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tendonitis - for georg!   You are logged in as Guest
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Stu

Posts: 1927
Joined: Jan. 30 2007
From: London (the South of it), England

tendonitis - for georg! 

hey georg. I read recently that you've been sufferin from tendonitis. Not sure if you were involved with the recent thread about rsi, but i revealed on there that i am also suffering from a dose of tendonitis too! How long have you had pain? Are you playing at all? Isn't it ****in frustrating?! I've been suffering for about seven weeks now and the last few days have been particularly awkward. I met a jazz pianist on monday who said his lasted about eight months! ****.
  REPORT THIS POST AS INAPPROPRIATE |  Date Nov. 25 2007 14:33:41
 
Georg

Posts: 405
Joined: Feb. 5 2006
From: Germany

RE: tendonitis - for georg! (in reply to Stu

First advice is of course: See a doctor. If you haven't already done it, do it!

I have it somehow every year, pretty much at the same time. Must have something to do with the cold weather and playing without warming up...and changing tires of my family's cars.

First, my left arm feels weak, and if I go on playing, or writing on a keyboard = any monotone work for your hands, it would hurt (that's where the tendonitis starts, as far as I understand my doctor). This year I had no chance to stop writing. I had to hand in some texts.

How long does it last? If you don't stop with the monotonous action, it can become chronic and you have it for years...sorry.

As soon as possible, I stop with guitar playing for about two weeks. Then I use a salve called "Voltaren" which helps against the inflammation (the agent of it is "Diclofenacium").
What helps even more in my opinion is cooling. By this treatment, most of it is over within two weeks. After these two weeks, I have to take care to warm up before playing and make breaks every 15 minutes.

I was told that eating gelatine would help...Don't know if that's true, but it can't be contraproductive.


Having a tendonitis is not the end of the world, but you really should stop playing for a while. That's where you recognize how addicted you are... (I practiced planting during this time)


I think we have some physiotherapists here. Do you have any advice for us?
  REPORT THIS POST AS INAPPROPRIATE |  Date Nov. 25 2007 16:18:49
 
Doog

Posts: 59
Joined: Sep. 17 2007
From: Tennessee

RE: tendonitis - for georg! (in reply to Georg

I posted the following information at another forum a while back. You should find this information to be helpful.

Tendenitis, Ligamentitis anyone?

Postby Doog on Mon Oct 22, 2007 9:39 pm
I post this information here because it can often occur as a result of working too vigorously, strenuously, or long on studies, scales, and arpeggios. Also, if one has not been playing for a while and then resumes and gets into a prolonged and/or vigorous session injury or strain can occur.

A little background information. Tendons cross joints and connect muscle to bone and thus provide for movement. Ligaments cross joints and connect bone to bone providing structural stability and integrity. When either of these tissues gets injured from strain, overwork, or direct trauma (injury) they become inflamed and tender [or painful] and the condition is referred to as tendenitis or ligamentitis [the suffix -itis denoting inflamation]. Over the years I have had recurrences of both of these problems. They can severely restrict ones ability to play the guitar ... the pain often making it impossible to play. Furthermore, trying to play through the pain produced by either of these conditions only serves to make them worse and it prolongs the recovery.

Now to the point of this post: There is a very simple, easy, safe, and effective treatment for these problems. It may sound too simple, but if you use it as described you will find that it actually works and is extremely effective.

The treatment is referred to as Ice Massage. It is performed by taking a single standard size ice cube and gliding the ice cube on the skin over the affected area in a continuous circular or back and forth movement - keep the ice moving. In order to hold the ice cube comfortably one can fold up a paper towel and grip the ice with that. When the ice is first applied to the skin it feels VERY COLD and it can hurt. NO problem! Just remove the ice until the area is comfortable and then re-apply it ... it takes just a matter of moments. Very shortly the ice can be glided over the skin continuously in perfect comfort because the skin gets numb. No harm is done to the skin and no frost bite or other cold injury can occur because the ice is constantly in gentle motion on the skin.

