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#1 2009-11-18 16:26:45

lowonthetotem
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From: Cape Coral, FL
Registered: 2008-04-05
Posts: 529
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Elbow Tendenitis

Ok.  I used to be a trainer and have worked with many athletes that get tennis elbow.  Actually, I am an avid tennis player myself, playing with my dad twice a week (It is so humbling to get whipped by a 74 year old guy, let me tell you).  Still, over the past six weeks, I have been developing a case of tennis elbow, but not so much from tennis.  I feel it when I play tennis, but I REALLY feel it after practicing shakuhachi for an hour or so.  Tennis elbow is usually accompanied by an inflammation that puts pressure on the nerve that runs throught the forearm, so I really don't have tennis elbow.  I have elbow tendonitis, and I can almost put my finger on the tendon that hurts.  Like the knee, the elbow has a single bone end and a double bone end.  My tendenitis is on the top "nub" of the elbow, so it is a muscle that articulates around the ulna.  I am thinking it is my ring finger on my right hand from hitting Ro from Tsu Meri or perhaps from going to Tsu meri from Ro.  I don't know.  It is definitely different that your run of the mill tennis elbow, with which I am very familiar.  Any similar accounts out there?  When I put my finger on the swollen "nub" I can feel it move with the articulation of the right ring finger.

Honestly, I think a course of anti-inflamatories would cure it.  I had a similar issue in my wrist when I got a dog and just threw balls as far as I could over and over for a couple of hours and naproxin fixed it.  I drink alot more now though and am worried about taking those due to the liver.  Maybe I just need to suck it up, sober up, and take the medicine.  I just wondered if anyone had some "musician" hand stretches or hand exercises that would help.  Sobriety is a bitch tongue.


"Turn like a wheel inside a wheel."

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#2 2009-11-18 16:53:15

Tairaku 太楽
Administrator/Performer
From: Tasmania
Registered: 2005-10-07
Posts: 3203
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Re: Elbow Tendenitis

Herr Meister Singer says swimming is the cure all for repetitive stress injuries.


'Progress means simplifying, not complicating' : Bruno Munari

http://www.myspace.com/tairakubrianritchie

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#3 2009-11-18 17:04:20

lowonthetotem
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From: Cape Coral, FL
Registered: 2008-04-05
Posts: 529
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Re: Elbow Tendenitis

Thanks for the advice, Brian.  However, I think I need some direction for the stroke.  A "crawl" stroke, at least text book crawl, is only going to amplify the pain.  I can tell from doing it standing up in my living room.  Even breast stroke hurts more.  Making it hurt more is not good, at least at this stage.  What worries me is that rest is what is needed, which means that I will lose ground.  Drugs, naproxin, are preferable to rest for me and my commitment to this at least.  I think swimming is great exercise.  However, pronation and supination of the palm causes pain and at this point.  Each stroke that I can think of involves one or the other.  Maybe elementary backstoke is an option, or some of the rescue strokes.  I will have to look further into that.


"Turn like a wheel inside a wheel."

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#4 2009-11-18 17:08:28

lowonthetotem
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From: Cape Coral, FL
Registered: 2008-04-05
Posts: 529
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Re: Elbow Tendenitis

Actually, straight up back stroke may help.  At least I hope.


"Turn like a wheel inside a wheel."

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#5 2009-11-18 20:50:15

Glenn Swann
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From: Central New Jersey
Registered: 2008-03-01
Posts: 151
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Re: Elbow Tendenitis

lowonthetotem wrote:

I just wondered if anyone had some "musician" hand stretches or hand exercises that would help.  Sobriety is a bitch tongue.

have a look at
http://japanshakuhachi.com/handcareformusic.html


I followed rivers, I followed orders,I followed prophets, I followed leaders
I followed rivers, I followed highways,I followed conscience,
I followed dreamers... And I'm back here,
and I'm back here... At the edge of the sky       (New Model Army)

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#6 2009-11-18 21:25:06

Jim Thompson
Moderator
From: Santa Monica, California
Registered: 2007-11-28
Posts: 421

Re: Elbow Tendenitis

lowonthetotem wrote:

What worries me is that rest is what is needed, which means that I will lose ground.  Drugs, naproxin, are preferable to rest for me and my commitment to this at least.

