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Struggling with tendonitis

Discussion in 'The RedBanned Bar & Grill' started by Amadeus Pakmur, Dec 9, 2017.

  1. Hi Guys,

    as the thread title says, I'm currently struggling with tendonitis for already 3 months now. Unfortunately it doesn't seem to get much better, although I tried to stop or at least to reduce all the activities that cause the pain and immobility (as much if possible, of course I couldn't stop completely). I got a splint from the doctor, which I used the past 1.5 month, I've visited 2 different orthopedic specialists, one injected cortisone - didn't help at all.

    I try to eat healthy and even take some supplements that should help the healing process. Also I do some stretching exercises, this seems to be the only thing that helped a little bit...but still I couldn't sit on the piano for more than 10 minutes until my wrist starts hurting and then I can't move it properly. So I really can only use my left hand right now, and it is already feeling a little bit overstrained as well.

    I just don't know what to do anymore, and I'm feeling extremly desperate...maybe someone went through this or something similiar and has any advice for me?

    I'd appreciate any help!

  2. Wow that sounds awful ! I am so sorry to hear this. ..... Have you tried snorting PCP before you practice?... I'M KIDDING !!! DON'T DO THAT !

    Actually, yes, I can refer to the perfect group. This is in fact the sole purpose of this methods existence.


    First, let me offer you a disclaimer;

    1. I personally have not taken any lesson/workshop nor purchased anything from this group. Only second-hand knowledge.
    Some of the aspiring concert pianist I knew from conservatories in NYC found themselves in the same spot as you, and they fanatically RAVE about this approach. Basically they went from having to stop playing in 10 minute due to pain to practicing/playing/accompany singers 6 hours a day, with no discomfort in about 6-8 month window.

    2. Every "method" has it's detractors, or things for you to consider as only you know you own situation. Here are the two most common criticisms:

    • The lessons/consultations are pretty expensive. Some are in the range of $150 USD,or more, per hour. For some that is a lot of money. Other people don't think this is expensive and actually spend that much each hour at a strip club snorting cocaine and buying booze and women --(waitress....can I get another round please.?)
    • It's primary design was for injuries to pianist, and allowing them to heal, and increase their technique etc. For those who have never had a bad injury, you get a "whats the point".

    But you do have an injury, so I think that is pointless. I am just telling you all this upfront as google/piano forum searches will reveal a debate and these are the two main detractions; A good analogy would be Hannon etudes. Some people love em, others hate em.

    Now the positives:

    The people I mentioned above were all Juilliard, Manhattan School etc. grads..... so when I hear them say "I swear by it" .....I raise an eyebrow.

    You can 100% know this is not a scam. Every year they have a big workshop at Princeton University (which would not let scams come back every year), and Golandsky has been around on faculty for decades in NYC. You don't get to be head of keyboard at these large, hyper competitive universities by selling snake oil.

    There are a number of follower who have now set up shop to teach this approach. http://www.pianomap.com/index.html

    Usually those just staring are the cheapest, and vice versa. http://www.wellbalancedpianist.com/bptaubman.htm

    I hope you get better !

    Take care and many best wishes

  3. Hi Doug,

    thank you very much for taking your time to write such a long and detailed answer, I really appreciate it!
    This is something I never heard of, but sounds very interesting and promising...so if I understand correctly, this is something you
    can do and train WHILE you are still injured? Or is it something you do after the inflammation is healed?

    Anybody ever tried this and has some first hand experience?
  4. I'm very busy these days, and I don't really have much time to spend on the forum, so I apologize for the rushed response here.

    I did have tendonitis some years ago, which lasted for a solid 3 months. My advice would be: stop playing completely. The injury will never fully heal if you continue to play (that's what I was told, and it made sense).

    Tendonitis sucks, it was easily one of the worst periods of my life. I got it because I was playing too many hours and because I was practicing in a somewhat bad way (some pretty demanding Chopin Etudes, which is why I probably got it). You have to have the discipline to step away from the piano, period. I fortunately got healed without cortisone, but it was rough. I guess continue to get some type of medical treatment (I'm not a doctor, I wouldn't know what to say about that), and of course stretching etc., but don't touch the piano. Your playing on and off probably is the reason why it didn't get away yet.