Crushed ice or tiny ice cubes will not work!

In addition to using ice massage, it is, of course, necessary to rest the affected area by not playing. Sometimes splinting the affected area for a short while is necessary to put the injured tissue at complete rest. Steroid injections can also be helpful, but interestingly enough are not sufficient when not supplemented with rest and ice massage. Also, steroid injections cannot be used repeatedly without the risk of "blowing out" [causing severe damage to] the affected tendon or ligament. If this happens, then one has a really serious problem!!!

The ice massage can be used as often as one has time to do so. The single cube treatment can be done back to back to back or can be repeated several times daily [usually four time a day is sufficient]. As recovery is progressing, one can use ice massage and then play for twenty minutes or so and then repeat the ice massage. Then as improvement continues, one can use ice massage before and after playing. When comfort is continuous the ice massage can be stopped.

I hope that this information will be helpful in case it is needed. If there are any questions, please feel free to ask them.

Dr. Doog

P.S.: It is also very helpful to use heat [as in hot soaks] alternately with the ice massage.
  REPORT THIS POST AS INAPPROPRIATE |  Date Nov. 25 2007 22:58:49
 
Doog

Posts: 59
Joined: Sep. 17 2007
From: Tennessee

RE: tendonitis - for georg! (in reply to Doog

Here is some additional information on this topic.

Postby Doog on Tue Oct 23, 2007 9:52 pm

LFP wrote:Doog, thanks for the explanation and the discussion of treatment that you have used. Could you give a brief description (duration degree of impairment) of the difficulty that you experienced with tendenitis and how long you used the treatment to control your symptoms. Fortunately I have not had this one, but knowing about it's management is very helpful for teaching purposes.

Yes, first of all there appears to have been a misunderstanding in terms of which of my hands were involved. I apologize for not being more clear and specific.

All of my troubles have been with my LEFT thumb and wrist. Specifically my left thumb at the distal interphalangeal joint [the last joint of the thumb - the one closest to the tip] in the early 1980s. This problem involved the the ligaments at that joint. It was so sensitive that I could not do anything that involved pinching the left thumb and index finger together. It was very disabling ... and not just for guitar playing. I had it injected twice which provided temporary relief only. I became aware of Ice Massage because I was involved with Sports Medicine where it is used abundantly. I tried it on my thumb and was delighted with the results. As best as I can recall, the problem went on for several months and gradually subsided and I was able to blend increased guitar playing with the decreased use of ice massage and then I was finally able to play with complete comfort and no longer needed Ice Massage. I have had no recurrences of this specific problem.

Then about a year ago I developed pain in my LEFT wrist near the base of the thumb. This was a tendenitis involving the extensor pollicis brevis tendon and it was caused by my repeatedly doing some difficult cord reaches and changes in Bb. Again, I had it injected a couple of time and wore a splint for a while, but it did not clear up. I was told that it could not be injected again because of the possible severe damage to the tendon. The next suggested step was surgery. As you might know, surgery does not always mean a simple cure; complications are always possible ... and I had heard of some bad results.

So I once again began using ice massage. [Yes, I know. Now I have learned to use that as my first option.] I also regularly used a special velcro wrist splint that also keeps the thumb from moving. [Any movement aggravates tendenitis.] I even wore the splint at night.

It took a few months to clear up completely. At first I stopped playing altogether; it hurt too much to play anyway. Then as improvement occurred I began to ice and play [only for about twenty minutes at a time initially] alternately at first and then ice before and after playing. I have been totally pain-free for several months now, but if there is any hint of discomfort, I start ice massage immediately.

Hey, LFP, I hope that this additional information helps. Feel free to ask if you have any other questions.

Dr. Doog
  REPORT THIS POST AS INAPPROPRIATE |  Date Nov. 25 2007 23:07:40
 
Doog

Posts: 59
Joined: Sep. 17 2007
From: Tennessee

RE: tendonitis - for georg! (in reply to Georg

One last bit of information.

