Index Finger Pain
It appeared suddenly, a sharp pain in the last joint of the index finger, one evening after a 3 hour practice session, and has been an issue for me for over 5 months now.
I tried abstaining from the violin for a couple of weeks, taking vitamin c and zinc, massaging the finger with aloe.
I changed my technique: I press as little as possible (this actually improved my vibrato), and use the base joint of my fingers more (so that the last join of the index finger doesn't need to bend that much).
I had an ultrasound and a MRI (both showed nothing significant), and also did 2 weeks of physical therapy (TENS, ultrasound, laser).
The conclusion of the doctor (orthopedic surgeon) and physical therapist was that it was just due to overuse.
Overall I can't say they showed much interest or had much experience in this thing, and understandably so; if it weren't for my violin playing I'd probably just shrug it off and accept the pain.
So, I need some advice from musicians, people who need their fingers to work smoothly and pain-free.
The only thing I've been able to find online is the following research paper:
Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon
The conclusion is that eccentric exercises, and use of nitroglycerin patches, can help heal the tendon.
Does anyone have personal experience with such a condition? What should I focus on, what can I expect?
I think a pain in the joint is unlikely to be a tendonitis. The scans should rule out a bone spur or arthritis - so it is a mystery. Only thing I can think of that would not be visible by a scan is a neuroma - a cluster growth of one of your small nerves. These can be caused by trauma to the nerve and tend to clear up on their own.
Hi Christian. It's mainly in the location of the last joint, but also radiates along the length of the finger, i.e. along the tendon.
"Dear Elise, a doctor or at least a physical therapist that has worked specifically with musicians is an excellent idea, unfortunately it seems it's not an option in my country" Not quite what I said ;) perhaps a language blip; I said a doctor that IS a musician.
Try reading up about Kyung Wha Chung, who had to interrupt her stellar career for five years after cortisone injections in her index ruined the tissues. her index is frequently bent back due to her tiny hands.
Another thought: do you have a professional orchestra nearby? How bout contacting them and see if they can recommend a physician?
I hesitate to suggest any medical advice or treatment, I am no doctor and cannot diagnose your finger issue. I can only offer what worked for me for arthritis induced pain in the index finger (from am old injury), which was the use of a squeeze ball (wax ball to be specific) throughout the day. For any other type of tendon inflamation (tendonitis in all its forms), I also find helpful to do gentle stretch of the tendons. Sometimes it works miracles. I recently developed such inflammation in both my heals, which have been painful since last Aug. Did the usual rest/ice treatment to little improvement. Last week I ended up stretching the right tendons while doing yoga (it was painful though) and the pain was gone 90% less than 2 days after! Best it has been in 2 months. Whatever you do, best to discuss first with a qualified practician/physio therapist however.
The usual caveat: see a specialist MD or physical therapist sympathetic to musicians, not us (incl. me) amateurs.
The first three questions I would ask are
I'm not a doctor, but the "3 hour practice session" is worrying - were you practising for 3 hours without taking significant breaks?
@joel: I basically use wrist vibrato, I haven't been able to do a purely arm vibrato without stiffing up my wrist. Even without vibrato I have an issue with e.g. natural F on the E string.
Reading between the lines of this and other threads: complete rest, but keep moving!
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