    When you're fully healed, then you can maybe try to implement the techniques that Doug suggested. I don't really know anything about that program, but I watched a free video, and the content seemed to be valid (it was about Chopin's first etude, which is an absolutely hand/arm killer).

    This is my 2 cents. Hang in there buddy, it's really rough. Best of luck! :)
  5. I might just have been really lucky, but I got acupunture for my tendonitis and have not had a problem since.
  6. I had repetitive strain injury in college from practicing classical guitar too much (and without the best technique - too much tension!) and I had to quit for several months as Francesco mentioned he did above. It really sucks but that is what my doctor advised me to do and it remedied the problem.
  7. Well, if you want to contact one of the concert pianist I mentioned who raved about it reach out to this guy.


    He plays the shit out of the piano, and due to 6 hours practice a day etc.... was in the same spot you were. Really hit a "nadir"

    Also you can check out a lot of small videos on youtube.

    There are a ton

    Well, I don't know the specifics of your case. Basically the whole premise is going back to square 1 to re-learn proper muscle movements.
    As you will see.... this means it's not so much fun to be an audience member. It's like watch a pack of sloths jamming.

    Don't expect, at first a lot of playing. It would be more like 5 minutes of playing one note every 10-15 seconds while aiming to be as focused and aware on the proper muscle movements as you can.

    Reach out to Jeremy. His is a super nice guy, and I am sure he would be happy to fill in the details that I would not know.
    T.j. Prinssen likes this.
  8. Oh man that sucks, I'm really sorry to hear that. I've had tendonitis and I know it's not fun but I was quite lucky to recover pretty quickly. My GP recommended ultrasound therapy and to take a break from playing. I think I had ten sessions and after about a month and a half away from the instrument, tendonitis was gone.
  9. Hey all,

    thanks a lot for all the information and tips you gave me :) Acupunture also might be something worth trying. Last week I finished the last project I was working on and now I'm finally able to stop working and playing for a while..hopefully resting completely will help.

    Thanks again!
  10. I currently study piano with a teacher who specializes in the Taubman Approach and it's helped my playing a great deal.

    When I started, I was experiencing numbness in my arms and hands and general tension everywhere. The numbness itself was due to tightness in my pectoralis minor (on both sides) and not anything piano-specific. However, since retraining, playing the piano has gotten easier. I have more facility now and a lot less tension than when I started.

    Ethan Iverson (of The Bad Plus) endorses it from a general skills perspective. I'm not an advanced player, but the basics of efficient movement can benefit anyone.

    They do say you can train in this technique while injured and I think that's possible in general. There are lots of testimonials from people who claim to have experienced healing after adopting it. However, I can't comment on your situation and I certainly wouldn't try anything without consulting someone who knows the technique, especially if you are still in pain.

    Ultimately, you should go with what works for you, but my own experience with it has been very positive.
    Rohann van Rensburg likes this.
  11. #11 Rohann van Rensburg, Feb 11, 2018
    Last edited: Feb 11, 2018
    I wish I could personally backhand any ortho or MD that has the gall to think their basic medical education taught them anything about dealing with soft tissue rehab. Doubly so to anyone who hands out cortisone shots for issues like this, especially given that the scientific lit is so obviously not in favour. Man alive that irritates me. Please stay miles away from any surgical intervention or further shots! You could cause irreversible issues down the road if some jackass decides to open you up or keep injecting for an over/mal-use injury.
    For starters, how do you know it's tendinitis? If it's chronic it could be tendinosis. All that is is a description of your symptoms, not the root problem.
    PM me which city you're in and I may be able to find you a competent physio/chiro (I'm extremely picky).
  12. Tendonitis can be a nightmare, especially in high-use joints like the wrist. Part of why it's so slow and difficult is that tendons and ligaments heal and strengthen slowly, much slower than muscles. Cortisone injections can provide relief in the short term, but in the medium to long term they can cause irreparable damage, as can NSAIDs. While they delay the inflammatory process they also delay healing and can degrade the tissues if subjected to prolonged use.