Your commitment to not giving it rest will be your undoing. You have to stop playing to let it heal.  Playing through the pain will burn you up for sure.  I had to take six weeks off one time to let it heal.  All this will be for naught if you don't change your hand and arm tension when you start playing again. I believe most of these types of injuries are caused by some muscle that is working much harder than necessary. Getting rid of extemporaneous tension is an important part of your progress a of becoming a good player. These kinds of things can turn out to be very positive experiences. Your body is showing you exactly what you need to change. I know you hate the idea of laying off but I would suggest that in the long run it'll save you time. Sometimes slowing down gets you there faster.  A compulsive approach can be harmful. Good luck. These types of injuries can be dealt with successfully but you have to be willing to change what caused the injury.
                         All the best
                               Jim


" Who do you trust , me or your own eyes?" - Groucho Marx

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#7 2009-11-18 21:49:32

Yungflutes
Flutemaker/Performer
From: New York City
Registered: 2005-10-08
Posts: 1038
Website

Re: Elbow Tendenitis

Didi you see this thread?
http://www.shakuhachiforum.com/viewtopic.php?pid=11133
I agree with Jim. If you take a break, when you return you'll come back stronger than ever.

Take care, Perry


"A hot dog is not an animal." - Jet Yung

My Blog/Website on the art of shakuhachi...and parenting.
How to make an Urban Shakuhachi (PVC)

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#8 2009-11-18 21:52:41

Lodro
Member
From: Australia
Registered: 2009-04-02
Posts: 105

Re: Elbow Tendenitis

'Hand Maintenance Guide for Massage Therapists - the art of an injury free career' by Shogo Mochizuki

I think I might have mentioned this book before, I find it an absolutely wonderful book, and written by one of the leading Japanese Massage Therapists - Shogo Mochizuki. It's designed for Massage Therapists as a means to maintaining hand/wrist/elbow/shoulder/neck, however it's an extremely efficient tool for maintenance for anyone.


Each part of the body should be connected to every other part.

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#9 2009-11-19 12:10:47

lowonthetotem
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From: Cape Coral, FL
Registered: 2008-04-05
Posts: 529
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Re: Elbow Tendenitis

This is definitely simple tendonitis.  It isn't a case of trigger finger or carpal tunnel.  There is tenderness at the joint, but there is none of the nerve pain/burning that is associated with nerve compression.

Thanks for your concern Jim.  I am sure that I grip the flute too tightly with my right hand.  I have noticed my death grip on several occasion, usually while playing songs that I find difficult.  I have been trying to stay mindful of it, but it is hard to be consistent with it.  Although I am no craftsman, I do alot with my hands.  I ran a chainsaw for a living for a couple of years and also worked as a laborer shoveling all day.  I dig alot in my garden.  All these things have kind of trained me to grasp things tightly.  It is certainly preferrable to have a hard grip when you are cutting up a couple of hundred trees in a day.  Chainsaws can be terribly unforgiving.  Like anything, it is much harder to unlearn this than it was to learn it.  I would be curious to know how one would "practice" having a relaxed grip on the flute, aside from just keeping it in mind while I play.

This issue arose from painting the inside of my house, actually.  Rolling the ceiling was the impetus of the pain, but it has not resolved itself and is mostly aggrevated by playing.  Typing for a living doesn't help much either.


"Turn like a wheel inside a wheel."