If you have taken the time to read through all of this, I will be surprised if you have not found it to be helpful.

Postby Doog on Wed Oct 24, 2007 9:06 am

spae wrote:Doog,

I've been having pain on the back of my L.H. between the thumb and index. I'm going to try this Ice Massage but out of curiosity did a physical therapist or doctor tell you about this? I don't want this to ease the pain but hide the real problem you know? Thanks for the tip either way.

I am a retired, Board Certified, Family Practice Physician. I practiced medicine for 44 years. I used Ice Massage a great deal with my patients and those that used it properly always experienced improvement and no one every sustained any harm from it. Also, as noted, I have used it myself [the ultimate proof of its effectiveness for me].

If I understand the description of your pain location, there is not much there except for muscle and the associated local blood vessels and nerves - no major structures. So, you should be able to use ice massage safely and effectively. Obviously, if the pain persists or gets worse, you should see your personal physician.

Dr. Doog
  REPORT THIS POST AS INAPPROPRIATE |  Date Nov. 25 2007 23:11:45
 
carlos soto

 

Posts: 126
Joined: Oct. 22 2005
 

RE: tendonitis - for georg! (in reply to Stu

I've had tendonitis 2 times. The first time in my hands and recently in my left leg. Some say tendonitis is from a bad posture but I'm really sure that may be a factor but not the main one. I think tendonitis it's mainly due to an over-use/over-training and not resting and sleeping well, I would also add to this factors how well you are eating, the connective tissue is made mostly of collagen, so if you eat fast food all the time you will stay with tendonitis for a while because you won't get the proper amino acids to synthesize the collagen protein.

Just like when you go to a gym or exercise your body you have to prevent injuries, specially if you are obsessive about stuff or an elite athlete. When I had my hands(yes, both) with tendonitis I thought I was ****ed for life, I bought pills and all kinds of stuff to get well and keep playing, but the thing that really worked for me was understanding how the body works and make the work load from that.

The thing is simple, what doesn't kill you makes you stronger -yes, that's true-
since the time of my injuries I'm a lot more stronger with my hands and doing a much less effort to play, but if you get to a point that you are so destroyed and you keep doing it in a way that you think that if you suffer it could be a benefit to you, you are wrong my friend, and from that you may never recover from, so my advice is the next one:

First, get well. You can't go to therapy to walk again if your bone is still fractured, the point is, let it heal, and just after you know you are better start playing again, gently; as if you know you are recovering from something.

Second, after a week or two without even touching a guitar, picking up weight, or even using your hands to open a soda(tendonitis was that ****ty to me), you can start the rehab process. To me this consisted in putting my hands in hot water for about 10 minutes- this will ease the pain a lot- and then playing in short sessions apart from each other. I played one or two times a day for 15 minutes each and no less than 4 hours of rest between them, leaving also a resting time the very next next day without touching the guitar.
During the rehab process you CANNOT feel pain, I found this frustrating at the beginning but then I realized that if I was able to stop and think for about 10 seconds what was wrong, where was the pain coming from and changing the way I was playing to find a better posture that would still give me the absolute freedom I wanted but with no pain at all, then that was the perfect posture to me, and I could use it later when I was healed to prevent myself coming back to that injured state. So not all is bad, you can actually benefit from having this injure, you will know yourself a lot better after this.

Third, adjust yourself. If you think you are only making it worse with the amount of rehab cut it, if you think you can increase do it, carefully.

Fourth, don't get down, attitude is a must and if you get down you won't get better.

Fifth, after a long period of just gently playing you can take longer rests to build up and then play hardcore stuff, but stop when you feel the pain or you know that's about to come.

That's pretty much the steps I took to heal, I'm fine with my hands now, they just make a nasty cracking noise but the pain is gone.
I now work in a very different way I used to, I don't use the hot water anymore but I split my work load leaving a whole day to rest, I have found this makes me improve my skills a lot faster and I feel strong and relaxed while I'm playing, it also depends if I worked picado too much then I might just do some thumb work the next day, but I feel I'm conscious about my health and this also improves directly the way I practice and hence my skills.