    The biggest challenge, at least with athletes, is getting people to rest the area sufficiently. Try to find a good clinician and be prepared to road-test a few of them in the process. If it's noticeably swollen and you've got the cash, consider getting something like a Compex. Ideally you'd run it at a low level, just enough to contract the muscles and cycle the inflammatory fluids in and out of the lymphatic system. Still, check out the people Doug recommended, or try to find a good Physio or Sports-Medicine Specialist.
  13. #13 Rohann van Rensburg, Feb 12, 2018
    Last edited: Feb 12, 2018
    Sam is unfortunately correct: the literature on cortisone injections is highly unfavourable. And indeed, stopping all use via a brace or the like will likely make it worse. The conventional medical system is atrocious at dealing with these issues -- your best bet is to use MDs only for ruling out arthritis, etc, they do little other than attempt to attack symptoms, which is a massive systemic issue (I once went to an MD to get an X-ray to rule out femoral-acetabular impingement [your hip and femor don't get along well] and he didn't even know what that was -- in the end it didn't even matter because I simply figured out how to train the area for proper stability/mobility). As I mentioned, you may not even have tendinitis, and it's likely that the problem isn't stemming from the painful area.

    I was a strength and conditioning coach for four years who worked for a rather bright sports med clinician, who currently works for Canada Basketball as well as ALTIS, who also happens to be in contact with some of the best clinicians in the world. If there's a decent chiro or physio in your area, I can probably figure out who it is.
    Kyle Judkins likes this.
  14. people taking medicine to fight inflammation make me sad.

    I watch people at the Gym do it all the time, thinking it's helping.

    But sometimes the inflammation itself is the most important part of the healing process... and if you keep cutting that off, it's like having a hole in your roof, calling a roofing company to come repair it - and someone calls them back and tells them "nevermind, we fixed it" but they didn't actually fix it.

    Sometimes inflammation is the cause of the problem - sometimes it's the symptom... when it comes to overuse - it's a symptom.

    As far as my joints go, 9/10 it's uneven tension on different sides... for instance, I've got naturally good biceps, but it's like watching grass grow with my triceps... so if I workout and do a lot of chin-ups/curls without doing tricep pushdowns or something - my biceps will get much tighter and then I'll have really bad elbow pain.

    Heck, I even fixed my "duck foot" from foam rolling - and got rid of the knee pain I was getting while deadlifting/squatting... simply because one muscle was tighter than the others - it was pulling my kneecap to the right for most of my life.

    you can try "foam rolling" pretty easily... foam rolling your forearms is as easy as finding something like a fat pvc pipe. Just make sure you try loosening up your biceps and triceps... they may not seem like it - but the biceps and triceps are secondary muscles for supination/pronation at the wrist, and sometimes it's the muscles nearby that cause a systemic issue. (like your hamstrings seem tight, but it's actually your calves)
    Rohann van Rensburg likes this.
  15. I think the biggest underlying issue is treating the neuromuscular system as individual, separated "parts", when it's demonstrably not the case. It's the reason why Dynamic Neuromusical Stabilization is so amazingly effective (retraining motor patterns and building workout programs with an understanding of how the neuromuscular system actually functions, ala developmental kinesiology). Kyle describes an extremely common, vital point -- don't chase pain. Doing things like stretching the affected area too frequently may simply result in irritation -- conventional stretching does little but fight the CNS when it's already trying to protect the inflamed area, or an area that happens to lack adequate stability (i.e. like Kyle mentioned, tight hamstrings -- typically the worst thing one can do is stretch them, because the issue is in a lack of adequate glute function. Training the glutes, and sometimes the hamstrings, tends to loosen them).

    I have dealt with a lot of injuries in my relatively short amount of years, and none of the issues (most being some form of joint pain or "tendonitis" in various areas) were because of the site of the problem. You can have "tightness" in your pinky and ring finger (thanks to your ulnar nerve) and have the issue stemming from your levator scaps and the surrounding area (what most people call "upper traps") while not feeling it there.
  16. The neurological aspect cannot be understated. Did you have an acute injury to the wrist/elbow/shoulder, or was this a gradual buildup into a chronic-pain situation? I ask because certain joint injuries cause Arthrogenic Muscle Inhibition. In essence it's a pre-synaptic inhibition in the brain that prevents muscles from contracting properly for 18-33 months. Strengthening the muscles, joints and tendons provides part of the solution, but it also reinforces a compensatory motor pattern that doesn't revert once the area has healed. That's another reason why something like a Compex can be useful, albeit expensive.
  17. Can confirm, I recently injured my back pretty bad(not permanent, but borderline disabling) and I finally went to a chiropractor(mainly to get Xrays) But He yanked on my feet and my groin muscles probably quadrupled in strength and I instantly gained better squat mobility. He cracked my neck and my upper traps stopped contracting for the first time in probably years.

