Curing tendonitis (Full Version)

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Pimientito -> Curing tendonitis (Aug. 8 2009 9:44:30)

After Sanlucar I developed a nasty tendonitis in my left hand which made it impossible to play the guitar. Tendonitis is an inflammation of a tendon and /or its sheath which is technically a tenosynovitis. The point is it is pain that comes from inflammation caused by overuse. Its normal to get muscular aches in the hands after playing. Tendon pain is more severe and very specific to one part of the tendon. It is a sharp pain that you feel when you move a finger. The tendon HAS TO BE RESTED. If tendonitis is not treated quickly it becomes chronic (long lasting) and can become very difficult to treat. My technique is to strap the affected tendon. Im going to show you guys the technique of how i did it. I got rid of the tendonitis in 36 hours.



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Pimientito -> RE: Curing tendonitis (Aug. 8 2009 9:47:09)

First thing is to get some strapping tape from a medical supplier or a sports shop.
Its much stonger than sticky plaster and importantly isnt elasticated. The glue is pretty tough and its designed to stay in place for a day or 2. Cut some lengths with scissors



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Pimientito -> RE: Curing tendonitis (Aug. 8 2009 9:50:08)

The next step is to form an "anchor" above and below the tendonitis. Wrap a small length of tape around the base of the affected finger. Apply another length below the tendonitis running from half way into the palm to halfway into the dorsum of the hand.





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Pimientito -> RE: Curing tendonitis (Aug. 8 2009 9:54:51)

Next step is to run strips of tape between the 2 anchors. Keep the affected finger straight and try to make the strips as taught as possible. The aim is to immobilise the tendon. Overlap the strips and continue until the front and back of the hand are covered in strips of tape between the 2 anchors.





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Pimientito -> RE: Curing tendonitis (Aug. 8 2009 10:00:41)

Now to keep the whole thing in place run a "figure of 8" with the tape around the thumb and wrist. The palm is quite sweaty and tha causes the tape to come off. This last step stops that from happening. This method means that you can use the rest of you hand reasonably normally but esures you are resting the affected tendon. 2 days after the onset I was playing again so its a useful trick.





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Pgh_flamenco -> RE: Curing tendonitis (Aug. 8 2009 10:09:19)

Your training as an osteopath came in handy. Thanks for the information.



Florian -> RE: Curing tendonitis (Aug. 8 2009 10:11:29)

WOW thanks bro !!! i have exactly the same problem ...i am gonna follow your instructions step by step ...I wish i could rate your post ...brilliant !!



Florian -> RE: Curing tendonitis (Aug. 8 2009 10:14:13)

Used your photo quickly


my pain is just here where the black mark is..its acctualy in the muscle ...feels like its teared or something...from grasping the guitar too hard when performing or playing for classes probably cause of nerves or when playing louder and faster rithm accompanying dancers i tense up in that hand..i grasp the guitar too hard..i keep trying to be concious of it but i get in the moment and i keep forgheting..any special advice ? how to prevent it (while still beeing able to play just as loud and as fast as i need for dancers and how to permanently get ride of it ?) if i leave it alone for about 3 days its back to normal but then i forghet again and the same thing happens again....i need to take care of this now somehow


id love to find a lasting solution as its not much fun doing gigs with it..it dosent affect me too badly and it only comes on after a while but its there and its annoying cause u thinking about it instead of what u doing...when i manage to control it its fine but whenever it happens it happens... during heavy loud fast rithm accompanying for dancers...the louder i wanna go the more i seem to tense up

it never ever happens at home in front of my pc


EDIT sorry was so glad to see your post on the subject kind of scanned trough it quicly and posted quickly about my problem and my excitement of you bringing it up.. knowing i would read the steps in detail after...seeing the bandage on the finger i quiclky assumed yours was in a different spot but after reading it i see now that we both got about the same spot ?...i think ?.. with me it feels more like the muscle thats under the thumb then the index finger..is it the same ? does your bone hurt or your muscle ? my pain is not just your typical muscle ache..its always the same spot and sharp enough to know its not the typical ...different positions kind of sore



