Tendinitis: how I got it and how I got rid of it

Photo’s, drawings and instruction video’s will follow later on. I’m just sharing the article with you for now, firstly because I’m proud I finally wrote it all down and secondly because I hope to be helping other musicians, so they don’t have to go through the same hell as me.

It all started on March 25, 2010. It was a long day, with clarinet and chamber music lessons, rehearsals, and in the evening an informal concert with the quartet in the kitchen/temporary concert hall of the studenthome where some of my friends lived. During the rehearsal we had right before the concert I noticed that my right arm was hurting. I assumed it was fatigue, and I just rubbed my wrist and forearm with Arnica creme. Halfway through the concert however I almost couldn’t hold my clarinet anymore. I forced myself to play through until the end, but after, my friend cleaned my clarinet, because I couldn’t even disassembled it myself anymore. Rest would help, I thought.

But the following morning my arm was still hurting, a lot. I couldn’t do anything, not even turning the key to open the door. Luckily I’m left-handed, but doing everything with one hand isn’t that comfortable. I spend my days at the cafeteria of the conservatory and I owe many thanks to the friends that kept me company, for being there, letting me complain, and keeping me distracted. Easter holidays were coming up, so I decided to rest and see what happened next, I didn’t think this could be serious, I’m not the girl that gets serious problems (I don’t practice enough for that). But at the end of the holidays I still couldn’t play properly for more than half an hour. So I went to the doctor after all. That’s when the word tendinitis came up for the first time. Tendinitis, or tendonitis, is an inflammation of the tendons, in my case those that hold the muscle that crosses the right fore arm, although it originaly came from my thumb. My doctor, who’s been treating me since I was born, knows that I’m allergic to most anti-inflammatory cremes and also that I’m anti-antibiotics, so he suggested physiotherapy. Two times a week I had my arm massaged, including massage with ultrasonic waves and one time even electroshocks. Sounds nice, massage, but it felt more like a torture. Luckily I healed fast, and after a few times I could start studying again, though I kept away from marathonsessions.

Everything went well until I went on a clarinet course in Ávila, Spain, at the end of July. The lessons weren’t a problem, but because of the uncomfortable sitting position during the clarinet choir I had to spend the whole fourth rehearsal following the score without playing, to make sure I would be able to play the concert. TO AVOID: low, uncomfortable chairs, combined with watching with two people on one stand (which won’t allow you to sit in front of the score nor put the stand at a height that is comfortable for you, you have to compromise). After that there was one more month of holidays and at the end everything seemed fine.

Until… the middle of October. I had to study both A and B flat clarinet in that period, so I was changing a lot between the two. So after a week I was back at the doctor’s. He resend me to the physiotherapist, as it had helped (though only temporarily) before. I chose another one, one that was close to the conservatory, so I could easily spread my practice hours at school during the day and go to the physiotherapy afterwards. Massages again (though less painfull, as I reacted quick in going to the doctor for a prescription) and stretchings that I had to do a few times a day, especially during and after my practice.

All’s well that ends well, I hear you thinking. True, but during the orchestra project in February I learned that it wasn’t the end yet. Same problem as before, changing between clarinets, one in the morning, the other one in the afternoon. And if you have ever played (or even just held) a Selmer Signature you should have noticed that there is a substencial difference between the A en B flat, both in spreading of the fingers as in weight. The first week of the project the stretchings still seemed to work, but then it got worse. The day before the concert I noticed there were a few runs that I couldn’t play fluently anymore, because I wasn’t able to move fingers equally because of the tension. I called the physiotherapist for an emergency session, but as she was in training that week she couldn’t take any more extra patients before the next Monday. So I was there, the next Monday morning.

She examined me and asked me some questions. It seemed that the inflammation and tension was now only in my thumb and wrist. And it only hurt in stressfull situations and when changing clarinets to often, so not from fatigue of marothon practice sessions (which I still love, I’m sorry for all of you who are against them). She said that she could probably help me get rid of the tendinitis with practice therapy. So I went back to the doctor for another prescripcion (in Belgium we have very strict social security rules for physiotherapy). I worked with my physiotherapist for over 2 months, until right after my last exam. This extensive practice therapy involved massages of thumb and wrist, training of the muscles of the forearm, the upper arm and the wrist, stretching of the muscles in wrist and forearm, flexibility of the thumb, and stretching and strengthening of the muscles in the fingers.

One time, somewhere in the middle of this two months, I forced something while playing and I couldn’t straighten my fingers anymore, my hand was stuck in playing position. Half an hour, and everything was fixed. At that point she gave me ‘the ball’, to practice at home. At first I thought of it as a torture instrument, but I’ve grown accustomed to using it and now I can’t live without it. It’s the Handmaster Plus. A small ball with an elastic cord to put your fingers through. You stretch your hand and fingers fully and then you close and squeeze the ball (so you also train your upperarm muscles). EVERY MUSICIAN SHOULD HAVE THIS. I immediately bought three of them on Amazon (in different strenghts) and tell everyone I know to buy them.

In one of the first sessions, I asked her were would be the best place to put my thumb rest (after explaining the use and functioning of the thumb rest). She answered immediately: as high as possible, to lighten the pressure you put on the thumb. I doubted her opinion at first, because a very trustworthy clarinet player once told me the best placement of the thumb is between the second and third finger. In other words, thumb rest as low as possible. Seems he was wrong. I tried it for one week and all of a sudden I had less pain, and my thumb was less tired. So, apparently, if you have thumb tendinitis, put the thumb rest AS HIGH AS POSSIBLE. Maybe in other cases another position of the thumb is better, so everyone has to chose for himself, or ask a specialist, but at least it helped me.

That one great Monday after my counterpoint exam I was declared free of tendinitis. Of course I have to be careful and keep doing my exercices, I’m build with bones and muscles that are apparently not really made to play clarinet professionally, but I now know how, so I hope I can avoid further physiotherapy in the future. A STITCH IN TIME SAVES NINE!!!

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