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#10 2009-11-19 13:58:35

Glenn Swann
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From: Central New Jersey
Registered: 2008-03-01
Posts: 151
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Re: Elbow Tendenitis

a few ideas for you-

before practicing, and in breaks during, just sit holding the flute and taking a few deep breaths, consciously relaxing whole body, but especially arms, hands and fingers. mindfully keep that softness in the hands as you put the flute in blowing position. tension will likely creep in again, but if you train yourself to start from a good place, that is at least a start. you may more easily identify when you are gripping too hard and let go.
using chinese health/iron balls is good. you pretty much can't roll them smoothly without clanging together unless you relax the hands.
a much more involved, but worthwhile option, is to practice taijiquan, studied with a competent teacher. it teaches exactly how to use the body effectively without excess, un-needed tension.
feldenkrais method could be good as well

for healing, aside from rest, the dit da jow perry mentioned in the other thread is great, and i've found MSM to be quite effective. i've had tennis elbow before, not from shakuhachi, but from overdoing it with my sword and spear practice coupled with too much yardwork(ie machete hacking).


I followed rivers, I followed orders,I followed prophets, I followed leaders
I followed rivers, I followed highways,I followed conscience,
I followed dreamers... And I'm back here,
and I'm back here... At the edge of the sky       (New Model Army)

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#11 2009-11-19 18:27:58

radi0gnome
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From: Kingston NY
Registered: 2006-12-29
Posts: 1030
Website

Re: Elbow Tendenitis

lowonthetotem wrote:

I would be curious to know how one would "practice" having a relaxed grip on the flute, aside from just keeping it in mind while I play.

The way I do it is to learn some simple pieces really well so all I have to think about with them is how relaxed I am. Then, when I notice too much tightening when I'm practicing, I revert back to one of the simple songs for a few minutes and then go back to the harder piece and try to bring some of the relaxed feeling with me. It usually doesn't last long so repeat as necessary or until you give up on trying to play relaxed for the harder piece. I guess that's what they mean by "paralysis by analysis".

I know with the lesson route we're always being pushed out of our comfort zone, which is fine for material for lessons, but don't forget that the purpose is supposed to be to learn to sound good. You've got to hammer at those earlier pieces you learned while you progress. Choose a few of the simple pieces (that means ones you learned) to run through every day, you'll be surprised how easy it is to relax when you really know a piece.

Last edited by radi0gnome (2009-11-19 18:30:24)


"Now birds record new harmonie, And trees do whistle melodies;
Now everything that nature breeds, Doth clad itself in pleasant weeds."
~ Thomas Watson - England's Helicon ca 1580

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#12 2009-11-20 11:13:47

lowonthetotem
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From: Cape Coral, FL
Registered: 2008-04-05
Posts: 529
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Re: Elbow Tendenitis

Had a revelation yesterday.  It is the bird finger on the right hand not the ring finger, so it is the finger that is holding the flute.


"Turn like a wheel inside a wheel."

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#13 2009-11-20 12:22:37

Jim Thompson
Moderator
From: Santa Monica, California
Registered: 2007-11-28
Posts: 421

Re: Elbow Tendenitis

lowonthetotem wrote:

Had a revelation yesterday.  It is the bird finger on the right hand not the ring finger, so it is the finger that is holding the flute.

Now your getting the idea. Become a tension detective. It's incredible how much tension our bodies carry that we are not even aware of. Becoming aware of them is the key to getting rid of them. Isn't that a spiritual practice?(Sorry that's a reference to another thread).
    I saw a demonstration of a trumpet player demonstrating the low pressure system of playing. He hung the trumpet from the ceiling by a wire and walked up to the trumpet with his hands behind his back and played double high C's. I sort of transferred the concept to shakuhachi by picking up the instrument and holding it no tighter than required to keep it from falling out of my hands. Then put your fingers in position to play. Play (for example) chi and slowly drop your left hand fourth finger to close hole number three to make re being mindful to squeeze it not one bit harder than required to shut the hole. Get used to the way that feels and expand it to your whole physical attitude to the instrument. When I did this I was surprised to hear my tone improve as well. It got a little less airy sound(less forced),  I certainly felt more comfortable playing and never had trouble with that particular injury again despite rigorous practice. In some sort of perverse way I now sort of half-assed welcome the pain because I know I can beat it and the pain is showing me something I wasn't aware of. Turning pain into enlightenment- isn't that some sort of Tantric practice?( Sorry again, I'm still stuck on that other thread). All this of course is only applicable after a solid healing rest. I know your still playing because I know the signs of a zealot when I see one but I beg you please stop. The thought of you playing while injured is making my hands hurt.
         Best wishes. Please let us know how your doing. This is an important hurdle. More than one great player has crashed on those rocks.
                                           Jim