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gj Michelob -> RE: Curing tendonitis (Aug. 8 2009 10:47:14)

IIncredibly ironic coincidence, I am not sure you followed my vicissitudes, which I memorialized on these pages. I had the same exact problem affecting exactly the same spot you marked. After a year of temporary relief through the most painful acupuncture, I finally saw an orthopedic surgeon, specializing in hand surgery. Perhaps my problem had in fact degenerated to “calcification’ and it required surgery. 3 weeks later I am now rehabilitating the LH index, by constant movement and finally -and most gingerly- played a few falsetas.

I wish I had tried your method, but above all I wished I had –as am now told I should have- done two critical things:

1. 15 minutes warm up before playing (guitar-less finger exercises, including the 2 Chinese spheres, or squeezing a rubber ducky ball, and stretching, stretching, stretching the fingers, and then stretch them a little more….); and
2. 15 minutes ice-pack application on the weak spot, particularly after lengthy sessions or generally before calling it a night.

We are getting’ old, amigos!!

below a pic of the remaining yet fading scar.



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Florian -> RE: Curing tendonitis (Aug. 8 2009 10:59:04)

i am glad to hear u recovering Michelob, i hope it feels as fresh as new for you amigo


quote:

I wish I had tried your method, but above all I wished I had –as am now told I should have- done two critical things:

1. 15 minutes warm up before playing (guitar-less finger exercises, including the 2 Chinese spheres, or squeezing a rubber ducky ball, and stretching, stretching, stretching the fingers, and then stretch them a little more….); and
2. 15 minutes ice-pack application on the weak spot, particularly after lengthy sessions or generally before calling it a night.



thank you... noted

to anyone else feeling any kind of litlle pain...if you dont allready do take this very serious...its no joke...and if anyone finds any other interesting articles, suggestions on this kind of stuff please share..i for one am very interested


perhaps we should have our own PDF guide of suggestions and good ideas for warm up exercises here, ideas like Pimientito, anyone elses who is either experienced it or has knowlodge on the subject like we once had a guide on recording an flamenco chords..

even if it dosent affect you now it might save u pain in the future..i for one have no idea where to look for information on this kind of stuff, i am sure theres others



Pgh_flamenco -> RE: Curing tendonitis (Aug. 8 2009 12:03:39)

I found this thread on carpal tunnel syndrome on the Jackson/Charvel Forum. Members talk about how diagnosis and surgery can cure this illness. Very informative and a must read…

http://www.jcfonline.com/forums/showthread.php?t=96356



Pgh_flamenco -> RE: Curing tendonitis (Aug. 8 2009 12:05:36)

quote:

perhaps we should have our own PDF guide of suggestions and good ideas for warm up exercises here, ideas like Pimientito, anyone elses who is either experienced it or has knowlodge on the subject like we once had a guide on recording an flamenco chords..


I agree, this would be useful to members. A sticky--or even a separate section dedicated to this type of topic--would be a good idea.



Florian -> RE: Curing tendonitis (Aug. 8 2009 12:16:52)

wow Pgh thanks ..now i know exactly what i have and 100% certain i have it carpal tunnel, everything this guys describe exactly how i feel and what i am going to have to do do after the next commitment (il spend about 30 minutes warming up before that time ) .. and after clear 4 - 5 weeks in classes and gigs and gonna go , get it done , get it out of the way. hope its not expensive [:-][:o]..can get through and by with just practicing my right hand for about 3 weeks..with open frets arpegio, pulgar, rasqueado, picado, permanently mute the strings with a cloth and practice rithm...brakes...no problem ( i would acctualy benefit and almost welcome it, i wont be able to move on or get sidteracked even if i wanted too trying to play falsetas so il be forced to pay more detailed attention then ever),

i can get creative with making sure i use the time well as long as i dont have to compleatly stop (theres no reason why i cant exercisse the other hand, i got no problems whatsoever in the other hand) ..that would drive me insaine...it was hard enough for one night when my guitar was getting a port fitted


really thank you amigo i appreciate u took the time [;)]

quote:

I had the same symptoms for about 9 years, it started very gradually and became progressively worse. Gripping the clutch on the motorcycle became an ordeal, I finally went to a neurologist this past Novemeber to get checked out.

