Tendenitus/Carpal Tunnel

[JeffS]

Anyone here know about what the typical flute player symptoms are?

thanks

[BrendanB]

Do you have any numbness or tingling in your fingers? The other thing to watch for would be some loss of muscle mass/soreness.

In addition to carpal tunnel, flute players can run into problems with the ulnar nerve going through the cubital tunnel (your funny bone) which runs on the opposite side of the arm from the median nerve/carpal tunnel.

Depending on how you hold the flute, the angle of your left wrist can also put pressure on the nerve. Is it your left or right arm?

hope that helps

B

[JeffS]

It's my left wrist. I'm sure many would say, "Yeah, it could be flute playing. So, given that it could be, I'm wondering if the area of the injury combined with how I hold the instrument is a likely cause. Here's a few pictures of myself holding the flute and a picture of where the pain is radiating from.

Again thanks to anyone who can help me.

http://www.box.net/shared/hbqlz2x5s6

http://www.box.net/shared/f77xojc934

http://www.box.net/shared/ieim4fv8iy

[treeshark]

Umm well, I could hear the tendons dragging with a rubbery sound when I clenched my fist... it did get better tho, but I can't use a spray gun for too long any more.
Whew just looked at those pix, you need to straighten the wrist, it does the tendons no good working around a bend like that, try the Rockstro grip or anything that gets the wrist straight. The other thing that can cause problems is sleeping with your wrists curled inwards.

[Doug_Tipple]

Jeff, I'm little puzzled by your photos. You mention that the pain is in your left hand, yet in your first photo you are pointing to your right hand. Since you are playing left-handed in the photos, the left hand is less likely to be bent using pipers grip, as you appear to be doing. It is your right hand in both photos that appears to be bent in an awkward position. I'm guessing that either your photos are mirror images or my wife put too much wine in my glass at dinner. In any case, as has been said by others, try to find a comfortable playing postion where both wrists are held as straight as possible. If you feel pain or numbness, I think that it is good to stop playing, at least until the pain goes away.

[Gabriel]

I found myself having strong pain in the hands (both!) while and after playing a few months ago. For me, switching to the grip Rockstro describes did the job. I try to keep my wrists as straight as possible - I see you're using your right (or left, if the photos are mirrored, I heard about Apple's iSight taking mirrored photos?) thumb to stabilize the flute. Actually there's nothing wrong with it (hey, I mean, Kevin Crawford does it that way, too), but that kind of grip stresses the "upper" wrist quite extremely if just a tad of pressure is applied.

[JeffS]

Yeah, I took the photos using iMac Photobooth so what appears as my right wrist in the photos is, in fact, the left.

[Tweeto]

Would someone be so kind as to put these photos up here via the image tags. Stuff on that box.net site never work for any of my browsers (not even on Firefox).

[JeffS]

Tweeto -
How do you use the "Img" function for a .jpg file? I've been trying to figure it out.

[Denny]

Guide to Posting Images

[BrendanB]

Jeff,

You are pointing to the spot on your hand where the ulnar nerve comes into your hand at the wrist. If you are having any numbness in your ring finger or pinky, then most likely that's your problem. Also, if you notice that you are losing some control of your grip, the ulnar nerve would also be the culprit.

I had this problem flare up after I took a really long bike ride. Turns out, I think I had already weakened the nerve and the muscles playing the flute and the ride put it over the edge. I ended up not being able to play flute for about a month and half and am still building back the strength six months later.

Check out this image to give you a sense of what I'm talking about. You'll also notice that the position of your left wrist is remarkably similar to the position when riding a road bike. - http://www.hughston.com/hha/a_15_3_2.htm

Anyway, search for ulnar nerve entrapment or go see your doctor and find out if this is what is bothering you. It turns out to be relatively common for flute players who hold the instrument that way. I'm not a doctor though, so definitely go get a professional opinion. They can give you an EMG test to find out for sure if you have decreased nerve function.

In terms of treatment, I tried a few things short of surgery (hope your situation isn't that bad).

1) Stop playing the flute for a little bit to let yourself heal
2) Make sure you are sleeping with your arm in a straight position. The nerve gets squeezed when it is being bent in the elbow or the wrist. You can either sleep with an elbow brace for a little bit or just immobilize your arm some other way.
3) Try physical therapy, acupuncture, or a chiropracter.
4) I have been using a gyro ball (http://www.onlinefitness.com/product.cfm?pr=1726) something like that to build up strength in my hand and forearm. It has worked pretty well for me.

Short of it, I would recommend going to see your doctor sooner rather than later if that is possible.

Hope that helps,
Brendan

[JeffS]

Thanks Danny for the posting the link about how to include pictures.

Brendan -

That's right on. I think that may be it. I've already been going to a doctor. Now I've got some good info. Does anyone else remember the time when you'd see a doctor and the doctor would tell you what the problem was????

Thanks again for the good info.

[Denny]

sure JoffS.....nuttin' to it!

[david_h]

I had/have an ulnar nerve problem. Diagnosed as such by a doctor friend (who then said 'ask a physiotherapist'). In my case it was from spending a long time leaning on left elbow with chin on hand (whilst working a computer mouse with the right hand...). The doc said stop doing that. Google found some stuff (ways of not sleeping with a bent arm, stretching exercises). Doc said try those. Much improved but have to be careful. If fluting makes it start to hurt where you pointed similar symtoms start to come back. But I have found a hand+arm+shoulder+head+ almost_everything_else position that works.

Ask a doctor, it may be something different.

[jim stone]

I find the best place to go for this sort of thing, especially diagnosis,
is to a university hospital where there is an orthopaedic hand specialist.
I'm not confident that many physicians know a lot about these problems.
Some of the best people, in my experience, are hand specialists or
hand surgeons teaching med students
as the teacher does clinical work. Also there is sometimes a hand therapist
in on the examination, as part of the team. And the latest diagnostic
equipment. Optimal.

The advice to straighten your wrist is very good--something worth doing
even if it isn't the problem. You don't need to shift to a new grip entirely
to do it (though that's OK). Just put some energy and attention into
straightening your wrist in your present grip. You may find you
have to shift your left hand fingers on the holes somewhat and
it may feel a bit awkward, but you probably will get used to it.