" Who do you trust , me or your own eyes?" - Groucho Marx

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#14 2009-11-20 12:37:35

lowonthetotem
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From: Cape Coral, FL
Registered: 2008-04-05
Posts: 529
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Re: Elbow Tendenitis

Actually, I haven't played in three days.  Called off tennis too for a while.  Haven't had a drink for a couple of days and eating lots of cabbagey stuff to get the liver back into fighting shape, so I can go through a course of naproxen.  It really does do wonders for the tendon and muscles in a way that the other OTC anti-inflammatories don't seem to approach.  I'll try those practices.


"Turn like a wheel inside a wheel."

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#15 2009-11-20 12:48:27

Jim Thompson
Moderator
From: Santa Monica, California
Registered: 2007-11-28
Posts: 421

Re: Elbow Tendenitis

Glad to hear it. Sometimes a break freshens up your viewpoint. Pressure is off for a bit. Enjoy!


" Who do you trust , me or your own eyes?" - Groucho Marx

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#16 2009-11-20 15:20:33

radi0gnome
Member
From: Kingston NY
Registered: 2006-12-29
Posts: 1030
Website

Re: Elbow Tendenitis

lowonthetotem wrote:

Had a revelation yesterday.  It is the bird finger on the right hand not the ring finger, so it is the finger that is holding the flute.

I hate to take on Edosan's search engineer role, but I remembered a previous discussion and our resident guru Chikuzen's well-written post near the end where he says it could be a hand position problem and decided to search on "death grip" with Chikuzen as the author. This is what I found (Chikuzen's posts are at the bottom): http://www.shakuhachiforum.com/viewtopi … 5963#p5963


"Now birds record new harmonie, And trees do whistle melodies;
Now everything that nature breeds, Doth clad itself in pleasant weeds."
~ Thomas Watson - England's Helicon ca 1580

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#17 2009-11-23 10:18:01

lowonthetotem
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From: Cape Coral, FL
Registered: 2008-04-05
Posts: 529
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Re: Elbow Tendenitis

It's hard to have a death grip in that position, but not impossible. wink


"Turn like a wheel inside a wheel."

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#18 2009-12-02 10:25:45

lowonthetotem
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From: Cape Coral, FL
Registered: 2008-04-05
Posts: 529
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Re: Elbow Tendenitis

Laid off tennis for a week and slowed practice to just a few minutes every three or four days.  This just isn't healing.  Like I said, it actually started when I painted the ceiling in the house and just never healed.  Since the flute and tennis were not the actual causes, I am not sure that stopping them would really fix this.  The pain has actually gotten worse since I have lessened the work load on the elbow.  I think I have to break down and see a doctor.  I am hoping that this is just severe tendonitis and not the beginning of arthritis for me.


"Turn like a wheel inside a wheel."

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#19 2009-12-02 11:32:03

nyokai
shihan
From: Portland, ME
Registered: 2005-10-09
Posts: 613
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Re: Elbow Tendenitis

Bummer! Best of luck to you on getting it taken care of.

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#20 2009-12-03 13:36:50

lowonthetotem
Member
From: Cape Coral, FL
Registered: 2008-04-05
Posts: 529
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Re: Elbow Tendenitis

So it isn't a problem specific to a finger or my grip.  It is all about wrist flexion and extension.  I got a prescription for a heavy duty anti-inflammatory and a goofy wrist brace that immobilizes my hand.  According to the doctor, I don't need to stop playing the flute or even tennis.  He said that what is likely aggrevating it most is how I sleep.  I have to wear the brace 24/7 for a couple of weeks but especially while I sleep.

Anybody who faces this may want to invest in one of these braces.  The doctor said that would go the furthest in helping it heal.


"Turn like a wheel inside a wheel."