The Dr. performed a nerve conductivity test, which is a painless (although irritating) series of mild electrical shocks from tiny needles placed into opposing ends of different muscle groups (read: painless).

The speed at which the electrical current travels from point A to point B can be compared against established baseline numbers. The Dr. compares your results to these...

If there is compression in the nerves from the carpal tunnel, it will be very easy to diagnose. Turned out that I had severe Bi-lateral carpal tunnel syndrome.

My Neurologist then recommended a great orthopedic surgeon whom he has referred many patients to. The Ortho did a couple x-rays in his office, and had a grip strength testing device. His conclusions supported the Neurologist's diagnosis. Before I left his office, I scheduled surgery for the left wrist which was the worst. That was this past Novemeber...

Surgery was performed under local anesthetic, and was really no big deal at all. It was NOT painful, that night I had regained full sensation in all fingers of my left hand!

Stitches cam out two weeks later, and I had to wear and Ace bandage for a week or so. There was nothing else to it, seriously.

This was by far the smartest health-related thing I have ever done. I will have the other hand taken care of this Holiday season. This is one of those things which I could kick myself for not having looked at sooner, it is such a relief to not have perpetually numb fingers in my left hand. I even sleep better too!

Blue Cross/Blue Shield picked up the enitre tab, I had no out of pocket for the procedure...


quote:

My first guess is you're gripping the neck too hard


someone else said exactly what i thought

amazing id have probably gonne on beeing uncomfortible without doing anything about it if Pimientito didnt bring it up...told u guys lately that i love you ? [;)]

chers, i am relived to read that its curable a fairly simple surgery..maybe il try and take a video cam with me to the surgery and see if hel let me film it ...that'l be fun [:D]



Pgh_flamenco -> RE: Curing tendonitis (Aug. 8 2009 14:31:13)

quote:

wow Pgh thanks


I'm glad it helped. Pretty smart group of people for a bunch of shredders. JCF has over 15,000 members and 1.2 million posts--so there's a lot of useful information over there.



gj Michelob -> RE: Curing tendonitis (Aug. 8 2009 14:46:29)

quote:

i am glad to hear u recovering Michelob, i hope it feels as fresh as new for you amigo


Thank you Florian, I hope so.

'looks like I am not alone in this; I completely agree with the need for a section dedicated to "hand exercises, disorders, treatment, therapy etc." it would be very helpful in both prevention and appreciation of problems if we sared this intel.... great resource.



Florian -> RE: Curing tendonitis (Aug. 8 2009 14:47:08)

quote:

I'm glad it helped


yeah it did man alot, i was quietly and slowly getting scared...ive never been so happy in my life to hear that i need a surgery [;)]...ofcourse that might change when i find out how much it costs [:-] i dont do insurance on anything ..i am romanian [:D] we dont die, dont have car accidents and we dont get our sh*t stolen...someone tried to mug me once and took my money...then..i zoned out started wistling the romanian natonal anthem.. i got home and had even more money then i had to begin with....and a nicer wallet [:)]
.....download this quickly !!



gj Michelob -> RE: Curing tendonitis (Aug. 8 2009 18:11:16)

quote:

ive never been so happy in my life to hear that i need a surgery ...ofcourse that might change when i find out how much it costs i dont do insurance on anything


As they say in LA, we are having a “senior” moment here gentlemen.