Well, I hope you get better, tendonitis is a bitch but you have to keep the possitive attitude, it's a sign that you are pushing your body beyond it's limits and that's good but just learn what that limit is and try to stay within it.

Carlos
  REPORT THIS POST AS INAPPROPRIATE |  Date Nov. 26 2007 6:31:43
 
Francisco

Posts: 879
Joined: Jun. 13 2005
From: SW USA

RE: tendonitis - for georg! (in reply to Stu

Great threads guys. I had a bout of tendon/arthritis about a year or two ago. Never really did find out if it was from a tendon or from my wrist. I had to stop playing for about three months, and only did some range of motion exercises at the wrist, then later some strengthening exercises with resistance training. Wish I had known about your ice massage back then Dr. Doog. I also felt at the time that my diet might be contributing on some level. It was very high in animal protein, artificial sweeteners and low in antioxidant. I have since changed my diet (only minimally), and began taking glucosamine w/ condroitin. I'm not sure what has made the difference, and not to say I never feel the pain, but when I do begin to feel it, I simply lay off the particular piece/technique that is causing it for a couple of days, and it usually resolves on its own fairly quickly. Do you have any input on the possible contribution of one's diet to something such as tendonitis/arthritis Dr. Doog?
  REPORT THIS POST AS INAPPROPRIATE |  Date Nov. 26 2007 8:53:20
 
HemeolaMan

Posts: 1514
Joined: Jul. 13 2007
From: Chicago

RE: tendonitis - for georg! (in reply to Stu

i'd like to stress the importance of good practice.

in your rest strokes and free strokes... any stroke for that matter use your whole arm and shoulder to put weight behind the note, you'll be more efficient, have better tone and using large muscle groups will lessen your chances of tendonitis etc

buy dr. farias' practice without playing. it will make a huge amount of dirfference to you chronic pain sufferers

again, large muscle groups!!!

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  REPORT THIS POST AS INAPPROPRIATE |  Date Nov. 26 2007 10:45:58
 
cneberg

Posts: 257
Joined: Apr. 20 2006
From: Sončno polje pri Večnosti

RE: tendonitis - for georg! (in reply to HemeolaMan

quote:

in your rest strokes and free strokes... any stroke for that matter use your whole arm and shoulder to put weight behind the note, you'll be more efficient, have better tone and using large muscle groups will lessen your chances of tendonitis etc


I've heard about that. But how you do that? I guess it's just a way of thinking (like everything), but still... Do you have any suggestions? I have big problems with my thumb in combination with other fingers (arpegios for example). My hand "cramps" quite easily. So I'm afraid I'm going to get in trouble like "doog".

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Luka
  REPORT THIS POST AS INAPPROPRIATE |  Date Nov. 26 2007 16:48:11
 
Stu

Posts: 1927
Joined: Jan. 30 2007
From: London (the South of it), England

RE: tendonitis - for georg! (in reply to cneberg

Georg, Dr. Doog, Carlos soto, Thanks for your advice and accounts of your experiences with this horrible ailment! I will certainly try some of the ice massage and look into my diet and how that may be affecting things. I'm actually quite a good eater and rarely touch fast food, could probably eat a bit more fruit though!

Some of the advice is stuff I do/or have heard about already, but its good to be reminded of.

Thanks hemeola man, are you talking about the right hand?? I play right handed but my trouble is my left hand
quote:

dr. farias' practice without playing

I'll check it out

Cheers for now, I'll let you know how the ice massage goes.

Stu
  REPORT THIS POST AS INAPPROPRIATE |  Date Nov. 26 2007 20:13:27
 
Doog

Posts: 59
Joined: Sep. 17 2007
From: Tennessee

RE: tendonitis - for georg! (in reply to Francisco

Hey samwise,

You wrote: "I have since changed my diet (only minimally), and began taking glucosamine w/ condroitin. I'm not sure what has made the difference, and not to say I never feel the pain, but when I do begin to feel it, I simply lay off the particular piece/technique that is causing it for a couple of days, and it usually resolves on its own fairly quickly. Do you have any input on the possible contribution of one's diet to something such as tendonitis/arthritis Dr. Doog?"

