an amount of x that is okay for one and not the other when one is already diseased. Some people can handle more posion than others but if you want your health back, if you want your fingers back there is often no room for compromises. The pleasures one loses are compensated for with a completely new way of experiencing the world and people.

Off for a cappucino,

Burp

September 12, 2007 at 02:10 AM · Greetings.

Buri, surely you don’t really believe the thousand years of experience argument? People believed the earth was flat for thousands of years in the past…

Chinese medicine? Well, most Chinese doctors I know (including my mother) and I worked with back in China who spent years practicing Chinese medicine, only not on themselves or their loved ones when they get sick. Go figure.

Off for some yummy Chinese herbal soup.

Yixi

September 12, 2007 at 02:09 AM · Greetings,

yes I do in specific cases. If healers find through repeated observation of the same thing over thousands of years that is pretty damn sound. The analogy of flat earth is weak because there was no observation in the same sense.

All I can tell you is aside from my own training in cooking and healing I underwnet life saving treatmnent using food as the primary weapon tool and then was drawn itno a world where this is considered normal. Since i now have considerable experience in this area I have no problems recommeding dietary changes that alleviate a variety of symptoms as long as it is nothing too serious. The cellist I mentioned wa sa case in point. I have also helped a number of people on this site improve the quality of their l9ife quite substantially though dietary changes. The information is out there for all. It is an unending source of amazment to me how much violinist are willing to sacrifice in terms of sweat blood and tears but never consider the whole structural base on which playing thrives. Quality of diet, mind, blood , organs etc.

Cheers,

Buri

September 12, 2007 at 04:08 AM · As usual, I always like to argue with the teacher I respect the most. So it is very tempting for me to disagree with you, Buri.

Flat Earthers are not ones without keen observations, but their observations are based on erroneous theories about the universe. The point I tried to make is simply that to appeal to years of experience is logically flawed. It’s like saying millions of people can’t be wrong if they believe Bush is a great leader or Chairman Mao was the greatest loving person. A lot of people can get something wrong for a long long time.

As for personal experience, we have to agree to disagree. You have positive experience and that’s great. I had horrible experience that is still haunting me to this day. I was trained as a nurse in China in both western and traditional Chinese medicine. I practiced nursing in a hospital that is affiliated with one of the most prestigious TCM universities and I worked on one of the top ten Chinese scientific projects at the time: treating cancer by using combination of traditional western and Chinese medicine. They brought in the best TCM doctors in the country to work on lung cancer and liver cancer patients. On daily basis, I treated hundreds of patients over 3 years by giving them acupunctures, moxibustion (burning a small amount of herb on certain acupuncture points). I administrated herbal medicine as well as chemotherapy and all sorts of western medicine both orally and by injection to patients as well. The hospital made nurses to routinely refresh their TCM knowledge by putting them through TCM theory courses and tests. I always came out the first among the nurses because the theories are ridiculously simplistic and metaphorical to the point anyone with moderate intelligence can easily BS one’s way through it. This is one of the reasons that I can’t take the stuff seriously. But what was worse was the way patients were treated. The whole thing was a huge psychological mind game. In three years I saw patients being lied to and died with unnecessary pain imposed on them by the kind of medication TCM cooked up (such as intravenous injection of garlic juice to battle infection). Of course, patient’s consent was unheard of and if you are in the hospital, you take whatever treatment you are given, like it or not. I don’t want to get too much detail into it, but get this, they call it science: double-blind test was understood that the doctors could decide which patients get to the placebo effect.

I’m not going to argue about Western vs. TCM and which is better. I only ask people to consider carefully what is behind all the TCM practice, what does it mean to have good evidence, what arguments are logically sound, and most of all, buyers beware. In the end, I know which doctor one goes to is really a matter of faith. I can’t convince anyone nor do I want to.

September 12, 2007 at 04:43 AM · Greetings,

I`m lucky because I have had contact with people who have understood and applied the best of TCM , Ayervedic medicine and other holistic disciplines. I am not at all surprised by your experience. Anybody who claims there is a cure for cancer and tries to sell it (as it were) to people is a fraud.

My doctor has many cancer patients. He gets them off chemo therapy as fast as possible (another travesty) optimizes their immuhne systems and minimizes ther epain, but he never sugar coats the pill. Whether or not someone that sick is goin to pass on depends on their personal story. I`m not sure I`d want to go to a hospital specializing in any particlar discpline. When we start talkign about -only- Tcm or only western medicine or whatever then narrowness and prejudice begins to creep in. Instituitionalize this problem and the results can be horrendous.

Incidentally, the food changes I recommend come from the macrobiotic appraoch rather than TCM. That system is also inconsistent and flawed so is best not reified as some practitioners do ;)

Cheers,

Buri

September 13, 2007 at 11:35 PM · Ok - lots of discussion about diet here. How about things like glucosamine? Anyone taken that for joints? Does it work?

September 14, 2007 at 02:27 PM · cathy, you may find this article interesting,,or confusing:)

http://www.medicinenet.com/script/main/art.asp?articlekey=82235

September 21, 2007 at 03:49 PM · I bought some herbal mittens you heat in the microwave for about three minutes. I heat my hands in them for about 20 minutes every few days or so. My joints love this!! Fingers are working great!

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