    I literally assumed my traps were just hard muscle, like I always had a pump going on or something... which made sense because I practically deadlifted everyday - or did some farmer walk variation, hex bar, something... Then I kept getting stronger - and noticed my traps almost got smaller over the past 2 years... probably because they would have never healed/recovered properly.

    Like 10 minutes of cracking me around and I was like a new person... Still have my injury I'm trying to baby - so I haven't been lifting for months, but I'm itching to get lifting again every day... And when I start making decent money again - A chiropractor visit will be a monthly thing for me. I thought the damn practice was snake oil, and originally only went in out of desperation just wanting to atleast see what was messed up in my back.

    And no Rohann, I didn't screw up my back deadlifting XD

    I have thoracic kyphosis - and I had been working on trying to reverse it for a while... and actually decided my bench press was pathetic - so I dedicated a full month to pressing variations and posture work, and I think my kyphosis mixed with my really hard bench - I hit some PRs, and then I was laying backwards with an Olympic curl bar loaded up for reverse grip bench press(which btw is absolutely my favorite variation, with the curl bar, grip about body width, thumbs up) and when I laid back with the bar to start a set, might have just been my ponytail or something just pushed my spine from the middle of my thoracic to my neck just slightly to the left. At first I thought I pulled my lower traps somehow - but its more or less just my spine is crooked there ATM.
    Rohann van Rensburg likes this.
  18. #18 Sam Miller, Feb 12, 2018
    Last edited: Feb 12, 2018
    I strongly, STRONGLY recommend against Chiropractors. I'm constantly astonished just how far they've been able to squeeze themselves into legitimate healthcare. Anything they're doing that is evidence based has not come from chiropractic, it's been pinched from more legitimate fields like physiotherapy, orthopaedics, etc. Chiropractic started as a faith, created by an actual snake-oil salesman and has somehow managed to survive. This is despite no randomised controlled studies and enough deaths to make anyone, especially parents of infants, uncomfortable.

    The principles that underpin it have been debunked over and over again. 'Innate' is bullshit and chiropractic subluxation is a myth. Shit, chiropractors can't even reliably palpate the subluxations that they claim exist. Their principles fall apart further when you realise that the body has autonomic nerve ganglions that don't depend on the nerves within the spine. I could go on, and on, and on, and on. Instead, check out ScienceBasedMedicine.org's spectacular breakdown on Chiropractic. https://sciencebasedmedicine.org/reference/chiropractic/

    Kyle, be aware that dysfunctional motor patterns for setting the scapulae are insanely common. I've only had a couple of people pass assessment and they only passed under very limited amounts stress. If the scapulae aren't set correctly the rotator-cuff muscles, traps, lats, pec major & minor become the primary stabilisers of the humerus and shoulder girdle. This compromises the spine and all those muscles stabilising the scapula. In extreme cases it can lead to thoracic kyphosis as the increased stress causes increased muscle tone of the pec major and minor, as well as some muscles associated with the cervical spine. There's work you can do to address the issue, but it's very slow and very boring.
    Rohann van Rensburg likes this.
  19. I mean my kyphosis is literally just the result of terrible posture growing up.

    forward head for miles by the time I was in my early 20s. game game game drum drum drum game game game drum drum drum. Then when I got a job as a delivery driver - that made sure I spent very little time actually upright. I don't have weird scapular issues, nor any kind of pec tightness. Poor overhead mobility, but that's because of my kyphosis.