With all disabilities and disorders now revealed through this thread, perhaps we should establish a “fund” to help with medical expenses for the aging flamencos on the forum… next prize for the upcoming challenge should be a “two month hand focused physical therapy” [I am not necessarily kidding.]



Florian -> RE: Curing tendonitis (Aug. 8 2009 18:16:22)

do you have to be aging ? what if you 25...can I be eligible ? [:)]

its not that common ...but perhaps we can research too see if theres detailed books that cover this type of subject...and warm up exercisses, u know educational stuff...and add it to prizes..

the therapy sounds so complicated...doctors, pills , appointments..we cant pay doctors with paypal...sounds like too much work honest and for someone that really needs this sounds kind of confligting to be pushing himself to win it to recive this price...imo

but ultimately its up to the rest of you guys



gj Michelob -> RE: Curing tendonitis (Aug. 8 2009 18:47:41)

quote:

its not that common ...but perhaps we can research too see if theres detailed books that cover this type of subject...and warm up exercisses, u know educational stuff...and add it to prizes..


I agree with you, Florian, regardless of any joke, it would be quite edifying a mission to gather information on these musicians’ disorders and start a separate subject on the Forum.

I will ask the surgeons I have seen here and Italy for sound literature and authority on this subject. I read everywhere that musicians related injuries and conditions have been neglected by orthopedic studies over the years, and only recently have aroused more attention. Hopefully, we will be able to share some critical information about this problem.

When I first posted this on the forum, about a year ago, I received so many comforting messages by many well meaning friends recommending rest and milk. However, it is not rest but movement, spiting pain and agony, which will save one’s hand from the problem’s worst escalation, calcification –then needing surgery.

It would be a tremendous service to the community to collect more information on this subject and educate ourselves out of folkloristic grandmothers’ remedies, often worse than the evil they mean to heal.



Florian -> RE: Curing tendonitis (Aug. 8 2009 20:27:52)

quote:

.
I will ask the surgeons I have seen here and Italy for sound literature and authority on this subject. I read everywhere that musicians related injuries and conditions have been neglected by orthopedic studies over the years, and only recently have aroused more attention. Hopefully, we will be able to share some critical information about this problem.


It would be a tremendous service to the community to collect more information on this subject and educate ourselves out of folkloristic grandmothers’ remedies, often worse than the evil they mean to heal


absoluteley..that would be brilliant

excuse me Pimientito, i didnt mean to take over your tread, i assumed perhaps when u posted this it was ok to ask questions and discuss it but since no replie i wont push the subject further..thanks for the tips



kozz -> RE: Curing tendonitis (Aug. 8 2009 21:49:50)

I've got this book "The Healthy Guitarist" by Virginia Azagura Rueda. Oscar Herrero proposes this book.

Here's a little "trick" to move away the fatique and pump up the metabolites in the hand and fore arm. (And if your back hurts maybe a shower version will do also :)

Contrast baths:
1. Fill one bowl with water heated to around 42-45 degrees celcius and another one with cold water (5-10 degrees)
2. First put your arms in the hot water for about 2 minutes
3. Then put them straight into the cold water for 30-60 seconds
4. Alternate this pattern for about 15 minutes
5. Fnish in luke warm water (pour some cold into the hot)

After that you should feel relaxation straight away.

Hopefully this can help, it surely won't cure the tendonites, but maybe can prevent it.


Here's a link to the preview:
http://books.google.nl/books?id=hWcAAuOUlUgC&pg=PA41&lpg=PA41&dq=the+healthy+guitarist&source=bl&ots=sNvlumVBDl&sig=4gal6JQhcx4VE0Ovw1RdDEEkWDM&hl=nl&ei=vmR-Stm8Kovr-AaLl4Ev&sa=X&oi=book_result&ct=result&resnum=2#v=onepage&q=&f=false

The book contains info and excercises, though the first part is quite hard because of all the anatomical therms.