I am not convinced that anything other than a normal, balanced, healthy diet is of any special benefit. If any arthritis is present, the current opinion is that glucosamine/chondroiton seems to be helpful. It is not a cure, but it does seem to make a positive difference. I take it every day!

samwise, you have got to try the ice massage. It would be perfect for that occasional 'flare up' that you experience. Do not abandon your 'rest break', but do add the ice massage. I expect that you will be quite pleased. I experience the same kind of thing, in fact, I had a little discomfort last night after playing and so I used the ice massage and today my left wrist feels just fine. I will be able to play tonight in perfect comfort.

Dr. Doog
  REPORT THIS POST AS INAPPROPRIATE |  Date Nov. 27 2007 3:58:35
 
HemeolaMan

Posts: 1514
Joined: Jul. 13 2007
From: Chicago

RE: tendonitis - for georg! (in reply to cneberg

well from the middle of your back feel the pull.

try to make it so that with each stroke you move your whole arm through the string... sort of like using your whole body to push the finger thru. start the pull from the middle of your back use your shoulder and your arm and just get as much energy from them as you can instead of trying to get all the force from your finger. this will help you avoid gettiny focal dystonia... a bad and cripplign thing

as for your left hand. relax more, let your fingers curl and hold your hand at your side, limp

notice how your fingers naturally come together (not spear apart form each other not extended) and curl? try to maintain that position on the fretboard as best you can, and use gravity and the weight of your arm to do the fretting. also, dont move your hand, just your arm when you change positions

a very helpful exercise is to wear a wristwatch or rubber band on your arm and put a butter knife or ruler on the palm side and the knuckle side of your wrist... keeping it straight in line with your arm. play like that for a while, and when you remove them your hand should be used to keeping a straight wrist.

the less travel around bent joints the tendons have to make, the less they will wear. and consequently the less they will become inflamed. i can try to make a you tube vid or soethign of the using the whole arm/body thing if you want

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  REPORT THIS POST AS INAPPROPRIATE |  Date Nov. 27 2007 7:21:33
 
cneberg

Posts: 257
Joined: Apr. 20 2006
From: Sončno polje pri Večnosti

RE: tendonitis - for georg! (in reply to HemeolaMan

quote:

try to make it so that with each stroke you move your whole arm through the string... sort of like using your whole body to push the finger thru. start the pull from the middle of your back use your shoulder and your arm and just get as much energy from them as you can instead of trying to get all the force from your finger. this will help you avoid gettiny focal dystonia... a bad and cripplign thing


Thanks! I will try to think in this direction.

And yeah, I try to keep the wrist of my "strumming" hand as narrow as possible lately.

Check out this guy. I think he plays marvellous. But man, check out his wrist. This can't be healthy (he corrects his position later in the video).



I know two flamenco guitarist who suffer from focal dystonia. A horrible thing indeed.

You don't have to bother and record videos just for me, but if you ever do a lesson of that, I would be happy to know!

_____________________________

Luka
  REPORT THIS POST AS INAPPROPRIATE |  Date Nov. 27 2007 9:50:32
 
edgar884

Posts: 1975
Joined: Nov. 16 2005
 

RE: tendonitis - for georg! (in reply to Stu

I get these pains my self sometimes.


What I do now is I don't really play guitar all week and then on saturday and sunday I play both days all day long, but doing basic exercises very slow and working on not wasting energy.


These pains are annoying as hell, hope mine doesn't get worse.

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May we find God through Flamenco instead of Angels and Demons

www.gabrieledgar.com
  REPORT THIS POST AS INAPPROPRIATE |  Date Nov. 28 2007 2:24:51
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