    I don't really care where the knowledge comes from really... theres hacky chiropractors, and then there's people that know what they're doing. He knows what imbalances I have, and is just as fluent in anatomy as I am(which I can't say for most physical therapy assistants I meet). I've met terrible physical therapists - and I've met excellent crossfit coaches. I happen to know the chiropractor - as well as my area pretty well(it's not really rocket science, I was a delivery driver for like 6 years in an area... you start to notice patterns of overall patient happiness/staff happiness in certain practices, which makes it easy to know which dentist/ent/dog groomer/ect you want to go to, and which you want to avoid). In this case, he might be the first living human I've heard pronounce psoas correctly - so I'll trust him with my body.(YMMV) I normally would have preferred a physical therapist, but they are significantly more expensive - and in this case, I mainly just went for an X-ray, but since it was part of the assessment/first visit I got the alignment - and it worked. I never suggested a chiropractor as the first place you should go with a wrist injury, merely that bodies are weird - and my experience with a chiropractor reflected that. If you end up looking at a chiropractor however - check your state's guidelines for them, because the amount of schooling a chiropractor needs varies significantly state to state... and check and see if they have a background in anything else(mine has a sports injury/rehab background as well).

    That said, in my case - I couldn't care less if he snake oil'd me, because I leave with tangible measurable results(as well as taking my pain from like an 8 to a 2 when I came in). But I'm the kind of person who would gladly take placebo's if they worked. But my only encounter with a placebo didn't - so I guess I lucked out this time.
    Rohann van Rensburg likes this.
  20. I always get excited when I hear someone talk about motor patterns :D.

    Yeah, there's an awful lot of what chiros do that tends to be kooky. That said, don't judge a clinician by their base qualification -- the practitioners most critical of chiropractic I know tend to be chiropractors, and there are some brilliant folks out there that are DC's (i.e Craig Liebenson, who's contributed a great deal to DNS, or my former boss, who spent close to or as much as his university tuition on continuing education courses), as well as a ton of garbage PT's and kin's who didn't do any learning beyond their basic education and view the neuromuscular system as nothing more than a disjointed mechanical system (I still marvel at PT's and docs who treat the "rotator cuff" as if it's actually a rotator cuff and not a "compression cuff"). These days, all you're looking for in your basic education is an ability to be insured, as well as a license to practice (DC's are able to order x-rays and blood tests, from what I remember, where as Master's PT's aren't, so that's an advantage). It's generally why I don't recommend people go an see a <insert degree> practitioner, and instead will consult people in the know about who is trustworthy, considering you get chiros who range from being fully DNS qualified to chiros with just about no continuing education under their belt who will tell you that if you don't come for adjustments every 2 weeks until you die then you'll be in pain forever. There are just as many useless PT's out there as chiros, quite frankly -- all that matters is the continuing education, beyond base stuff like anatomy. The problem is deeply systemic -- there is little no emphasis on the neuromuscular system (at least when I was considering school a few years ago), and way too much stock put into a mechanical view of the body. I do agree that most chiropractic draws heavily from other fields, but some of the techniques they use do tend to be quite useful, and to their credit, the people who are most critical of chiropractic as a whole tend to be people qualified as such. Basically, if someone has "chiropractic" as their advertisement for their business, stay away (haha!). But something like "athletic performance" or "sports medicine" that happens to have a DC on board tends to be a better bet.

    Kyle: There's nothing inherently wrong with adjustments, but being a one-trick pony in any field is perilous. All adjustments do are give relevant areas a sort of neurological "reset", which gives you space to create some requisite mobility and stability in areas that need it. Super useful, but mostly just creates a window. Not a bad idea to get it done occasionally, nor ART or the like, as long as you're taking advantage of the time to correct deficits -- even for healthy athletes we usually programmed a 2:1 ratio of "back" to "chest" exercises (read: pulls to pushes -- lots of TRX rows or one-arm rows barring that). I really wish Functional Range Release was more prevalent because it's (from my understanding) actually well researched and probably the most effective manual therapy (fascial manipulation) system I know of.
    Re: Deadlifting -- haha, deadlifting is great as long as it's done properly. Surprisingly good for shoulder joint centration as well -- I've seen massive improvements in my shoulder functionality due largely to farmer's walks and partly to proper deadlifting mechanics, no thanks to years of conventional "rotator cuff" movements.

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