I gave this book as a present to my physiotherapist who is now acutally doin courses specifically towards musician related injuries and she was very pleased with it.



at_leo_87 -> RE: Curing tendonitis (Aug. 8 2009 22:23:31)

you guys have me very paranoid and worried now.

think the foro funds can pay my $11,000 bill for my hand surgery? i dont think my cute doctor will go out with me if i dont pay her. [8|]



edguerin -> RE: Curing tendonitis (Aug. 9 2009 1:13:49)

quote:

but perhaps we can research too see if theres detailed books that cover this type of subject


The book Kozz recommends is ok (if not very detailed)

In a more general and edifying vein "Musicophelia" by Oliver Sacks will help fill the time while you're recovering, waiting at the doctor's etc.



Pimientito -> RE: Curing tendonitis (Aug. 9 2009 3:13:43)

quote:

excuse me Pimientito, i didnt mean to take over your tread, i assumed perhaps when u posted this it was ok to ask questions and discuss it but since no replie i wont push the subject further..thanks for the tips


No probs Flo. Its the time zone difference. I posted last nite and now im getting up again.

Ok there are several good points been raised here.
quote:

If tendonitis is not treated quickly it becomes chronic (long lasting) and can become very difficult to treat.

Gj - yours is a good example of what can happen when tendonitis becomes chronic. Tendons need to be rested as soon as they become inflammed. This strapping technique is something anyone can do straight away. It needs to be done the same day that you get the problem. If the tendonitis is strapped up quickly and allowed to rest then everything goes back to normal in a day or 2.
The thing is most people have to wait to see a doctor (who probably isnt a specialist) take some anti inflamatories, be referred to a physio etc. maybe get the wrong treatment, go to someone else for tests, edventually see a private specialist..........(sound familiar) and meanwhile the tendon problem can be getting worse. If the inflammation remains that leads to fibrous tissue being laid down in the tendon sheath and can edventually (after long time) lead to calcification. Surgery is then the only solution. Gj - it looks like you have seen an excellent surgeon so I'm pretty sure that you will be fine. If you get a sore day then tape it up as I showed you and it will settle quickly.

quote:

now I know exactly what I have and 100% certain i have it carpal tunnel


Flo- Its not a good plan to diagnose yourself. I have been treating musicians for years so before you rush off and get carpel tunnel surgey there are a few other possibilities and options to consider.
Carpel tunnel syndrome is caused by pressure of the median nerve under the flexor retinaculum. It can be due to contracture or adhesion of the retinaculum itself and in this case a sugeon may relieve the pressure. However there are alternatives. It may be that you have injured a wrist joint and this is causing the compression. This can be solved with physical therapy. A dietry lack of B vitamins in particular B6 can also cause carpel tunnel so first thing is go to the health store. Other causes are water retention and pregnancy (although I think you are safe there)

Secondly and importantly the biggest problem with carpel tunnel is not so much pain but weakness. Classically you lose muscle on the flesh part of your thumb due to the compression.

You might consider that it isnt carpel tunnel, or tendonitis causing the problem. It could simply be an active trigger point of the opposer muscle of the thumb or a compression of the saddle joint of the thumb (or both). Im working for a few days but will try to show you a thumb strapping technique this week.
Surgey is always a last resort. Its when you have no good choices left. The reason for that is because its ¡rreversable and doesnt always work. Dont get carpel tunnel surgey until a hand specialist tells you there is no other way.



XXX -> RE: Curing tendonitis (Aug. 9 2009 4:14:37)

quote:

ORIGINAL: Pimientito
Secondly and importantly the biggest problem with carpel tunnel is not so much pain but weakness.


I dont think i have carpal tunnel, but i may be close to it. I did a massage on the muscle under the thumb, it always felt thick and dense. Today my hand feels not only relaxed but ironically also stronger than before! I can only recommend this!

Sometimes there is also a pain right in the center of the wrist, under the palm. I went to a doctors and he said that could indicate carpal tunnel.