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#21 2009-12-03 19:26:49

Jam
Member
From: Oxford, England
Registered: 2009-10-02
Posts: 254

Re: Elbow Tendenitis

All the best mate, hope it feels better soon.

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#22 2009-12-04 11:29:09

lowonthetotem
Member
From: Cape Coral, FL
Registered: 2008-04-05
Posts: 529
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Re: Elbow Tendenitis

Thanks Phil and Jam.  I think it is coming along, but the script is really making me queezy.  Still, I can already see a reduction in swelling, so no need to worry over me.


"Turn like a wheel inside a wheel."

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#23 2010-01-14 09:17:09

lowonthetotem
Member
From: Cape Coral, FL
Registered: 2008-04-05
Posts: 529
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Re: Elbow Tendenitis

Well after weeks on anti-inflammatories, minimal flute playing, and no tennis there has really been no change.  I even wore a brace to immobilize my wrist for a couple of weeks.  I followed all the Dr.'s orders with no short cuts.

This morning I did recall a little tid bit from my training days.  In addition to post therapy patients, I worked in a gym with lots of iron pumping meat head types.  They would constantly get biceps tendonitis from "pumping their guns."  The originating tendon of the long head of the biceps passes through a narrow channel as it makes its way into the shoulder.  It is a very similar set up to the muscle in the forearm that passes through the upper condile (sp?) as it goes to the upper arm.  Tendonitis, generally speaking, occurs when there are a great number of micro-injuries to a tendon from tearing and the subsequent scarring.  Scar tissue, left unstretched, calcifies and often adheres to bone when the two are in close proximity to one another.  For the muscle heads, I used to dig my thumb deep into their shoulder and feel for the biceps tendon and when I found it manipulate rather forcefully until I could feel it move a little within that channel.  I have to admit it was fun to see those big jerks wince in pain, but after I was done they all would say that it felt much better.  This morning my elbow was pretty sore after I awoke.  With a flash of memory, I dug my thumb down into the top of my elbow and manipulated the offending tendon.  BAM! No pain for at least 6 hours so far this morning.  It is starting to get tender again now, but it takes many sessions of rough massage to continually break the tendon away from the neighboring bone.

Once the tendon has adhered, no amount of immobility or anti-inflammatories will reverse the calcification, and I had this building over a period of months before seeing the Doc.  Furthermore, once adhered, the tendon is stuck and movement just causes more tearing, scaring, and ultimately more calcification.  So it is a condition that builds on itself.  Hopefully more deep and aggressive massage and manipulation, along with stretching, will at least make it easier to live with.  I've also been looking into therapuetic stretching (as opposed to stretching for maintenance) and found one that seems to help.  With the upper arm parallel to the floor and the lower arm vertical, flex the wrist back so the hand is pointing at your face and extend the fingers as far towards the to floor as much as possible.  Hold it for 10 to 30 seconds and come out of the stretch slowly.  An Irish piper who plays with a guy that happens to be a Physical Therapist told me about that one, and it seems to be the best one so far.

I hope this helps some other folks with the same issue.  I will let you know if it works over the long run.  Considering the immediate relief from pain, I think it will.  I'd recommend the tendon manipulation for 10 to 30 seconds (if you have thin arms like me, you'll feel that small, thin tendon) followed by three to six "sets" of the stretch I described.  I did it again between the last paragraph and this one, and the pain has subsided again.  We'll see.


"Turn like a wheel inside a wheel."

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#24 2010-01-14 10:26:31

Musgo da Pedra
Member
From: South of Brazil
Registered: 2007-12-02
Posts: 332
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Re: Elbow Tendenitis

Stop the 5 against one for some time... mr. porn!


Omnia mea mecum porto

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#25 2010-01-14 10:32:14

lowonthetotem
Member
From: Cape Coral, FL
Registered: 2008-04-05
Posts: 529
Website

Re: Elbow Tendenitis

I just go lefty to save the elbow big_smile

Added bonus, it feels like a stranger is doing it.

Old joke ... so old, sorry.


"Turn like a wheel inside a wheel."

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