Exitao -> RE: Curing tendonitis (Aug. 9 2009 5:43:43)

Pimientito:

Beg your pardon, but if you got rid of your tendonitis in 36 hours, it probably wasn't tendonitis.

Part of my job is recognising and treating repetitive stress injuries(RSIs), and technically, that's what you had (unless this is a flare-up of a previously diagnosed case of tendonitis). It may seem like nit-picking but there is a distinction, and it can be important. It can be a bad idea for people to diagnose themselves.

In this case you've done a good job describing how you treated an RSI , and probably prevented actual tendonitis from setting in. So it's good and useful information for other guitarists.
In my work I would have likely immobilised a bit more than you did, but it's my job to err on the side of caution (keep people working instead of on compensation).



Tendonitis tends to be persistent and requires much more care and rest than 36 hours. An RSI can be handled in the time frame you described.

e.g. My tennis elbow took months to get better and it still twinges a year later, so it's not fully cured.

In a workplace, if the injury had not markedly improved within 2-3 days I'd definitely be sending the person to medical aid.



luke.park -> RE: Curing tendonitis (Aug. 9 2009 6:04:07)

mark,

sorry to hear bout your tendon! its a sign of a good week though eh?! looks like you're definitely going the right way about it! won't be long and you'll be hammering out siempre es tarde again!!
luke



Florian -> RE: Curing tendonitis (Aug. 9 2009 9:23:11)

oh oK Pimientito..cool glad to hear it cause i really am interested in all you guys have to say about it..

thanks...yeah whatever else u can think of please put it down, i wanna make informed decisions..i cant get anything done about it until about 2 monhs anyway so i am going to do streatching, exercises and try vitamin b and b 6...btw..what food group contains that ?

and yea u right i was speculating because it seems like all the sympthoms this guys were describing could relate to me but i would seek out doctors advice before i would commit to any kind of surgery



Pimientito -> RE: Curing tendonitis (Aug. 10 2009 1:20:10)

Exitao

Thanks for the somantic clear up. Some countries have small variations in nomenclature. I call any inflammation of the tendon or its sheath tendonitis regardless of whether its acute or chronic. I would not differentiate RSI from tendonitis if there is tendon inflammation present.

However I accept your point that there is a big difference in treating chronic and persistant tendonitis. My point of this thread is to show how in many cases one can get rid of it quickly if you treat on the same day to try to avoid a more chronic problem.

Secondly, treating work injuries can be different from treating musicians. Its a bit unfair to compare a condylitis with my example as tennis elbow is notorius for taking time to sort out. I have a clinic that specialises in treating flamenco musicians in Granada and this advice is based on my experience and experimentation.

I will agree 100 per cent with your quote "It can be a bad idea for people to diagnose themselves". The internet is useful for information and advice but at the end of the day you need a specialist for a personal diagnosis.



Exitao -> RE: Curing tendonitis (Aug. 10 2009 4:37:41)

I think you meant semantic.

While condylitis (mine was lateral epicondylitis, BTW) is much more persistent, than most types of tendonitis, it's worth pointing out that once any type of tendon injury is aggravated (or simply untreated) and does become chronic these types of injuries can really take time to heal.

As some of the foro members are (semi)professional or just serious enthusiasts, I think that they might be more upset at an extended interference with their ability to play, than something that affects a regular job (sometimes it's our hobbies that make our work lives tolerable).

Anyway, I liked your treatment method, I had no beef with that.

I might suggest that a self-adhesive crepe might be more convenient for longer term treatment (for people who are already chronic). Fingerless glove(s) on top of that if you need to work with your hands so you don't need to retape too often.

As I said before, 3 days and no improvement, go see a doctor.


In regards to whoever mentioned using heat, that should be avoided while there's swelling. Heat tends to aggravate swelling. Once the swelling has been gone a day, maybe...



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